Post-acute P300 predicts recovery of consciousness from traumatic vegetative state

Marianna Cavinato, Ulderico Freo, Carlo Ori, Manuel Zorzi, Paolo Tonin, Francesco Piccione, Antonio Merico

Research output: Contribution to journalArticle

Abstract

Background: Evoked potentials allow one to assess functional integrity of sensory pathways projecting to primary sensory cortices and event-related potentials assess higher order cortical functions associated with stimulus detection and decision-making. Evoked and event-related potentials have been used to predict emergence from coma. This study aimed to determine whether they can help prediction of consciousness recovery in post-traumatic vegetative state (VS). Methods: Thirty-four patients in post-traumatic VS were assessed clinically and neurophysiologically at 2-3 months after injury and followed up to 1 year. Patients were assessed with the Disability Rating Scale (DRS) and with electroencephalogram (EEG), brainstem auditory (BAEP) and somatosensory evoked potentials (SEP) and P300. Demographic, clinical and neurophysiological measures were analysed by descriptive and logistic regression techniques. Results: At 1 year from injury, 26 patients (76%) had recovered consciousness and eight patients (24%) had not. In univariate analyses, a detectable P300, a reactive EEG and lower DRS scores were found at entry assessment more frequently (p 0.05) in patients who later recovered consciousness than in those who did not. Logistic regression analysis revealed that P300 was the only factor contributing to prediction of conscious recovery with an area under the ROC curve of 0.94 (95% CI, 0.80-0.99). Conclusions: P300 is a strong predictor of conscious recovery in VS.

Original languageEnglish
Pages (from-to)973-980
Number of pages8
JournalBrain Injury
Volume23
Issue number12
DOIs
Publication statusPublished - Nov 2009

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Keywords

  • Brainstem auditory evoked potentials
  • Disability Rating Scale
  • Electroencephalogram
  • P300
  • Sensory evoked potentials
  • Vegetative state

ASJC Scopus subject areas

  • Clinical Neurology

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