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Jin Lee, Morag Andrew, Dee B. Birtles, John Wattam-Bell, Janette Atkinson, Oliver J. Braddick; Development Of Pattern- And Orientation-reversal Latencies In Healthy Infants And Those At Risk Of Cerebral Palsy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6084.
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Pattern-reversal (PR) VEPs are present in newborns while orientation-reversal (OR) VEP emerges age 3-8 weeks (Braddick et al, Nature 1986). PR-VEP latencies are known to decrease rapidly from 250 ms at birth and asymptote to adult P100 values by 15 weeks. This study compared this development with that for OR-VEP to understand better the maturation of visual cortical function, and investigated both PR- and OR-VEP as measures for evaluating infants with perinatal brain damage at risk of cerebral palsy.
Occipital VEPs were measured with PR and OR stimuli at 2-16 reversals/s, in a group of 100 healthy infants (age 4- 53 weeks) and a clinical group of 30 infants (0.9- 81 weeks post-term) with perinatal brain damage. Latencies were (a) taken from the positive peak in a transient recording; (b) calculated from the slope of phase vs. temporal frequency plots.
For normally developing infants, the developmental course of PR peak latencies to adult values at 15 weeks (peak latency) and 20 weeks (calculated latency) was confirmed (Lee et al, ECVP 2010). OR latencies develop more slowly, with peak measure reaching the adult asymptote around 20 weeks. The clinical group as a whole reach adult PR latencies on average 5 weeks later. OR latencies (in the subset of infants who yield statistically reliable responses) did not differ between groups.
PR peak latencies reflect the initial cortical response to produce a maximum peak. OR latencies, and calculated PR latencies, reflect the time course of cortical processing and show a slower developmental course. PR latencies may provide an early indicator of visual pathway and wider cerebral damage in children at risk for cerebral palsy. For OR responses, the absence of a significant response may be a better indicator of cerebral impairment than latency (Atkinson et al, Arch Dis Child 2008).
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