Study On the Changes of Pattern Reversal Visual Evoked Potential In PSCI Patients
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Objective
To study the pattern reversal visual evoked potential (PRVEP) in patients with post stroke cognitive impairment (PSCI) and to provide an objective and accurate basis for the neurophysiological assessment of cognitive function in stroke patients.
Methods
First stroke patients admitted to the department of Rehabilitation Medicine of the Second Hospital of Jilin University between 01-10-2022 and 31-10-2023 were enrolled as subjects according to the inclusion criteria, exclusion criteria, shedding and exclusion criteria. They were screened for whole cognitive function using the Montreal Cognitive Assessment (MoCA), and were divided into a post-stroke cognitive impairment (PSCI) group (n=44) and a control group (post-stroke patients with normal cognitive function, n=25). The PSCI group was divided into three group including mild, moderate and severe PSCI patients according to the severity of their cognitive impairment. Clinical data of the above patients were collected, PRVEP examination was performed and index of P100 waves were calculated for both eyes. SPSS 25.0 statistical analysis was used to analyze data of patients.
Results
69 first-stroke patients completed the whole experiment, including 25 cases in control group, 14 cases in mild PSCI group, 14 cases in moderate PSCI group, and 16 cases in severe PSCI group. In patients with detectable VEP, the difference in latent period of P100 in both eyes of the PSCI group (n=20) was greater than that of the control group (n=19) ( P <0.01), and the amplitude ratio of P100 waves on both sides in PSCI group was higher than that of the control group ( P <0.05). Compared with PSCI patients with left-sided hemiplegia, PSCI patients with right-sided hemiplegia had a longer P100 latency in the right eye ( P <0.05); Compared with PSCI patients without brainstem involvement, PSCI patients with brainstem involvement had an increased P100 latency in both eyes ( P <0.01); Pearson correlation analysis showed that the binocular amplitude ratio in the VEP parameters in the PSCI group was correlated with the MoCA score ( r =-0.624, P <0.01). The ROC curve showed that the difference in the latent period of P100 in both eyes and the ratio of P100 amplitude in both eyes had certain predictive value for the diagnosis of PSCI (AUC=0.875, 0.842; P <0.05).
Conclusion
PRVEP examination and VEP parameters can help to distinguish stroke patients with or without cognitive impairment. In first-stroke patients with detectable VEP, the difference in binocular P100 latency and the ratio of binocular P100 amplitude have certain predictive value for diagnosis of PSCI, which is worthy of further study and application.
