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Visual evoked potentials and serum magnesium levels in juvenile migraine patients.

Changes in visual evoked potentials and decreased intracellular magnesium levels have been separately described in patients affected by migraine both during the attacks and in the interictal periods. An inverse correlation between increased P100 amplitude and lowered serum magnesium levels was found in children suffering from migraine with and without aura in a headache-free period. A 20-day treatment with oral magnesium pidolate seemed to normalize the magnesium balance in 90% of patients. After treatment, the reduced P100 amplitude confirmed the inverse correlation with the serum magnesium level. These data seem to suggest the hypothesis that higher visual evoked potential amplitude and low brain magnesium level can both be an expression of neuronal hyperexcitability of the visual pathways related to a lowered threshold for migraine attacks.

Adolescent↗

Visual evoked potential (VEP): basic concepts and clinical applications.

The Visual Evoked Potential is the objective measurement of visual function monitored at the level of the occipital cortex with scalp electrodes. This article summarizes many of the recent clinical applications of the VEP. Included are basic concepts of the VEP and its clinical utilization for the objective assessment of refractive error, visual acuity, amblyopia, binocularity, demyelinating diseases, psychogenic disorders, pre-surgical prediction of post-surgical visual function, visual fields, color blindness and neurological development.

Amblyopia↗

[Monitoring control of the visual evoked potentials during the surgical treatment of tumors of the chiasmal-sellar area].

Visual evoked potentials were recorded in different stages of the operation in 12 patients with tumors of the chiasmal-sellar region. A correlation was noted between the dynamics of the P100 latent period and the changes of visual functions after the operation. Intraoperative monitoring of visual evoked potentials makes it possible to appraise the functional condition of the optic nerves objectively and correct the techniques and tactics of the operative intervention.

Adenoma↗

Stereoscopic visual evoked potentials in normal subjects and patients with open-angle glaucomas.

PURPOSE: To evaluate stereoscopic visual evoked potentials (S-VEP) in normal controls and in patients with glaucomatous optic nerve damage. METHODS: Computer-generated dynamic random-dot stereograms were used to elicit cortical visual evoked potentials using wireless electric liquid crystal shutter glasses. Normal subjects (n=22) and patients with glaucoma (n=22) were investigated using five different disparities from 9 to 40 arc min. Statistical dependency of measurements with different stimulus at identical patients was adjusted for. RESULTS: Peak times of onset and offset response of S-VEP can be significantly delayed in glaucomas. A general linear regression model confirmed that differences between patients and normals depend on disparity. S-VEP onset shows no significant difference between controls and glaucomas at 9 arc min disparity. At high disparities, however, peak time of the onset response was significantly (p<0.01) delayed in glaucomas when compared with normals (normals: 125.8+/-13 ms, glaucomas: 148.2+/-25.6 ms at 40 arc min). CONCLUSIONS: Visual evoked potential elicited by the onset of a random-dot stereogram can be used for objective measurement of stereoacuity in a clinical setting. Differences between controls and glaucomas in high and low disparities could indicate a stereo-specific deficit in glaucoma.

Depth Perception↗

The power spectra of visually evoked potentials to pseudorandom contrast reversals of gratings.

Visually evoked potentials (VEPs) were recorded in response to the temporal pseudorandom contrast reversal of spatially sinusoidal gratings with different spatial frequencies. The stimulus mimicked bandwidth limited white noise in the temporal domain except for an inherent periodicity which permitted signal averaging. The power spectra of the resulting VEPs were calculated. For high spatial frequency gratings (7.5-15 c/degree) VEP power was localized to the temporal frequency range from 3 to 7 Hz. For medium spatial frequency gratings (0.75-3 c/degree) VEP power was distributed in a roughly bimodal way with peaks near 6 and 18 Hz. The VEP power spectra due to high frequency gratings were similar in 2 subjects studied in detail, but the power spectra to medium frequency gratings differed substantially.

Brain↗

The objective assessment of visual contrast sensitivity by pattern reversal visual evoked potentials in diabetes.

Recent studies have described abnormalities of visual evoked potentials and pattern electroretinography in diabetics without retinopathy. The visual contrast sensitivity, determined by psychophysical tests, has proved to be abnormal in diabetic patients with and without clinical retinopathy. In this study we evaluated contrast sensitivity function using both electrophysiologic and psychophysical methods. The objective assessment of functional visual contrast sensitivity was superior to psychophysical evaluation in the detection of contrast sensitivity alterations. No relationships were found between contrast sensitivity dysfunction and abnormalities of pattern electroretinography or fluorescein angiography. Our data suggest that functional visual deficits might precede background retinopathy and that the involvement of foveal function is early and very frequent in diabetic patients, even if they have normal visual acuity.

