Myasthenia gravis in a patient with chronic active hepatitis C during interferon-alpha treatment.
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Autoimmune Diseases↗
Biomedical subjects
M Versino
Publications and source records attributed to M Versino.
Saccade latency toward auditory targets depends on the relative position of the sound source with respect to the eyes.
The latency of saccadic eye movements evoked by the presentation of auditory and visual targets was studied while starting eye position was either 0 or 20 deg right, or 20 deg left. The results show that for any starting position the latency of visually elicited saccades increases with target eccentricity with respect to the eyes. For auditory elicited saccades and for any starting position the latency decreases with target eccentricity with respect to the eyes. Therefore auditory latency depends on a retinotopic motor error, as in the case of visual target presentation.
Adult↗
Recovery functions of early cortical median nerve SSEP components: normative data.
The recovery functions of parietal P14-N20, N20-P27 and frontal P22-N30 amplitudes were assessed in 17 healthy controls aged 20-50 years by means of the paired stimulus technique. One unpaired and 4 paired stimuli with interstimulus intervals (ISIs) of 25, 50, 75 and 100 msec were cyclically presented in a single run. Responses to the unpaired stimulus were subtracted off-line from paired stimulus responses. The highest suppression was reached at shorter ISIs for components with shorter latencies. The mean suppression of P22-N30 was influenced by the subject's age, being greater in younger subjects. Normative data are reported.
Adult↗
Usefulness of trigeminal somatosensory evoked potentials to detect subclinical trigeminal impairment in multiple sclerosis patients.
Trigeminal somatosensory evoked potentials (TSEPs) by surface electric pulse stimulation were recorded in 30 normal subjects and in 70 multiple sclerosis (MS) patients, 13 of whom presenting clinical trigeminal impairment. We observed significant prolongation of all TSEPs parameters in MS group. TSEPs were abnormal in 45 patients (64.3%). Clinical and neurophysiological data agreed in 36 patients (51%) on 84 sides (60%). TSEPs were able to detect clinically silent lesions 54 times. TSEPs recording proves to be an additional useful test in MS multimodal evoked potential protocols.
Adolescent↗
Eye movement quantitative evaluation before and after high-dose 6-methylprednisolone in multiple sclerosis.
We studied saccadic and smooth pursuit eye movements in 24 patients suffering from multiple sclerosis during disease worsening, before and after high-dose 6-methylprednisolone infusions. Quantitative evaluation of saccades was based on amplitude/duration and amplitude/peak velocity relationships, precision (i.e. the ratio of actual to desired saccade amplitude) and the latency, whereas smooth pursuit eye movements were studied using target velocity/performance index relationship. At basal recordings, 22/24 (91.7%) of the patients showed at lest one abnormality. Eleven of the 24 patients (45.8%) showed modification of one or several parameters: improvement in 6 patients, worsening in 2, coexistence of both trends in 3. Latency improvement was the only significant modification when patients were considered as a group. Neurophysiological modifications did not correspond to clinical changes.
Adult↗
A clinically oriented approach to smooth pursuit eye movement quantitative evaluation.
The electrooculographic technique was used to record smooth pursuit eye movements in 71 healthy subjects homogeneously distributed within an age range between the 2nd and the 6th decades. The target moved at constant velocity (triangular ramps) and 9 different target velocities (V), from 10 deg/s to 50 deg/s were considered and presented according to pseudorandom sequence. Ad hoc software suppressed catch-up saccades so that a pursuit index (PI) value was computed for each ramp taking into account only the smooth pursuit tracking modality. It was demonstrated that the relationship between V and PI could be described by the linear model PI = a + b * V. Pursuit index was proved to be influenced by the age of subject (decade factor in the analysis of variance), since an almost linear increase in b values yields a reduction of pursuit index values. The method was tested in 22 multiple sclerosis patients and an association was found between the occurrence of cerebellar signs and the reduction of a value.
Adolescent↗
Somatosensory evoked potentials by median nerve stimulation recorded with cephalic and non-cephalic references. I). Normative study.
Somatosensory evoked potentials by median nerve stimulation were obtained in 50 healthy subjects (aged 15-70 years) with cephalic and non cephalic references. Most parameters were influenced by one or more independent variables (sex, age, arm lengths). The coefficients of the appropriate linear models are reported to compute correct individual normal limits.
Adolescent↗
Somatosensory evoked potentials by median nerve stimulation recorded with cephalic and non-cephalic references. II). Reliability study.
Reliabilities of parameters of median nerve short-latency somatosensory, evoked potential obtained using both cephalic and non-cephalic references was measured in 20 healthy volunteers (aged 20-50 years) who repeated the recording session after one week. All latency measures and peak-to-peak times were highly reliable; amplitudes were less reliable. Upper normal test-retest variability limits of all the analyzed parameters were also computed.
