Brain-stem auditory evoked potentials in adults with Down's syndrome.

Brain-stem auditory evoked potentials (BAEPs) were examined in 37 adult patients with Down's syndrome and in 37 age-matched normal subjects. All absolute and interpeak latencies except for the interpeak latency IV-V were shorter in patients than in normal subjects. The amplitude of wave V and the amplitude ratio V/I were smaller in patients than in normal subjects. Short latencies in patients were considered to be due to the smaller size of the brain-stem or to faster conduction velocity. The prolonged interpeak latency IV-V and the smaller wave V may indicate physiological dysfunctions between the upper pons and the lower midbrain.     

Pattern-reversal visual evoked potentials in Down's syndrome

We examined pattern-reversal visual evoked potentials (PRVEPs) in 36 adult patients with Down's syndrome, and analyzed the effects of the opthalmological abnormalities on results of PRVEPs. The P100 latency was significantly delayed in 24 eyes of 16 patients. The P100 latency was significantly longer and its amplitude was significantly smaller (P < 0.001) in Down's syndrome patients than in age-matched normal controls. In 9 patients without any ophthalmological abnormalities, P100 latency showed no significant difference from that in normal controls, but three of them showed a significant delay of P100. Their P100 amplitudes were significantly smaller than those in normal controls. Therefore, we considered that the ophthalmological abnormalities are one of the main factors causing PRVEPs abnormalities in Down's syndrome patients, but some unknown factors should be also responsible.     

Effects of spatially structured stimulus fields on pattern reversal visual evoked potentials

Pattern-reversal visual evoked potentials (PRVEPs) were tested in 11 healthy individuals. A photic stimulator for pattern production on a TV monitor, an electroencephalograph for EEG signal amplification and a computer for averaging the potentials and displaying the traces were used in the experiments. The peak latencies and both trough-to-peak and baseline-to-peak amplitudes of the main PRVEP components were found to be closely related to both the check size of checkerboard pattern and the bar width of barred pattern. The latencies decreased exponentially and amplitudes varied non-monotonically with check size or bar width. Most of the amplitudes of these components were greatest when checkerboard patterns with check sizes subtending visual angles of 60--70 min of arc, or barred patterns with bar widths subtending angles of 7--15 min of arc, were presented.     

Auditory brain stem evoked potentials: clinical promise of increasing stimulus rate

Auditory brain stem evoked potentials (ABEPs) were recorded from 10 adults and 10 children who where neurologically and audiometrically normal. ABEPs were recorded in response to 75 dB HL clicks presented at rates of 10/sec and 50/sec. Normative values were calculated for amplitude and latency, as well as for inter-peak amplitude ratio and a variety of inter-peak latency differences and interaural differences at the two stimulus presentation rates. Normative values of the effect of increasing stimulus rate were calculated as well. Measures of changes in ABEPs between stimulus rates of 50/sec and 10/sec were the only derived measures that were significantly different between our adult and child normal populations. In addition, 50 patients with various conditions affecting the brain stem were examined. Increasing stimulus presentation rate had a significant effect on detection of abnormality in ABEPs from the patients examined. Measures of changes in ABEPs between stimulus rates of 50/sec and 10/sec seemed to be sensitive to a subset of abnormalities in our patient population. The case histories of the patients indicate that the subset may be impaired synaptic function. Measures of the effect of rate on ABEPs may complement the traditional measures that are primarily sensitive to white matter lesions.     

Mechanically and electrically evoked somatosensory potentials in humans: effects of stimulus presentation rate

Somatosensory evoked potentials were recorded in response to: (1) electrical stimulation of the median nerve at the wrist; (2) electrical stimulation of the index finger; (3) mechanical stimulation of the index fingernail. Stimuli were presented at rates of 2, 4, 8, 16 and 32/sec, and the effects of presentation rate on components of the evoked potentials were evaluated. The effect of varying the duration of the mechanical stimulus was also observed. The findings suggest that stimulus rates of up to 8/sec can be used without significant loss in detectability of most of the components. The potentials recorded in response to a short duration mechanical stimulus were essentially identical to those evoked by the long duration stimulus. The findings of this study are consistent with a peripheral nerve generator for the Erb's point recorded component, a postsynaptic generator for the upper neck recorded component, and in general with a larger number of synapses leading to the generators of the later components than to earlier ones.     

