Visual evoked potentials in multiple sclerosis

A study was carried out of 32 patients suffering from multiple sclerosis the diagnois of which was quite definite according to Mac Alpine's criteria and which had developed over more than two years. Comparison was made with patient suffering from optic neuritis of a different aetiology and with normal subjects. The method of investigation was dynamic electroretinoencephalography : the visual evoked potentials were investigated after stimulation by white and coloured light before and after adapatation to darkness. The specificity of the results was tested by, firstly, electro-retinogram recording for control of the visual system, and secondly, by the recording of auditory evoked potentials for control cerebral function. Abnormalities in visual evoked potentials were found in 77 percent of the cases. In particular, there was delayed latency, that is, a slowing of retino-cortical conduction. The significance of these abnormalities is discussed, by analyzing the electroclinical correlationships according to whether there was obvious or subclinical optic neuritis, and the dissemination, activity or duration of the disease. The incidence of visual evoked potential abnormalities was considerably greater than that in optic neuritis (35 percent). The links between abnormalities in nervous conduction and demyelinisation are emphasized. The role and specificity of electrophysiological investigation in diagnosis of multiple sclerosis are discussed.     

Effect of phenytoin and carbamazepine on evoked potentials in patients with newly diagnosed epilepsy. Part I. Visual evoked potentials

Pattern-reversal visual evoked potentials (VEPs) were recorded in 64 patients with newly diagnosed epilepsy. Before starting medication the patients with partial and primary generalized epilepsy, had prolonged latencies of the VEPs component P100, as compared with controls. VEPs were repeated after 3 months in 43 patients with focal epilepsy, during carbamazepine (22 cases) or phenytoin (21 cases) treatment. The plasma concentration of the drugs were within therapeutic levels. Carbamazepine but not phenytoin, was associated with prolongation of the P100 peak latency and induced increase of its amplitude, as compared with the baseline condition. The VEPs abnormality was most pronounced in patients whose seizures were poorly controlled. We conclude, that administration of carbamazepine or phenytoin, at therapeutic serum level, have minimal effect on the VEPs.     

Visual evoked potentials in Alzheimer''s disease: investigations in a PET-defined collective

Evidence indicates that the lipoxygenase (LO) pathway of arachidonic acid is a key mediator of angiotensin II (AII)-induced aldosterone synthesis in adrenal glomerulosa cells. Although protein kinase C (PKC) may play a role in AII action, the precise PKC isoforms involved and whether LO products can activate PKC is not clear. We therefore evaluated the effect of AII and LO products such as 12- and 15-hydroxyeicosatetraenoic acids (HETEs) on PKC activation in isolated rat adrenal glomerulosa cells. PKC activity was measured by the phosphorylation of a PKC specific peptide while the PKC isoforms were identified by Western immunoblotting using antibodies that recognize the alpha, beta, gamma or epsilon isoforms of PKC. Treatment of the cells for 15 min with AII (10[-8]M) or the LO products 12- or 15-HETE caused a marked increase in PKC activity in membrane fractions with reciprocal decreases in the cytosolic PKC activity. Rat glomerulosa cells expressed only the alpha, and epsilon isoforms of PKC. AII increased membrane bound levels of both PKC-alpha and -epsilon (1.9- and 1.5-fold, respectively), whereas the LO products predominantly activated PKC-epsilon. Reciprocal decreases in immunoreactive cytosolic PKC levels were seen. AII-induced aldosterone synthesis was blocked by H-7 and retinal as well as by a PKC-specific pseudosubstrate inhibitor, PKC(19-36). These results suggest that AII and LO pathway-induced actions in the adrenal glomerulosa may be mediated by specific PKC isoforms.     

Visual slow brain potentials in children with attention deficit disorder

Using a two-stimulus reaction time paradigm, with two separate reward conditions (contingent and noncontingent), we compared slow wave brain potentials (ERPs) in 144 children with attention deficit disorder (ADD) and 30 normal control children. This article reviews the findings during the 900 msec visual warning stimulus. As we had expected, based on ERP work of Forth and Hare (1989) and Raine, Venables and Williams (1990), and on previous work from our own laboratory, the group differences were found in the negative slow wave portions of the ERP complex during the contingent reward condition but not during the noncontingent condition. Aggressive hyperactive subjects with attention deficit disorder (ADDHA) were discriminated from nonaggressive subjects (including control subjects) during the contingent reward condition in the following ways: (1) greater fronto-central negativity (640-900 msec slow wave) and (2) greater right parietal than left parietal negativity (430-750 msec slow wave). All ADD subgroups, when compared to control (CONTR) subjects, showed greater slow wave negativity (700-900 msec) at the midline occipital electrode site during the contingent reward condition. This could be explained in part as an IQ effect on ERPs reflecting the IQ difference between the ADD subgroups and the controls. These slow wave findings seem to relate to attentional problems of these children. They are discussed in terms of a psychobiological model of inhibition/disinhibition and appetitive activation.     

