INTRODUCTION: We developed a new portable device called "VEPpeak" for the examination of visual evoked potentials (VEPs) to extend VEP examination beyond specialized electrophysiological laboratories and to simplify the use of this objective, noninvasive, and low-cost method for diagnostics of visual and central nervous system dysfunctions. METHODS: VEPpeak consists of a plastic headset with a total weight of 390 g containing four EEG amplifiers, an A/D converter, a control unit, and a visual LED stimulator built in the front, vertically adjustable peak. The device is powered and controlled via USB connection from a standard PC/notebook using custom software for visual stimuli generation and for VEP recording and processing. Up to four electrodes can be placed at any scalp location or in combination with two dry electrodes incorporated into the headset. External visual stimulators, such as a tablet, can be used with synchronization. Feasibility and validation studies were conducted with 86 healthy subjects and 76 neuro-ophthalmological patients including 67 who were during the same session also tested with a conventional VEP system. RESULTS: VEPpeak recordings to standard (pattern-reversal) and non-standard (motion-onset, red-green alternation) were robust and repeatable and obtained also in immobilized patients. Good comparability of results was achieved between VEPpeak and standard examination. Some systematic differences in peak latencies and amplitudes are consistent with differences in stimulus characteristics of the two compared systems. DISCUSSION: VEPpeak provides an inexpensive system for clinical use requiring portability. In addition to ISCEV standard VEP protocols, free choice of stimuli and bio-signal recordings make the device universal for many electrophysiological purposes.

Electrophysiological Lab Dept of Pathophysiology Faculty of Medicine Charles Univ Simkova 870 500 03 Hradec Králové Czech Republic

Zobrazit více v PubMed

Sokol S. Visually evoked potentials: theory, techniques and clinical applications. Surv Ophthalmol. 1976;21:18–44. doi: 10.1016/0039-6257(76)90046-1. PubMed DOI

Walsh P, Kane N, Butler S. The clinical role of evoked potentials. J Neurol Neurosurg Psychiatry. 2005;76:16–22. doi: 10.1136/jnnp.2005.068130. PubMed DOI PMC

Kuba M, Kubová Z. Visual evoked potentials specific for motion-onset. Doc Ophthalmol. 1992;80:83–89. doi: 10.1007/BF00161234. PubMed DOI

Schlykowa L, van Dijk BW, Ehrenstein WH. Motion-onset visual-evoked potentials as a function of retinal eccentricity in man. Cognitive Brain Res. 1993;1:169–174. doi: 10.1016/0926-6410(93)90024-Y. PubMed DOI

Kremláček J, Kuba M, Chlubnová J, Kubová Z. Effect of stimulus localisation on motion-onset VEP. Vision Res. 2004;44:2989–3000. doi: 10.1016/j.visres.2004.07.002. PubMed DOI

Bartl G, van Lith GHM, van Marle W. Cortical potentials evoked by a TV pattern reversal stimulus with varying check sizes and stimulus field. Br J Ophthalmol. 1978;62:216–219. doi: 10.1136/bjo.62.4.216. PubMed DOI PMC

Heinrich SP. A primer on motion visual evoked potentials. Doc Ophthalmol. 2007;114:83–105. doi: 10.1007/s10633-006-9043-8. PubMed DOI

Kuba M, Kubová Z, Kremláček J, et al. Motion-onset VEPs: characteristics, methods, and diagnostic use. Vision Res. 2007;47:189–202. doi: 10.1016/j.visres.2006.09.020. PubMed DOI

Odom JV, Bach M, Brigell M, et al. ISCEV standard for clinical visual evoked potentials (2016 update) Doc Ophthalmol. 2016;133:1–9. doi: 10.1007/s10633-016-9553-y. PubMed DOI

Kremláček J, Kuba M, Kubová Z, et al. Within-session reproducibility of motion-onset VEPs: effect of adaptation/habituation or fatigue on N2 peak amplitude and latency. Doc Ophthalmol. 2007;115:95–103. doi: 10.1007/s10633-007-9063-z. PubMed DOI

Cant BR, Hume Ann L, Shaw NA. Effects of luminance on the pattern visual evoked potentials in multiple Sclerosis. Electroenceph Clin Neurophysiol. 1978;45:496–504. doi: 10.1016/0013-4694(78)90293-6. PubMed DOI

Kremláček J, Kuba M, Kubová Z, Chlubnová J. Motion-onset VEPs to translating, radial, rotating and spiral stimuli. Doc Ophthalmol. 2004;109:169–175. doi: 10.1007/s10633-004-4048-7. PubMed DOI

Kuba M, Kremlacek J, Langrova J, Kubova Z, Szanyi J, Vit F. Aging effect in pattern, motion and cognitive visual evoked potentials. Vis Res. 2012;62:9–16. doi: 10.1016/j.visres.2012.03.014. PubMed DOI

Altman DG, Bland JM. Measurement in medicine: the analysis of method comparison studies. The Statistician. 1983;32:307–317. doi: 10.2307/2987937. DOI

Lin LI. A concordance correlation coefficient to evaluate reproducibility. Biometrics. 1989;45:255–268. doi: 10.2307/2532051. PubMed DOI

Parker RA, Scott C, Vanda I, Stevens NT. Using multiple agreement methods for continuous repeated measures data: a tutorial for practitioners. BMC Med Res Methodol. 2020;20:1–14. doi: 10.1186/s12874-020-01022-x. PubMed DOI PMC

Terracciano R, Sanginario A, Puleo L, et al. A novel system for measuring visual potentials evoked by passive head-mounted display stimulators. Doc Ophthalmol. 2022;144:125–135. doi: 10.1007/s10633-021-09856-6. PubMed DOI

Kubová Z, Szanyi J, Langrová J, et al. Motion-onset and pattern-reversal VEPs in diagnostics of Neuroborreliosis. J Clin Neurophysiol. 2006;23:416–420. doi: 10.1097/01.wnp.0000218241.95542.4f. PubMed DOI

Kuba M, Kremláček J, Hulek P, et al. Advanced electrophysiological diagnostics of hepatic and portosystemic encephalopathy. Acta Medica (Hradec Kralove) 1996;39:21–26. PubMed

Kamino D, Almazrooei A, Pang EW, et al. Abnormalities in evoked potentials associated with abnormal glycemia and brain injury in neonatal hypoxic-ischemic encephalopathy. Clin Neurophysiol. 2021;132:307–313. doi: 10.1016/j.clinph.2020.09.024. PubMed DOI PMC

Szanyi J, Kremláček J, Kubová Z, Kuba M, Gebouský P, Kapla J, Szanyi J, Vít F, Langrová J. Visual evoked and event-related brain potentials in HIV-infected adults: a longitudinal study over 2.5 years. Doc Ophthalmol. 2019;139:83–97. doi: 10.1007/s10633-019-09697-4. PubMed DOI