Adolescent↗

Electroluminescent display visual stimulator - a new method for visual evoked potential studies.

A new atomic layer epitaxy electroluminescent display visual stimulator for visual evoked potential studies is described. The display has several advantages over TV monitor stimulators, slide and projector stimulators and LED stimulators. The display is versatile, various patterns, letters or even words may be generated. The display has short rise and decay times, a high and stable luminosity.

Electroencephalography↗

Fluctuations of visual evoked potential amplitudes and of contrast sensitivity in Uhthoff's symptom.

Visual evoked potentials (VEPs) to pattern reversal and psychophysical contrast sensitivity (CS) were tested in five patients with Uhthoff's symptom before and after exercise. Four of the cases were related to a demyelinating disease and one patient had a severe brain injury. Uhthoff's symptom occurred also in neuropathies without previous clinical neuritis and in eyes with normal latency time of the VEPs. A depression of CS was observed by all five patients after exercise; a transient "overshoot" of CS following the depression was present in three of the patients. VEP amplitudes were reduced by exercise in three cases. Responses by stimulation with small checks were more affected. Paradoxical increased VEP amplitudes after exercise in the presence of a loss of psychophysical CS were found in one case.

Adult↗

Maturational topography of the visual evoked potential in fetal lambs.

The normal maturational course of the visual evoked potential (VEP) in human newborns and infants is well documented. Unfortunately, there is a paucity of data about VEP maturation in the 'normal' preterm infant. Since this population is at risk to develop many abnormalities affecting the VEP (intraventricular hemorrhage, hydrocephalus, and retinopathy of prematurity), one must question whether such VEP data collected from this group is representative of normal maturation. To provide normative parametric developmental data we have been studying VEP development in fetal lambs. Six fetal lambs between 105 and 120 days gestational age were externalized and surgically instrumented with subcutaneous recording electrodes placed over the occipital and parietal regions. High-intensity light-emitting diodes (LEDs) externalized fiberoptic cables were secured adjacent to the orbit. from 108 to 141 days gestation, fetal VEPs were recorded in response to bright flash stimulation and the maturational topography was investigated. Over the occipital regions, the emergence of major positivities at P400 and P650 were observed beginning around 120 days gestation. Over the parietal area, the emergence of P200 and P500 components was observed by 128 days gestation. The latency-maturation functions revealed that the slope of the parietal function was steeper than the occipital counterpart, suggesting that the maturation of parietal neurons occurs at a faster rate than neuronal development in the occipital regions.

Animals↗

The effect of contrast and spatial frequency on the visual evoked potential of the hooded rat.

Transient and steady-state visual evoked potentials, obtained with counterphase modulated grating patterns, were recorded through chronically implanted electrodes in lightly anesthetized and unanesthetized hooded rats. As a function of spatial frequency, the latency of the major positive wave (P1) of the transient VEP was minimal with a 0.1 cycles per degree (cpd) grating as stimulus. The amplitude of the P1-N2 component remained constant from 0.04 to 0.20 cpd and then decreased with higher spatial frequencies. The function relating amplitude of steady-state VEP to spatial frequency at high contrast depended on temporal frequency: It had a band-pass form at 5.0 Hz and a low-pass form at 8.4 Hz. As a function of contrast, the latency of the P1 wave linearly decreased and its amplitude increased with increments of contrast up to 55%. The contrast function of the amplitude of the second harmonic of the steady-state VEP (8.4 Hz) showed two linear segments: one for low contrasts with a shallow slope and one for high contrasts with a steep slope, suggesting two distinct contrast mechanisms.

Animals↗

Visual evoked potentials in relation to factors of imprisonment in detention camps.

Visual evoked potentials (VEPs) of the pattern shift reversal type were determined in a representative group of 57 prisoners of war (POWs) released in 1992 from detention camps in former Yugoslavia. The parameters were correlated with the conditions in four camps (1-4). All subjects were male, with a mean age of 34.75 years (SD +/- 8.92), average length of imprisonment 192.7 days (SD +/- 77.6), mean loss of body mass during imprisonment 19.32% (SD +/- 9.54), and the average number of reported blows to the head and neck was 25.7 (SD +/- 20.3). VEPs were determined on average 290.5 days after the last craniocerebral trauma caused by blows to the head and neck (SD +/- 152.0) i.e., on average 218.5 days after release from the camp (SD +/- 164.3). Although all the 57 POWs reported being maltreated to a certain extent, 14 reported being subjected to particularly brutal forms of torture, 5 had been held in solitary confinement and 25 had lost consciousness at least once. Solitary confinement and loss of consciousness had the most significant effect on VEPs, and the altered VEP parameters correlated significantly with the craniocerebral trauma experienced, loss of body mass and the length of time since the last craniocerebral trauma until examination, and from release until examination. However, the length of imprisonment and treatment in the camps did not have a significant effect on VEP parameters. The study confirmed that under such conditions the age of the subject is a risk factor. The results of this study also confirmed that prisoners in one camp had been subjected to the worst maltreatment.

