Multifocal visual evoked potentials in chronic inflammatory demyelinating polyneuropathy

Abstract

ObjectiveStudies using conventional full‐field visual evoked potentials (ffVEP) have reported subtle abnormalities in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). We hypothesize that these abnormalities can be detected in the majority of CIDP patients using enhanced methods.MethodsWe performed a cross‐sectional noninterventional study comparing 18 CIDP patients and 18 matched healthy controls using multifocal VEP (mfVEP) as a technique with enhanced sensitivity to detect conduction abnormalities across the spectrum of optic nerve fibers. Patients with confounding diseases (ophthalmologic, diabetes mellitus) were excluded.ResultsThe mean amplitude and latency, as well as the low‐contrast visual acuity, did not differ between CIDP patients and controls. Subanalyses revealed latency differences concerning the superior sector of the visual field. Severity markers of CIDP (ODSS, motor nerve conduction velocity) were associated with mfVEP latency delay.InterpretationWe could not adduce evidence for clinically or diagnostically relevant visual pathway involvement in CIDP. The latency differences identified were very subtle and restricted to the superior visual field which cannot be readily explained biologically, anatomically, or pathologically. In summary, we conclude that our study revealed no relevant differences in mfVEP parameters between CIDP patients and controls.

Retinal layers and visual conductivity changes in a case series of microangiopathic ischemic stroke patients

“…mfVEPs assessing the visual pathway function were recorded by the Visionsearch mfVEP device according to the manufacturer’s instructions as previously used and described [ 24 – 26 ]. In brief, for monocular stimulation the Visionsearch device applied simultaneous multi-focal stimulation of a cortically scaled dartboard pattern of 56 segments (Michelson contrast, 99%) of the visual field (24 degrees of eccentricity) with a 68 s pseudorandom sequence.…”

CNS Involvement in Chronic Inflammatory Demyelinating Polyneuropathy

“…In a previous effort, investigating conductivity changes of the visual pathway in patients with CIDP using multifocal visual evoked potentials (mfVEP), we were not able to detect relevant changes compared with age-matched and sex-matched healthy individuals. 14 This finding was recently corroborated by another controlled study using full-field VEPs. 15 …”

“…We looked at mfVEPs in CIDP and found no clear-cut evidence of CIDP-dependent alterations. 14 Dziadkowski et al 15 compared multimodal evoked potentials in patients with CIDP and HCs and detected prolonged latencies in VEP, brainstem acoustic evoked potentials, and somatosensory-evoked potentials.…”

“…Subjects were included as previously described. 14 Inclusion criteria were of age >18 years, probable or definite CIDP according to the European Federation of Neurological Societies/Peripheral Nerve Society CIDP guidelines and response to immunomodulatory treatment. The flowchart in Figure 1 gives an overview of the subject recruitment.…”

Abnormality of multimodal evoked potentials in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)

“…The spectrum of central and peripheral inflammatory demyelinating disease is very wide. The susceptibility for developing CIDP, MS, or both suggests a general predisposition to autoimmunity, depending on the haplotype background [19][20][21].…”