Visual Evoked Potentials Amplitude Research Articles

Pediatric craniopharyngioma with significantly increased intraoperative visual evoked potential amplitude and postoperative visual acuity improvement: a case report.

Visual evoked potential (VEP) is an established modality that allows safe brain tumor resection and preservation of optical function. We herein present a case of a pediatric craniopharyngioma with significant improvement in the VEP amplitude detected during endoscopic transsphenoidal surgery (ETS) and obvious postoperative improvement in visual acuity. A 13-year-old boy presented with visual acuity disturbance in his right eye and was followed up for 5 months by an ophthalmologist. His visual acuity rapidly worsened, and a suprasellar lesion with calcification was found on brain computed tomography. The patient underwent tumor resection during ETS with intraoperative transcranial VEP monitoring. Gross total tumor resection was achieved without injury to the perforators, including the superior hypophyseal arteries. The VEP amplitude was unstable, and significant waves were not detectable before tumor resection; however, a positive wave was detected after removing most of the tumor and exposing the bilateral optic nerves and optic chiasm. Subsequently, negative and positive VEP waves were continuously detected. Visual acuity improved remarkably on postoperative day 10. This case demonstrated both a significant increase in the intraoperative VEP amplitude and rapid postoperative improvement in visual acuity. We surmised that the preoperative rapid worsening of visual dysfunction, intraoperative increase in the VEP amplitude, and significant postoperative improvement in visual acuity were associated with the compression of the optic nerves by the internal carotid artery, anterior cerebral artery, and tumor.

Efficacy of intraoperative visual evoked potential amplitude reduction in predicting visual outcome after extended endoscopic endonasal resection of craniopharyngiomas.

Postoperative visual outcome is a major concern of neurosurgeons for patients with craniopharyngiomas. The current study aimed to investigate the value of visual evoked potential (VEP) amplitude reduction (N75-P100 and P100-N145) for predicting postoperative visual dysfunction (POVD) and refining current warning criteria for VEP monitoring. Data from 96 patients who underwent the extended endoscopic endonasal approach for craniopharyngiomas between October 2020 and November 2021 were retrospectively reviewed. VEP amplitude reduction ratios were calculated and compared between patients with POVD and those without. Subsequently, the critical threshold values of VEP amplitude reduction ratios for predicting POVD were obtained through receiver operating characteristic curve analysis. Finally, multivariate binary logistic regression analysis was applied to evaluate the effect of potential factors on the probability of experiencing POVD. Both N75-P100 and P100-N145 amplitude reduction ratios were significantly higher in patients with POVD (p < 0.001 for both). The threshold value of the N75-P100 amplitude reduction ratio for predicting POVD was 51.76% with an area under the curve (AUC) of 0.816 (p < 0.001), while the threshold value of the P100-N145 amplitude reduction ratio was 38.80% with an AUC of 0.738 (p < 0.001). Both N75-P100 and P100-N145 amplitude reduction ratios were identified as independent predictors for POVD via multivariate analysis (p < 0.001 and p = 0.018, respectively). Both N75-P100 and P100-N145 amplitude reduction ratios showed great potential to be indicators for POVD in patients with craniopharyngiomas. Regarding warning criteria for VEP monitoring, the authors recommend that both N75-P100 and P100-N145 amplitude reduction should be considered, with early warning criteria of a 50% reduction for N75-P100 amplitude and/or a 40% reduction for P100-N145 amplitude.

Psychophysical, electrofunctional, and morphological evaluation in naïve neovascular AMD patients treated with intravitreal anti-VEGF.