Adult↗

Visual evoked potentials during thiopentone-fentanyl-nitrous oxide anaesthesia in humans.

Visual evoked potentials (VEP) during thiopentone-fentanyl-nitrous oxide anaesthesia were studied in 15 healthy patients undergoing non-neurosurgical procedures. The VEP was recorded before and at 1 and 2 min after induction of anaesthesia with 5-6 mg.kg-1 of thiopentone. After recording the 1 and 2 min VEPs, anaesthesia was maintained with a fentanyl-nitrous oxide-oxygen combination, and further recordings were made at 5, 10, 15 and 20 min after induction. The 1 and 2 min VEPs showed a marked decrease in the amplitudes. Latencies were increased. The amplitudes gradually returned to the control level at 15 min, while the latencies remained increased throughout the study period. In conclusion, thiopentone should be avoided during the critical period of VEP recording. Once it is given, at least 15 min should elapse before an appropriate interpretation of the VEP can be made. Thiopentone-fentanyl-nitrous oxide anaesthesia slightly increases the latencies of the VEP. These effects should be considered in the interpretation of the VEP when thiopentone-fentanyl-nitrous oxide anaesthesia is used.

Adult↗

The effects of aging on the pattern electroretinogram and visual evoked potential in humans.

We have recorded patterns electroretinograms (PERGs) and visual evoked potentials (VEPs) from 14 elderly subjects (mean age 72 yr) and 12 young subjects (mean age 21 yr) in response to stimulation by high contrast sinusoidal grating patterns of variable spatial frequency (at 9 Hz) and temporal frequency (at 1.7 c/deg). The major effect of aging on the PERG was an aspecific reduction in amplitude (of about 40%) at most spatial and temporal frequencies, together with a small but systematic phase lag. Control measurements suggest that senile miosis may be responsible for the phase lag, but not for the reduction in amplitude. The effects of aging on the VEP were more dramatic and depended on the spatial and temporal properties of the stimulus. VEP amplitudes (at 1.7 c/deg) were significantly lower for the aged at low temporal frequencies (below about 6 Hz), but were similar at high temporal frequencies. At 9 Hz, there was no effect of spatial frequency on VEP amplitude. At high temporal frequencies (above 10 Hz), the latencies of VEPs (estimated from the rate at which phase varied with temporal frequency) were similar for old and young (94 and 99 msec respectively). Below 10 Hz, however, the latencies of the old observers was much greater (153 compared with 108 msec). The second-harmonic phase of VEPs of the old but not the young decreased considerably with spatial frequency, by about 1.9 pi radians (52 msec) over the range from 0.5 to 11 c/deg. The selective reduction in amplitude at low temporal frequencies, the longer latencies at low temporal frequencies and the phase lag at high spatial frequencies are consistent with the hypothesis that mechanisms sensitive to high spatial and low temporal frequencies are selectively degraded by aging.

Adult↗

P100 amplitude variability of the pattern visual evoked potential.

This study quantifies the amplitude variability of the pattern visual evoked potential (P-VEP) and compares this variability between the two eyes and between individual runs recorded in the typical clinical laboratory. Cooperative adults were studied in order to obtain measurements under optimal conditions. Average P100 amplitudes of 10 runs for one eye were essentially equal to average P100 amplitudes of the other eye, as were the variances. Mean amplitude ratio (the smaller amplitude divided by the larger amplitude) was 0.91. With a group mean P100 amplitude of 10.06 microV, standard deviation for intrasubject data was 1.84, and for intersubject data was 3.75. Therefore, most of the amplitude variability between the two eyes is due to run-to-run variability. A minimum of 3 runs (100 stimuli each) and an optimum of 5 runs should be recorded before making an evaluation.

Adult↗

Neuronal generators of the visual evoked potentials: intracerebral recording in awake humans.