Adolescent↗
One-week test-retest reliability of spinal and cortical somatosensory evoked potentials by tibial nerve stimulation.
Spinal (Th12) and cortical somatosensory evoked potentials by right and left posterior tibial nerve stimulation at the ankle were performed in 20 healthy volunteers (10 females and 10 males) aged 23-50 years. The procedure was repeated after one week to assess the reliability of the parameters and to establish upper normal variability limits. Reliability was measured by the intraclass correlation coefficient and was excellent for all absolute latencies and at least good for amplitudes and for the spinal-cortical conduction time. Upper variability limits were calculated using a method based on the within-subject mean square, which can be also applied in the case of more than two repetitions.
Adult↗
High-dose methylprednisolone infusions in relapsing and in chronic progressive multiple sclerosis patients. One year follow-up.
Sixty Multiple Sclerosis patients hospitalized either in relapse (28) or in chronic progressive (32) phase of the disease were treated with high-dose methylprednisolone infusions (1 g/daily for 6 days). Clinical examinations, scored by Kurtzke's functional systems (FSs) and expanded disability status scale (EDSS), were performed before treatment, immediately after, and thereafter at 1,3,6 and 12 month intervals. In relapsing cases, 22 patients (78.6%) improved and EDSS mean value decreased by 1.39 points after the treatment; 8 patients had a new bout within one year. In chronic progressive cases, 18 patients (56.2%) improved and EDSS mean value decreased by 0.56 points after the treatment; 13 patients showed a new worsening throughout the follow-up period. The treatment proved to be safe and effective both in relapsing and in chronic progressive patients, determining rapid clinical improvement in most of the cases, and a slowing down of progression in some chronic patients.
Adolescent↗
Quantitative evaluation of saccadic and smooth pursuit eye movements. Is it reliable?
PURPOSE: The authors evaluated the reliability of the coefficients of the (1) amplitude/duration and (2) amplitude/peak velocity relationships of the mean precision values and the mean latency values (saccadic eye movements) and the coefficients of the target velocity/gain relationship (smooth pursuit eye movements). They computed test-retest maximum variability limits for these parameters. METHODS: After a 1-week interval, saccadic and smooth pursuit eye movements were recorded twice from 20 healthy subjects; 12 of these subjects underwent a third recording session. The estimate of the intraclass coefficient of reliability, R, was adopted to evaluate the reliability of eye movement quantitative analysis. RESULTS: The data demonstrated that the reliability was fairly good for the amplitude/peak velocity relationship, was good for the precision, and was excellent for the amplitude/duration, the target velocity/gain relationships, and the latency. CONCLUSIONS: Quantitative analysis of both saccadic and smooth pursuit eye movements is reliable. One statistic used to estimate reliability, ie, the within-subjects mean square value, also enables the determination of test-retest normal variability values for both the variances and the differences of measurements.
Adult↗
Multimodal evoked potentials in myotonic dystrophy (MyD).
By means of multimodal evoked potentials (EPs), we evaluated the central nervous system (CNS) involvement in 25 subjects suffering from myotonic dystrophy: brainstem auditory evoked potentials (BAEPs), middle-latency auditory evoked potentials (MLAEPs) and somatosensory evoked potentials (SEPs) from the upper limb were performed on all subjects, whereas only the 19 patients, whose clinical ocular abnormalities were slight, underwent pattern-electretinograms (PERGs) and pattern visual-evoked potentials (VEPs) in order to identify the site of lesion among visual pathways (retinal and/or retroretinal). PERGs were abnormal in 8/19 subjects, VEPs in 8/19 subjects (the two techniques were simultaneously abnormal in 8 eyes), BAEPs in 7/25 subjects, MLAEPs in 4/25 subjects (in one subject both BAEps and MLAEPs were abnormal) and SEPs were abnormal in 1/25 subjects. 13/25 of our subjects showed at least one EP that revealed a CNS involvement. The electrophysiological alterations were not correlated either with subject age or with disease duration. Multimodal EPs enabled us to demonstrate that CNS involvement in myotonic dystrophy is important and mainly affects the visual and auditory system.
Adult↗
Spinal and cortical potentials evoked by tibial nerve stimulation in humans: effects of sex, age and height.
Somatosensory evoked potentials by posterior tibial nerve stimulation at the ankle were performed in 74 healthy volunteers (36 females and 38 males) aged 14-76 years. Cortical potentials were obtained in all subjects and spinal potentials (N22) in 71 subjects. All parameters were related to subject's age, height and sex. Sex influenced only P40-N50 amplitude, which was greater in females. All latencies of spinal and cortical components increased in a similar manner with subject's height (about 0.16-0.18 ms per cm), whereas the N22-P40 interpeak latency was independent from height, but related to T12-Cz distance. Absolute latencies of the spinal and of most cortical components, but not interpeak latencies, increased with subject's age (about 0.06-0.09 ms per year). The parameters to compute normative data (according to univariate or bivariate regression models) are furnished. Limits of right-left differences are reported.
