Catherine Fischer1, Frédéric Dailler, Dominique Morlet. 1. Hospices Civils de Lyon, Neurological Hospital Lyon, Clinical Neurophysiology Unit, 59 Blvd. Pinel, F-69677, Bron cedex, France. catherine.fischer@chu-lyon.fr
Abstract
OBJECTIVE: To assess patterns of novelty P3 elicited by the subject's own name (SON) in comatose patients and to compare SON novelty P3 prognostic value with that of mismatch negativity (MMN). METHODS: A passive oddball paradigm, previously validated in healthy subjects, including duration deviants and SON presented as a novel was applied in 50 severe comatose patients on average 20 days after coma onset. The outcome was assessed 3 months after coma onset. RESULTS: MMN to deviants was found in 14/50 patients and a central-parietal P3 to SON was found in 21/50 patients. In 12 patients, a parietal component (P3b) was also clearly present in the late part of P3. Four patients showed an MMN but no P3. Eleven patients had a novelty P3, with a late parietal component for 5 of them, but no MMN. The presence of a P3 was highly correlated with awakening. Compared to MMN, P3 showed as large a specificity for awakening (0.85). It showed a much higher sensitivity (0.71 versus 0.42). All but one patient with P3b woke up. CONCLUSIONS: The use of novelty P3 elicited by SON increases the prognostic value of MMN alone and improves the assessment of comatose patients by demonstrating the activation of higher-level cognitive functions in some of them. It shows that unconsciously perceived stimuli are processed and activate brain areas similarly to consciously perceived stimuli. SIGNIFICANCE: SON as a novel in an MMN design can be used to increase the prognostic value of ERPs in comatose patients and to assess unconscious cognitive processes in uncommunicative patients.
OBJECTIVE: To assess patterns of novelty P3 elicited by the subject's own name (SON) in comatosepatients and to compare SON novelty P3 prognostic value with that of mismatch negativity (MMN). METHODS: A passive oddball paradigm, previously validated in healthy subjects, including duration deviants and SON presented as a novel was applied in 50 severe comatosepatients on average 20 days after coma onset. The outcome was assessed 3 months after coma onset. RESULTS: MMN to deviants was found in 14/50 patients and a central-parietal P3 to SON was found in 21/50 patients. In 12 patients, a parietal component (P3b) was also clearly present in the late part of P3. Four patients showed an MMN but no P3. Eleven patients had a novelty P3, with a late parietal component for 5 of them, but no MMN. The presence of a P3 was highly correlated with awakening. Compared to MMN, P3 showed as large a specificity for awakening (0.85). It showed a much higher sensitivity (0.71 versus 0.42). All but one patient with P3b woke up. CONCLUSIONS: The use of novelty P3 elicited by SON increases the prognostic value of MMN alone and improves the assessment of comatosepatients by demonstrating the activation of higher-level cognitive functions in some of them. It shows that unconsciously perceived stimuli are processed and activate brain areas similarly to consciously perceived stimuli. SIGNIFICANCE: SON as a novel in an MMN design can be used to increase the prognostic value of ERPs in comatosepatients and to assess unconscious cognitive processes in uncommunicative patients.
Authors: Betty Wutzl; Stefan M Golaszewski; Kenji Leibnitz; Patrick B Langthaler; Alexander B Kunz; Stefan Leis; Kerstin Schwenker; Aljoscha Thomschewski; Jürgen Bergmann; Eugen Trinka Journal: Brain Sci Date: 2021-05-25
Authors: Giulio E Lancioni; Andrea Bosco; Marta Olivetti Belardinelli; Nirbhay N Singh; Mark F O'Reilly; Jeff Sigafoos; Francesca Buonocunto; Jorge Navarro; Crocifissa Lanzilotti; Fiora D'Amico; Marina De Tommaso Journal: Front Hum Neurosci Date: 2014-02-10 Impact factor: 3.169