H-Index
85
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
12%
Acceptance
Rate
call: +1.631.470.9640
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
AmJCaseRep

Annals
ISI-Home

eISSN: 1643-3750

Get your full text copy in PDF

Changes in Event-Related Potentials Underlying Coma Recovery in Patients with Large Left Hemispheric Infarction

Qingxia Jia, Yingying Su, Gang Liu, Zhongyun Chen

(Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China (mainland))

Med Sci Monit 2019; 25:5098-5113

DOI: 10.12659/MSM.917157


BACKGROUND: The aim of this study was to investigate changes in event-related potentials (ERPs) between coma and awakening in patients with large left hemispheric infarction (left LHI).
MATERIAL AND METHODS: Ten patients with left LHI who suffered coma and survived to awaken were enrolled in this study. The eye-opening subscore of the Glasgow Coma Scale (GCS) was used to assess the extent of patients’ arousal. ERPs elicited by the passive oddball paradigm were collected during coma and awakening states, respectively. Peak latencies, peak amplitudes, topography, and time-frequency information of P1, N1, P2, and mismatch negativity (MMN) were compared between the 2 sessions.
RESULTS: No significant differences in the peak amplitudes and peak latencies of P1 and N1, but significantly greater P2 amplitude with shorter latency in left hemisphere and midline was shown in the awakening state compared with that in coma. A marked shift of P2 topography in response to deviant tones was also seen, from the right centro-parieto-frontal areas during coma to left frontal-midline areas during awakening. MMN waveforms were not detected in 6/10 patients during the coma state, but these 6 patients all recovered to awakening. Evoked oscillations in bilateral hemisphere were profoundly inhibited during the coma state, with poor inter-trial phase synchronization, while obvious activities with broader frequency ranges and consistent inter-trial phase synchronization were observed during awakening state, and different frequency activities were distributed in distinct brain regions.
CONCLUSIONS: P2 may be a central index of coma recovery and a component of the arousal system. Changes in time-frequency information could provide more information during coma recovery, perhaps including some cognitive processing of the sensory stimulus.

Keywords: cerebral infarction, Coma, Consciousness, Evoked Potentials

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree