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Early detection of P-VEP and PERG changes in ophthalmic Graves' disease.

BACKGROUND: In Graves' disease the optic neuropathy (ON) is due to direct compression of the nerve and/or of its blood supply. The aim of the present study was to detect early changes in the visual functions of patients affected by ophthalmic Graves' disease (OGD) by using electrophysiological tests (P-VEP and PERG). METHODS: We studied 50 OGD patients who were in a range between class 2 and class 5 according to the Donaldson-American Thyroid Association classification, i.e. had no evident ON and normal visual acuity. We recorded transient reversal PERG and P-VEP in response to the stimulation of one eye at three spatial frequencies (2.2, 1.1 and 0.5 c/d). RESULTS: Our results showed a statistically significant reduction in PERG amplitude in class 5, while the P-VEP amplitude was already reduced in class 2. CONCLUSION: The electrofunctional tests were useful to detect small changes in the visual function of patients affected by initial stages of OGD. Therefore, P-VEP and PERG recordings appear to be a useful tool for early diagnosis of the optic nerve involvement in Graves' disease.

Adult↗

Checkerboard reversal pattern and flash VEPs in dialysed and non-dialysed subjects.

In forty-three patients suffering from chronic renal failure (CRF; 32 non-dialysed, 11 dialysed) the flash VEP and the pattern VEP to different spatial (7.5', 15', 30', 60' checks) and temporal (2, 10, 20, 40 Hz) frequencies were investigated. Abnormally delayed flash VEPs were obtained in 53.6% of the cases; transient pattern VEPs had a delayed major positive deflection in 46% of the tested eyes and altered steady-state response in 58% with a total of 65% abnormal responses. Chronically dialysed subjects showed higher levels of altered VEPs for both the techniques. The shorter latencies normally observed with coarser checks in healthy people were maintained in CRF patients, resulting in an abnormal prolongation of the shift between high and low spatial frequencies. Higher statistical correlations linked the pattern VEP with blood urea nitrogen (P less than 0.001) and other renal chemistry than the flash VEP. These and other features could be ascribed to a specific involvement of a maculo-calcarine channel devoted to 'detailed' vision and suggest the usefulness of this method to provide a tool for the early detection of an encephalopathic uraemia.

Adult↗

Visual evoked potentials and positron emission tomographic mapping of regional cerebral blood flow and cerebral metabolism: can the neuronal potential generators be visualized?

Visual evoked potentials (VEPs) and visual evoked spectrum array (VESA) to flashes and pattern-reversal were correlated with regional cerebral blood flow (rCBF) or local cerebral glucose metabolism in 4 hemianopsic patients and one subject with cortical blindness. Normal VEPs, topographical distribution and occipital rCBF were noted in hemianopsic patients with macular sparing. A dissociation of topographical distribution of VEPs to flashes and pattern-reversal was demonstrated in one patient with hemianopsia and macular splitting. In this case, rCBF showed unilateral activation of visual areas 17, 18 and 19 of the cortex. The distribution of surface-recorded potentials reflected the complex interaction of electrical field potentials within at least 3 cortical areas rather than volume transmission of striate dipoles alone. VEPs were preserved in a cortically blind patient. rCBF and local cerebral glucose metabolism revealed a functioning island of occipital cortex that most likely represented the generator of the VEP. The combination of VEP and PET permits the correlation of electrophysiological events with the visualization of cortical areas presumably activated by the same visual stimulus.

Blindness↗

Comparison of fiber optical and video monitor stimulators in normals and multiple sclerosis patients.

A comparison of VEP findings using a fiber optical stimulator with three color combinations (black/red, black/green and red/green) and a conventional video monitor stimulator in black/white was performed in 3 groups of subjects: a group with definite lesions in the visual pathway, a group with suspected lesions and a control group. No significant correlations of P100 latency were found in the normative group, probably because of the small range of their values. All correlations were significant in the two patient groups, except for the red/green stimuli in the definite group. In general, the red/green combination was inferior to other color combinations in eliciting VEPs. The patient groups with definite, as well as suspected, lesions indicated no benefit from the color stimuli, as compared with black/white. The major advantage of the fiber optical stimulator is its simplicity, the lack of stimulus artifacts and the accessibility to the patient's bed side, thanks to its small size. Stimulators with higher illuminance and improved pattern element shape should narrow the still unacceptable normative variability of the wave forms recorded.

Adolescent↗

Attention and memory trials during neuronal recording from the primate pulvinar and posterior parietal cortex (area PG).