The aim of this study was to investigate the retinal morpho-functional characteristics of patients with neovascular wet age-related macular degeneration (nAMD) treated with intravitreal injection (IV) of aflibercept (AFL). The study was conducted on 35 patients previously diagnosed with type 1 nAMD who received a fixed-dosing regimen of aflibercept injections over 12 months. The goal was to assess trends in visual abilities over time by measuring visual acuity (VA), contrast sensitivity (CS), visual evoked potentials (VEPs), and spectral domain-optical coherence tomography (SD-OCT). The same psychophysical, electro-functional, and morphological tests administered at baseline (T0) were repeated 4 to 8 weeks after the last aflibercept injection (Tn), resulting in a total of six examinations. At Tn, all subjects exhibited improved VA for both far and near distances compared to values detected at T0. Similarly, VEP amplitude and latency values at Tn showed a greater P100 improvement than those observed at T0. Additionally, the CS examination at Tn demonstrated improvement, particularly at high spatial stimulation frequencies. The Tn SD-OCT results highlighted a reduction in macular thickness compared to T0 values. This exploratory research indicates that intravitreal injections of AFL, following a fixed-dosing regimen, represent a valuable therapeutic approach for enhancing visual performance. This conclusion is supported by comprehensive statistical analysis of psychophysical, electro-functional, and morphological examinations within the same group of patients with nAMD, as demonstrated for the first time.

The clinical efficacy of preoperative flash visual evoked potential (VEP) for mature cataracts without a response to pattern VEP.

This study aims to assess the effectiveness of the preoperative flash visual evoked potential (VEP) test in predicting postoperative visual acuity for monocular mature cataract cases when compared to the contralateral normal eye. The study included 60 patients, each with a monocular mature cataract diagnosis, who underwent preoperative flash VEP testing showing no pattern VEP response. Subsequently, phacoemulsification was performed. The relationship between the flash VEP test latency values (P1, N2, P2) and amplitude value (N2-P2), and the degree of visual acuity recovery 3 months post-cataract surgery, was evaluated using the LogMAR scale. Furthermore, a linear regression analysis was conducted to explore the connection between preoperative flash VEP components and postoperative visual acuity. The average age of the patients was 65.4 ± 13.6 years, with a range of 43 to 87 years. The study included 36 males and 24 females. A significant disparity in visual acuity was observed between the preoperative and 3-month postoperative stages (p < 0.001). The preoperative flash VEP test for mature cataracts revealed significant delays in P1, N2, and P2 latency, as well as a reduction in N2-P2 amplitude potential when compared to the contralateral normal eye (p < 0.001). Notably, delayed P2 latency and reduced N2-P2 amplitude potential were particularly indicative of poor visual acuity prognosis after cataract surgery in the multiple regression analysis (p < 0.05). The N2-P2 amplitude potential was the important value that exhibited statistically significant results, with an area under the curve (AUC) of 80% sensitivity and 88% specificity, using a cutoff value of 6.07 μV. In cases of monocular mature cataract, a reduction in N2-P2 amplitude potential compared to the contralateral normal eye emerged as the most reliable predictor of postoperative visual prognosis following cataract surgery.

Knocking out the LRRK2 gene increases sensitivity to wavelength information in rats

Leucine-rich repeat kinase 2 (LRRK2) is a gene related to familial Parkinson’s disease (PD). It has been associated with nonmotor symptoms such as disturbances in the visual system affecting colour discrimination and contrast sensitivity. This study examined how deficiency of LRRK2 impacts visual processing in adult rats. Additionally, we investigated whether these changes can be modelled in wild-type rats by administering the LRRK2 inhibitor PFE360. Visual evoked potentials (VEPs) and steady-state visual evoked potentials (SSVEPs) were recorded in the visual cortex and superior colliculus of female LRRK2-knockout and wild-type rats to study how the innate absence of LRRK2 changes visual processing. Exposing the animals to stimulation at five different wavelengths revealed an interaction between genotype and the response to stimulation at different wavelengths. Differences in VEP amplitudes and latencies were robust and barely impacted by the presence of the LRRK2 inhibitor PFE360, suggesting a developmental effect. Taken together, these results indicate that alterations in visual processing were related to developmental deficiency of LRRK2 and not acute deficiency of LRRK2, indicating a role of LRRK2 in the functional development of the visual system and synaptic transmission.

