Documenta Ophthalmologica

, Volume 122, Issue 1, pp 29–37 | Cite as

Optimal conditions for multifocal VEP recording for normal Japanese population established by receiver operating characteristic analysis

  • Kumiko Ishikawa
  • Takayuki Nagai
  • Yuko Yamada
  • Akira Negi
  • Makoto Nakamura
Original Research Article


The purpose of this study was to establish optimal conditions for recording multifocal visual evoked potentials (mVEPs) in Japanese individuals, whose skull frame presumably differs from Caucasians. The scalp point that was extended from the calcarine fissure was identified using magnetic resonance imaging scans of 200 subjects. MVEPs were recorded from 56 individuals using three single channels and combinations of vertical and horizontal channels. Five electrodes were placed at the inion, 4 cm above the inion, 2.5 cm below the inion, 4 cm to the left or 4 cm to the right of the inion. The signal-to-noise ratio (SNR) was obtained by measuring the root-mean-square (RMS) amplitude of a signal window (45–150 ms) from each of 60-local responses that was divided by the average of the 60 RMS amplitudes of the noise window (325–430 ms). Receiver operating characteristic (ROC) analyses were performed based on the proportion of mVEP responses that exceeded a specific SNR criterion, calculated for both the signal window and the noise window. The position of the calcarine fissure relative to the inion was significantly lower than the value reported for Caucasians. The ROC analyses disclosed that bi-channel combinations (one vertical and one horizontal) had significantly better performance to discriminate signal from noise in 60-local mVEP responses compared to any single channel and performed similarly to the tri-channel combination. Two sets of perpendicular channels should be simultaneously used in recording mVEP responses from Japanese people, among whom skull frame characteristics differ from those observed in Caucasians.


Multifocal visual evoked potential Normative database Receiver operating characteristic Ethnic difference Calcarine fissure 



This study was supported in part by Grants-in-Aid 22390324 (A.N., Y.Y., M.N.) and 20592043 (M.N., A.N.) from the Ministry of Education, Culture, Sports, and Science and Technology of the Japanese government.


