Visual evoked potentials in survivors of extracorporeal membrane oxygenation (ECMO) are correlated with cognitive developmental testing

R. D. Amaker, M. E. Gangarosa, Y. D. Park, H. C. Davis, W. P. Kanto, J. Bhatia

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We have previously demonstrated that seizures during ECMO are a risk factor for developmental delay. Studies on five year old asphyxiated (non-ECMO treated) children have shown a correlation of the amplitude and latency of visual evoked potentials (VHP) with neonatal condition. No study of VEPs has been done on school age survivors of neonatal venoarterial ECMO. The purpose of this study was to determine if VEPs recorded at school age would be predictive of neonatal condition (seizure vs. non-seizure) and outcome. Two groups of children were recruited at random from our cohort of five to nine year old ECMO survivors [Group 1, (n=9) no seizures; Group 2, (11) seizures]. Data recorded: birth weight, gestational age, Apgar scores, maternal age and education, and diagnoses. All children underwent pattern reversal VHP recorded by surface electrodes, OZ-FZ, OZ-A1, PZ-A1, and FZ-A1 (Nicolet Compact 4; 200 ms time base, 4.1 Hz, sensitivity 100μV). VEPs were measured and scored by a neurologist blinded to patient status. All subjects underwent Standford-Binet Intelligence Scale (4th Ed.), Berry Visual Motor Integration Test, and Wide Range Achievement Test- Revised. Demographic measures did not differ between the two groups. VEPs for all test subjects were normal in latency and amplitude of the P100 wave. However, both right and left amplitudes were negatively correlated with the diagnosis of seizures. Subjects in the seizure group had significantly lower amplitudes for both the left (p=0.01) and the right (p=0.001) when compared to the non-seizure group. For all subjects, lower left amplitudes were significantly correlated with lower scores for abstract visual reasoning, and for all three subsets of the WRAT-R; i.e. arithmetic, reading and spelling. Lower left amplitude also correlated with the need for physical or occupational therapy (p=0.014). The absolute difference between right and left latency (a measure of asymmetry) was negatively correlated with WRAT-R subsets for reading (p=0.003) and spelling (p=0.021). The presence of seizures did not correlate with any of the outcome testing. VEPs appear to be a sensitive indicator for performance on the WRAT-R in ECMO treated school age children. This relationship warrants further investigation to determine if VEPs can predict outcome in the newborn recently treated with ECMO.

Original languageEnglish (US)
Pages (from-to)75A
JournalJournal of Investigative Medicine
Issue number1
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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