Standardization and Validation of the Flash Visual Evoked Potential-P2 Conversion Scores in the Diagnosis of Amnestic Mild Cognitive Impairment and Alzheimer's Dementia

Amnestic mild cognitive impairment (aMCI), which is characterized by normal daily activity, but a significant decline in episodic memory, is now widely accepted as a risk factor for the development of Alzheimer's dementia (AD). Research suggests that many of the same neuropathological changes associated with AD also occur in patients diagnosed with aMCI. A recent review of the literature revealed that the latency of the flash visual-evoked potential-P2 (FVEP-P2) may possess pathognomonic information that may assist in the early detection of aMCI. While standards exist for the recording of FVEP-P2, individual clinics often use recording parameters that may differ, resulting in latencies that may not generalize beyond the clinic that produced them. The present article illustrates the process by which the FVEP-P2 latency can be standardized across clinics using FVEP-P2 Conversion Scores. We then demonstrate the diagnostic accuracy of the newly developed scores. Method: In the present investigation, we used the previously unpublished data containing the FVEP-P2 latencies of 45 AD and 60 controls. Result: We were able to demonstrate the process by which individual clinics may first standardize FVEP-P2 latencies and then examine patient performance using FVEP-P2 Conversion Scores, providing clinicians with a richer context from which to examine the patient performance. Conclusion: Consistent with the findings of previous research, the findings of the present investigation support the use of the FVEP-P2 Conversion Scores in the diagnosis of AD. Future directions, including the modification of recording parameters associated with the FVEP-P2, are also discussed.

Effects of Ultrasound Contrast Agent-Mediated Nerve Growth Factor on Apoptosis of Retinal Ganglion Cells in Mice with Glaucoma

With an increasing incidence in recent years, glaucoma (GL) has gradually become a global public health problem for humans of all ages. Nerve growth factor (NGF) eye drops, with well-documented stable effect in the treatment of GL, can be potentiated by the administration of NGF drugs via ultrasound contrast agent (UCA). This study analyzed the efficacy of NGF+UCA on GL mice and the influencing mechanism on retinal ganglion cells and further explored the pathological changes of GL mice under different UCA irradiation duration. In this study, we established GL mouse models and treated the mouse with NGF+UCA. The effect of NGF+UCA on intraocular pressure in mice was observed; the flash visual evoked potential of mice was compared; the changes of retinal structure, inflammation index, and oxidative stress index were observed, and autophagic protein levels were tested. Finally, the influence of UCA irradiation duration on GL symptoms was observed. The results showed that the intraocular pressure of mice decreased greatly, while their flash visual evoked potential and nervous layer of retina increased, and their ganglion cells showed stronger proliferation activity and weaker apoptosis and autophagy, indicating that UCA-mediated NGF can strongly improve the pathological condition of GL mice. In addition, PI3K/AKT pathway-associated proteins were inhibited in retina under the intervention of NGF+UCA, which further suggests that the influence of UCA-mediated NGF on GL is achieved by inhibiting autophagy of retinal ganglion cells and enhancing their apoptosis via the PI3K/AKT signaling pathway. Moreover, we found that in the treatment of GL, three weeks of UCA irradiation and six weeks caused no significant difference in the pathological manifestations and ganglion cells of mice, while after six weeks of irradiation, the level of NLRP3 in mice increased. In conclusion, UCA-mediated NGF can significantly improve the pathological condition of GL mice and improve the apoptosis of retinal ganglion cells by inhibiting autophagy, which is associated with the inhibition of the PI3K/AKT signal pathway. In terms of selection of UCA irradiation duration, three weeks of irradiation is enough to yield good clinical results.

