Abstract
Primary objective: The aim of this study is to assess if laser evoked potentials (LEPs) examination should be considered as an objective evidence of potential or residual pain perception capacity in vegetative (VS) and minimally conscious state (MCS) patients and if it could be a feasible methodology in order to differentiate these two clinical entities.Research design: This is a cross-sectional observational study focusing on the role of LEP examination, which is an easy and objective neurophysiological approach of the nociceptive system.Methods and procedures: Thirteen VS and 10 MCS patients were enrolled. All subjects were evaluated clinically by using validated behavioural scales and underwent to upper and lower limbs LEP recording.Main outcomes and results: Intra-group LEPs analysis in VS patients highlighted significant differences for N2P2 latency (p = 0.036) and amplitude (p = 0.018). Inter-group LEPs analysis showed significant differences in post-anoxic condition for N2P2 latency (p = 0.034), amplitude (p = 0.034) and a trend in N2P2 latency in brain trauma (p = 0.07). Interestingly, correlation analysis showed a significant relationship between N2P2 amplitude and Coma Recovery Scale-Revised scoring in the post-traumatic VS (r = 0.823, p = 0.044).Conclusions: The findings lead to detection of potential markers of conscious pain perception in patients with DOC, with important impact on therapeutic and rehabilitative management, and provide new information that may allow a better differential diagnosis.
| Original language | English |
|---|---|
| Pages (from-to) | 1467-1474 |
| Number of pages | 8 |
| Journal | Brain Injury |
| Volume | 29 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Oct 15 2015 |
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Keywords
- Laser evoked potentials
- minimally conscious state
- outcome evaluation
- pain
- vegetative state
ASJC Scopus subject areas
- Clinical Neurology
- Arts and Humanities (miscellaneous)
- Developmental and Educational Psychology
Cite this
Assessment of nociceptive system in vegetative and minimally conscious state by using laser evoked potentials. / De Salvo, S.; Naro, A.; Bonanno, L.; Russo, M.; Muscarà, N.; Bramanti, P.; Marino, S.
In: Brain Injury, Vol. 29, No. 12, 15.10.2015, p. 1467-1474.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Assessment of nociceptive system in vegetative and minimally conscious state by using laser evoked potentials
AU - De Salvo, S.
AU - Naro, A.
AU - Bonanno, L.
AU - Russo, M.
AU - Muscarà, N.
AU - Bramanti, P.
AU - Marino, S.
PY - 2015/10/15
Y1 - 2015/10/15
N2 - Primary objective: The aim of this study is to assess if laser evoked potentials (LEPs) examination should be considered as an objective evidence of potential or residual pain perception capacity in vegetative (VS) and minimally conscious state (MCS) patients and if it could be a feasible methodology in order to differentiate these two clinical entities.Research design: This is a cross-sectional observational study focusing on the role of LEP examination, which is an easy and objective neurophysiological approach of the nociceptive system.Methods and procedures: Thirteen VS and 10 MCS patients were enrolled. All subjects were evaluated clinically by using validated behavioural scales and underwent to upper and lower limbs LEP recording.Main outcomes and results: Intra-group LEPs analysis in VS patients highlighted significant differences for N2P2 latency (p = 0.036) and amplitude (p = 0.018). Inter-group LEPs analysis showed significant differences in post-anoxic condition for N2P2 latency (p = 0.034), amplitude (p = 0.034) and a trend in N2P2 latency in brain trauma (p = 0.07). Interestingly, correlation analysis showed a significant relationship between N2P2 amplitude and Coma Recovery Scale-Revised scoring in the post-traumatic VS (r = 0.823, p = 0.044).Conclusions: The findings lead to detection of potential markers of conscious pain perception in patients with DOC, with important impact on therapeutic and rehabilitative management, and provide new information that may allow a better differential diagnosis.
AB - Primary objective: The aim of this study is to assess if laser evoked potentials (LEPs) examination should be considered as an objective evidence of potential or residual pain perception capacity in vegetative (VS) and minimally conscious state (MCS) patients and if it could be a feasible methodology in order to differentiate these two clinical entities.Research design: This is a cross-sectional observational study focusing on the role of LEP examination, which is an easy and objective neurophysiological approach of the nociceptive system.Methods and procedures: Thirteen VS and 10 MCS patients were enrolled. All subjects were evaluated clinically by using validated behavioural scales and underwent to upper and lower limbs LEP recording.Main outcomes and results: Intra-group LEPs analysis in VS patients highlighted significant differences for N2P2 latency (p = 0.036) and amplitude (p = 0.018). Inter-group LEPs analysis showed significant differences in post-anoxic condition for N2P2 latency (p = 0.034), amplitude (p = 0.034) and a trend in N2P2 latency in brain trauma (p = 0.07). Interestingly, correlation analysis showed a significant relationship between N2P2 amplitude and Coma Recovery Scale-Revised scoring in the post-traumatic VS (r = 0.823, p = 0.044).Conclusions: The findings lead to detection of potential markers of conscious pain perception in patients with DOC, with important impact on therapeutic and rehabilitative management, and provide new information that may allow a better differential diagnosis.
KW - Laser evoked potentials
KW - minimally conscious state
KW - outcome evaluation
KW - pain
KW - vegetative state
UR - http://www.scopus.com/inward/record.url?scp=84947037275&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947037275&partnerID=8YFLogxK
U2 - 10.3109/02699052.2015.1071430
DO - 10.3109/02699052.2015.1071430
M3 - Article
C2 - 26362906
AN - SCOPUS:84947037275
VL - 29
SP - 1467
EP - 1474
JO - Brain Injury
JF - Brain Injury
SN - 0269-9052
IS - 12
ER -