The Combination of N60 with Mismatch Negativity Improves the Prediction of Awakening from Coma
- 21.07.2021
- Original work
Erschienen in:
- Verfasst von
- Yifei Liu
- Huijin Huang
- Yingying Su
- Miao Wang
- Yan Zhang
- Weibi Chen
- Gang Liu
- Mengdi Jiang
- Erschienen in
- Neurocritical Care | Ausgabe 3/2022
Abstract
Background
Our objective was to evaluate the use of event-related potentials and the middle-latency somatosensory evoked potential (MLSEP) for the prediction of awakening in coma, determine the evaluation day that evoked potentials (EPs) best predict an awakening outcome, and determine whether the mismatch negativity (MMN) combined with the MLSEP, when recorded at 7 days after coma, improved the prediction of awakening from coma.
Methods
Design prospective blinded cohort study. Setting neurointensive care unit of a university hospital. Patients 113 consecutive patients who were severely comatose, whose etiologies of coma included stroke (65 patients), hypoxic-ischemic encephalopathy (28 patients), intracranial infection (6 patients), and other (14 patients). Interventions none. Measurements we gathered Glasgow Coma Scale scores and recorded EPs for all patients who were comatose at 7, 14, and 30 days after coma onset, unless the patients returned to consciousness. The EPs examined included the MLSEP, the middle-latency auditory evoked potential, the N100, and the MMN. With telephone follow-up after 3 months, the patients were classified as awakening or nonawakening according to Glasgow Outcome Scale.
Results
When predicting an awakening outcome, at least the unilateral presence of the N60 had the highest sensitivity (82.7%), whereas the presence of the MMN showed the highest specificity (82.0%). The area under the receiver operating characteristic curve for the EPs were high at 7 days after coma onset. At 7 days after coma onset, the combination of the N60 and MMN offered good predictive performance for awakening (area under the receiver operating characteristic curve = 0.852, 95% confidence interval 0.765–0.940), with increased sensitivity (70.0%) and improved specificity (91.7%).
Conclusions
The N60 and MMN were the strongest prognostic factors for an awakening outcome. Furthermore, at 7 days after coma onset, the combination of the N60 and MMN improved the prediction of an awakening outcome in patients who were comatose.
Anzeige
- Titel
- The Combination of N60 with Mismatch Negativity Improves the Prediction of Awakening from Coma
- Verfasst von
-
Yifei Liu
Huijin Huang
Yingying Su
Miao Wang
Yan Zhang
Weibi Chen
Gang Liu
Mengdi Jiang
- Publikationsdatum
- 21.07.2021
- Verlag
- Springer US
- Erschienen in
-
Neurocritical Care / Ausgabe 3/2022
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961 - DOI
- https://doi.org/10.1007/s12028-021-01308-y
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
