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Longitudinal assessment of childhood optic gliomas: relationship between flicker visual evoked potentials and magnetic resonance imaging findings

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Abstract

The aim of this study was to evaluate longitudinally functional and neuro-radiologic findings in childhood optic gliomas (OG), by comparing flicker visual evoked potentials (F-VEPs) with brain magnetic resonance imaging (MRI) changes. Fourteen children (age range: 1–13 years) with OGs underwent serial F-VEP, MRI and neuro-ophthalmic examinations over a 38 month (median, range: 6–76) follow-up. F-VEPs were elicited by 8 Hz sine-wave flicker stimuli presented in a mini-Ganzfeld. Contrast-enhanced MRI examinations were performed. Results of both tests were blindly assessed by independent evaluators. F-VEPs were judged to be improved, stable or worsened if changes in the amplitude and/or phase angle of the response exceeded the limits of test–retest variability (±90th percentile) established for the same patients. MRI results were judged to show regression, stabilization or progression of OG based on its changes in size (±20%) or extension. Two to seven pairs of F-VEP/MRI examinations per patient (median: 4) were collected. Based on a total of 38 pairs of F-VEP/MRI examinations, both tests agreeed in showing worsening (progression), stabilization and improvement (regression) in 5, 15 and 10 cases, respectively. In 3 cases, F-VEPs showed a worsening and MRI a stabilization, while in 5 cases F-VEPs showed an improvement and MRI a stabilization. Agreement between F-VEP and MRI changes was 78.9% (95% CI: ± 37%, K statistics = 0.67, P < 0.001). The results indicate that longitudinal F-VEP changes can predict changes in MRI-assessed OG size and extension, providing a non-invasive functional assay, complementary to neuro-imaging, for OG follow-up.

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Authors and Affiliations

  1. Institute of Ophthalmology, Catholic University, Lgo F. Vito 00136, Rome, Italy

    Benedetto Falsini, Luca Placentino, Anna Dickmann, Marco Piccardi & Emilio Balestrazzi

  2. Department of Pediatrics and Developmental Neurosciences, Catholic University, Rome, Italy

    Ilaria Lazzareschi, Antonio Ruggiero, Lucia Liotti, Concezio Di Rocco & Riccardo Riccardi

  3. Fondazione GB Bietti per l’Oftalmologia, IRCCS, Rome, Italy

    Lucia Ziccardi

  4. Department of Imaging Diagnostics, Catholic University, Rome, Italy

    Cesare Colosimo

Authors
  1. Benedetto Falsini
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  2. Lucia Ziccardi
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  3. Ilaria Lazzareschi
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  4. Antonio Ruggiero
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  5. Luca Placentino
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  6. Anna Dickmann
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  7. Lucia Liotti
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  8. Marco Piccardi
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  9. Emilio Balestrazzi
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  10. Cesare Colosimo
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  11. Concezio Di Rocco
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  12. Riccardo Riccardi
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Correspondence to Benedetto Falsini.

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Falsini, B., Ziccardi, L., Lazzareschi, I. et al. Longitudinal assessment of childhood optic gliomas: relationship between flicker visual evoked potentials and magnetic resonance imaging findings. J Neurooncol 88, 87–96 (2008). https://doi.org/10.1007/s11060-008-9537-1

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  • DOI: https://doi.org/10.1007/s11060-008-9537-1

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