Effects of exercise on visual evoked potentials

The aim of this study was to investigate the effects of acute or habitual exercise on visual evoked potentials (VEP). The study group consisted of 9 female and 7 male volleyball players and the control group contained 9 female and 7 male students who were not involved in any sportive activity. The N75, P100, and N145 latency and amplitudes were measured before and after exercise. Intragroup comparison was made to evaluate the acute effects and intergroup comparison for the chronic effects of exercise. Significant differences were noted between athletes and the sedentary subjects in terms of pre-exercise left-N145 latencies and amplitudes and left -P100 amplitudes. Right-eye N145 latencies of inactive female subjects obtained before and after exercise were also statistically different. The results suggest that acute and habitual exercise affects the VEP responses independent from the body temperature and other physiological parameters. Small sized pre-exercise P100 amplitudes in the athletes can be attributed to the effect of rapid visual-activity-demanding sports on the central nervous system. Visual evoked potentials maybe used as neurophysiological criteria in defining the performance of an athlete.     

Menstrual cycle synchronized changes in brain stem auditory evoked potentials and visual evoked potentials.

BACKGROUND: Several studies have reported changes in the spontaneous electroencephalogram of women across the menstrual cycle (MC), raising questions on whether sensory or cognitive evoked potentials would change with MC as well. Some of these studies have found changes synchronized with MC in visual event-related brain potentials (ERPs) and brain stem auditory evoked potentials (BAEPs), whereas others have reported none. METHODS: In the present study, we attempted to study the changes in P300 component of visual ERPs, and in BAEPs across the MC in healthy women. RESULTS: The latency of P300 was longer during the ovulatory phase. Decrease across the MC phases was found for the amplitude of BAEP waves I and III, and for the wave V latency and the III-V interpeak latency. CONCLUSIONS: The results indicate that there may be a small relationship between visual ERP or BAEP and MC phase.     

Magnetic stimulation motor evoked potential in multiple sclerosis. Comparison with visual evoked potentials, brain stem auditory evoked potentials and somatosensory evoked potentials]

This study consists of 45 patients with clinically definite MS, laboratory supported definite MS and clinically probable MS. We compared MEP results with other multimodal evoked potentials (VEP, BAEP and SEP). The abnormal rate of MEP was 87.6%, which was the highest. Abnormal MEP showed prolonged central motor conduction time (CMCT), consistent with pathological change of the demyelination. There was a evident correlation between the abnormal MEP and VEP, which is consistent with the most common MS (Devic Syndrome) in our country.     

Effects of stimulus intensity on posterior tibial nerve somatosensory evoked potentials.

Relationships between stimulus intensity and peak latencies and amplitudes in posterior tibial nerve somatosensory evoked potential patterns were evaluated in ten healthy subjects. Eight intermediate latency peaks between 30 and 125 milliseconds (ms) after stimulus onset and seven amplitudes were analyzed. In general, there was a decrease in latency with each increase in stimulus intensity over a five step intensity range between 5 and 19 milliamps (mA) for most peaks. Similarly, increases in amplitudes generally occurred with increases in stimulus intensity for most peaks. Later peaks N105 and P115 as well as amplitudes P90-N105 and N105-P115 were least sensitive to stimulus intensity changes. The greatest changes in peak latency and amplitude occurred as stimulus intensity was increased from 7 to 11 mA. Beyond 11 mA relatively little change was observed in either peak latencies or amplitudes. Under anesthesia, by contrast, there was no stimulus intensity-peak latency interaction and beyond 11 mA there were decreases in amplitudes. Possible reasons for these findings are discussed.     

Effects of visual attention on the intensity of auditory evoked potentials.