Adolescent↗
A one-week test-retest reliability study of Brainstem Auditory Evoked Potentials.
Brainstem Auditory Evoked Potentials (BAEPs) are increasingly used in longitudinal evaluation of brainstem function. The reliability of the neurophysiological parameters and definition of the normal test-retest variability are required for such investigations. In the present study we submitted 20 healthy volunteers (10 males and 10 females; mean age 35.1 years, range 24-49) to BAEPs in two sessions separated by seven days. The reliability of the parameters was estimated by means of intraclass correlation coefficient (R). All BAEP parameters showed excellent R values (above 0.75). In addition, the confidence interval lower limits of all R coefficients had good to excellent values. Finally we computed the upper normal limits of the test-retest variability of each parameter, with alpha = 0.01, using the within-subjects mean square. The confirmed good reliability of the analyzed parameters enables us to employ BAEPs as useful monitoring instruments in longitudinal studies.
Adult↗
The reliability of eye movement quantitative evaluation. I. Saccadic eye movements.
We adopted the estimate of the intraclass coefficient of reliability, R, to evaluate the reliability of saccadic eye movements quantitative analysis. At a one-week interval we recorded refixative saccadic eye movements twice from fifteen healthy subjects by means of the binocular electrooculographic technique. R was computed for the constants and the slopes of the amplitude/duration and the amplitude/peak velocity relationships, for the mean precision values and for the mean latency values adjusted for subject's age. Our data demonstrated that the reliability of saccade parameters is fairly good for the amplitude/peak velocity relationship, good for the precision and very good for the amplitude/duration relationship. Finally, we believe that the normal variability values we obtained can be usefully employed in neurophysiological longitudinal studies not only in normal subjects, but also in pathological condition provided the more reliable parameters and the more adequate strategies to compute normal variability values are chosen.
Adult↗
The reliability of eye movement quantitative evaluation. II. Smooth pursuit eye movements.
We adopted the estimate of the intraclass coefficient of reliability, R, to evaluate the reliability of smooth pursuit eye movement quantitative analysis. At a one-week interval, we recorded twice smooth pursuit eye movements from fifteen healthy subjects by means of the binocular electrooculographic technique. R was computed for the constant and the slope of the target velocity/gain relationships. R values were rated good for the slope and excellent for the constant. Finally, we computed for each parameter the maximum variability value according to two differing methods; on the basis of the within-subjects mean square values, we defined the normal range of biological test-retest variability for the two parameters.
Adult↗
Multimodal evoked potentials in progressive external ophthalmoplegia with mitochondrial myopathy.
Multimodal evoked potentials were studied in 13 patients affected by progressive external ophthalmoplegia with histologically proven mitochondrial myopathy. Progressive external ophthalmoplegia occurred with craniosomatic spreading in all the patients and with a varying degree of nervous and/or other system involvement in most of them. In all but one of the subjects, at least one evoked potential modality was abnormal; 11 of them demonstrated an abnormal visual evoked potential, but this finding might have been influenced by concurrent retinal dysfunction. Abnormalities in brainstem auditory evoked potentials and/or somatosensory evoked potentials, revealing an impairment of central sensory pathways, were detected in 7 subjects, 5 of whom lacked clinical evidence of central nervous system involvement. Thus, evoked potentials represent an useful tool for the detection of subclinical central nervous system involvement in patients affected by progressive external ophthalmoplegia with mitochondrial myopathy.
Adult↗
Somatosensory evoked potentials by electrical stimulation of the third trigeminal branch in humans.
Somatosensory Evoked Potentials by stimulation of the trigeminal nerve (TSEPs) were recorded from 30 healthy subjects (15 males, 15 females; mean age: 45.2 years; range: 21-66 years) in order to assess normative data for clinical purposes. To elicit the TSEPs, electrical square pulses (duration: 0.1 msec; frequency: 3.3 Hz; intensity: 4-6 mA) were delivered by bipolar skin electrodes (cathode over the foramen mentale and anode on the middle of the chin, stimulating the trigeminal third branch). TSEPs were obtained from C3-Fpz and C4-Fpz by twice averaging 1000 responses. Time base was 100 msec; bandpass filter setting was 5-1500 Hz. In our normal subjects the TSEPs were composed of several components (N1, P1, N2, P2 and N3); the components, with the exception of N3, were always bilaterally detectable. Statistical analysis (repeated measures analysis of variance) demonstrated a dependence of TSEP latencies on sex; it did not demonstrate an analogous dependence on either side of stimulation or age. Finally, we propose some guidelines for the evaluation of TSEPs: consider N1, P1, N2 and P2 waves, base the judgement of normality on latencies rather on amplitudes, use differing normative data according to sex.
Adult↗