The Effect of Ethambutol Therapy in terms of Visual Evoked Potential, Color Vision Test, and Contrast Sensitivity Test at the Subclinical Level

Abstract&#x0D; Introduction &amp; Objectives : Ethambutol is one of the first-line drugs in the treatment of tuberculosis and known to induce optic neuropathy. However, there are unknown protocols for detecting subclinical level of toxicity. The aim of this study was to assess the difference in amplitude and latency of visual evoked potential (VEP), color vision, and contrast sensitivity in tuberculosis patients before and after taking ethambutol for 1 and 2 months.&#x0D; Methods : This was a prospective observational cohort study of 38 eyes of 19 newly diagnosed patients with category-1 tuberculosis being treated with ethambutol. All patients were given ethambutol for 2 months at a dose of 15 - 20 mg/kg body weight/day. The participants underwent complete eye and visual function examination including pattern-reversal VEP, color vision with Farnsworth Munsell D-15 test, and contrast sensitivity with LEA Low Contrast Flip Chart before and after 1 and 2 months of treatment. Wilcoxon test was employed for data analysis.&#x0D; Results : During the study, no changes in visual acuity was observed. The results showed that the latencies of VEP after 1 month (p = 0.000) and 2 months (p = 0.000) of treatment were significantly delayed. There was a significant difference in contrast sensitivity after 2 months (p = 0.014) of treatment. However, no significant difference was found in color vision and amplitude of VEP.&#x0D; Conclusion : Latency of VEP and contrast sensitivity test could prove useful in detecting subclinical and hence very useful for monitoring patients under ethambutol therapy for ocular toxicity.

An analytical longitudinal observational study on the association of Vitamin D insufficiency in subjects with primary (idiopathic) demyelinating optic neuritis using visual evoked potential and optical coherence tomography

Background: Optic neuritis (ON) is an acute and often immune-mediated inflammatory condition of the optic nerve. Vitamin D acts as an anti-inflammatory agent and may confer neuroprotection. Visual evoked potential (VEP) and optical coherence tomography (OCT) are emerging tools for demyelinating diseases. Aims and Objectives: We tried to correlate between Vitamin D insufficiency and acute demyelinating ON using different parameters such as VEP, ganglion cell layer (GCL) thickness, and retinal nerve fiber layer (RNFL) thickness. Materials and Methods: This observational longitudinal analytical study included thirty non-consecutive patients with primary ON and 30 healthy controls. All patients with ON underwent detailed clinical and ophthalmological examination, and detailed blood workup, including serum 25 (OH) Vitamin D. VEP P100 latency, amplitude, OCT, RNFL thickness, and GCL thickness at presentation and after 3 months from May 2019 to November 2020. Results: Vitamin D insufficiency (below 30 ng/mL) was present in 60% of cases of ON. The baseline VEP showed significantly prolonged P100 latency in affected eyes in the Vitamin D insufficient group (mean 129.78±7.97 ms vs. 121.0±4.99 ms) whereas the P100 amplitude was not significantly altered between the two groups (5.5±3.13 μV vs. 7.08±3.01 μV). The baseline RNFL thickness (132.21±10.69 μm vs. 118.01±10.4 μm) and GCL thickness (76.82±2.04 μm vs. 73.06±3.2 μm) were greater in affected eyes of vitamin D insufficiency ON. There was greater RNFL thinning (79.93±3.42 μm vs. 74.80±3.5 μm) and GCL thinning (64.78±1.9μm vs. 69.02±2.22 μm) in affected eyes of ON with Vitamin D insufficiency at 3 months. Conclusion: Vitamin D insufficiency was found in most cases of ON. Insufficient Vitamin D positively correlated with optic nerve affection severity as evidenced by significantly increased baseline thickness of RNFL and GCL and more thinning of RNFL and GCL at the end of 3 months of follow-up.

Eyetracking-enhanced VEP for nystagmus

Visual evoked potentials (VEPs) are an important prognostic indicator of visual ability in patients with nystagmus. However, VEP testing requires stable fixation, which is impossible with nystagmus. Fixation instability reduces VEP amplitude, and VEP reliability is therefore low in this important patient group. We investigated whether VEP amplitude can be increased using an eye tracker by triggering acquisition only during slow periods of the waveform. Data were collected from 10 individuals with early-onset nystagmus. VEP was obtained under continuous (standard) acquisition, or triggered during periods of low eye velocity, as detected by an eye tracker. VEP amplitude was compared using Bonferroni corrected paired samples t-tests. VEP amplitude is significantly increased when triggered during low eye velocity (95% CI 1.42–6.83 µV, t(15) = 3.25, p = 0.0053). This study provides proof-of-concept that VEP amplitude (and therefore prognostic reliability) can be increased in patients with early onset nystagmus by connecting an eye tracker and triggering acquisition during periods of lower eye velocity.

