Optic nerve potentials and cortical potentials after stimulation of the anterior visual pathway during neurosurgery

Benedičič, Mitja; Bošnjak, Roman

doi:10.1007/s10633-011-9265-2

Cited by 13 publications

(7 citation statements)

References 50 publications

(91 reference statements)

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“…Optic nerve potentials after flash stimulation have been reported to consist of a positive peak with a latency around 40 msec. 19) In extended TSS for suprasellar craniopharyngiomas or tuberculum sellar meningiomas, direct optic nerve potential recording with VEP monitoring might be a more sensitive method that is useful for preserving postoperative visual function.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Intraoperative Monitoring of Visual Evoked Potentials in Transsphenoidal Surgery

Kamio

Sakai

Sameshima

et al. 2014

Neurol. Med. Chir.(Tokyo)

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Postoperative visual outcome is a major concern in transsphenoidal surgery (TSS). Intraoperative visual evoked potential (VEP) monitoring has been reported to have little usefulness in predicting postoperative visual outcome. To re-evaluate its usefulness, we adapted a high-power light-stimulating device with electroretinography (ERG) to ascertain retinal light stimulation. Intraoperative VEP monitoring was conducted in TSSs in 33 consecutive patients with sellar and parasellar tumors under total venous anesthesia. The detectability rates of N75, P100, and N135 were 94.0%, 85.0%, and 79.0%, respectively. The mean latencies and amplitudes of N75, P100, and N135 were 76.8 ± 6.4 msec and 4.6 ± 1.8 μV, 98.0 ± 8.6 msec and 5.0 ± 3.4 μV, and 122.1 ± 16.3 msec and 5.7 ± 2.8 μV, respectively. The amplitude was defined as the voltage difference from N75 to P100 or P100 to N135. The criterion for amplitude changes was defined as a > 50% increase or 50% decrease in amplitude compared to the control level. The surgeon was immediately alerted when the VEP changed beyond these thresholds, and the surgical manipulations were stopped until the VEP recovered. Among the 28 cases with evaluable VEP recordings, the VEP amplitudes were stable in 23 cases and transiently decreased in 4 cases. In these 4 cases, no postoperative vision deterioration was observed. One patient, whose VEP amplitude decreased without subsequent recovery, developed vision deterioration. Intraoperative VEP monitoring with ERG to ascertain retinal light stimulation by the new stimulus device was reliable and feasible in preserving visual function in patients undergoing TSS.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Intraoperative Monitoring of Visual Evoked Potentials in Transsphenoidal Surgery

Kamio

Sakai

Sameshima

et al. 2014

Neurol. Med. Chir.(Tokyo)

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“…Several authors used invasive methods of intraoperative visual evoked response registration with encouraging results [75,[84][85][86][87][90][91][92].…”

Section: Ep Monitoring During Surgery On the Brain Vep (Cn Ii)mentioning

confidence: 99%

Neurophysiological Monitoring during Surgery on the Central Nervous System: The Role of Evoked Responses

Soghomonyan

2015

IJAR

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Neurosurgical, orthopedic and vascular interventions may be associated with an inherent risk of ischemia and structural damage to the central nervous system. Along with other modalities used to monitor the intraoperative nervous function, registration of evoked responses is intended to provide real-time feedback about the functional integrity of the central nervous system and help to prevent avoidable trauma during surgery. In this review, the principal indications and limitations of monitoring various evoked responses during surgery on the brain and spinal cord are discussed. Current approaches, recent advances and problems associated with intraoperative rhomboid fossa mapping, cranial nerve stimulation and electrooculographic monitoring are presented as well. The authors discuss the effects of general anesthesia on evoked responses and possible ways to avoid signal variability during registration. It is emphasized that only with close cooperation between neurosurgeons, anesthesiologists and neurophysiologists it will be possible to maximize the benefits of intraoperative monitoring of evoked responses and avoid misinterpretation of the results.

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“…Visual evoked potential (VEP) is recorded invasively on the surface of the visual cortex by an electrode penetrating the skull or non-invasively on the surface of the skull. Alternatively, optic nerve potential (ONP) is recorded from an electrode inserted into the retino-geniculo-occipital pathway by invasive open-skull surgery 1 , 2 . The signal of traditional VEP is low due to retino-genicular convergence and intracortical inhibition 3 - 5 and is variable due to artifacts caused by intra-cranial neural activities 6 ; whereas ONP recording is limited by its invasive procedure and restricted operating space 1 , 7 .…”

Section: Introductionmentioning

confidence: 99%

Optic chiasmatic potential by endoscopically implanted skull base microinvasive biosensor: a brain-machine interface approach for anterior visual pathway assessment

Zhang¹,

Lu²,

Huang³

et al. 2022

Theranostics

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Background: Visually evoked potential (VEP) is widely used to detect optic neuropathy in basic research and clinical practice. Traditionally, VEP is recorded non-invasively from the surface of the skull over the visual cortex. However, its trace amplitude is highly variable, largely due to intracranial modulation and artifacts. Therefore, a safe test with a strong and stable signal is highly desirable to assess optic nerve function, particularly in neurosurgical settings and animal experiments. Methods: Minimally invasive trans-sphenoidal endoscopic recording of optic chiasmatic potential (OCP) was carried out with a titanium screw implanted onto the sphenoid bone beneath the optic chiasm in the goat, whose sphenoidal anatomy is more human-like than non-human primates. Results: The implantation procedure was swift (within 30 min) and did not cause any detectable abnormality in fetching/moving behaviors, skull CT scans and ophthalmic tests after surgery. Compared with traditional VEP, the amplitude of OCP was 5-10 times stronger, more sensitive to weak light stimulus and its subtle changes, and was more repeatable, even under extremely low general anesthesia. Moreover, the OCP signal relied on ipsilateral light stimulation, and was abolished immediately after complete optic nerve (ON) transection. Through proof-of-concept experiments, we demonstrated several potential applications of the OCP device: (1) real-time detector of ON function, (2) detector of region-biased retinal sensitivity, and (3) therapeutic electrical stimulator for the optic nerve with low and thus safe excitation threshold. Conclusions: OCP developed in this study will be valuable for both vision research and clinical practice. This study also provides a safe endoscopic approach to implant skull base brain-machine interface, and a feasible in vivo testbed (goat) for evaluating safety and efficacy of skull base brain-machine interface.

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Optic nerve potentials and cortical potentials after stimulation of the anterior visual pathway during neurosurgery

Cited by 13 publications

References 50 publications

Usefulness of Intraoperative Monitoring of Visual Evoked Potentials in Transsphenoidal Surgery

Usefulness of Intraoperative Monitoring of Visual Evoked Potentials in Transsphenoidal Surgery

Neurophysiological Monitoring during Surgery on the Central Nervous System: The Role of Evoked Responses

Optic chiasmatic potential by endoscopically implanted skull base microinvasive biosensor: a brain-machine interface approach for anterior visual pathway assessment

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