PURPOSE: The aim of this neurophysiological study was to retrospectively analyze visual evoked potentials (VEPs) acquired during an examination for diagnosing optic nerve involvement in patients with Lyme neuroborreliosis (LNB). Attention was focused on LNB patients with peripheral facial palsy (PFP) and optic nerve involvement. METHODS: A total of 241 Czech patients were classified as having probable/definite LNB (193/48); of these, 57 were younger than 40 years, with a median age of 26.3 years, and 184 were older than 40 years, with a median age of 58.8 years. All patients underwent pattern-reversal (PVEP) and motion-onset (MVEP) VEP examinations. RESULTS: Abnormal VEP results were observed in 150/241 patients and were noted more often in patients over 40 years (p = 0.008). Muscle/joint problems and paresthesia were observed to be significantly more common in patients older than 40 years (p = 0.002, p = 0.030), in contrast to headache and decreased visual acuity, which were seen more often in patients younger than 40 years (p = 0.001, p = 0.033). Peripheral facial palsy was diagnosed in 26/241 LNB patients. Among patients with PFP, VEP peak times above the laboratory limit was observed in 22 (84.6%) individuals. Monitoring of patients with PFP and pathological VEP showed that the adjustment of visual system function occurred in half of the patients in one to more years, in contrast to faster recovery from peripheral facial palsy within months in most patients. CONCLUSION: In LNB patients, VEP helps to increase sensitivity of an early diagnostic process.
- MeSH
- dítě MeSH
- dospělí MeSH
- faciální paralýza patofyziologie diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymská neuroborelióza * patofyziologie diagnóza komplikace MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci zrakového nervu * patofyziologie diagnóza MeSH
- nervus opticus patofyziologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zraková ostrost fyziologie MeSH
- zrakové evokované potenciály * fyziologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Despite positive prior results obtained by using event-related potentials (ERPs) in psychiatric patients, they are not routinely used in the clinical setting. This may in part be due to problems regarding a lack of transportable equipment availability. It can be difficult for these patients to repeatedly visit electrophysiological laboratories. To address this issue, we propose using a new, fully portable device for visually evoked potentials (VEP) and cognitive function assessment, that can be used for quick examinations (https://www.veppeak.com). Our device, called "VEPpeak", is built into a headset with a color LED visual stimulator. It weighs 390 g and is connected to a notebook (PC) with evaluation software via USB. In this pilot study, we verified the device's usability in 31 patients with schizophrenia. We used the oddball paradigm with the recognition of colors for the P300 wave and choice reaction time evaluation. The examination lasted only about ten minutes. The results indicated good reproducibility of large cognitive potentials (P300) with prolonged P300 latencies and reduced amplitudes in patients compared to 15 control subjects. The P300 latency and reaction time prolongation in patients correlated with their age and the sedative effect of the pharmacotherapy.
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.
BACKGROUND: Patients with chronic lymphocytic leukemia (CLL) have a higher risk of developing other malignancies (OMs) compared to the general population. However, the impact of CLL-related risk factors and CLL-directed treatment is still unclear and represents the focus of this work. METHODS: We conducted a retrospective international multicenter study to assess the incidence of OMs and detect potential risk factors in 19,705 patients with CLL, small lymphocytic lymphoma, or high-count CLL-like monoclonal B-cell lymphocytosis, diagnosed between 2000 and 2016. Data collection took place between October 2020 and March 2022. FINDINGS: In 129,254 years of follow-up after CLL diagnosis, 3513 OMs were diagnosed (27.2 OMs/1000 person-years). The most common hematological OMs were Richter transformation, myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Non-melanoma skin (NMSC) and prostate cancers were the most common solid tumors (STs).The only predictor for MDS and AML development was treatment with fludarabine and cyclophosphamide with/without rituximab (FC ± R) (OR = 3.7; 95% CI = 2.79-4.91; p < 0.001). STs were more frequent in males and patients with unmutated immunoglobulin heavy variable genes (OR = 1.77; 95% CI = 1.49-2.11; p < 0.001/OR = 1.89; 95% CI = 1.6-2.24; p < 0.001).CLL-directed treatment was associated with non-melanoma skin and prostate cancers (OR = 1.8; 95% CI = 1.36-2.41; p < 0.001/OR = 2.11; 95% CI = 1.12-3.97; p = 0.021). In contrast, breast cancers were more frequent in untreated patients (OR = 0.17; 95% CI = 0.08-0.33; p < 0.001).Patients with CLL and an OM had inferior overall survival (OS) than those without. AML and MDS conferred the worst OS (p < 0.001). INTERPRETATION: OMs in CLL impact on OS. Treatment for CLL increased the risk for AML/MDS, prostate cancer, and NMSC. FCR was associated with increased risk for AML/MDS. FUNDING: AbbVie, and EU/EFPIAInnovative Medicines Initiative Joint Undertaking HARMONY grant n° 116026.
