Analysis of pattern reversal visual evoked potentials (PRVEP's) by spline wavelets

In this study, the pattern-reversal visual evoked potentials (PRVEP's) collected from normal and demented subjects are investigated by applying the quadratic spline wavelet analysis. The data are decomposed into six octave frequency bands. For quantitative purposes, the wavelet coefficients in the residual waveform representing the delta-theta band activity (0-8 Hz) are explored to characterize the (N70-P100-N130) complex. Specifically, the coefficients corresponding to the location of N70, P100, and N130 peaks are investigated for their sign in order to test whether they represent a consistent (N70-P100-N130) complex in the averaged waveform. Waveforms with normal latency (N70-P100-N130) complex are observed to have positive second, negative third, and positive fourth coefficients in amplitude in their residual scale standing for the delta-theta (0-8 Hz) band activity. The method allows for the analysis of oscillatory-phase behavior of the normal and pathological PRVEP's in their delta-theta band based on a few quantitative measures consistent with the time-frequency occurrence of the major components of the evoked potential.     

Evoked potentials and head injury. 1. Rating of evoked potential abnormality

This paper describes a method for rating the degree of abnormality of auditory, visual and somatosensory evoked potential patterns in head injury (HI) patients. Criteria for judging degree of EP abnormality are presented that allow assessment of the extent and severity of subcortical and cortical dysfunction associated with traumatic brain damage. Interrater reliability data based upon blind ratings of normal and HI patients are presented and shown to be highly significant. Tables of normative values of peak latencies and amplitudes are given and illustrations of EP patterns of different degrees of abnormality are presented.     

P300 potentials evoked by visual stimulation

INTRODUCTION: The P300 potential is a long-latency endogenous component of the event-related potentials to low-probability target stimuli. The same stimulus delivered without cognitive process does not provoke endogenous components; moreover event-related potentials are not dependent of the sensory pathways used for stimulating the subjects. P300 potential is a biological parameter used in scientific investigations in Clinical Neurophysiology, Neurology, Psychophysiology and Psychiatry. The most frequent methodology for obtaining P300 event-related potential is based on the 'odd-ball' paradigm using auditory stimulation. In this revision we analyzed the difficulties of this methodology and we propose to use the visual stimulation in order to obtain well defined P300 potential, based on a better signal to noise ratio and minor overlapping of exogenous and endogenous components of the evoked potentials. The improvement in the quality of the results obtained when comparing with auditory stimulation, it is supposed to facilitate that the use of P300 potential overflows the field of the investigation and permits their extensive use in the clinical practice.     

Pattern-reversal visual evoked potentials in migraineurs with or without visual aura

To determine the possible electrophysiologic changes in migraineurs with or without visual aura, we investigated pattern-reversal visual evoked potentials in 39 patients. We compared the mean P100 latency and amplitude of 16 patients with aura, 23 patients without aura, and 17 age- and sex-matched normal subjects. There were no significant differences between groups. There was no correlation between age and the parameters in any group. However, in 7 of 23 patients without aura, the P100 latency was longer than the mean control value +2 SD. The mean disease duration in this subgroup was significantly longer than the means of the remaining 16 patients without aura or the patients with aura (P < 0.05 for each). This suggests the possibility that P100 latency prolongation is a consequence, but not an entity caused by the pathogenetic mechanism of the disease from the beginning.     

Pattern shift visual evoked response in carotid occlusion

Pattern shift visual evoked response (PSVER) latency has been shown to be an extremely sensitive but nonspecific measure of optic nerve dysfunction. The test has been most useful in detecting unsuspected demyelinating lesions of the optic nerve, but abnormal results have been reported in a variety of other conditions affecting the optic nerve, including ischemic optic neuropathy. We report a patient with left internal carotid artery occlusion, possibly secondary to neck trauma, with normal ophthalmological examination and abnormal PSVER. The suggested mechanism is subclinical optic nerve ischemia due to decreased blood flow in the ophthalmic artery. PSVER may have value as a sensitive indicator of internal carotid artery disease.     