  1. 1.
    Baseler HA, Sutter EE, Klein SA, Carney T (1994) The topography of visual evoked response properties across the visual field. Electroencephalogr Clin Neurophysiol 90:65–81CrossRefPubMedGoogle Scholar
  2. 2.
    Klistorner AI, Graham SL, Grigg JR, Billson FA (1998) Multifocal topographic visual evoked potential: improving objective detection of local visual field defects. Invest Ophthalmol Vis Sci 39:937–950PubMedGoogle Scholar
  3. 3.
    Hood DC, Greenstein VC (2003) Multifocal VEP and ganglion cell damage: applications and limitations for the study of glaucoma. Prog Retin Eye Res 22:201–251CrossRefPubMedGoogle Scholar
  4. 4.
    Klistorner A, Graham SL (2000) Objective perimetry in glaucoma. Ophthalmology 107:2283–2299CrossRefPubMedGoogle Scholar
  5. 5.
    Hood DC, Thienprasiddhi P, Greenstein VC, Winn BJ, Ohri N, Liebmann JM, Ritch R (2004) Detecting early to mild glaucomatous damage: a comparison of the multifocal VEP and automated perimetry. Invest Ophthalmol Vis Sci 45:492–498CrossRefPubMedGoogle Scholar
  6. 6.
    Klistorner A, Fraser C, Garrick R, Graham S, Arvind H (2008) Correlation between full-field and multifocal VEPs in optic neuritis. Doc Ophthalmol 117:121–128CrossRefGoogle Scholar
  7. 7.
    Laron M, Cheng H, Zhang B, Schiffman JS, Tang RA, Frishman LJ (2010) Comparison of multifocal visual evoked potential, standard automated perimetry and optical coherence tomography in assessing visual pathway in multiple sclerosis patients. Multiple Sclerosis 16:412–426CrossRefPubMedGoogle Scholar
  8. 8.
    Yu M, Brown B, Edwards MH (1998) Investigation of multifocal visual evoked potential in anisometropic and esotropic amblyopes. Invest Ophthalmol Vis Sci 39:2033–2040PubMedGoogle Scholar
  9. 9.
    Hood DC, Zhang X, Hong JE, Chen CS (2002) Quantifying the benefits of additional channels of multifocal VEP recording. Doc Ophthalmol 104:303–320CrossRefPubMedGoogle Scholar
  10. 10.
    Meigen T, Krämer M (2007) Optimizing electrode positions and analysis strategies for multifocal VEP recordings by ROC analysis. Vis Res 47:1445–1454CrossRefPubMedGoogle Scholar
  11. 11.
    Bland JM, Altman DG (1995) Multiple significance tests—the Bonferroni method. Br Med J 310:170Google Scholar
  12. 12.
    Fortune B, Zhang X, Hood DC, Demirel S, Johnson CA (2004) Normative ranges and specificity of the multifocal VEP. Doc Ophthalmol 109:87–100CrossRefPubMedGoogle Scholar
  13. 13.
    Hood DC, Zhang X, Winn BJ (2003) Detecting glaucomatous damage with the mVEP: how can a monocular test work? J Glaucoma 12:3–15CrossRefPubMedGoogle Scholar
  14. 14.
    Zhang X, Hood DC, Chen CS, Hong JE (2002) A signal-to-noise analysis of multifocal VEP responses: an objective definition for poor records. Doc Ophthalmol 104:287–302CrossRefPubMedGoogle Scholar
  15. 15.
    Dobie RA, Wilson MJ (1993) Objective response detection in the frequency domain. Electroencephalogr Clin Neurophysiol 88:516–524CrossRefPubMedGoogle Scholar
  16. 16.
    Hanley JA (1989) Receiver operating characteristic (ROC) methodology: the state of the art. Crit Rev Diagn Imaging 29:307–335PubMedGoogle Scholar
  17. 17.
    Swets JA (1973) The relative operating characteristic in psychology: a technique for isolating effects of response bias finds wide use in the study of perception and cognition. Science 182:990–1000CrossRefPubMedGoogle Scholar
  18. 18.
    Hood DC, Zhang X (2000) Multifocal ERG and VEP responses and visual fields: comparing disease-related changes. Doc Ophthalmol 100:115–137CrossRefGoogle Scholar
  19. 19.
    Steinmetz H, Gunter F, Bernd-Ulrich M (1989) Craniocerebral topography within the international 10–20 system. Electroencephalogr Clin Neurophysiol 72:499–506CrossRefPubMedGoogle Scholar
  20. 20.
    Stensaas SS, Eddington DK, Dobelle WH (1974) The topography and variability of the primary visual cortex in man. J Neurosurg 40:747–755CrossRefPubMedGoogle Scholar
  21. 21.
    Klistorner AI, Graham SL (2001) Electroencephalogram-based scaling of multifocal visual evoked potentials: effect on inter subject amplitude variability. Invest Ophthalmol Vis Sci 42:2145–2152PubMedGoogle Scholar
  22. 22.
    Celesia GG, Kaufman D, Cone S (1987) Effects of age and sex on pattern electroretinograms and visual evoked potentials. Electroencephalogr Clin Neurophysiol 68:161–171CrossRefPubMedGoogle Scholar
  23. 23.
    Mitchell KW, Howe JW, Spencer SR (1987) Visual evoked potentials in the older population: age and gender effects. Clin Phys Physiol Meas 8:317–324CrossRefPubMedGoogle Scholar
  24. 24.
    Tobimatsu S, Kurita-Tashima S, Nakayama-Hiromatsu M, Akazawa K, Kato M (1993) Age-related changes in pattern visual evoked potentials: differential effects of luminance, contrast and check size. Electroencephalogr Clin Neurophysiol 88:12–19CrossRefPubMedGoogle Scholar
  25. 25.
    Emmerson-Hanover R, Shearer DE, Creel DJ, Dustman RE (1994) Pattern reversal evoked potentials: gender differences and related changes in amplitude and latency. Electroencephalogr Clin Neurophysiol 92:93–101CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kumiko Ishikawa
    • 1
  • Takayuki Nagai
    • 1
  • Yuko Yamada
    • 1
  • Akira Negi
    • 1
  • Makoto Nakamura
    • 1
  1. 1.Division of Ophthalmology, Department of Surgery, Graduate School of MedicineKobe UniversityChuo-ku, KobeJapan

Personalised recommendations