Nejvíce citovaný článek - PubMed ID 17016151
Motion-onset and pattern-reversal visual evoked potentials in diagnostics of neuroborreliosis
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.
- Klíčová slova
- Lyme neuroborreliosis, Peripheral facial palsy, Visual evoked potential,
- 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
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.
- Klíčová slova
- Cognitive ERP, Motion-onset, Pattern-reversal, VEP diagnostics, VEP portable device, VEPpeak,
- MeSH
- elektrody MeSH
- elektroretinografie MeSH
- lidé MeSH
- světelná stimulace MeSH
- zrakové evokované potenciály * MeSH
- zrakové korové centrum * fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: To describe the effect of dioptric blur on visual evoked potentials (VEPs) induced by motion onset (MO-VEPs). METHODS: The effect of dioptric blur up to 4 D on MO-VEPs was tested on 12 subjects using central, peripheral, and full-field stimulation with a low-contrast structure of concentric circles with spatial frequency <1 c/°. The results were compared to VEPs evoked by 15' and 60' checkerboard pattern-reversal (PR-VEPs). The relationship between peak time and interpeak amplitude of the dominant components was related to the level of dioptric blur using linear regression. RESULTS: The MO-VEPs did not show a significant peak prolongation (P > 0.28) or amplitude attenuation (P > 0.14) with the blur, whereas for the PR-VEPs we observed a significant decrease in amplitude (P < 0.001) and increase in peak time (P < 0.001) for both checkerboard sizes. CONCLUSIONS: For MO-VEPs induced by radial motion of low contrast and low spatial frequency pattern, the change in retinal blur does not affect the peak time or the interpeak amplitude of the dominant N2 component. TRANSLATIONAL RELEVANCE: The resistance to retinal blur that we demonstrated for MO-VEP provides a diagnostic opportunity to test the integrity of the visual system and reveal a retrobulbar impairment even in uncorrected refractive errors.
- MeSH
- lidé MeSH
- zrakové evokované potenciály * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: The aim of this neurophysiological study was to monitor changes in the visual and cognitive function of HIV-infected patients treated with combination antiretroviral therapy. METHODS: Eleven adult Czech HIV+ patients, with a mean age of 35 years and CD4 cell count ≥ 230 × 106 cells/L of blood at the time of enrollment, underwent four to six examinations over the course of 2.5 years to evaluate pattern-reversal and motion-onset visual evoked potentials (P-VEPs and M-VEPs), visually driven oddball event-related potentials (ERPs) and Montreal Cognitive Assessments. In addition to evaluating the intraindividual change in the observed parameters, we also compared patient data to data from eleven age- and gender-matched controls. RESULTS: We did not find any significant differences in P-VEPs between the patients and controls or in the paired comparison of the first and last visit. The only significant finding for P-VEPs was a linear trend in prolongation of the 20' P-VEP P100 peak time. In M-VEPs, we found a significant intergroup difference in the N160 peak time recorded during the first visit for peripheral M-VEPs only. During the last visit, all N160 peak times for patients differed significantly from those of the control group. The only intervisit difference close to the level of significance was for peripheral M-VEPs, which confirmed the trend analysis. No significant differences between patients and controls were found in the ERPs, but the P300 peak time showed a significant difference between the first and last visits, as confirmed by the trend. Patient reaction time was not significantly delayed at the first visit; however, it was prolonged with time, as confirmed by the trend. CONCLUSION: Our aim was to evaluate whether antiretroviral treatment in HIV+ patients is sufficient to preserve brain visual function. The optic nerve and primary visual cortex function tested by the P-VEPs seem to be preserved. The prolongation of the M-VEPs suggests an individually detectable decline in CNS function, but these changes did not show a progression during the follow-up. From a longitudinal perspective, the trends in peak time prolongation of the 20' P-VEP, peripheral M-VEP, ERP and reaction time suggest a faster decline than that caused by aging in healthy populations, as previously described in a cross-sectional study.
- Klíčová slova
- Event-related potentials (ERPs), Human immunodeficiency virus (HIV), Motion-onset VEP, Pattern-reversal VEP, Visual evoked potentials (VEPs),
- MeSH
- antiretrovirové látky terapeutické užití MeSH
- dospělí MeSH
- elektroretinografie MeSH
- evokované potenciály fyziologie MeSH
- HIV infekce farmakoterapie patofyziologie MeSH
- kognice fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladý dospělý MeSH
- počet CD4 lymfocytů MeSH
- průřezové studie MeSH
- reakční čas fyziologie MeSH
- vnímání pohybu fyziologie MeSH
- zraková ostrost fyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- zrakové korové centrum fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antiretrovirové látky MeSH
PURPOSE: The goal of the current study was to explore visual function in virally suppressed HIV patients undergoing combined antiretroviral therapy (cART) by using pattern-reversal and motion-onset visual evoked potentials (VEPs). METHODS: The pattern-reversal and motion-onset VEPs were recorded in 20 adult HIV+ patients with a mean age of 38 years and CD4 cell counts ≥230 × 106 cells/L of blood. RESULTS: Nine out of 20 patients displayed VEP abnormalities. Pattern-reversal VEPs pathology was observed in 20% of subjects, and 45% HIV patients had impaired motion-onset VEPs. Five out of 16 neurologically asymptomatic HIV patients had prolonged motion-onset VEP latencies in both eyes. Four neurologically symptomatic patients displayed simultaneously abnormal motion-onset and pattern-reversal VEP latencies: monocular involvement was observed in two patients with Lyme and cytomegalovirus unilateral optic neuritis. Binocular involvement was noted in two patients with cognitive deficits. Correlation analysis between disease duration, CD4 cell count, HIV copies in plasma, MoCA and electrophysiological parameters did not show any significant relationships. CONCLUSIONS: The functional changes of the visual system in neurologically asymptomatic virally suppressed HIV patients displayed higher motion-onset VEP sensitivity than in standard pattern-reversal VEP examinations. This promising marker, however, has no significant association with clinical conditions. Further exploration is warranted.
