Cortical visual evoked potentials in very low birthweight premature infants
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Published on: October 24, 2019
1Visual Development Unit, Psychology Department, University College London, UK. j.atkinson@ucl.ac.uk
Insights
Healthy very low birthweight infants show similar visual cortical development onset to term infants. The pattern orientation reversal visual evoked potential (OR-VEP) can predict early neurological outcomes.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- The pattern orientation reversal visual evoked potential (OR-VEP) assesses visual cortical functioning.
- Cortical neurons are sensitive to changes in orientation, making OR-VEP a specific indicator.
- Understanding visual development in premature infants is crucial for early intervention.
Purpose of the Study:
- To compare the age of onset of the OR-VEP in very low birthweight (VLBW) premature infants versus term infants.
- To evaluate the OR-VEP as a potential prognostic indicator of early brain development.
- To determine if extra visual experience in preterm infants alters visual cortical development.
Main Methods:
- Studied 24 VLBW infants (born 24-32 weeks gestation, <1500g) and 31 term infants.
- Recorded steady-state evoked potentials to a reversing grating pattern (45-135 degrees) at 4 and 8 reversals/second.
- Correlated OR-VEP onset with neonatal ultrasound findings and neurological outcomes at 3 years.
Main Results:
- VLBW infants with normal ultrasounds and neurological outcomes exhibited OR-VEP onset similar to term infants.
- Four preterm infants with abnormal ultrasounds did not show normal OR-VEP onset and had adverse neurological outcomes.
- No acceleration or delay in visual development was observed in preterm infants due to extra visual experience.
Conclusions:
- The onset of visual cortical function is comparable in healthy preterm and term infants.
- The OR-VEP serves as a valuable prognostic tool for early brain development assessment.
- OR-VEP may predict later neurological outcomes in infants, particularly those born prematurely.
Objectives:
To compare the age of onset of the pattern orientation reversal visual evoked potential (OR-VEP) in a group of very low birthweight (VLBW) premature infants with term infants matched for postconceptual age at testing. The OR-VEP measure is used as an indicator of visual cortical functioning because of the specificity of cortical neurones in showing sensitivity to changes of slant or orientation.
Design:
Results are given for 24 VLBW infants, born at 24-32 weeks gestation weighing less than 1500 g, and 31 infants born at term. The steady state evoked potential to a grating pattern reversing in orientation (between 45 degrees and 135 degrees) at 4 reversals/second and 8 reversals/second was recorded.
Results:
The VLBW infants with normal neonatal ultrasound results (and normal neurological outcome at 3 years of age) showed a significant OR-VEP with a similar postnatal time course to the term infants. Four premature infants, showing appreciable abnormalities on ultrasound examination, did not show normal onset of the OR-VEP, and all had an abnormal neurological outcome.
Conclusions:
This result can be taken to indicate that the onset of cortical function is similar in healthy preterm infants to term infants. The visual development of the premature infants was neither accelerated nor delayed as a result of their extra visual experience. The OR-VEP can be used as a prognostic indicator of early brain development alongside other neurological measures. It may also be a very early indicator of later neurological outcome.
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