Cynomolgus monkeys were trained on a delayed match-to-sample (DMS) task. Several controls were performed for the separation of memory effects from other factors such as attention, stimulus attributes and eye movements. One of the controls employed a standardised sequence of events ('window trial') during which a window in a black screen was opened and a face, an object or a picture was presented. Unit cell activity was recorded from 209 sites in the posterior parietal cortex (area PG) and 186 sites in the pulvinar. Some units responded during the presentation of the DMS stimuli, mostly those in that part of area PG located in the superior temporal sulcus. They often appeared to be related to the task-related state of attention. There was no indication of pure memory-related changes in activity such as sustained responses during the inter-stimulus interval or specific responses to the second stimulus that would indicate a dependence on the kind of the preceding stimulus. In the window trial, some parietal units, mostly in that part of area PG located in the intraparietal sulcus (a region termed area LIP), responded in a relatively specific manner during and sometimes even after, the presentation of a human face. The responses often seemed to be related to the animal's state of attention. Almost no pulvinar unit responded in this paradigm. It is concluded that area PG and, to a lesser extent, the pulvinar are involved in the modulation of attention in relation to behaviourally relevant changes in the environment. If these structures have a role in memory function, it must be secondary to a role in controlling or regulating attention.

Animals↗

"Initial-" and "change-orienting reactions": an analysis based on visual single-trial event-related potentials.

The present study was concerned with brain potentials elicited by, respectively, the first of a series of stimuli ("initial-orienting reaction", I-OR), and infrequent deviants ("change-orienting reaction", C-OR). Single-trial event-related potentials (ERPs) to visual stimuli were estimated from recordings at Oz, Pz, Cz and Fz. The design included both a habituation series as well as a series of occasional deviant trials against a background of standards. This was done with both task-relevant and neutral stimuli, and in two interstimulus interval (ISI) conditions: 2.45 s and 8.45 s. In the latter ISI condition, skin conductance responses (SCRs) were recorded as well. Decrease (Habituation) in the habituation series was found for a non-specific N1, a posteriorly distributed P3, and the SCR, but not for P2-N2. Deviant stimuli produced an enhancement of the central P2-N2, the P3, the N1 (on the first few deviant trials only, in both ISI conditions), and the SCR (with task-relevant stimuli only). Elongation of ISI delayed both short-term and long-term decrease of P3, but had no effect on enhancement of P2-N2 due to stimulus deviance. It was concluded that, with respect to ERP parameters, the I-OR is marked by the N1, whereas the C-OR coincides with the P2-N2.

Adult↗

Magnetic stimulation of extrastriate body area impairs visual processing of nonfacial body parts.

Functional magnetic resonance imaging indicates that observation of the human body induces a selective activation of a lateral occipitotemporal cortical area called extrastriate body area (EBA). This area is responsive to static and moving images of the human body and parts of it, but it is insensitive to faces and stimulus categories unrelated to the human body. With event-related repetitive transcranial magnetic stimulation, we tested the possible causal relation between neural activity in EBA and visual processing of body-related, nonfacial stimuli. Facial and noncorporeal stimuli were used as a control. Interference with neural activity in EBA induced a clear impairment, consisting of a significant increase in discriminative reaction time, in the visual processing of body parts. The effect was selective for stimulus type, because it affected responses to nonfacial body stimuli but not to noncorporeal and facial stimuli, and for locus of stimulation, because the effect from the interfering stimulation of EBA was absent during a corresponding stimulation of primary visual cortex. The results provide strong evidence that neural activity in EBA is not only correlated with but also causally involved in the visual processing of the human body and its parts, except the face.

Adult↗

ERP topography and human perceptual learning in the peripheral visual field.

We studied human perceptual learning in the peripheral visual field in 16 healthy adults. Horizontal or vertical vernier stimuli were presented simultaneously at 8 locations at an eccentricity of 4 degrees . One of the stimuli displayed an offset, and subjects were asked to detect the target offset. Training was performed with either vertical or horizontal stimuli by the repeated presentation of stimuli. Discrimination performance was also measured with the untrained stimuli. Before and after the psychophysical experiment, EEG was recorded from 30 electrodes over the occipital areas (between the inion and Cz) while targets were presented at all locations as vernier onset/offset stimuli. The EEG was averaged for each orientation separately. Improvement in discrimination performance was observed in about 70% of the subjects with the trained orientation only. The evoked potential maps displayed three components occurring between 80 and 160, 180 and 260, and 280 and 340 ms. The potential field topography of the first and third component showed significant differences before and after learning. In addition, field strength (global field power) of the second and third component increased with learning. No effects were seen with the untrained stimuli in the psychophysical and electrophysiological experiments. Our findings suggest that perceptual learning in the peripheral visual field is specifically related to neurophysiological changes induced by training, and it is not caused by unspecific changes of spatial attention. The changes of electrical brain activity reflect short-term plasticity related to human perceptual learning.

Adolescent↗