Steady-State Visually Evoked Potentials Elicited by Multifrequency Pattern-Reversal Stimulation

Objective detection of visual field defects with multifrequency VEPs

PURPOSE

To correlate multifrequency pattern reversal VEPs in quadrants (QmfrVEPs) with perimetric field losses for objective detection of visual field losses.

METHODS

QmfrVEP measurements were performed using four LED-based checkerboard stimulators to stimulate the four quadrants of the visual field. QmfrVEPs were measured monocularly in 5 normal subjects and in 5 glaucoma patients who showed losses in conventional Octopus perimetry. The pattern reversal frequency varied slightly between the stimulators: (11.92, 12.00, 12.08 and 12.16 reversals/sec). The responses to the different stimuli were identified by discrete Fourier analysis. VEPs were recorded using different electrode configurations, and the recording with the highest signal-to-noise ratio (SNR) was used for further analysis.

RESULTS

QmfrVEP responses from the different quadrants can be reliably measured and separated using the 0.08 reversals/sec interstimulus reversal frequency differences. The signal-to-noise ratio in the four quadrants was significantly correlated with the equivalent visual field losses obtained with perimetry (Spearman rank correlation: P < 0.001). In the five glaucoma patients, the SNR was reduced in 15 out of the 16 quadrants with a perimetric defect, in comparison to the results in quadrants of healthy subjects. This confirms the sensitivity of the procedure.

CONCLUSION

QmfrVEP responses can be measured reliably. This pilot study suggests that high SNR values exclude visual field defects and that focal defects can be identified in glaucoma patients.

TRIAL REGISTRATION

www.

CLINICALTRIALS

gov . NCT00494923.

Basic Examination of Haemoglobin Phase of Oxygenation and Deoxygenation in Resting State and Task Periods in Adults Using fNIRS

Functional near-infrared spectroscopy (fNIRS) is a neuroimaging technique used to measure the relative changes in concentrations of oxygenated haemoglobin (oxy-Hb) and deoxygenated haemoglobin (deoxy-Hb) in the cerebral cortex. While most previous studies using fNIRS have relied only on a single oxy-Hb or deoxy-Hb parameter to infer about neural activation, the phase difference between the oxy- and deoxy-Hb signals (haemoglobin phase of oxygenation and deoxygenation: hPod) has been reported to be an important biomarker for analysing haemodynamic characteristics of the brain in infants. In this study, we examined the basic characteristics of adult hPod to develop a new analysis method to detect more sensitive signals that reflect neural activation in adults using fNIRS. We measured the hPod of 12 healthy adults in the frontal and occipital cortex during rest and upon exposure to visual stimuli and the verbal working memory (WM) task. We found that the average hPod values during the entire measurement period ranged between π and 1.5π rad in all conditions. This result indicates that the phase differences in adults were generally close to a stable antiphase pattern (hPod values around π), regardless of the presence or absence of tasks and stimuli. However, when dynamic changes in hPod values were analysed, significant differences between the resting state and WM tasks were observed during activation period in the frontal and occipital regions. These results suggest that the analysis of dynamic hPod change is useful for detecting a subtle activation for cognitive tasks.

Blue-Yellow VEP with Projector-Stimulation in Glaucoma

Background and aim

In the past, increased latencies of the blue-on-yellow pattern visually evoked potentials (BY-VEP), which predominantly originate in the koniocellular pathway, have proven to be a sensitive biomarker for early glaucoma. However, a complex experimental setup based on an optical bench was necessary to obtain these measurements because computer screens lack sufficient temporal, spatial, spectral, and luminance resolution. Here, we evaluated the diagnostic value of a novel setup based on a commercially available video projector.

Methods

BY-VEPs were recorded in 126 participants (42 healthy control participants, 12 patients with ocular hypertension, 17 with “preperimetric” glaucoma, and 55 with perimetric glaucoma). Stimuli were created with a video projector (DLP technology) by rear projection of a blue checkerboard pattern (460 nm) for 200 ms (onset) superimposed on a bright yellow background (574 nm), followed by an offset interval where only the background was active. Thus, predominantly S-cones were stimulated while L- and M-cone responses were suppressed by light adaptation. Times of stimulus onset to VEP onset-trough (N-peak time) and offset-peak (P-peak time) were analyzed after age-correction based on linear regression in the normal participants.

Results

The resulting BY-VEPs were quite similar to those obtained in the past with the optical bench: pattern-onset generated a negative deflection of the VEP, whereas the offset-response was dominated by a positive component. N-peak times were significantly increased in glaucoma patients (preperimetric 136.1 ± 10 ms, p < 0.05; perimetric 153.1 ± 17.8 ms, p < 0.001) compared with normal participants (123.6 ± 7.7 ms). Furthermore, they were significantly correlated with disease severity as determined by visual field losses retinal nerve fiber thinning (Spearman R = –0.7, p < 0.001).

Conclusions

Video projectors can be used to create optical stimuli with high temporal and spatial resolution, thus potentially enabling sophisticated electrophysiological measurements in clinical practice. BY-VEPs based on such a projector had a high diagnostic value for detection of early glaucoma.

Registration of study

Registration site: www.clinicaltrials.gov

Trial registration number: NCT00494923.