Physiological determinants of cortical P100 responses in pattern visual evoked potentials: a scoping review

Pattern visual evoked potentials (pattern VEP) are widely used for functional assessment of the visual pathways. The P100 component represents the principal clinical parameter owing to its relative interindividual stability and diagnostic value. However, both latency and amplitude are modulated by multiple physiological and environmental factors, which complicates interpretation and the establishment of reliable reference standards. This scoping review aimed to systematically map determinants of P100 parameters in healthy individuals.

The review was conducted in accordance with PRISMA-ScR and Joanna Briggs Institute methodology. Databases were searched for studies published between 2015 and 2025 that examined biological, refractive, anthropometric, metabolic, or environmental influences on pattern VEP parameters in healthy populations. Owing to methodological heterogeneity, findings were synthesized descriptively. Thirty-nine studies met the inclusion criteria. Age emerged as the most consistent determinant of P100 parameters. Latency followed a non-linear trajectory across the lifespan, with shortening during maturation, stabilization in early adulthood, and progressive prolongation after approximately 40 years of age, whereas amplitude generally declined with aging. Sex differences predominantly affected amplitude, with women typically demonstrating higher P100 or N75-P100 amplitudes in adult populations; latency differences were less consistent and often minimal in paediatric cohorts. Retinal image quality exerted a strong dose-dependent effect on P100 parameters: increasing refractive blur and higher-order aberrations were associated with progressive latency prolongation and amplitude reduction, particularly for small check sizes. Ocular dominance showed no clinically meaningful interocular asymmetry. Metabolic disturbances were associated with prolonged latency in selected populations, whereas anthropometric variables such as head size and height demonstrated weak or inconsistent associations. Among environmental factors, acute alcohol intake prolonged P100 latency, while moderate caffeine consumption had no significant effect.

Age and retinal image quality represent the primary physiological determinants of P100 latency and amplitude in healthy individuals. Most other modifiers exert modest or context-dependent effects. Consideration of these variables is essential for accurate interpretation of pattern VEP recordings and for establishing reliable local reference standards consistent with ISCEV recommendations.