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Lee JI, Gemerzki L, Weise M, Boerker L, Graf J, Jansen L, Guthoff R, Aktas O, Gliem M, Jander S, Hartung HP, Albrecht P. Retinal layers and visual conductivity changes in a case series of microangiopathic ischemic stroke patients. BMC Neurol 2020; 20:333. [PMID: 32883246 PMCID: PMC7469096 DOI: 10.1186/s12883-020-01894-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
Background It is unknown whether microangiopathic ischemic strokes outside the visual pathway go along with subclinical changes of the retinal structure or the visual system. The objectives of this prospective non-interventional case series were to investigate if spectral-domain optical coherence tomography (SD-OCT) or multifocal visual evoked potentials (mfVEPs) can detect structural retinal changes or functional impairment of the visual system in patients with microangiopathic ischemic stroke. Methods We used SD-OCT to cross-sectionally analyze the retinal morphology of 15 patients with microangiopathic ischemic stroke according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification not affecting the visual pathway. We employed semi-automated segmentation of macular volume scans to analyze the thickness of the macular retinal layers and peripapillary ring scans to investigate the retinal morphology in comparison to a control group without stroke. Visual function was assessed by the mfVEP technique in 13 microangiopathic ischemic stroke patients. Results First peak latency of mfVEPs was significantly delayed in the microangiopathic ischemic stroke group compared to the control patients. Neither the retinal layers nor the mfVEPs’ amplitude differed between the microangiopathic ischemic stroke patients and the control group. Conclusions In conclusion, microangiopathic ischemic stroke patients presented a delayed first peak latency in mfVEPs as a sign of subclinical functional impairment of the visual pathway. However, our case series suggests no influence on retinal structure resulting from microangiopathic ischemic stroke outside the visual system. Larger and longitudinal studies are needed to confirm these mfVEP findings.
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Lee JI, Boerker L, Gemerzki L, Harmel J, Guthoff R, Aktas O, Gliem M, Jander S, Hartung HP, Albrecht P. Retinal Changes After Posterior Cerebral Artery Infarctions Display Different Patterns of the Nasal und Temporal Sector in a Case Series. Front Neurol 2020; 11:508. [PMID: 32582017 PMCID: PMC7290045 DOI: 10.3389/fneur.2020.00508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/07/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Visual field defects are a common and disabling consequence of stroke and a negative prognostic factor of patient's quality of life. They result from lesions in different parts of the visual system, most commonly the visual cortex and optic radiation. An important pathophysiological mechanism is transsynaptic retrograde degeneration (TRD). Methods: In a case series 21 patients with posterior cerebral artery (PCA) territory infarctions were analyzed by spectral-domain optical coherence tomography (SD-OCT) and multifocal visual evoked potentials (mfVEPs) cross-sectionally and longitudinally for up to 6 months. In OCT, symptomatic affected nasal and temporal sectors and corresponding visual fields in mfVEPs were compared to the contralateral side. Results: SD-OCT revealed a significant reduction (−2.92 ±2.53 μm, mean ± SD) of the symptomatic nasal macular retinal nerve fiber layer (RNFL) thickness and of the symptomatic temporal peripapillary RNFL after 6 months compared to baseline whereas the symptomatic temporal macular quadrant already showed a significantly thinner RNFL at baseline. The mfVEP first peak latency at baseline was significantly different (nasal visual field +11.69 ±11.17 ms, mean ± SD; temporal visual field +16.63 ±7.97 ms, mean ± SD) on the symptomatic compared to the asymptomatic field. The nasal visual fields partly recovered in amplitude and first peak latency of mfVEPs over the following 6 months compared to baseline. Conclusion: The dynamics of OCT and mfVEP outcomes for degeneration and recovery after PCA infarction differ between the nasal and temporal retinal sector. We postulate that retinal sectors may differ in their temporal pattern of TRD over time after retrogeniculate cerebral infarction.
