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曾患视神经炎的多发性硬化症患者在光应激反应后视觉诱发电位受损。

Impaired VEP after photostress response in multiple sclerosis patients previously affected by optic neuritis.

作者信息

Parisi V, Pierelli F, Restuccia R, Spadaro M, Parisi L, Colacino G, Bucci M G

机构信息

Cattedra di Clinica Oculistica, Università di Roma Tor Vergata, Italy.

出版信息

Electroencephalogr Clin Neurophysiol. 1998 Jan;108(1):73-9. doi: 10.1016/s0168-5597(97)00063-4.

Abstract

The aim of our work was to evaluate if an optic nerve involvement (multiple sclerosis patients previously affected by optic neuritis) may induce any change in visual evoked potential (VEP) after photostress response. VEP in basal conditions and after photostress were assessed in 10 patients with defined multiple sclerosis without a history of optic neuritis (MSWO); in 14 patients with defined multiple sclerosis previously affected by optic neuritis but with complete recovery of the visual acuity (MSON) and in 14 age-matched controls. In order to complete the investigation of the retinal function, Transient Pattern electroretinogram (PERG) and steady-state focal-ERG (counterphased gratings presented at 8 Hz in the macular region) were performed in MSON patients only. In MSWO eyes VEP parameters in basal condition and after photostress did not undergo significant changes compared to controls (ANOVA; P > 0.05). In MSON eyes we observed basal VEP with delayed P100 peak latency and reduced N75-P100 amplitude when compared with the control ones (P < 0.01). In MSON eyes the parameters of VEP after photostress underwent large changes and longer recovery time (RT) than in control and MSWO eyes (P < 0.01). In addition; in MSON eyes we found increased transient PERG P50 latency (P < 0.01) and reduced P50-N95 amplitude (P < 0.01); Focal-ERG (that displays a major component at 16 Hz; 2nd harmonic:2P) with reduced 2P amplitudes and delayed 2P phases (P < 0.01). Our results indicate that patients previously affected by optic neuritis present an abnormal VEP after photostress response and this may be ascribed predominantly to an involvement of the inner retinal layers as indicated by the concomitant impairment of PERG and focal-ERG responses.

摘要

我们研究的目的是评估视神经受累(既往患有视神经炎的多发性硬化症患者)是否会在光应激反应后引起视觉诱发电位(VEP)的任何变化。对10例明确诊断为多发性硬化症但无视神经炎病史的患者(MSWO)、14例既往患有视神经炎但视力已完全恢复的明确诊断为多发性硬化症的患者(MSON)以及14例年龄匹配的对照组进行了基础状态下和光应激后的VEP评估。为了全面研究视网膜功能,仅对MSON患者进行了瞬态图形视网膜电图(PERG)和稳态局部视网膜电图(在黄斑区以8Hz呈现反相光栅)检查。与对照组相比,MSWO组患者基础状态下和光应激后的VEP参数无显著变化(方差分析;P>0.05)。与对照组相比,MSON组患者基础VEP的P100峰潜伏期延迟,N75 - P100波幅降低(P<0.01)。与对照组和MSWO组相比,MSON组患者光应激后的VEP参数变化较大,恢复时间(RT)更长(P<0.01)。此外,在MSON组患者中,我们发现瞬态PERG的P50潜伏期延长(P<0.01),P50 - N95波幅降低(P<0.01);局部视网膜电图(在16Hz显示主要成分;二次谐波:2P)的2P波幅降低,2P相位延迟(P<0.01)。我们的结果表明,既往患有视神经炎的患者在光应激反应后VEP异常,这可能主要归因于视网膜内层受累,这由PERG和局部视网膜电图反应的同时受损所表明。

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