Combination among VEP, OCT and TCD data in patients with relapsing-remitting multiple sclerosis during attack-free period

Aims Multiple sclerosis (MS) is characterized by inflammation, demyelination, glial cell pathology and axonal injury in the central nervous system, and also progressive axonal loss of the optic nerve in cases with optic neuritis (ON). The previous transcranial Doppler (TCD) investigations suggest cortical hyperreactivity in patients with relapsing-remitting Multiple sclerosis (RRMS). We investigated the effect of ON involvement on visual reactivity. Material and methods One hundred thirty patients with RRMS during attack-free period and 12 healthy subjects were enrolled to the study. Visual evoked potential (VEP), optic coherence tomography (OCT) and TCD examinations of all subjects were performed. Results Cerebrovascular reactivity measured with breath holding (BH) test was found to be normal. VEP amplitude, visual reactivity and peripapillary retinal nerve fibre layer (pRNFL) measurements were found to be low in patients with ON involvement, whereas VEP latencies were long. Visual reactivity was negatively correlated with VEP amplitude and RFNL measurements, and positively correlated with VEP latency. Conclusions The present study supports that cerebrovascular reactivity is preserved in patients with RRMS except for attacks, and neurovascular reactivity is increased in patients without ON involvement.

Patterned edge-illuminated display for clinical examination of visual evoked potentials using simultaneous magnetic resonance imaging

PurposeCommonly used technologies for visual pattern stimulation cannot operate in a magnetic resonance imaging room because they can interfere with the operation of the scanner and are vulnerable to its electromagnetic and magnetic fields. The aim of this single-center prospective observational study was to introduce a novel, structurally uncomplicated, easy-to-maintain, patterned edge-illuminated display (PEID) device for visual pattern-reversal stimulation, compare it with a commonly used cathode ray tube screen, and verify the equivalence of quantitative assays. Materials and methodsThe left and right eyes of 36 healthy participants with undilated pupils were examined on a commercial visual evoked potential (VEP) apparatus and on the PEID device, where pattern-reversal transient VEPs were elicited by checkerboard stimuli with large (0.89°; 0.86°–0.92°) and small (0.21°; 0.20°–0.23°) checks. ResultsThe PEID device demonstrated the required reliability and dynamic characteristics, as well as precise time-locking required for a VEP diagnosis. The results of Deming's correlation analysis showed that both the commercial cathode ray tube monitor and the PEID device produced identical VEP results within the context of experimental uncertainty. The standard deviation of Deming's regression may indicate the uncertainty of the VEPs measured in clinical practice. The Bland-Altman analysis of the mean showed no significant difference in the amplitude and peak time of VEPs measured on the PEID device compared to that of the commercial cathode ray tube monitor. ConclusionsThe presented PEID device meets all the required standards and can be easily installed in various types of commercial magnetic resonance imaging scanners.

The effect of different blood groups on visual evoked potentials

Introduction and aim. Purpose of the study is to determine whether it is required to use different standards when evaluating visual evoked potential (VEP) measurements of healthy individuals with different blood groups. Material and methods. The study consisted of healthy individuals with different blood groups who have applied to the ophthalmology and neurology outpatient clinic of Düzce University Medical Faculty from January to December 2022. The patients went through detailed ophthalmologic examination and VEP test and only the ones with normal results were included to the study. Results. The study consisted of 119 individuals, with a blood group distribution of 30 A, 29 B, 30 AB and 30 O. VEP latency and amplitude changes were compared and no significant difference was observed within 4 groups in terms of P100 and N70 latency and amplitudes. There was N70 latency prolongation in Rh- group and this difference was found to be statistically significant (p=0.009). Rh+ group was found to be high in terms of P100 amplitudes and this was considered statistically significant (both p=0.023). Conclusion. There was no statistically significant difference in the VEP parameters of the individuals with the ABO blood groups hence same VEP normal values can be used for ABO blood groups.

