ERPs obtained with the auditory oddball paradigm in coma and altered states of consciousness:: clinical relationships, prognostic value, and origin of components
ERPs obtained with the auditory oddball paradigm in coma and altered states of consciousness:: clinical relationships, prognostic value, and origin of components
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DOI：
10.1016/s1388-2457(99)00061-9
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发表时间：
1999-07-01
影响因子：
4.7
通讯作者：
Witdoeckt, C
中科院分区：
文献类型：
--
作者：
Guérit, JM;Verougstraete, D;Witdoeckt, C
目的：研究昏迷和意识改变时的事件相关电位（ERP）及其与临床状态和昏迷结果的关系。方法：采用被动听觉奇怪范式记录 103 例患者的 ERP。研究了它们发生的概率以及峰值潜伏期和振幅与格拉斯哥昏迷评分 (GCS) 的函数关系。在前 4 天内检查的 83 名患者的子集中研究了它们与结果的关系，并以敏感性、特异性以及阴性或阳性预后值来表达。 结果：当存在时，罕见刺激的 ERP 由额中央负性（N-endog 平均潜伏期：330 毫秒）和额中央正性（P-endog，平均潜伏期：431 毫秒）组成。 N100-P200 复合物。它们发生的概率及其潜伏期和幅度均与缺氧和创伤性昏迷中的 GCS 相关。 N-endog和P-endog灵敏度高，阴性预测值分别为70%和100%；但特异性较低，阳性预测值分别为 44% 和 41%。结论：在一些昏迷患者中可以记录 ERP，并且可能反映内隐定向过程而不是保留的意识。它们的存在意味着良好的预后，但不能从它们的缺失中得出结论。 (C) 1999 Elsevier Science ireland Ltd. 保留所有权利。
Objective: To study the event related potentials (ERPs) in coma and altered states of consciousness, their relationship with the clinical status and coma outcome.Methods: ERPs were recorded with a passive auditory oddball paradigm in 103 patients. Their probability of occurrence and the peak latencies and amplitudes were studied as a function of the Glasgow Coma Score (GCS). Their relationship with outcome was studied in a subset of 83 patients examined within the first 4 days, and expressed in terms of sensitivity, specificity, and negative or positive prognostic values.Results: When present, the ERPs to rare stimuli consisted of a fronto-central negativity (N-endog mean latency: 330 ms) and a fronto-central positivity (P-endog, mean latency: 431 ms) following the exogenous N100-P200 complex. Both their probability of occurrence and their latencies and amplitudes were related with the GCS in anoxic and traumatic comas. The N-endog and P-endog had high sensitivity with a negative predictive value of 70% and 100%, respectively; but a low specificity, with a positive predictive value of 44% and 41%, respectively.Conclusions: ERPs can be recorded in some comatose patients and are likely to reflect implicit orienting processes rather than preserved consciousness. Their presence implies a good prognosis but no conclusion can be drawn from their absence. (C) 1999 Elsevier Science ireland Ltd. All rights reserved.