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Updated: Jul 6, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Cortical vision, MRI and developmental outcome in preterm infants
J Atkinson1, O Braddick, S Anker
1Visual Development Unit, Department of Psychology, University College London, Gower Street, London WC1E 6BT, UK. j.atkinson@psy.ox.ac.uk
Insights
Visual cortical tests, including orientation-reversal visual event-related potentials (OR-VERP) and fixation shifts (FS), can identify brain damage in preterm infants. These tests show promise as early markers for functional deficits and later neurodevelopmental status.
Area of Science:
- Neonatal neuroscience
- Developmental pediatrics
- Visual system function
Background:
- Preterm infants are at high risk for brain injury.
- Early identification of brain damage is crucial for intervention.
- Visual cortical function assessment offers potential early markers.
Purpose of the Study:
- To evaluate orientation-reversal visual event-related potentials (OR-VERP) and fixation shifts (FS) as early markers of brain damage in preterm infants.
- To correlate these visual tests with MRI findings and later neurodevelopmental outcomes.
Main Methods:
- 26 preterm infants (<32 weeks GA) underwent MRI, OR-VERP, and FS testing before 12 months.
- MRI assessed brain lesions, hemorrhage, and white matter injury.
- Neurodevelopment was assessed at 2 years using Griffiths Scales.
Main Results:
- Reduced OR-VERP responses and abnormal FS performance correlated with increased MRI severity.
- FS test predicted a developmental quotient < 80 with 100% sensitivity and 100% negative predictive value.
- OR-VERP predicted a developmental quotient < 80 with 86% sensitivity and 92% negative predictive value.
Conclusions:
- Visual cortical function tests (OR-VERP and FS) can serve as early indicators of functional impact from perinatal brain damage in preterm infants.
- These tests show potential for predicting later neurodevelopmental status.
Objectives:
To test two measures of visual cortical function in the first year of life as early markers of functionally significant brain damage in infants born preterm: orientation-reversal visual event-related potentials (OR-VERP) and a behavioural test of cortically controlled visual attention-fixation shifts under competition (FS). Also to examine how these measures relate to (1) perinatal brain insults identified by MRI, and (2) later neurodevelopmental status.
Patients And Methods:
After neonatal and term-age-equivalent MRI, 26 preterm infants (<32 weeks of gestational age, mean 28.1 weeks) were given the OR-VERP and FS tests before 12 months post-term age and a neurodevelopmental assessment (Griffiths Scales) at 2 years. MRI scans examined for parenchymal lesions, intraventricular haemorrhage, ventricular dilatation and diffuse excessive high signal intensity were classified into three categories of severity. Cortical visual test results were compared across these categories and examined as predictors of developmental status at 2 years.
Results:
26 infants were studied. 13/25 infants showed significant OR-VERP responses. 12/26 showed normal FS performance. On both tests, the proportion of infants meeting these criteria decreased significantly with MRI severity. As predictors of Griffiths developmental quotient < or =80, the FS test had a sensitivity of 100%, a specificity of 61%, and positive and negative predictive values of 50% and 100%, respectively; corresponding values for OR-VERP were 86%, 65%, 50% and 92% .
Conclusions:
Visual cortical tests can provide early indicators of the functional impact of perinatal brain damage in the preterm infant.
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