Pattern visual evoked potential and foveal sensitivity in amblyopia.

Amblyopic eyes show impaired visual functions such as poor visual acuity and reduced foveal sensitivity. The purpose of this study was to determine the association between foveal threshold and visual evoked potentials (VEP) in strabismic and anisometropic amblyopia. Forty-five subjects (age range: 7-28years, 43.3% female) including 15 strabismic and 15 anisometropic amblyopes, and 15 age-similar control subjectsparticipated in this study. Each subject had pattern visual evoked potentialsand foveal threshold recorded in each eye using RetiScan (Roland Consult, Germany) and Humphrey Visual Field Analyzer II (HFA II; Carl Zeiss Meditec Inc., Dublin, CA), respectively. These outcomes were comparedamong the amblyopic eyes, their fellow eyes, and the control eyes. Compared to the amblyopic eyes (Mean ± SD: 33.4 ± 3.48dB), the foveal threshold was higher in fellow eyes (37.0 ± 2.04dB, p = 0.0002) and incontrol eyes (38.7 ± 0.96dB, p < 0.0001). Strabismic amblyopes had a lower foveal threshold than anisometropic amblyopes (31.8 ± 3.86 vs. 35.0 ± 2.17dB, p = 0.005). Relative to the P100 peak time in fellow eyes (1°checks:116.1 ± 9.00ms; 0.25°checks:118.8 ± 5.67ms), amblyopic eyes had delayed P100 peak times for both 1° (122.7 ± 11.4ms, p < 0.0001) and 0.25° (130.4 ± 11.2ms, p < 0.0001) check sizes. There were also significant differences in P100 peak time between amblyopic and control eyes (1°:122.7 ± 11.4 vs.112.4 ± 5.01ms, p = 0.15; 0.25°:130.4 ± 11.2 vs.113.9 ± 5.71ms, p < 0.0001) and between fellow and control eyes (0.25°:118.8 ± 5.67 vs.113.9 ± 5.71ms, p = 0.009). Amblyopic eyes exhibited lower N75-P100 amplitudes than fellow eyes (1°:12.6 ± 7.96 vs.15.9 ± 8.82µV, p = 0.01; 0.25°:10.6 ± 6.11 vs. 15.8 ± 10.6µV, p = 0.001) and control eyes (0.25°: p = 0.0008). Foveal threshold correlated negatively with P100 peak time (1°: r = -0.45, p = 0.002 and 0.25°: r = -0.58, p < 0.0001) and positively with N75-P100 amplitude responses (1°: r = 0.42, p = 0.004 and 0.25°: r = 0.52, p = 0.002). Amblyopic eyes showed reduced pattern VEP amplitudes and delayed peak times with significant associations with the foveal sensitivity. However, the VEP measures overlapped extensively between amblyopic and control eyes with no apparent criterion value for optimal discrimination, suggesting that foveal sensitivity might be a better discriminator of amblyopia than pattern VEP.

Neurobehavioral measures of coincidence anticipation timing.

Coincidence anticipation (CA) refers to the ability to coordinate responses to the arrival of a moving object. This study investigates the neurobehavioral processes that underlie CA through the measurement of electroencephalography (EEG) recorded during a CA task on a 17-foot plastic rail with evenly spaced LED lights. Participants responded at the anticipated moment a sequence of successively lit LEDs coincided with a stationary target. Healthy young adult participants (Mage = 21) performed six blocks with movement at 20, 30, or 40 mph and the direction either inbound or outbound relative to the participant. Behavioral results demonstrated a main effect of speed and an interaction between speed and direction, with outbound motion producing early responses and inbound motion producing delayed responses that increased at greater speeds. EEG demonstrated characteristic P1, N2, and P3-like visual evoked potentials (VEPs). VEP amplitudes revealed a significant direction by channel interaction for the P1, indicative of more medial responses for inbound motion. Significant laterality differences were present in the N2, whereas the P3 component produced significant main effects and interactions of speed and direction. This novel combination of three-dimensional CA with EEG demonstrates systematic brain responses that are tuned for motion speed and sensitive to different egocentric motion patterns thereby shedding new light on the mechanism of human visual-motor control.