Click-evoked potentials were recorded from the round window (cochlear microphonic and auditory nerve), cochlear nucleus, and auditory cortex of unanesthetized cats during periods of visual attention and increased auditory intensity. The clicks (irrelevant stimuli) were presented continuously as background before, during, and after the presentation of a visual discrimination task (relevant stimuli) which attempted to alter the attentive state of the animals. At all electrode sites, the mean peak-to-peak amplitudes of click-evoked potentials were significantly smaller during attention to the visual discrimination stimuli when compared with the pretest and posttest control periods. Although the amplitudes of the click-evoked potentials were suppressed at all intensities during visual attention, much greater suppression occurred at low auditory intensities than at high auditory intensities. The results suggest that during attention, a central inhibitory mechanism suppresses irrelevant auditory stimuli presumably via the olivo-cochlear bundle at the peripheral stages in the afferent auditory pathways.     

Effects of hyperventilation on pattern-reversal visual evoked potentials in patients with demyelination.

The effects of hyperventilation on the pattern-reversal visual evoked potential (VEP) were studied in seven normal subjects and 13 multiple sclerosis patients with visual pathway involvement. Significantly greater reductions in P100 latency occurred in the multiple sclerosis patients than in controls and normalisation of the half-field response topography occurred in one patient after hyperventilation. The VEP changes are attributed to improved impulse transmission in demyelinated fibres in the visual pathway as a result of the alkalosis and changes in ionised calcium levels induced by hyperventilation.     

Studies of human visual pathophysiology with visual evoked potentials.

Visual evoked potentials (VEPs) offer reproducible and quantitative data on the function of the visual pathways and the visual cortex. Pattern reversal VEPs to full-field stimulation are best suited to evaluate anterior visual pathways while hemi-field stimulation is most effective in the assessment of post-chiasmal function. However, visual information is processed simultaneously via multiple parallel channels and each channel constitutes a set of sequential processes. We outline the major parallel pathways of the visual system from the retina to the primary visual cortex and higher visual areas via lateral geniculate nucleus that receive visual input. There is no best method of stimulus selection, rather visual stimuli and VEPs' recording should be tailored to answer specific clinical and/or research questions. Newly developed techniques that can assess the functions of extrastriate as well as striate cortices are discussed. Finally, an algorithm of sequential steps to evaluate the various levels of visual processing is proposed and its clinical use revisited.     

Effects of visual contrast on visual evoked potentials and Doppler signal

We studied visually evoked cerebral blood flow responses (VEFR) and visual evoked potentials (VEP) to different visual contrasts and analysed the relationship between them. The records were made from 35 healthy volunteers aged 38.6 +/- 10.1 years. The stimulus was a black-and-white checkerboard with visual contrasts (VC) of 1%, 10% and 100%. The VEFR were measured in the posterior cerebral artery using transcranial Doppler, and the VEP were recorded from the occipital leads. We found the relationship between visual contrast and VEFR (r = 0.79, P < 0.01) as well as between visual contrast and VEP (r = 0.71, P < 0.01). We also found moderate association between the VEP and the VEFR (r = 0.69, P < 0.01). The analysis of the regression slopes between two different age subgroups (P < 0.01) did not show a significant difference (P = 0.020). We concluded that a simultaneous recording of VEFR and VEP to visual contrasts could allow an assessment of neurovascular coupling in humans.     

Subthalamic nucleus deep brain stimulus evoked potentials: physiological and therapeutic implications.

The effect of subthalamic nucleus (STN) stimulation on cortical electroencephalographic activity was examined in 10 patients with Parkinson's disease and 4 patients with epilepsy. Evoked potentials were created by time-locking electroencephalography to the onset of electrical stimulation delivered through the lead implanted in the STN of patients who had previously undergone deep brain stimulation (DBS) surgery. The effect of different patterns of stimulation on the evoked response, including single- and paired-pulse as well as burst stimulation, was explored. Cortical evoked potentials to single pulses were observed with latencies as short as 1 to 2 msec after a single pulse of stimulation, with activity continuing, in some cases, for up to 400 msec. Paired-pulse experiments revealed refractory periods on the order of 0.5 msec, suggesting that stimulation of axons contributed to the generation of at least some portion of the evoked potential waveform. Evoked potentials were also present in response to 100-msec bursts of stimulation, with some evidence that the potential was initiated within the burst artifact. The potential implications of the types of responses observed as well as potential applications are discussed.     