- Publikační typ
- časopisecké články MeSH
Cíl: Zrakové evokované potenciály (visual evoked potentials; VEP) představují objektivní, neinvazivní a levnou diagnostickou metodu, zejména v neurooftalmologii. Mnoho diagnostických aplikací je však limitováno tím, že k jejich vyšetření se dosud používá robustní, obtížně transportovatelné zařízení, přičemž imobilní nebo jinak handicapovaní pacienti nemohou navštěvovat specializované laboratoře. Cílem naší práce bylo vyvinout snadno přenosný, levný VEP přístroj použitelný prakticky kdekoliv. Metodika: Všechny části posledního prototypu přístroje (vestavěný zrakový stimulátor, snímací elektrody, čtyřkanálový EEG zesilovač, analogově-číslicový převodník a řídicí jednotka) s celkovou hmotností 390 g jsou uloženy v náhlavním nosiči (umělohmotný „kšilt“ s upínacím páskem). Snímací a vyhodnocovací software pro natáčení a vyhodnocení VEP je použitelný na standardním notebooku (PC). Parametry přístroje splňují doporučení mezinárodních společností pro klinickou elektrofyziologii zraku a klinickou neurofyziologii, ale také umožňují nové aplikace dosud běžně nepoužívaných variant evokovaných potenciálů. Testování přístroje zatím proběhlo u 91 kontrolních osob a 135 neurooftalmologických pacientů. Výsledky: Pilotní studie prokázaly srovnatelné parametry VEP a diagnostickou senzitivitu jako u standardního zařízení (shoda nálezů v 93 % případů). Byla ověřena možnost použití přístroje v různých prostředích, u lůžka pacienta i pro laické samovyšetření. Závěr: Přenosný přístroj pro VEP výrazně zvyšuje dostupnost vyšetření, a tím umožňuje daleko širší diagnostické aplikace této metody.
Aim: Visual evoked potentials (VEP) represent an objective non-invasive and inexpensive diagnostic method, particularly in neuro-ophthalmology. A lot of possible diagnostic applications are limited because they are only examined with the use of robust equipment which is hardly transportable and immobile and handicapped patients cannot visit the specialized labs. The aim of our research work was the development of a portable inexpensive VEP device that could be used almost anywhere. Methods: All parts of the last prototype of the device (built-in visual stimulator, recording electrodes, 4-channel EEG amplifier, analog-digital converter, and control unit) with a total weight of 390 g are placed in a headset (plastic “shield” with an adjustable strap). The software for VEP recording and evaluation is used on a standard notebook (PC). The parameters of the device fulfill recommendations of the international societies for clinical electrophysiology of vision and clinical neurophysiology also enabling new applications of so far not routinely used variants of evoked potentials. Testing of the device was done so far in 91 control subjects and 135 neuroophthalmological patients. Results: Pilot studies proved comparable parameters of VEP and diagnostic sensitivity as in standard devices (equal results in 93% of cases). It was verified that the device is usable in various environments, at the patient’s bedside, and also for basic self-examination. Conclusion: The portable device for VEP significantly increases the availability of their examination and thus enables much broader diagnostic applications of this method.
- MeSH
- diagnostické techniky neurologické přístrojové vybavení statistika a číselné údaje MeSH
- diagnostické techniky oftalmologické přístrojové vybavení statistika a číselné údaje MeSH
- lidé MeSH
- zrakové evokované potenciály * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Klíčová slova
- venetoklax, Akalabrutinib, ibrutinib, FLUDARABIN,
- MeSH
- bendamustin hydrochlorid MeSH
- chronická lymfatická leukemie * farmakoterapie MeSH
- cyklofosfamid MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- monoklonální protilátky MeSH
- piperidiny MeSH
- proteinkinasa BTK antagonisté a inhibitory MeSH
- rituximab MeSH
- Check Tag
- lidé MeSH
Chronic lymphocytic leukaemia (CLL) is a genetically, morphologically and phenotypically heterogeneous chronic disease with clinical variability between patients. Whether the significant heterogeneity of cell size within the CLL population contributes to the heterogeneous features of this disease has not been investigated. The present study aimed to characterise the phenotypic and functional properties of two subpopulations of typical CLL cells that differ in cell size: small (s-CLL) and large (l-CLL) CLL cells delineated by forward scatter cytometry. The s-CLL cells were characterised by the CD5lowCXCR4hi phenotype, while the l-CLL cells were characterised by the CD5hiCXCR4dim phenotype and indicated a higher expression of CXCR3, CD20, CD38 and HLA-DR. The l-CLL cells displayed higher migration activity towards CXCL12, a tendency towards a higher proliferation rate and an increased capacity to produce IgM in the presence of CpG compared with s-CLL cells. When stimulated with CpG and CXCL12, l-CLL cells were characterised by a higher polarisation phenotype and motility than s-CLL cells. Our study revealed that the differences in CLL cell size reflected their activation status, polarisation and migratory abilities. Our data provide evidence of the importance of cell-size heterogeneity within a CLL pool and the dynamics of cell-size changes for disease pathogenesis, thus deserving further investigation.
- Publikační typ
- časopisecké články MeSH