Comparison of Sub-Scalp EEG and Endovascular Stent-Electrode Array for Visual Evoked Potential Brain-Computer Interface.

Brain-computer interfaces (BCI) have the potential to improve the quality of life for persons with paralysis. Sub-scalp EEG provides an alternative BCI signal acquisition method that compromises between the limitations of traditional EEG systems and the risks associated with intracranial electrodes, and has shown promise in long-term seizure monitoring. However, sub-scalp EEG has not yet been assessed for suitability in BCI applications. This study presents a preliminary comparison of visual evoked potentials (VEPs) recorded using sub-scalp and endovascular stent electrodes in a sheep. Sub-scalp electrodes recorded comparable VEP amplitude, signal-to-noise ratio and bandwidth to the stent electrodes.Clinical relevance-This is the first study to report a comparision between sub-scalp and stent electrode array signals. The use of sub-scalp EEG electrodes may aid in the long-term use of brain-computer interfaces.

Effects of Smoking on Pattern Visual Evoked Potentials

Aim: The aim of the study is to get a better understanding of the side effects of smoking by evaluating the effect of recently elevated smoking rate on Visual Evoked Potentials (VEP) and to determine whether it is necessary to use different normals when evaluating the VEP measurements of smoking patients. Material and Methods: The patients who have applied to our ophthalmology and neurology outpatient clinics during 2021-2022 are included to the study. Detailed ophthalmologic examination of the patients as well as their VEP test is completed followed by a dilated fundus examination assessment. The patients with normal results are included to the study. The smoking rate is calculated on pack/year basis. Pattern VEP (PVEP) recording is performed based on Keypoint (Dantec, Denmark) and International Society for Clinical Electrophysiology of Vision (ISCEV) criteria. Data obtained through the study are analyzed by SPSS 21.0 version software. Countable variables with normal distribution between two independent groups are analyzed with Independent Sample T test whereas variables without normal distribution are analyzed with Mann Whitney U test. Chi-square test is used for comparing categorical variables. Results: 71 patients were included to the study where 33 of them were placed in smoking group and 38 in non-smoking group (control group). Smoking group had a yearly cigarette package consumption of 5.20±8.93 (0.2-40). VEP latency and amplitude changes were compared and according to the obtained results; there was P100 latency prolongation in between left and right eye of the patients in the control group and smoking group but it did not have any statistical significance (p=0.910 and p=0.697 respectively). There was no statistically significant difference in either left nor right eye in terms of smoking and P100 and N70 latencies (p=0.707, p=0.838, p=0.717 and p=0.621 respectively). Similarly, there was no significant correlation between yearly package consumption and P100 and N70 latencies and amplitudes of left and right eyes (p=0.503, p=0.410, p=0.776 and p=0.940 respectively). Conclusion: No significant effect of smoking is found on VEP values thus leading us to believe that the same normal intervals can be used in the evaluation of VEP results of both smoking and non-smoking patients.

Morpho-Functional Assessment of Retinal Ganglion Cells and Visual Pathways in Patients with Optic Disc Drusen: Superficial Drusen Visible Height as a Marker of Impairment.