- Klíčová slova
- Human immunodeficiency virus (HIV), Motion-onset VEP, Pattern-reversal VEP, Visual evoked potentials (VEPs),
- MeSH
- analýza rozptylu MeSH
- antiretrovirové látky terapeutické užití MeSH
- dospělí MeSH
- HIV infekce farmakoterapie imunologie patofyziologie virologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- počet CD4 lymfocytů MeSH
- rozpoznávání obrazu fyziologie MeSH
- virová nálož MeSH
- vnímání pohybu fyziologie MeSH
- zánět zrakového nervu patofyziologie virologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antiretrovirové látky MeSH
BACKGROUND: In adults, motion-onset visual evoked potentials (M-VEPs) with a dominant N2 peak represent a useful diagnostic tool. However, it is difficult to use this type of VEP in children because of the long maturation (up to 18 years) of M-VEPs, which is characterised by a gradual decrease in N2 peak latency and shape development. Moreover, in some children, M-VEPs are difficult to identify with standard stimuli. METHODS: We tested features of M-VEPs in 30 children (7-12 years) with the following set of standard stimuli used in our lab for examining adults ( https://web.lfhk.cuni.cz/elf ): low-contrast translation motion (TM) and expansion/contraction motion (ExCoM) in full field and in periphery (with central 20° masked). In 16 children, a high-contrast TM was also tested. RESULTS: With standard (low-contrast) stimuli, a common M-VEP to TM and to ExCoM was detected in 77 and 83 % of children, respectively. The M-VEPs to ExCoM in the periphery were detected in only 43 % of children. An abnormal dominant P1 peak was found in 9 % of VEPs to TM, 12 % of VEPs to full-field ExCoM and 14 % of VEPs to peripheral ExCoM. The M-VEPs to all low-contrast stimuli displayed large inter-individual latency variability (N2 peak latency differed for more than 100 ms). High contrast (more suitable for the non-mature magnocellular pathway) shortened M-VEP latencies and improved amplitudes. CONCLUSIONS: Our findings show that the maturation of motion perception in children is inter-individually variable, which limits the diagnostic use of M-VEPs.
- MeSH
- citlivost na kontrast fyziologie MeSH
- dítě MeSH
- lidé MeSH
- oči růst a vývoj MeSH
- senzorické prahy fyziologie MeSH
- vnímání pohybu fyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- zrakové korové centrum fyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Five children with a history of preterm birth (mean gestational age of 27 weeks; birth weight 870-1,380 g) and perinatal post-hemorrhagic hydrocephalus were examined ophthalmologically at ages ranging from 4-11 years. An extended visual evoked potentials (VEPs) examination was simultaneously performed, using pattern-reversal, motion-onset, and cognitive visual stimuli. Although 3 of the 10 eyes displayed about normal visual acuity (> or =0.9), all of the examined eyes were abnormal for at least one variant of the tested VEPs. Pathological changes in VEPs (missing responses, shape abnormalities due to delayed VEPs maturation, prolonged peak latencies, and reduced amplitudes) were roughly proportional to both gestational age and reduction in visual acuity. A more severe pathology was found in the motion-onset VEPs (in all five subjects - nine eyes) when compared to the pattern-reversal VEPs (in four subjects - eight eyes). These observations suggest that the magnocellular system/dorsal stream of the visual pathway (which is particularly activated in response to motion stimuli) may be more frequently affected in preterm children than the parvocellular system/ventral stream (tested mostly by the standard pattern-reversal VEPs). This pilot study may encourage further testing of the combined pattern and motion-related VEPs examinations in preterm children as a way of detecting hidden cortical/cerebral visual impairment (CVI).
- MeSH
- dítě MeSH
- gestační stáří MeSH
- lidé MeSH
- nemoci centrálního nervového systému patofyziologie MeSH
- novorozenec nedonošený MeSH
- novorozenec s nízkou porodní hmotností MeSH
- novorozenec MeSH
- pilotní projekty MeSH
- předškolní dítě MeSH
- refrakce oka fyziologie MeSH
- zraková ostrost fyziologie MeSH
- zrakové dráhy patofyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- zrakové korové centrum patofyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH