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Strigaro G, Gori B, Zoccola C, Vinassa A, Cattaneo F, Avino G, Barbero P, Varrasi C, Cantello R. Impaired Visual Inhibition in Amnestic Mild Cognitive Impairment. Clin EEG Neurosci 2024; 55:347-353. [PMID: 36325692 DOI: 10.1177/15500594221136856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective.The pathophysiology of amnestic mild cognitive impairment (aMCI) and Alzheimer disease (AD) is still a matter of debate. Visual system might be precociously altered, especially for its cholinergic connections. We thus studied patients with aMCI compared to AD with paired-pulse flash-visual evoked potentials (paired-F-VEPs), a putative marker of cholinergic function. Methods. We enrolled 12 adult patients with aMCI and 12 with AD. 14 normal age- and sex-matched subjects acted as controls (HS). Stimuli were single flashes, with interspersed random flash pairs at critical interstimulus intervals (ISIs, 16.5 to 125 ms) with closed eyes. The "single" (unconditioned) F-VEP was split into a "main complex" (50 to 200 ms after the flash) and a "late response" (200 to 400 ms). As for paired stimulation, the "test" F-VEP emerged from electronic subtraction of the "single" F-VEP from the "paired"-F-VEP. Results. In the single F-VEP, P2 latency was prolonged in patients (aMCI and AD) compared to HS (p < .05). As to the paired F-VEPs, in aMCI the "late response" normal inhibition was abolished at ISIs 50-62.5 ms (p ≤ .016), compared to AD and controls. No changes were detected for the "main complex". Conclusions. Paired-F-VEPs demonstrate a defective neural inhibition in the visual system of patients with aMCI at critical intervals. It may represent a compensatory mechanism against neuronal loss, the failure of which may be involved in AD development. Paired-F-VEPs may warrant inclusion in future preclinical/clinical studies, to evaluate its potential role in the pathophysiology and management of aMCI.
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Affiliation(s)
- Gionata Strigaro
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Benedetta Gori
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Clara Zoccola
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Alessandro Vinassa
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Federica Cattaneo
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Gianluca Avino
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Paolo Barbero
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Claudia Varrasi
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
| | - Roberto Cantello
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara, Italy
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Duan L, Ding Y, Sun GH, Li YT. An exploratory study of delayed flash visual evoked potential P2 wave latency in subcortical arteriosclerotic encephalopathy. BMC Neurol 2023; 23:345. [PMID: 37784047 PMCID: PMC10544574 DOI: 10.1186/s12883-023-03388-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 09/12/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Patients with cognitive dysfunction may present with significantly prolonged the P2 wave latency of flash visual evoked potential. However, no studies have been reported on whether the P2 wave latency of flash visual evoked potential is prolonged in patients with subcortical arteriosclerotic encephalopathy (SAE). OBJECTIVE To examine the relationship between flash visual evoked potential P2 wave latency (FVEP-P2 wave latency) and cognitive impairment in patients with SAE. METHODS Overall, we recruited 38 SAE patients as the observation cohort (OC) and 34 healthy volunteers as the control cohort (CC). We measured the FVEP-P2 wave latency for both groups. The SAE patients' cognitive abilities were evaluated via mini-mental state examination (MMSE) and the association between the latency of FVEP-P2 and MMSE score was explored by Pearsons´s correlation test. RESULTS There is no significant difference between OC (21 males and 17 females; 68.6 ± 6.7 years of age and 9.6 ± 2.8 years of education) and CC (19 males and 15 females; 65.3 ± 5.9 years of age and 10.1 ± 2.6 years of education) in gender and age composition and education level. The FVEP-P2 wave latency of the CC group was (108.80 ± 16.70) ms and the OC FVEP-P2 wave latency was (152.31 ± 20.70) ms. The OC FVEP-P2 wave latency was significantly longer than the CC (P < 0.05). In terms of MMSE scores, the MMSE scores of CC was (28.41 ± 2.34), and that of OC was (9.08 ± 4.39). Compared to the CC, the OC MMSE score was significantly lower (P < 0.05). In addition, the FVEP-P2 wave latency was inversely related to the MMSE (r = -0.4465, P < 0.05) in SAE patients. CONCLUSION The FVEP-P2 wave latency wave latency was significantly prolonged in SAE patients and strongly associated with the degree of cognitive dysfunction.
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Affiliation(s)
- Lei Duan
- Department of Encephalopathy, Nanjing Jiangning Hospital of Traditional Chinese Medicine, Nanjing, 211100, China
| | - Yu Ding
- Department of Encephalopathy, Nanjing Jiangning Hospital of Traditional Chinese Medicine, Nanjing, 211100, China
| | - Gao-Hui Sun
- Department of Neurology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, China
| | - Yun-Tao Li
- Department of General Medicine, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, China.
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Liang N, Wang C, Li S, Xie X, Lin J, Zhong W. The classification of flash visual evoked potential based on deep learning. BMC Med Inform Decis Mak 2023; 23:13. [PMID: 36658545 PMCID: PMC9851116 DOI: 10.1186/s12911-023-02107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Visual electrophysiology is an objective visual function examination widely used in clinical work and medical identification that can objectively evaluate visual function and locate lesions according to waveform changes. However, in visual electrophysiological examinations, the flash visual evoked potential (FVEP) varies greatly among individuals, resulting in different waveforms in different normal subjects. Moreover, most of the FVEP wave labelling is performed automatically by a machine, and manually corrected by professional clinical technicians. These labels may have biases due to the individual variations in subjects, incomplete clinical examination data, different professional skills, personal habits and other factors. Through the retrospective study of big data, an artificial intelligence algorithm is used to maintain high generalization abilities in complex situations and improve the accuracy of prescreening. METHODS A novel multi-input neural network based on convolution and confidence branching (MCAC-Net) for retinitis pigmentosa RP recognition and out-of-distribution detection is proposed. The MCAC-Net with global and local feature extraction is designed for the FVEP signal that has different local and global information, and a confidence branch is added for out-of-distribution sample detection. For the proposed manual features,a new input layer is added. RESULTS The model is verified by a clinically collected FVEP dataset, and an accuracy of 90.7% is achieved in the classification task and 93.3% in the out-of-distribution detection task. CONCLUSION We built a deep learning-based FVEP classification algorithm that promises to be an excellent tool for screening RP diseases by using FVEP signals.
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Affiliation(s)
- Na Liang
- grid.190737.b0000 0001 0154 0904College of Computer Science, Chongqing University, Chongqing, China
| | - Chengliang Wang
- grid.190737.b0000 0001 0154 0904College of Computer Science, Chongqing University, Chongqing, China
| | - Shiying Li
- grid.12955.3a0000 0001 2264 7233Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Xiamen University, Xiamen, China ,grid.12955.3a0000 0001 2264 7233Department of Ophthalmology, Eye Institute of Xiamen University, Xiamen, China
| | - Xin Xie
- grid.190737.b0000 0001 0154 0904College of Computer Science, Chongqing University, Chongqing, China
| | - Jun Lin
- Department of Ophthalmology, Yongchuan People’s Hospital of Chongqing, Chongqing, China
| | - Wen Zhong
- Chongqing Health Statistics Information Center, Chongqing, China
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Duan L, Wang C, Wang X, Wang A, Xu T, Peng X, Gao Z. Evaluation of the hyperbaric oxygen therapy on the flash visual evoked potential P2 in patients with severe traumatic brain injury. NeuroRehabilitation 2021; 50:101-104. [PMID: 34776420 DOI: 10.3233/nre-210165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies have shown that hyperbaric oxygen therapy (HBOT) can improve the extraction rate and latency of cortical evoked potential N20 in patients with severe traumatic brain injury, but there are only a few studies on the effect of flash visual evoked potential. OBJECTIVE This study investigated the effect of hyperbaric oxygen therapy on the P2 wave of flash visual evoked potentials in patients with severe traumatic brain injury. METHODS In total, we examined 40 TBI patients who received HBOT, in combination with medication, and 38 TBI patients who received medication alone. The FVEPs apparatus was used to detect the P2 wave extraction rate and the latency of the elicited waveform before and after treatment in both the medicated-only controls and HBOT-treated cohorts. RESULTS Compared with the control group, the HBOT treatment group showed a higher P2 wave elicitation rate, and the P2 wave latency of the HBOT treatment group was significantly shortened (p < 0.05, all). CONCLUSIONS HBOT, in combination with drug therapy, can significantly increase the P2 wave extraction rate and shorten P2 latency in patients with TBI.
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Affiliation(s)
- Lei Duan
- Nanjing Zijin Hospital, Nanjing, Jiangsu, China
| | | | - Xia Wang
- Nanjing Zijin Hospital, Nanjing, Jiangsu, China
| | - Aiping Wang
- Nanjing Zijin Hospital, Nanjing, Jiangsu, China
| | - Tingting Xu
- Nanjing Zijin Hospital, Nanjing, Jiangsu, China
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Arruda JE, McInnis MC, Steele J. The flash visual evoked potential-P2 and the detection of amnestic mild cognitive impairment: A review of empirical literature. Int J Psychophysiol 2020; 155:162-167. [PMID: 32562653 DOI: 10.1016/j.ijpsycho.2020.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 11/18/2022]
Abstract
Amnestic Mild Cognitive Impairment (aMCI) is now recognized as an early risk state for the development of Alzheimer's dementia (AD). Biomarkers, including those that are cerebrospinal fluid or brain imaging based, have yet to provide the ultimate marker variable. A need currently exists for a non-invasive, easy to administer biomarker that contains aMCI/AD specific pathognomic information. OBJECTIVE The objective of the present investigation was to provide an updated review of the Flash Visual Evoked Potential-P2 (FVEP-P2) as a biomarker for aMCI and AD. The FVEP-P2 has been shown to possess AD specific pathognomic information. METHOD A review was conducted of all articles published between the years 1976 and 2019 that examined the clinical utility of the FVEP-P2 in the diagnosis of aMCI or AD. Only 17 published investigations met the criteria of the review. RESULT The weighted average effect size, as measured by Cohen's d, was 1.07, with patients diagnosed with either aMCI or AD exhibiting a significant delay in the FVEP-P2 latency. The weighted mean latency for the controls was 143.92 ms (SD = 17.13). The weighted mean latency for the aMCI/AD was 164.02 ms (SD = 21.33). Estimates of sensitivity, specificity, and accuracy were based on the weighted means and standard deviations and were equal to 0.73. The area under the curve was equal to 0.78. CONCLUSION The results of the current review suggest that the FVEP-P2 latency possesses AD specific pathognomic information and that it should be included as part of a much larger assessment process that includes neuropsychological, cerebrospinal fluid, and brain imaging findings.
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Affiliation(s)
- James E Arruda
- Department of Psychology, University of West Florida, United States.
| | | | - Jessica Steele
- Department of Psychology, University of West Florida, United States
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Comparison Of Xenon And LED Light Sources In Electroretinography And Visual Evoked Potential Measurements. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2019. [DOI: 10.21673/anadoluklin.472427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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