Effects of scopolamine on visual evoked potentials in aging and dementia.

The unusual combination of a normal pattern reversal VEP and a delayed flash VEP has been reported in patients with dementia of Alzheimer's type (DAT). Hyoscine hydrobromide has been reported to produce a similar VEP abnormality in young, healthy subjects. In the present study, we assessed the relative sensitivity of DAT patients and healthy young, middle-aged and elderly subjects to temporary cholinergic blockade. We report VEP latency values following 3 doses of scopolamine and after a peripheral anticholinergic agent. Flash P2 latency was not significantly slower in DAT patients than in the healthy elderly. Scopolamine increased P2 latency in the young controls but did not affect any other group. The pattern reversal P100 was normal in DAT, and a significant increase in latency occurred following scopolamine administration in both the control and patient groups.     

Effects of oestrogen replacement therapy on pattern reversal visual evoked potentials.

As a result of a regression in the ovarian functions, oestrogen level in circulation during the menopause drops to 1/50 of its value in the normal reproductive cycle. Excitatory oestrogen increases the sensitivity of the central nervous system to catecholamines by changing the opening frequency of voltage-related L-type calcium channels and augmenting the effect of glutamate; in addition it inhibits the formation of gamma-amino butyric acid (GABA) by the inhibition of glutamate decarboxylase enzyme. It is argued that oestrogen increases transmission in the optic pathways and that oestrogen is responsible for the shorter latency values and higher amplitudes of visual evoked potentials in women. We recorded the monocular pattern reversal visual evoked potentials (PRVEP) of both eyes of 54 post-menopausal women before treatment and of 30 of them after replacement therapy with Tibolon, and of 24 women receiving placebo treatment. The explicit values of P100 latency of right and left eyes before treatment were 98.8 +/- 3.5 and 99.0 +/- 3.3 ms, respectively. The explicit values of P100 latency of right and left eyes after placebo treatment were 98.6 +/- 3.7 and 98.8 +/- 4.0, respectively. The explicit values of P100 latency of right and left eyes after replacement treatment were 94.6 +/- 3.7 and 94.8 +/- 4.0, respectively. We found a statistically significant decrease in the mean PRVEP latencies and a statistically significant increase in mean amplitudes after replacement treatment (P < 0.001) compared with those before treatment and those after placebo treatment. We attributed the changes in PRVEP values after replacement treatment to the action of Tibolon, which acted as a natural sex steroid and speeded the visual transmission time via the widespread receptors in the central nervous system. It is concluded that PRVEP is an objective electrophysiological assessment method in evaluating the efficiency of hormone replacement therapy in post-menopausal women.     

Effects of halothane dose and stimulus rate on canine spinal, far-field and near-field somatosensory evoked potentials

Evidence that canine spinal, far-field and near-field somatosensory evoked potentials resemble those recorded in humans and other species has been presented, and the vulnerability of each component to varying depths of halothane anesthesia is reported. Lumbar spinal peak latencies are not affected by halothane dose, but the negative peak is significantly prolonged by rapid rates of stimulation. Elevated stimulus rates and halothane doses reduce lumbar spinal cord potential amplitudes. Early far-field cephalic components are refractory to halothane. Late far-field components and near-field cortical potentials are substantially altered by increments in halothane dose. Both near-field and far-field responses are more readily identified in vertex-neck than vertex-brow derivations. Early far-field somatosensory evoked potentials recorded from vertex to neck, together with lumbar spinal cord potentials, may be the preferred monitoring technique when the use of halothane anesthesia is desired. Rapid rates of stimulation may facilitate earlier recognition of cord dysfunction, but supplement rather than replace baseline recordings at slow stimulus rates.