Short-latency somatosensory evoked potentials in patients with brain stem tumor: study of N20 and N18 potentials

Short-latency somatosensory evoked potentials (SSEPs) elicited by median nerve stimulation were studied in 17 patients with brain stem tumor. A total of 35 SSEP records were obtained and classified into five groups: 13 in Group I, central conduction time (CCT) < 7.56 msec (within the normal limits); eight in Group II, CCT > or = 7.56 msec; nine in Group III, N20 potential was abolished; four in Group IV, N20 and N18 potentials were abolished; and one in Group V, N20, N18, and P14 potentials were abolished. These SSEP groups were correlated with the size and location of the brain stem tumor on magnetic resonance images. N20 potentials were unchanged in latency in patients with small localized gadolinium (Gd)-enhanced lesions. In contrast, the N20 potentials were abolished in patients with tumors extending to the dorsal pons and the upper medulla oblongata. The extent of nonenhanced low-intensity lesion did not correlate with the changes of the N20 potentials. The degree of the impairment of the N20 potentials reflected the severity of the clinical symptoms. The N20 potential can evaluate brain stem dysfunction caused by brain stem tumor. The N18 potentials were abolished in four patients, in whom the tumor extension (one Gd-enhanced lesion, three low-intensity lesions) involved not only the pons but also the medulla oblongata. Therefore, the N18 potentials are probably generated from the medulla oblongata.     

Brainstem auditory evoked potentials and visually evoked potentials in young patients with IDDM

OBJECTIVE: To investigate whether young IDDM patients develop central nervous dysfunction and to establish a possible relationship with various disease parameters. RESEARCH DESIGN AND METHODS: Thirty-two patients, aged 13.5 +/- 2 years, with disease duration of 6 +/- 2.6 years and age of onset of 7.7 +/- 3.2 years (group 1), and 21 patients with short-term disease, age 9.7 +/- 3.5 years, duration of disease < 2 years and age of onset of 9.4 +/- 3.3 years (group 2) were compared with age- and sex-matched control subjects. Exclusion criteria were clinical signs of neuropathy, retinopathy, nephropathy, or hearing impairment. Neurophysiological studies included auditory and visually evoked potentials (EPs). RESULTS: Patients in group 1 revealed increased P100 latencies of visually EPs (103.4 +/- 4.5 vs. 96.8 +/- 3.7 ms) and interpeak latencies I-V of auditory EPs (4.16 +/- 0.10 vs. 3.99 +/- 0.09 ms) and had abnormal latencies (values outside 2.5 SD) in 37%. However, short-term patients (group 2) had results within normal limits compared with control subjects. In group 1, longer disease duration and younger age at onset correlated with an increase of P100 latency (P < 0.001) and IPL I-V (P < 0.001). Patients with a history of severe hypoglycemic episodes had increased latencies compared with patients without hypoglycemia (P < 0.05). Furthermore, metabolic control during the last 2 years was related to P100 latencies (P < 0.05). CONCLUSIONS: EPs noninvasively detect subclinical central nervous system involvement in children and adolescents with IDDM. Most important risk factors are duration of disease and frequency of severe hypoglycemia.     

Visual evoked potentials in patients with refraction amblyopia in the presence of high myopia

The informative value of a method for assessing the degree of amblyopia, developed by the author, was assessed in examinations of 16 children (29 eyes) with ametropic amblyopia caused by high myopia and 41 healthy controls. The method consists in recording the pattern-reversal visual evoked potentials (VEP) evoked by 4 patterns of different checksize and contrast. A relationship has been revealed between the VEP types detected by the proposed method and the degree of amblyopia (degree of vision acuity loss). The author came to a conclusion that in ametropic amblyopia, similarly as in stimulus deprivation amblyopia, changes of VEP develop that reflect the deterioration of contrast sensitivity function in low spatial frequencies. The developed VEP method with the modifications described in this paper may be useful in the diagnosis and objective evaluation of the degree of amblyopia.     

Visual evoked potentials are affected by trunk rotation in neglect patients

Steady-state visual evoked potentials (VEPs) were recorded in four patients with unilateral visuo-spatial neglect, stimulating either the left or the right hemifield. In the standard condition (head and body oriented straight ahead towards the stimulus) the left hemifield VEP was delayed. When the body was turned to the left, however, the two hemifield latencies were comparable. These results were confirmed with the transient VEP technique. No effect of trunk rotation was observed in a group of patients with left brain damage and without neglect. The results imply that the sensory afferents from neck muscles might restore the altered occipital activity and suggest that the same conditions which modulate neglect modulate VEPs latencies.     

Coping with dietary therapy in phenylketonuria: A case report.

Describes the long-term effects of maintaining the diet required for treatment of phenylketonuria in a 7-yr-old girl on 1 family's eating and mealtime events. A behavioral/family systems oriented assessment was taken using a battery of tests including the McCarthy Scales of Children's Abilities, Wide Range Achievement Test, the Child Behavior Checklist, and an eating behavior inventory. An intervention program is described, utilizing family systems oriented/parent training and individual child sessions. Implications for enhancing dietary adherence and long-term management of dietary therapy are discussed. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual evoked potentials during appetitive behavior after septal lesions in rats.

