Hospices Civils de Lyon, Neurological Hospital, Department of Clinical Neurophysiology, Lyon, France.
Clin Neurophysiol. 2010 Jul;121(7):1032-42. doi: 10.1016/j.clinph.2010.02.005. Epub 2010 Mar 3.
To assess markers of cognition, if any, in patients in a permanent vegetative state (PVS).
Event-related potential (ERP) mapping was performed on 27 patients in permanent (4-261 months after coma onset) vegetative (PVS, n=16) or minimally conscious states (MCS, n=11) due to anoxia (n=18) or other aetiologies (n=9). Mismatch negativity (MMN) to duration-deviant tones and novelty P3 (nP3) to the subject's own name were recorded according to a paradigm previously validated in healthy volunteers and comatose patients. SEPs, MLAEPs and BAEPs were also recorded.
MMN was present in 5/27 and nP3 in 7/27 patients. ERPs were not related to the time from coma onset and not different in MCS and in PVS. Normal SEPs and MLAEPs, and present nP3s were less frequent in anoxia than in other aetiologies.
Irrespective of their clinical assessment, a few patients are likely to process sound deviance (MMN) or novelty (nP3), mainly when their state is not due to anoxia.
Some PVS patients may be able to put certain awareness marker processes to work. The diagnostic criteria for PVS or MCS, currently based on mere behaviour, should also include functional brain investigations, such as ERPs, related to the aetiology.
评估处于永久性植物状态（PVS）患者的认知标志物。
对 27 例因缺氧（n=18）或其他病因（n=9）导致永久性（昏迷后 4-261 个月）植物状态（PVS，n=16）或最小意识状态（MCS，n=11）的患者进行事件相关电位（ERP）映射。根据先前在健康志愿者和昏迷患者中验证的范式，记录时长偏差音的失匹配负波（MMN）和受试者自身姓名的新颖性 P3（nP3）。还记录了 SEPs、MLAEPs 和 BAEPs。
27 例患者中，有 5 例出现 MMN，7 例出现 nP3。ERPs 与昏迷发作后的时间无关，且在 MCS 和 PVS 中没有差异。正常 SEPs 和 MLAEPs 以及存在的 nP3 在缺氧患者中比其他病因患者更少见。
无论临床评估如何，少数患者可能会处理声音偏差（MMN）或新颖性（nP3），主要是当他们的状态不是由于缺氧引起时。
一些 PVS 患者可能能够利用某些意识标志物过程。目前基于单纯行为的 PVS 或 MCS 的诊断标准，还应包括与病因相关的功能性脑研究，如 ERP。
