Wang Yao, Huang Kaibin, Wang Shengnan, Wang Honghao, Ji Zhong, Pan Suyue, Wu Yongming
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Front Neurol. 2018 Dec 17;9:1093. doi: 10.3389/fneur.2018.01093. eCollection 2018.
The 40-Hz steady state response (SSR) reflects early sensory processing and has the potential to differentiate disease severity. This study aims to evaluate the predictive value of 40-Hz SSRs on the prognosis of patients with large hemispheric infarction (LHI). We conducted a retrospective study in patients with LHI admitted to the neurological intensive care unit (NICU) of Nanfang Hospital, Southern Medical University, Guangzhou, China, between June 2008 and December 2014. Forty-hertz SSRs were recorded within 72 h of onset and categorized into 3 grades. The correlation between 40-Hz SSR grading and clinical outcome was examined. Of the 97 eligible participants, 41 (42.3%) died within 30 days and 68 (70.1%) exhibited a poor outcome (modified Rankin Scale of 5 and 6) at 90 days after the onset of LHI. We found that 40-Hz SSRs correlated significantly with NIHSS scores at admission and patient outcome. Moreover, Grade III 40-Hz SSR (bilateral sine waves that either disappeared or were not clearly identifiable) had a specificity of 97% and a positive predictive value of 94% in predicting 90-days poor outcome; Grade III 40-Hz SSR also had a specificity of 91% and a positive predictive value of 74% in predicting 30-days mortality. 40-Hz SSR could be used as a simple and specific method in predicting poor prognosis after LHI.
40赫兹稳态反应（SSR）反映早期感觉处理过程，并且有可能区分疾病严重程度。本研究旨在评估40赫兹SSR对大脑半球大面积梗死（LHI）患者预后的预测价值。我们对2008年6月至2014年12月期间在中国广州南方医科大学南方医院神经重症监护病房（NICU）收治的LHI患者进行了一项回顾性研究。在发病72小时内记录40赫兹SSR，并将其分为3个等级。研究了40赫兹SSR分级与临床结局之间的相关性。在97名符合条件的参与者中，41名（42.3%）在30天内死亡，68名（70.1%）在LHI发病90天后预后不良（改良Rankin量表评分为5分和6分）。我们发现40赫兹SSR与入院时的美国国立卫生研究院卒中量表（NIHSS）评分及患者结局显著相关。此外，III级40赫兹SSR（双侧正弦波消失或无法清晰识别）在预测90天不良结局时特异性为97%，阳性预测值为94%；III级40赫兹SSR在预测30天死亡率时特异性为91%，阳性预测值为74%。40赫兹SSR可作为预测LHI后预后不良的一种简单且特异的方法。
