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Visual evoked potentials - Following and prognostic method for neurodevelopmental outcome of children with congenital CMV virus

INTRODUCTION: Congenital cytomegalovirus (CMV) infection is the most common serious viral infection. Clinical consequences of CMV infection (as a result of placentitis and secondary chronic perfusion insufficiency) are IUGR and a wide spectrum of neurodevelopmental disorders. It is well known that congenital CMV infection can cause auditory dysfunction and choreoretinitis ; a recent study shows that maturation of periventricular white matter is also affected. Visual evoked potentials are a good prognostic factor of neurodevelopmental outcome, with high predictive values for visual function as well as neuromotor outcome. Visual evoked response undergoes changes during the first year of life, as consequence of brain maturation (synaptogenesis and myelinisation). HYPOTHESIS: As is well known, most children with congenital CMV infection have delayed neuromotor development. From our clinical experience and results of a pilot study, they also have delayed maturation of visual pathways. It seems that is a good correlation of maturation of visual evoked response and neurological development in children with congenital CMV infection. Therefore, visual evoked potentials could be an effective diagnostic tool for the assessment of the clinical severity of neurodevelopmental dysfunction in children with congenital CMV infection and also a following and prognostic method for their neurodevelopmental outcome. AIMS: To describe specific characteristics of visual evoked response in children with congenital CMV infection and to try proving that visual evoked response could be effective following and prognostic method for neurodevelopmetal outcome in children with congenital CMV infection. MATERIALS AND METHODS: Multidisciplinary prospective follow-up study of children with congenital CMV infection. Initial clinical examination will be performed in University Hospital for Infectious Diseases. Follow-up will be performed in Children’s Hospital Zagreb with repeated neurological examinations, brain US and neurophysiologic tests (VEP, EEG), together with TCCD, ophthalmologic, ORL examinations, psychological and early communication evaluation. EXPECTED SCIENTIFIC CONTRIBUTION OF THE PROPOSED RESEARCH: Research on the study will contribute to understanding the functional electrophysiological maturation of the visual pathway in children with congenital CMV infection. It will also prove if visual evoked potentials (painless, non-invasive and repetitory method) could be performed as useful assessment and prognostic method for neurodevelopmental outcome in children with congenital CMV infection.

Visual evoked potentials; Neurodevelopmental outcome; Congenital cytomegalovirus infection

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