Flash and pattern reversal visual evoked potentials were recorded in awake patients undergoing stereotactic procedures for severe dyskinetic disorders resistant to medical treatment. The nucleus ventralis lateralis thalami was reached via an occipital approach. VEPs were recorded on the scalp at the entrance of the intracerebral electrode, and serially from sites at different depths. A polarity reversal of the surface recorded wave form took place as the intracerebral electrode was advanced beneath the surface cortical layers. As concerns F-VEPs, most of the scalp activity mirrored the potentials recorded down to the depth of 70-65 mm from the thalamus. The largest amplitude of intracerebral F-VEPs was obtained from recording sites at 50-70 mm from the thalamus, i.e., in the depth of the calcarine fissure. A negative wave, peaking around 47-50 msec, became evident in recording sites at 30-40 mm from the thalamus but vanished as the electrode was advanced farther. In only one patient could we record a small negative wave, peaking at 33 msec, in the vicinity of the corpus geniculatum externum. Furthermore, the oscillatory activity recorded from the scalp appeared to be generated in the cortical layers. PR-VEPs also underwent polarity reversal as the electrode traversed the cortex. PR-VEPs disappeared more superficially than F-VEPs. No PR-evoked activity could be recorded in the vicinity of the corpus geniculatum externum. We conclude that slow and fast components of VEPs recorded from the scalp are entirely generated in cortical layers.

Brain Mapping↗

Power spectrum and optimal filtering for visual evoked potentials to pattern reversal.

The optimal bandwidth for recording the visual evoked potential (VEP) to pattern reversal was investigated in 8 normal subjects by re-analyzing off-line data recorded on tape using an open bandwidth of 0.1 Hz-3 kHz. Power spectral analysis of the VEP revealed little energy above 50 Hz. With digital filtering, the amplitude N70-P100 was significantly attenuated only when the low-pass filter was reduced to 50 Hz or when the high-pass filter was raised to 8 Hz. With analogue filtering, there was significant prolongation of latency of P100 when the low-pass filter (12 dB/octave) was reduced to 250 Hz and a significant decrease in latency when the high-pass filter (6 dB/octave) exceeded 3 Hz. However, the effects of analogue filtering were not uniform across subjects: in 2 subjects the latency of P100 was prolonged using a low-pass filter of 600 Hz and in 2 other subjects the latency was shortened when the 1 Hz high-pass filter was introduced. If a restricted bandwidth is used, non-uniform distortion of latency could make a significant contribution to the variability in latency of P100. The optimal bandwidth is one which minimises this contribution to the variability, 0.3 Hz to greater than 600 Hz.

Adult↗

Effects of prenatal substance exposure: altered maturation of visual evoked potentials.

We investigated the effects of prenatal substance use on visual evoked potentials (VEPs). Seventy-four children were tested at birth and 1 month of age with binocular flash VEPs and at 4, 8, and 18 months of age with binocular pattern VEPs. Regressions were run by trimester to assess the independent effects of substance exposure. Variables included in the regression model were alcohol, marijuana, tobacco, other drug use for each trimester, maternal age, education, income, race, marital status, infant sex, birthweight, and Dubowitz score. Changes in specific components of the binocular VEP were both substance- and trimester-specific. First trimester alcohol use was associated with prolonged P1 wave latencies at 1 month of age. Prolonged P1 wave latencies at birth and 18 months were associated with tobacco use during each of the three trimesters, at 1 and 18 months with third trimester marijuana use, and at 1 and 18 months with first trimester other illicit drug use. Although these women were moderate substance users during pregnancy, their offspring exhibited maturational changes in components of the VEP in the absence of neonatal behavioral disturbances.

Aging↗

Comparison of techniques for detecting visually evoked potential asymmetry in albinism.

PURPOSE: We compared techniques for analyzing visually evoked potential (VEP) asymmetry in children with albinism to find one that could be used effectively and efficiently. METHOD: Subjects included 21 child volunteers, ages 10 months to 6 years (control group) and 21 children with albinism, ages 2 months to 6 years (albinism group). Five-channel flash VEP was performed on all subjects. Electrodes were positioned at Oz, O1, O2, O3, and O4 (10/20 system). Data were analyzed by use of techniques previously described. These included inspection of the VEP waveforms, measurement of hemispheric waveform parameters, calculation of an asymmetry index, and use of a bipolar derivation between left and right hemispheric responses (interhemispheric difference potential). In addition, we quantified the interhemispheric difference potential by use of Pearson's correlation coefficient. Measurements of sensitivity and specificity determined the success of the 5 analysis paradigms. The accuracy of each paradigm represented the ability to classify the data according to volunteer or albinism group and is derived from both sensitivity and specificity measures. RESULTS: Measurement of hemispheric differences in VEP waveform parameters was the least sensitive measure method for detecting multichannel VEP asymmetry in albinism. Comparison of left and right eye interhemispheric difference potential increased accuracy to 67%. Nonquantitative inspection of waveform demonstrated an accuracy of 76%. The asymmetry index and Pearson's correlate measure yielded accuracy rates of 79% and 83%, respectively. CONCLUSION: The efficiency and capability of Pearson's correlate measure in quantifying interhemispheric difference potentials to detect albinotic misrouting makes this a useful and practical technique in a pediatric clinic.

Albinism↗