视觉诱发电位的快速提取及其临床应用可行性的初步研究

The single-trial of visual evoked potential and the preliminary study on feasibility in clinical practice

目的 探讨视觉诱发电位的快速提取及其临床应用的可行性。方法 采用Galileo视觉诱发电位检测系统进行VEP常规检查和快速提取 ,即每例均用前 5次行少次平均 ,经小波变换、独立分量分析联合的最优滤波信号处理。检测 36例视神经病患者 ,并以 4 6例正常健康人为对照组 ,对以上两种检查方法所得的VEP参量进行测量。最后以传统检测方法的P10 0潜伏期为金标准 ,验证新方法的敏感性、特异性、准确性。结果 新方法的敏感性为 95 .6 % (4 3/45 ) ,特异性为 95 .0 % (113/119) ,准确性为 95 .1% (15 6 /16 4 )。Kappa为 0 .88。 结论 ①新方法与传统方法相比 ,对视觉系统病变的检测结果相似 ;②新方法对某些视觉系统亚临床病变较为敏感 ;③新方法可明显减少刺激次数 ,经进一步完善 。

Objective To explore single trial of PRVEP and its feasibility in clinical practice.Methods By using the Galileo EP System,we tested both routine VEP and single trial (the first 5 single trial PRVEP epochs,sub average) with a new method which are combined optimal filtering,wavelet analysis and independent component analysis in 36 patients with the optic neuropathy and in 46 healthy subjects as control.Finally the result of all parameters were processed by the new method comparing with the results of custom method as gold standard.The sensitivity,specificity and accuracy were calculated.Results Taking P100 PL as criteria,the sensitivity of the new method was 95.6%(43/45),the specificity 95.0%(113/119),exact 95.1%(156/164).Conclusions The results obtained by the new method were similar to that of the custom method.Further more,the new method may be more sensitive than the custom one in detecting some sub clinical patients.It takes less time and can enhance the reliability of PRVEP.So the new method could be applied to clinical practice.