Event-related potentials (MMN and novelty P3) in permanent vegetative or minimally conscious states
Event-related potentials (MMN and novelty P3) in permanent vegetative or minimally conscious states
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DOI：
10.1016/j.clinph.2010.02.005
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发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
Morlet, Dominique
中科院分区：
文献类型：
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作者：
Fischer, Catherine;Luaute, Jacques;Morlet, Dominique
目的：评估永久植物状态 (PVS) 患者的认知标志物（如果有）。方法：对 27 名由于缺氧 (n = 18) 或其他病因 (n = 9).根据之前在健康志愿者和昏迷患者中验证的范式，记录了与持续时间偏差的音调的不匹配负性（MMN）和与受试者自己名字的新颖性 P3（nP3）。还记录了 SEP、MLAEP 和 BAEP。结果：5/27 名患者存在 MMN，7/27 名患者存在 nP3。 ERP 与昏迷发作时间无关，并且在 MCS 和 PVS 中没有差异。与其他病因相比，缺氧时正常的 SEP 和 MLAEP 以及当前的 nP3 出现频率较低。结论：无论临床评估如何，少数患者可能会处理声音异常 (MMN) 或新奇 (nP3)，主要是当他们的状态不是由缺氧引起时。意义：一些 PVS 患者可能能够将某些意识标记过程发挥作用。目前仅基于行为的 PVS 或 MCS 诊断标准还应包括与病因相关的功能性脑部检查，例如 ERP。 (C) 2010 年国际临床神经生理学联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: To assess markers of cognition, if any, in patients in a permanent vegetative state (PVS).Methods: Event-related potential (ERP) mapping was performed on 27 patients in permanent (4-261 ! months after coma onset) vegetative (PVS, n = 16) or minimally conscious states (MCS, n = 11) due to anoxia (n = 18) or other aetiologies (n = 9). Mismatch negativity (MMN) to duration-deviant tones and novelty P3 (nP3) to the subject's own name were recorded according to a paradigm previously validated in healthy volunteers and comatose patients. SEPs, MLAEPs and BAEPs were also recorded.Results: MMN was present in 5/27 and nP3 in 7/27 patients. ERPs were not related to the time from coma onset and not different in MCS and in PVS. Normal SEPs and MLAEPs, and present nP3s were less frequent in anoxia than in other aetiologies.Conclusions: Irrespective of their clinical assessment, a few patients are likely to process sound deviance (MMN) or novelty (nP3), mainly when their state is not due to anoxia.Significance: Some PVS patients may be able to put certain awareness marker processes to work. The diagnostic criteria for PVS or MCS, currently based on mere behaviour, should also include functional brain investigations, such as ERPs, related to the aetiology. (C) 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.