Topographic distribution of visual evoked potentials in optic neuropathy

INTRODUCTION: Digital treatment of electrical signals coming from the central nervous system on stimulation of the optic nerve path offers an objective method for evaluation of visual evoked potentials (VEP) shown graphically on a cerebral map. OBJECTIVE: To evaluate the topographical distribution of VEP in cases of optic neuropathy adding this parameter to the usual parameters of latency and amplitude. MATERIAL AND METHODS: We studied 35 patients with suspected optic neuropathy and normal findings on basic ophthalmological examination, in whom VEP and VEP mapping (VEPM) was done. RESULTS: In 26% of the cases there was no response for evaluation with the usual VEP recording techniques, whilst in those with VEPM this percentage was reduced to 11.5%. In the other cases there was a potential with characteristic distribution in the occipital areas and a maximally positive dipole posteriorly. CONCLUSION: VEPM is an objective method for evaluation of the visual pathway offering better discrimination than the usual VEP in more severe cases of neuropathy.     

Transiet atrial fibrillation after minor head injury

Two patients developed transient rapid atrial fibrillation after a blow on the head. There was no evidence of neurological damage or organic heart disease on subsequent investigation. Neither patient was aware of the cardiac irregularity.     

Effect of levodopa therapy on visual evoked potentials and visual acuity in amblyopia

Between 10 and 11 years after children were vaccinated with Vi capsular polysaccharide of Salmonella typhi or meningococcal A + C control vaccine in a double blind randomized trial, we traced 83 subjects, aged 16-20 years. A blood sample was taken for determination of Vi antibody titres in both groups by radioimmunoassay. TO and TH titres were also done to assess if the participants had had recent exposure to typhoid fever. Fifty-eight percent of subjects in both groups had protective levels of Vi antibody against Salmonella typhi (a titre greater than 1 microgram ml-1). There was no significant difference in the levels of Vi antibodies in the cases versus the controls (p = 0.5). Two of the children who had received meningococcal A + C vaccine had recently had typhoid fever. Our data show that adolescents in typhoid endemic areas have high levels of Vi antibodies regardless of previous vaccination status, suggesting that Vi antibodies are acquired in adolescence by a large percentage of the population in this area. Moreover, Vi vaccination has led to ongoing antibody production in greater than 50% of Vi vaccinated children in an endemic area for a period of 10 years. Ongoing antigenic exposure may have contributed to these antibody levels.     

Fractal analysis of steady-state-flicker visual evoked potentials: feasibility

Electrophysiological models of visual evoked potential recording have assumed that response variability is caused predominantly by random noise added to a true steady signal. Since neuronal geometry has a fractal structure, neural activity may demonstrate deterministic nonlinear dynamics, i.e., chaos. We recorded several-minute time-series traces of the visual evoked potential magnitude in response to full-field flicker from three glaucoma patients and one normal subject. When plotted in phase space, the steady-state response derived from a lock-in amplifier shows an apparent so-called strange attractor (extended nonrepeating loops) rather than the pattern expected from a signal-plus-noise model (a fuzzy dot). The fractal dimension of this attractor may be a more sensitive indicator of early optic-nerve damage than are visual evoked potential latency or amplitude measures.     

Macular pigment and the colour-specificity of visual evoked potentials

A modified Moreland anomaloscope was used to examine two subjects, one with dense macular pigment, the other with relatively light pigmentation. Chromatic visual evoked potentials (VEPs) were elicited from these two subjects using coarse, isoluminant gratings of different sizes. Colour-specificity was verified by comparing chromatic onset VEPs (reflecting sustained activity) with chromatic reversal VEPs (reflecting mainly transient activity) and also by Fourier analysis (colour-specific responses are dominated by the fundamental, transient activity by the second harmonic). Achromatic (transient-type) intrusions, produced by large blue-green gratings could be related to the extent of subject-specific macular pigmentation.     

Neuronal generators of visual evoked potentials in humans: visual processing in the human cortex

PURPOSE: We wished to define the localization of cortical generators of visual (pattern) evoked potentials (VEP) and the temporal sequence of activation in the occipital region. METHODS: In 4 candidates for epilepsy surgery, a large array of subdural electrodes was placed over occipital areas. Checkerboard pattern reversal stimuli were generated and the epileptogenic focus was localized and functionally mapped. Magnetic resonance imaging did not show any occipital lesions in any of the 4 patients. RESULTS: The area first activated was the lingual gyrus in the mesial occipital lobe (negative potential peaks at approximately 70 ms), followed by an area superior to the calcarine fissure (negative peaks at approximately 80 ms). Later (starting at approximately 90 ms), there were positive potentials over the occipital pole and lingual gyrus, followed by potentials at the lateral occipital lobe. CONCLUSIONS: These data support the idea that VEP are generated in the mesial and lateral occipital cortex by different circumscribed neuronal generators with different latencies of activation. The scalp-recorded N1 and P1 potential peaks most likely derive from the progressive activation of neuronal masses in different regions of the occipital lobe.     

