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学龄儿童运动起始视觉诱发电位解读的困难

Difficulties of motion-onset VEP interpretation in school-age children.

作者信息

Kubova Zuzana, Kuba Miroslav, Kremlacek Jan, Langrova Jana, Szanyi Jana, Vit Frantisek, Chutna Marie

机构信息

Department of Pathophysiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Simkova 870, 500 38, Hradec Kralove, Czech Republic,

出版信息

Doc Ophthalmol. 2014 Apr;128(2):121-9. doi: 10.1007/s10633-014-9429-y. Epub 2014 Feb 23.

Abstract

BACKGROUND

In adults, motion-onset visual evoked potentials (M-VEPs) with a dominant N2 peak represent a useful diagnostic tool. However, it is difficult to use this type of VEP in children because of the long maturation (up to 18 years) of M-VEPs, which is characterised by a gradual decrease in N2 peak latency and shape development. Moreover, in some children, M-VEPs are difficult to identify with standard stimuli.

METHODS

We tested features of M-VEPs in 30 children (7-12 years) with the following set of standard stimuli used in our lab for examining adults ( https://web.lfhk.cuni.cz/elf ): low-contrast translation motion (TM) and expansion/contraction motion (ExCoM) in full field and in periphery (with central 20° masked). In 16 children, a high-contrast TM was also tested.

RESULTS

With standard (low-contrast) stimuli, a common M-VEP to TM and to ExCoM was detected in 77 and 83 % of children, respectively. The M-VEPs to ExCoM in the periphery were detected in only 43 % of children. An abnormal dominant P1 peak was found in 9 % of VEPs to TM, 12 % of VEPs to full-field ExCoM and 14 % of VEPs to peripheral ExCoM. The M-VEPs to all low-contrast stimuli displayed large inter-individual latency variability (N2 peak latency differed for more than 100 ms). High contrast (more suitable for the non-mature magnocellular pathway) shortened M-VEP latencies and improved amplitudes.

CONCLUSIONS

Our findings show that the maturation of motion perception in children is inter-individually variable, which limits the diagnostic use of M-VEPs.

摘要

背景

在成人中,以N2峰为主的运动起始视觉诱发电位(M-VEP)是一种有用的诊断工具。然而,由于M-VEP的成熟时间较长(长达18年),其特征是N2峰潜伏期逐渐缩短和波形发展,因此在儿童中使用这种类型的VEP很困难。此外,在一些儿童中,使用标准刺激难以识别M-VEP。

方法

我们测试了30名7至12岁儿童的M-VEP特征,使用了我们实验室用于检查成人的以下一组标准刺激(https://web.lfhk.cuni.cz/elf):全视野和周边(中央20°遮挡)的低对比度平移运动(TM)和扩张/收缩运动(ExCoM)。在16名儿童中,还测试了高对比度TM。

结果

使用标准(低对比度)刺激时,分别在77%和83%的儿童中检测到了对TM和ExCoM的常见M-VEP。仅在43%的儿童中检测到周边ExCoM的M-VEP。在9%的TM诱发的VEP、12%的全视野ExCoM诱发的VEP和14%的周边ExCoM诱发的VEP中发现了异常的主P1峰。所有低对比度刺激诱发的M-VEP在个体间潜伏期差异较大(N2峰潜伏期差异超过100毫秒)。高对比度(更适合未成熟的大细胞通路)缩短了M-VEP潜伏期并改善了波幅。

结论

我们的研究结果表明,儿童运动感知的成熟在个体间存在差异,这限制了M-VEP的诊断应用。

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