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Affiliation(s)
- John-Ih Lee
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Laura Boerker
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Lena Gemerzki
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Jens Harmel
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Rainer Guthoff
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Michael Gliem
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Sebastian Jander
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
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Empirical mode decomposition processing to improve multifocal-visual-evoked-potential signal analysis in multiple sclerosis. PLoS One 2018; 13:e0194964. [PMID: 29677200 PMCID: PMC5909914 DOI: 10.1371/journal.pone.0194964] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/12/2018] [Indexed: 11/19/2022] Open
Abstract
Objective To study the performance of multifocal-visual-evoked-potential (mfVEP) signals filtered using empirical mode decomposition (EMD) in discriminating, based on amplitude, between control and multiple sclerosis (MS) patient groups, and to reduce variability in interocular latency in control subjects. Methods MfVEP signals were obtained from controls, clinically definitive MS and MS-risk progression patients (radiologically isolated syndrome (RIS) and clinically isolated syndrome (CIS)). The conventional method of processing mfVEPs consists of using a 1–35 Hz bandpass frequency filter (XDFT). The EMD algorithm was used to decompose the XDFT signals into several intrinsic mode functions (IMFs). This signal processing was assessed by computing the amplitudes and latencies of the XDFT and IMF signals (XEMD). The amplitudes from the full visual field and from ring 5 (9.8–15° eccentricity) were studied. The discrimination index was calculated between controls and patients. Interocular latency values were computed from the XDFT and XEMD signals in a control database to study variability. Results Using the amplitude of the mfVEP signals filtered with EMD (XEMD) obtains higher discrimination index values than the conventional method when control, MS-risk progression (RIS and CIS) and MS subjects are studied. The lowest variability in interocular latency computations from the control patient database was obtained by comparing the XEMD signals with the XDFT signals. Even better results (amplitude discrimination and latency variability) were obtained in ring 5 (9.8–15° eccentricity of the visual field). Conclusions Filtering mfVEP signals using the EMD algorithm will result in better identification of subjects at risk of developing MS and better accuracy in latency studies. This could be applied to assess visual cortex activity in MS diagnosis and evolution studies.
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Malmqvist L, de Santiago L, Boquete L, Hamann S. Multifocal visual evoked potentials for quantifying optic nerve dysfunction in patients with optic disc drusen. Acta Ophthalmol 2017; 95:357-362. [PMID: 28139892 DOI: 10.1111/aos.13347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/05/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore the applicability of multifocal visual evoked potentials (mfVEPs) for research and clinical diagnosis in patients with optic disc drusen (ODD). This is the first assessment of mfVEP amplitude in patients with ODD. METHODS MfVEP amplitude and latency from 33 patients with ODD and 22 control subjects were examined. Mean amplitude, mean inner ring (IR) amplitude (0.87-5.67° of visual field) and mean outer ring amplitude (5.68-24° of visual field) were calculated using signal-to-noise ratio (SNR) and peak-to-peak analysis. Monocular latency was calculated using second peak analysis, while latency asymmetry was calculated using cross-correlation analysis. RESULTS Compared to normals, significantly decreased mean overall amplitude (p < 0.001), IR amplitude (p < 0.001) and outer ring amplitude (p < 0.001) were found in ODD patients when using SNR. An overall monocular latency delay of 7 ms was seen in ODD patients (p = 0.001). A significant correlation between amplitude and automated perimetric mean deviation as well as retinal nerve fibre layer thickness was found (respectively, p < 0.001 and p = 0.003). The overall highest correlation was found in this order: outer ring, full eye and IR. In the control group, SNR intersubject variability was 17.6% and second peak latency intersubject variability was 2.8%. CONCLUSION Decreased mfVEP amplitude in patients with ODD suggests a direct mechanical compression of the optic nerve axons. Our results suggest that mfVEP amplitude is applicable for the assessment of optic nerve dysfunction in patients with ODD.