The stabilization of cortical evoked potentials during selective visual attention

The event-related potentials (ERP) to lateralized moving visual stimuli (administered to the right and to the left of the subject) were recorded in six derivations in eight healthy subjects during passive viewing and selective attention to one of the stimuli (the relevant one), which demanded precise and rapid motor reaction. It was shown that during the selective voluntary attention correlation between successive ERP was substantially higher than that under conditions of passive (involuntary) attention, i.e. the ERP in the occipital, parietal, and frontal derivations during voluntary attention were more stable. The less was correlation between the ERP at passive viewing, the greater was the difference between the values of correlation coefficients during selective and passive attention. It is suggested that role of selected attention consists in stabilization of activity of the cortical structures, which are involved in solving the behavioral task.     

Effects of postinatal stress on visual and auditory evoked potentials

Maturation of visual and auditory evoked potentials (mainly the P3 wave) of 10 controls and of 10 infants exposed to recurrent postnatal stressful events (crying spells lacking organic basis) have been compared. The sourse of maturation of P3 waves may serve as indicator of growth and nature of cognitive processes (including perception). Recurrent srying spells seemed to delay appearance of visual P3 wave, prolonged its latency, and delayed appearance of visible differences in the shape of visual P3 wave upon exposure of the subjects to different visual experiences. A compensatory increase of maturation of the auditory P3 wave appeared. The results suggest that recurrent exposure to stressful events during the early postnatal period may delay the ability of the memory banks of auditory engrams with unusual contents (including memory traces of stresses), a potential basis for future auditory hallucinations.     

Objective specification of tritanopic confusion lines using visual evoked potentials

The minimum distinct border (MDB) between different isoluminant hues of a bipartite field was set subjectively by adjustment and then according to a 3-point rating allowing determination of the S-cone specific (tritanopic) axis. This rating was compared with visual evoked potentials (VEPs) generated by coarse, isoluminant gratings, modulated along the same chromatic axes. Psychophysically determined tritanopic gratings elicited monophasic onset VEPs with the longest latency for each subject. Departure from this axis produced additional earlier negative components (reflecting additional response mechanisms). Colour-selective VEPs can, therefore, objectively specify tritanopic confusion lines with a comparable degree of accuracy to MDB judgements.     

Nonlinear analysis of visual evoked potentials elicited by color stimulation

The relationship between chromatically modulated stimuli and visual evoked potentials (VEPs) was considered. VEPs of normal subjects elicited by chromatically modulated stimuli were measured under several color adaptations, and their binary kernels were estimated. Up to the second-order, binary kernels obtained from VEPs were so characteristic that the VEP-chromatic modulation system showed second-order nonlinearity. First-order binary kernels depended on the color of the stimulus and adaptation, whereas second-order kernels showed almost no difference. This result indicates that the waveforms of first-order binary kernels reflect perceived color (hue). This supports the suggestion that kernels of VEPs include color responses, and could be used as a probe with which to examine the color visual system.     

Brain stem evoked potentials and visual evoked potentials in relation to the length of occupational exposure to low levels of toluene

In 49 printing-press workers occupationally exposed to toluene for approximately 21.6 years, the values of BEAP and VEP parameters were examined in relation to the length of exposure. With the exception of P2 wave, there was a significant increase in the latencies of all the BEAP waves examined as well as in the interpeak latency (IPL) P3-P4, whereas IPL P4-P5 decreased significantly with the length of exposure. The amplitude of all the VEP examined decreased significantly with the length of exposure. Toluene exposure was evaluated by measuring the concentration of toluene in peripheral blood and of hippuric acid in urine on Wednesday morning prior to the workshift, and of hippuric acid in urine after the workshift on the same day. According to the average concentration of hippuric acid in urine after the workshift, the levels of toluene exposure were estimated to range from 40-60 ppm. Evoked potentials were determined on Mondays 10-12 hours after a nonworking weekend.     