Analyzed averaged visual evoked responses (VERs) at the cortex to flashes used as probe stimuli during different phases of fixed-ratio barpressing for sucrose, using 5 lesioned and 7 nonlesioned male Holtzman rats. Results reveal changes in late components (including after-discharge responses) of VERs of septal preparations that would suggest enhanced electrophysiological arousal to appetitive conditions. The brain-damaged Ss also displayed heightened electrophysiological reactivity to conditions of frustration instituted by intermittent withholding of reinforcement. These dysfunctions were related to the reduced distractibility to trains of extraneous stimuli shown by septal preparations during appetitive behavior. It is suggested that impairment in inhibitory modulation of arousal mechanisms is related to augmentation in behavioral response tendencies often displayed by septal preparations. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of magnetoencephalography, functional MRI, and motor evoked potentials in the localization of the sensory-motor cortex

To clarify the topographical relationship between peri-Rolandic lesions and the central sulcus, we carried out presurgical functional mapping by using magnetoencephalography (MEG), functional magnetic resonance imaging (f-MRI), and motor evoked potentials (MEPs) on 5 patients. The sensory cortex was identified by somatosensory evoked magnetic fields using MEG (magnetic source imaging (MSI)). The motor area of the hand region was identified using f-MRI, during a hand squeezing task. In addition, transcranial magnetic stimulation localized the hand motor area on the scalp, which was mapped onto the MRI. In all cases, the sensory cortex was easily identified by MSI and the results of MSI correlated well with the findings obtained by the intraoperative recording of somatosensory evoked potentials. In contrast, the motor cortex could not be localized by f-MRI due to either the activated signal of the large cortical vein or the lack of any functional activation in the area of peri-lesional edema. MEPs were also unable to localize the entire motor strip. Therefore, at present, MSI is considered to be the most reliable method to localize peri-Rolandic lesions [corrected].     

Parental problem-solving skills, stress, and dietary compliance in phenylketonuria.

Parents of 30 children with phenylketonuria (PKU) who were classified as being in good dietary control (compliant, measured as within the medically acceptable range of blood phenylalanine levels of 2–20 mg) or poor dietary control (noncompliant, measured as either below or above medically acceptable 2–20 mg blood phenylalanine levels) engaged in verbal and written problem-solving situations under conditions of both high and low time-pressure induced stress. Overall, compliant parents gave higher quality verbal and written problem-solving solutions than noncompliant parents. Stress reduced the quality of problem solving in both compliant and noncompliant parents, but even under high stress, compliant parents demonstrated better problem-solving abilities than noncompliant parents. The potential importance of these findings for preventive intervention in PKU families is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visually evoked potentials: theory, techniques and clinical applications

The visually evoked potential (VEP), the recording of which has recently been made possible by the development of computer averaging techniques, is a gross electrical signal generated by the occipital region of the cortex in response to visual stimulation. It is more specific than the electroencephalogram (EEG) and more sensitive to changes in the visual stimulus; thus, it can provide ophthalmologists and vision researchers with information about the human visual system that is unavailable by other methods. Clinically, the VEP is of special value in the areas of refraction, infant acuity, diseases of the optic nerve, color blindness, amblyopia and field defects. Theory, techniques and instrumentation are described, and applications of the VEP to clinical situations and to vision research are discussed.     

Some issues regarding the use of electroencephalography and brain evoked potentials in occupational medicine

Acute experiments were performed on cats with intracellular recording of efferent and unidentified neurons of the anterior suprasylvian and posterior lateral gyri of the parietal cortex, to study the antidromal and synaptic responses to stimulation of the lateral and medial groups of intrinsic nuclei of the pons. Oligo- and polysynaptic components were detected, along with complex EPSP due to convergence of axons from fast- and slow-conducting neurons. Antidromal and synaptic responses were demonstrated in the same parietal cortex neurons, demonstrating a double connection between the intrinsic nuclei of the pons and the associated parietal cortex. The possible pathways of these connections are discussed, along with their features and importance in the functioning of pontocortical connections.     

MRI of optic nerve and postchiasmal visual pathways and visual evoked potentials in secondary progressive multiple sclerosis

We studied the relationship between abnormalities shown by MRI and functional disturbances in the visual pathway as assessed by the visual evoked potential (VEP) in 25 patients with established multiple sclerosis (MS); only 4 of whom had a history of acute optic neuritis. Optic nerve MRI was abnormal in 19 (76%) and is thus useful in detecting subclinical disease. Optic nerve total lesion length and area on the STIR sequence was found to correlate significantly with prolongation of the VEP latency. This may reflect a predominantly demyelinating rather than inflammatory origin for the signal change in the optic nerve.