The aim of this study was to assess the morpho-functional involvement of the retinal ganglion cells (RGCs) and of the visual pathways in patients with superficial (ODD-S) or deep (ODD-D) optic disc drusen. This study enrolled 17 patients with ODD (mean age of 59.10 ± 12.68 years) providing 19 eyes and 20 control subjects (mean age 58.62 ± 8.77 years) providing 20 eyes. We evaluated the following: best-corrected visual acuity, visual field mean deviation (MD), the amplitude (A) of Pattern Electroretinogram (PERG), the implicit time (IT) and A of Visual Evoked Potentials (VEPs), retinal nerve fiber layer thickness (RNFL-T) and ganglion cell thickness (GC-T). In ODD-S eyes, the drusen visible height was measured. ODD-D and ODD-S were detected in 26.3% and 73.7% of ODD eyes, respectively. Significantly (p < 0.01) reduced MD, PERG A, VEP amplitude, RNFL-T and GC-T values and significantly (p < 0.01) increased VEP IT values were found in the ODD Group as compared to the Control one. In the ODD Group, no significant correlation (p > 0.01) between PERG As and VEP ITs was found. In ODD-S, the visible height was significantly correlated (p < 0.01) with reduced MD, PERG As and RNFL-T and with increased PSD and VEP IT values. Our findings suggest that ODD might induce morpho-functional changes in RGCs and their fibers and an unrelated visual pathway dysfunction leading or not leading to visual field defects. The observed morpho-functional impairment should be ascribed to an alteration in retrograde (from the axons to the RGCs) and anterograde (from the RGCs up to the visual cortex) axoplasmic transport. In ODD-S eyes, a minimum visible height of 300 microns represented the threshold for the abnormalities, suggesting that "the higher the ODD, the worse the impairment".

Early visual perceptual processing is altered in obsessive–compulsive disorder

ObjectiveExisting studies have shown changes in attention and emotion processing of disorder-relevant visual stimuli in those with obsessive compulsive disorder (OCD). However, early visual processing in OCD has not been assessed, as previous studies did not examine the entire time course of visual processing but instead assessed potential differences in pre-determined visual evoked potentials (VEPs). This study investigates the entire visual processing stream in OCD compared to healthy age-matched controls (HC) using emotionally-neutral visual stimuli and a data-driven rather than hypothesis-driven approach. Methods35 HC and 26 participants with OCD underwent EEG recording while completing a modified Eriksen flanker task. Permutation-controlled t-tests were used to identify group differences in the data’s full time course of visual evoked potentials. Baseline-corrected amplitudes at time points where the groups were significantly different were analyzed using ANCOVAs with BDI, BAI, and SNAP-inattentiveness scores included as covariates. ResultsThis analysis identified enhanced P1 amplitudes to two visual stimuli (the initial flanker and the stimulus), corresponding to time windows of 65–93 ms and 157–187 ms post-flanker presentation in the OCD group compared to controls. Group (OCD vs. HC) was the strongest predictor of VEP amplitude during both time windows, with no significant influences of any covariates. ConclusionsThis study showed an enhanced P1 component in people with OCD to neutral visual stimuli, potentially reflecting either inefficient or excessive early visual processing in this population. Additional inquiry is necessary to determine whether altered visual processing is associated with the sensory hypervigilance observed in those with OCD. SignificanceThis work identifies early visual processing alterations in OCD using neutral stimuli and a data-driven approach.

Comparison of evoked potentials across four related developmental encephalopathies

BackgroundDeveloping biomarkers is a priority for drug development for all conditions, but vital in the rare neurodevelopmental disorders where sensitive outcome measures are lacking. We have previously demonstrated the feasibility and tracking of evoked potentials to disease severity in Rett syndrome and CDKL5 deficiency disorder. The aim of the current study is to characterize evoked potentials in two related developmental encephalopathies, MECP2 duplication syndrome and FOXG1 syndrome, and compare across all four groups to better understand the potential of these measures to serve as biomarkers of clinical severity for the developmental encephalopathies.MethodsVisual and auditory evoked potentials were acquired from participants with MECP2 duplication syndrome and FOXG1 syndrome across five sites of the Rett Syndrome and Rett-Related Disorders Natural History Study. A group of age-matched individuals (mean = 7.8 years; range = 1–17) with Rett syndrome, CDKL5 deficiency disorder, and typically-developing participants served as a comparison group. The analysis focused on group-level differences as well as associations between the evoked potentials and measures of clinical severity from the Natural History Study.ResultsAs reported previously, group-level comparisons revealed attenuated visual evoked potentials (VEPs) in participants with Rett syndrome (n = 43) and CDKL5 deficiency disorder (n = 16) compared to typically-developing participants. VEP amplitude was also attenuated in participants with MECP2 duplication syndrome (n = 15) compared to the typically-developing group. VEP amplitude correlated with clinical severity for Rett syndrome and FOXG1 syndrome (n = 5). Auditory evoked potential (AEP) amplitude did not differ between groups, but AEP latency was prolonged in individuals with MECP2 duplication syndrome (n = 14) and FOXG1 syndrome (n = 6) compared to individuals with Rett syndrome (n = 51) and CDKL5 deficiency disorder (n = 14). AEP amplitude correlated with severity in Rett syndrome and CDKL5 deficiency disorder. AEP latency correlated with severity in CDKL5 deficiency disorder, MECP2 duplication syndrome, and FOXG1 syndrome.ConclusionsThere are consistent abnormalities in the evoked potentials in four developmental encephalopathies some of which correlate with clinical severity. While there are consistent changes amongst these four disorders, there are also condition specific findings that need to be further refined and validated. Overall, these results provide a foundation for further refinement of these measures for use in future clinical trials for these conditions.