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Affiliation(s)
- Lasse Malmqvist
- Department of Ophthalmology; Rigshospitalet; University of Copenhagen; Glostrup Denmark
| | - Luis de Santiago
- Department of Electronics; University of Alcalá; Alcalá de Henares Spain
| | - Luciano Boquete
- Department of Electronics; University of Alcalá; Alcalá de Henares Spain
| | - Steffen Hamann
- Department of Ophthalmology; Rigshospitalet; University of Copenhagen; Glostrup Denmark
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de Santiago L, Klistorner A, Ortiz M, Fernández-Rodríguez A, Rodríguez Ascariz J, Barea R, Miguel-Jiménez J, Boquete L. Software for analysing multifocal visual evoked potential signal latency progression. Comput Biol Med 2015; 59:134-141. [DOI: 10.1016/j.compbiomed.2015.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/05/2015] [Accepted: 02/07/2015] [Indexed: 10/24/2022]
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Fernández A, de Santiago L, Blanco R, Pérez-Rico C, Rodríguez-Ascariz JM, Barea R, Miguel-Jiménez JM, García-Luque JR, Ortiz del Castillo M, Sánchez-Morla EM, Boquete L. Filtering multifocal VEP signals using Prony's method. Comput Biol Med 2014; 56:13-9. [PMID: 25464344 DOI: 10.1016/j.compbiomed.2014.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 10/21/2014] [Accepted: 10/25/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND This paper describes use of Prony's method as a filter applied to multifocal visual-evoked-potential (mfVEP) signals. Prony's method can be viewed as an extension of Fourier analysis that allows a signal to be decomposed into a linear combination of functions with different amplitudes, damping factors, frequencies and phase angles. METHOD By selecting Prony method parameters, a frequency filter has been developed which improves signal-to-noise ratio (SNR). Three different criteria were applied to data recorded from control subjects to produce three separate datasets: unfiltered raw data, data filtered using the traditional method (fast Fourier transform: FFT), and data filtered using Prony's method. RESULTS Filtering using Prony's method improved the signals' original SNR by 44.52%, while the FFT filter improved the SNR by 33.56%. The extent to which signal can be separated from noise was analysed using receiver-operating-characteristic (ROC) curves. The area under the curve (AUC) was greater in the signals filtered using Prony's method than in the original signals or in those filtered using the FFT. CONCLUSION filtering using Prony's method improves the quality of mfVEP signal pre-processing when compared with the original signals, or with those filtered using the FFT.
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Affiliation(s)
- A Fernández
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - L de Santiago
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain.
| | - R Blanco
- Department of Surgery, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - C Pérez-Rico
- Department of Surgery, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - J M Rodríguez-Ascariz
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - R Barea
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - J M Miguel-Jiménez
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - J R García-Luque
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - M Ortiz del Castillo
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - E M Sánchez-Morla
- Department of Psychiatry, University Hospital of Guadalajara, Guadalajara, Spain
| | - L Boquete
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
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Narayanan D, Cheng H, Tang RA, Frishman LJ. Reproducibility of multifocal visual evoked potential and traditional visual evoked potential in normal and multiple sclerosis eyes. Doc Ophthalmol 2014; 130:31-41. [DOI: 10.1007/s10633-014-9467-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/15/2014] [Indexed: 12/21/2022]
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Improved measurement of intersession latency in mfVEPs. Doc Ophthalmol 2014; 129:65-9. [DOI: 10.1007/s10633-014-9438-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
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Lim SH, Lim KH. Diagnostic Criteria of Pattern VEP in Adult Monocular Amblyopic Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.12.1875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sun Hee Lim
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Key Hwan Lim
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
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Souza GS, Schakelford HB, Moura ALA, Gomes BD, Ventura DF, Fitzgerald MEC, Silveira LCL. Comparison of the reliability of multifocal visual evoked cortical potentials generated by pattern reversal and pattern pulse stimulation. Braz J Med Biol Res 2012; 45:955-61. [PMID: 22782556 PMCID: PMC3854182 DOI: 10.1590/s0100-879x2012007500112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 07/04/2012] [Indexed: 12/04/2022] Open
Abstract
This study compared the effectiveness of the multifocal visual evoked cortical potentials (mfVEP) elicited by pattern pulse stimulation with that of pattern reversal in producing reliable responses (signal-to-noise ratio >1.359). Participants were 14 healthy subjects. Visual stimulation was obtained using a 60-sector dartboard display consisting of 6 concentric rings presented in either pulse or reversal mode. Each sector, consisting of 16 checks at 99% Michelson contrast and 80 cd/m2 mean luminance, was controlled by a binary m-sequence in the time domain. The signal-to-noise ratio was generally larger in the pattern reversal than in the pattern pulse mode. The number of reliable responses was similar in the central sectors for the two stimulation modes. At the periphery, pattern reversal showed a larger number of reliable responses. Pattern pulse stimuli performed similarly to pattern reversal stimuli to generate reliable waveforms in R1 and R2. The advantage of using both protocols to study mfVEP responses is their complementarity: in some patients, reliable waveforms in specific sectors may be obtained with only one of the two methods. The joint analysis of pattern reversal and pattern pulse stimuli increased the rate of reliability for central sectors by 7.14% in R1, 5.35% in R2, 4.76% in R3, 3.57% in R4, 2.97% in R5, and 1.78% in R6. From R1 to R4 the reliability to generate mfVEPs was above 70% when using both protocols. Thus, for a very high reliability and thorough examination of visual performance, it is recommended to use both stimulation protocols.
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Affiliation(s)
- G S Souza
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, PA, Brasil.
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