Specific vocalized complaints in whiplash and minor head injury patients

BACKGROUND: Serum FSH levels rise with increasing age in normal women, particularly as they enter the menopausal transition and progress to the postmenopausal state. The contributions of decreasing levels of inhibin-A (INH-A) and inhibin-B (INH-B) to this rise are presently unclear, as there are no reports of dimeric INH levels in relation to menopausal status. The present study was undertaken in order to provide preliminary data on relationships amongst the dimeric inhibins, oestradiol (E2) and FSH in normal subjects of defined menopausal status. METHODS: Single serum samples were obtained between cycle days 3 and 8 in regularly cycling women, or at random in those with irregular cycles or amenorrhoea, in 110 women, aged 48-59 years, in the third year of a prospective longitudinal study of the menopausal transition, 'The Melbourne Women's Mid-Life Health Project'. Samples were assayed for FSH, E2, INH-A, INH-B and immunoreactive inhibin (IR-INH) and results were analysed following logarithmic transformation. Undetectable values were assigned the limit of sensitivity of the respective assays. The relationships between hormones were evaluated as a function of menopausal stage. The latter was assigned as Stage 1, premenopausal (no reported change in menstrual cycle pattern), Stage 2, early peri-menopausal (reported change in menstrual cycle frequency in the preceding year with a bleed in the preceding 3 months), Stage 3, late peri-menopausal (no menses in the preceding 3-11 months) and Stage 4, postmenopausal (no menses in the preceding 12 months). RESULTS: The hormone concentrations in premenopausal subjects (geometric means, FSH 13.5 IU/l, E2 306 pmol/l, IR-INH 217 U/l, INH-A 96 ng/l, and INH-B 48 ng/l) were used as reference points for the other stages of menopausal status. Early peri-menopausal subjects had significantly lower levels of IR-INH (147 U/l) and INH-B (13.5 ng/l) in the presence of a small, statistically nonsignificant rise in FSH (to 21.4 U/l) and no significant change in E2 or INH-A. In late peri-menopausal subjects, IR-INH fell to 76 U/l, INH-A fell to 4.2 ng/l, whilst INH-B was not significantly different at 14 ng/l. FSH had risen significantly to 72.21 U/l. Oestradiol also fell significantly to 89 pmol/l. In the postmenopausal subjects there were no further significant changes in the peptide hormones or FSH, but E2 fell further to 41 pmol/l. There was a significant (P < 0.05) inverse correlation between FSH and E2 (R = -0.78), FSH and IR-INH (R = -0.66), FSH and INH-A (R = -0.53), FSH and INH-B (R = -0.29) while IR-INH and either INH-A or INH-B were positively correlated (R = +0.57 and +0.35, respectively). The data are consistent with negative feedback roles for both dimeric inhibins and E2 as contributors to the regulation of FSH secretion as menopausal status changes. CONCLUSIONS: The major significant endocrine event in women in the early peri-menopausal phase of the menopausal transition is a substantial fall in the circulating levels of inhibin-B with no significant change in inhibin-A or oestradiol. Progression to late peri-menopausal status is accompanied by a marked fall in inhibin-A and oestradiol and a rise in FSH without further change in inhibin-B. Inhibin-B, a marker of follicle number, is a significant factor in the endocrinology of the menopausal transition.     

Directional asymmetries in interhemispheric transmission time: evidence from visual evoked potentials

The hypothesis was tested that interhemispheric transfer time (IHTT), as measured in the latency of bilaterally recorded visual evoked potentials, is directionally asymmetric, i.e. that an IHTT is faster for transmission from right-to-left hemisphere, than from left-to-right. A meta-analysis of 18 experiments within the published literature reporting visual evoked potential IHTTs indicates a significant experiment-wise predominance of faster right-to-left IHTTs. A new experiment is also reported in which significantly faster right-to-left IHTT was found in visual evoked potentials recorded from parietal electrodes to lateral visual field presentations while subjects performed a task requiring complex stimulus recognition and analysis, and a choice response.     

Human visual evoked potentials during the recognition of facial emotional expression

Visual evoked potentials (VEPs) were recorded in 22 right-handed healthy subjects in the occipital, parietal, central, frontal and posterotemporal cortical areas during recognition and passive viewing of positive, negative, and neutral emotional facial expression. Peak latencies of N90, P150, and N180 VEP components appeared to be significantly shorter in response to the negative emotional expression than during administration of other facial stimuli. The differences were observed both during active recognition and passive viewing. Correct recognition was characterized by involvement of both hemispheres and high level of interhemispheric correlation between the peak latencies of P150 in the posterotemporal and of N180 in the frontal areas. It is suggested that the facial expressions are primarily recognized at the subthreshold level with participation of the posterotemporal areas. The role of the frontal areas is discussed in the completion of this process and making the correct decision about the image.