Visually evoked potentials (VEPs) across the visual field in hearing and deaf cats.

Congenitally deaf cats perform better on visual localization tasks than hearing cats, and this advantage has been attributed to the posterior auditory field. Successful visual localization requires both visual processing of the target and timely generation of an action to approach the target. Activation of auditory cortex in deaf subjects during visual localization in the peripheral visual field can occur either via bottom-up stimulus-driven and/or top-down goal-directed pathways. In this study, we recorded visually evoked potentials (VEPs) in response to a reversing checkerboard stimulus presented in the hemifield contralateral to the recorded hemisphere in both hearing and deaf cats under light anesthesia. Although VEP amplitudes and latencies were systematically modulated by stimulus eccentricity, we found little evidence of changes in VEP in deaf cats that can explain their behavioral advantage. A statistical trend was observed, showing larger peak amplitudes and shorter peak latencies in deaf subjects for stimuli in the near- and mid-peripheral field. Additionally, latency of the P1 wave component had a larger inter-sweep variation in deaf subjects. Our results suggested that cross-modal plasticity following deafness does not play a major part in cortical processing of the peripheral visual field when the "vision for action" system is not recruited.

Can visual cortex non-invasive brain stimulation improve normal visual function? A systematic review and meta-analysis.

Multiple studies have explored the use of visual cortex non-invasive brain stimulation (NIBS) to enhance visual function. These studies vary in sample size, outcome measures, and methodology. We conducted a systematic review and meta-analyses to assess the effects of NIBS on visual functions in human participants with normal vision. We followed the PRISMA guidelines, and a review protocol was registered with PROSPERO before study commencement (CRD42021255882). We searched Embase, Medline, PsychInfo, PubMed, OpenGrey and Web of Science using relevant keywords. The search covered the period from 1st January 2000 until 1st September 2021. Comprehensive meta-analysis (CMA) software was used for quantitative analysis. Fifty studies were included in the systematic review. Only five studies utilized transcranial magnetic stimulation (TMS) and no TMS studies met our pre-specified criteria for meta-analysis. Nineteen transcranial electrical stimulation studies (tES, 38%) met the criteria for meta-analysis and were the focus of our review. Meta-analysis indicated acute effects (Hedges's g = 0.232, 95% CI: 0.023-0.442, p = 0.029) and aftereffects (0.590, 95% CI: 0.182-0.998, p = 0.005) of tES on contrast sensitivity. Visual evoked potential (VEP) amplitudes were significantly enhanced immediately after tES (0.383, 95% CI: 0.110-0.665, p = 0.006). Both tES (0.563, 95% CI: 0.230-0.896, p = 0.001) and anodal-transcranial direct current stimulation (a-tDCS) alone (0.655, 95% CI: 0.273-1.038, p = 0.001) reduced crowding in peripheral vision. The effects of tES on visual acuity, motion perception and reaction time were not statistically significant. There are significant effects of visual cortex tES on contrast sensitivity, VEP amplitude, an index of cortical excitability, and crowding among normally sighted individuals. Additional studies are required to enable a comparable meta-analysis of TMS effects. Future studies with robust experimental designs are needed to extend these findings to populations with vision loss. ClinicalTrials.gov/, identifier CRD42021255882.