Evaluation of the hyperbaric oxygen therapy on the flash visual evoked potential P2 in patients with severe traumatic brain injury

BACKGROUND: Studies have shown that hyperbaric oxygen therapy (HBOT) can improve the extraction rate and latency of cortical evoked potential N20 in patients with severe traumatic brain injury, but there are only a few studies on the effect of flash visual evoked potential. OBJECTIVE: This study investigated the effect of hyperbaric oxygen therapy on the P2 wave of flash visual evoked potentials in patients with severe traumatic brain injury. METHODS: In total, we examined 40 TBI patients who received HBOT, in combination with medication, and 38 TBI patients who received medication alone. The FVEPs apparatus was used to detect the P2 wave extraction rate and the latency of the elicited waveform before and after treatment in both the medicated-only controls and HBOT-treated cohorts. RESULTS: Compared with the control group, the HBOT treatment group showed a higher P2 wave elicitation rate, and the P2 wave latency of the HBOT treatment group was significantly shortened (p < 0.05, all). CONCLUSIONS: HBOT, in combination with drug therapy, can significantly increase the P2 wave extraction rate and shorten P2 latency in patients with TBI.

Clinical Application of Intracranial Pressure Monitoring Based on Flash Visual Evoked Potential in Treatment of Patients with Hypertensive Intracerebral Hemorrhage

Objective To investigate the application value of flash visual evoked potential (FVEP) noninvasive intracranial pressure (nICP) monitoring technology in patients with hypertensive intracerebral hemorrhage (HICH).Methods There were 116 eligible subjects included in the experiment, the final sample size was 102 for this study. They were randomly divided into FVEP nICP monitoring group (experimental group) and the non-monitoring group (control group). The experimental group were examined lumbar puncture immediately after intracranial pressure was monitored by FVEP. Mannitol was used in reducing the elevated intracranial pressure. The serum concentrations of creatinine and urea nitrogen were recorded to assess the renal function. To evaluate the efficacy of FVEP nICP monitoring technique for clinical adjustment of mannitol. The Glasgow prognosis scores (GOS) were evaluated for patients' prognosis between two groups.Results There was no statistical significance between FVEP nICP measurement and lumbar puncture intracranial pressure measurement (195.76 ±58.88 mmH2O vs 197.04 ±53.72 mmH2O, P>0.05). Linear correlation analysis indicated that there was a strong positive relationship between the measurements (r=0.950, P<0.01). The duration prescription time and the average usage amount of mannitol in the experimental group was significantly less than that in the control group (P< 0.05), and the serum creatinine and urea nitrogen concentrations in the two groups were not statistically significant (P> 0.05). The cure rate of the experimental group was higher than that of the control group (χ2=3.889, P=0.048).Conclusion FVEP nICP monitoring technology could replace invasive intracranial pressure monitoring technology in part HICH patients. The application of FVEP nICP technique can reduce the dosage of mannitol and improve the prognosis of patients with HICH.

Clinical Application of Intracranial Pressure Monitoring Based on Flash Visual Evoked Potential in Treatment of Patients with Hypertensive Intracerebral Hemorrhage

Objective To investigate the application value of flash visual evoked potential (FVEP) noninvasive intracranial pressure (nICP) monitoring technology in patients with hypertensive intracerebral hemorrhage (HICH). Methods There were 116 eligible subjects included in the experiment, the final sample size was 102 for this study. They were randomly divided into FVEP nICP monitoring group (experimental group) and the non-monitoring group (control group). The experimental group were examined lumbar puncture immediately after intracranial pressure was monitored by FVEP. Mannitol was used in reducing the elevated intracranial pressure. The serum concentrations of creatinine and urea nitrogen were recorded to assess the renal function. To evaluate the efficacy of FVEP nICP monitoring technique for clinical adjustment of mannitol. The Glasgow prognosis scores (GOS) were evaluated for patients' prognosis between two groups. Results There was no statistical significance between FVEP nICP measurement and lumbar puncture intracranial pressure measurement (195.76 ±58.88 mmH2O vs 197.04 ±53.72 mmH2O, P>0.05). Linear correlation analysis indicated that there was a strong positive relationship between the measurements (r=0.950, P<0.01). The duration prescription time and the average usage amount of mannitol in the experimental group was significantly less than that in the control group (P< 0.05), and the serum creatinine and urea nitrogen concentrations in the two groups were not statistically significant (P> 0.05). The cure rate of the experimental group was higher than that of the control group (χ2=3.889, P=0.048). Conclusion FVEP nICP monitoring technology could replace invasive intracranial pressure monitoring technology in part HICH patients. The application of FVEP nICP technique can reduce the dosage of mannitol and improve the prognosis of patients with HICH.