Abstract：
BACKGROUND: The objective of this study was to investigate the value of mismatch negativity (MMN) and P300 event-related potentials for discriminating the consciousness state and predicting improvement of consciousness at 6 months in patients with coma and other disorders of consciousness (DOC).
METHODS: We performed MMN and P300 on 42 patients with DOC with a mean onset time of 40.21 ± 19.43 days. These patients with DOC were categorized into coma, unresponsive wakefulness syndrome (UWS), minimal consciousness minus (MCS-), and minimal consciousness plus (MCS +) groups according to neurobehavioral assessment and the Coma Recovery Scale-Revised score. The primary outcome was the improvement of consciousness at 6 months in patients with DOC. We assessed the efficacy of MMN and P300 in quantitatively predicting the prognosis at 6 months and the capability of MMN and P300 parameters to differentiate between DOC.
RESULTS: At least one significant difference in either MMN or P300 parameters was displayed among the DOC groups, but not between the MCS- and MCS+ groups (significance level: 0.05). Both MMN and P300 amplitudes showed desirable predictive accuracy at 6 months, with areas under the curve (AUCs) of 0.859 and 0.856, respectively. The optimal thresholds for MMN and P300 amplitudes were 2.044 and 1.095 μV. However, the combined MMN-P300 amplitude showed better 6-month predictive accuracy (AUC 0.934, 95% confidence interval 0.860-1.000), with a sensitivity of 85% and a specificity of 90.9%.
CONCLUSIONS: MMN and P300 may help discriminate among coma, UWS, and MCS, but not between patients with MCS- and patients with MCS+ . The MMN amplitude, P300 amplitude, and especially combined MMN-P300 amplitude at 6 months may be interesting predictors of consciousness improvement at 6 months in patients with DOC.
BACKGROUND: Chinese Clinical Trial Registry identifier ChiCTR2400083798.
METHODS: We performed MMN and P300 on 42 patients with DOC with a mean onset time of 40.21 ± 19.43 days. These patients with DOC were categorized into coma, unresponsive wakefulness syndrome (UWS), minimal consciousness minus (MCS-), and minimal consciousness plus (MCS +) groups according to neurobehavioral assessment and the Coma Recovery Scale-Revised score. The primary outcome was the improvement of consciousness at 6 months in patients with DOC. We assessed the efficacy of MMN and P300 in quantitatively predicting the prognosis at 6 months and the capability of MMN and P300 parameters to differentiate between DOC.
RESULTS: At least one significant difference in either MMN or P300 parameters was displayed among the DOC groups, but not between the MCS- and MCS+ groups (significance level: 0.05). Both MMN and P300 amplitudes showed desirable predictive accuracy at 6 months, with areas under the curve (AUCs) of 0.859 and 0.856, respectively. The optimal thresholds for MMN and P300 amplitudes were 2.044 and 1.095 μV. However, the combined MMN-P300 amplitude showed better 6-month predictive accuracy (AUC 0.934, 95% confidence interval 0.860-1.000), with a sensitivity of 85% and a specificity of 90.9%.
CONCLUSIONS: MMN and P300 may help discriminate among coma, UWS, and MCS, but not between patients with MCS- and patients with MCS+ . The MMN amplitude, P300 amplitude, and especially combined MMN-P300 amplitude at 6 months may be interesting predictors of consciousness improvement at 6 months in patients with DOC.
BACKGROUND: Chinese Clinical Trial Registry identifier ChiCTR2400083798.
摘要：
背景：本研究的目的是探讨错配阴性（MMN）和P300事件相关电位在昏迷和其他意识障碍（DOC）患者6个月时辨别意识状态和预测意识改善的价值。
方法：我们对42例DOC患者进行了MMN和P300，平均起效时间为40.21±19.43天。这些患有DOC的患者被归类为昏迷，反应迟钝的觉醒综合征（UWS），最小意识减去(MCS-)，根据神经行为评估和昏迷恢复量表修订评分，以及最低意识加（MCS）组。主要结果是DOC患者在6个月时意识的改善。我们评估了MMN和P300在6个月时定量预测预后的功效以及MMN和P300参数区分DOC的能力。
结果：在DOC组中显示出至少一个MMN或P300参数的显着差异，但在MCS-组和MCS+组之间没有(显著性水平:0.05)。MMN和P300振幅在6个月时均显示出理想的预测准确性，曲线下面积（AUC）分别为0.859和0.856。MMN和P300振幅的最佳阈值为2.044和1.095μV。然而,组合的MMN-P300振幅显示出更好的6个月预测准确性（AUC0.934，95％置信区间0.860-1.000），灵敏度为85%，特异性为90.9%。
结论：MMN和P300可能有助于区分昏迷，UWS,MCS,但不是在MCS患者和MCS+患者之间。MMN振幅，P300振幅,尤其是6个月时的MMN-P300振幅组合可能是DOC患者6个月时意识改善的有趣预测因子。
背景：中国临床试验注册标识符ChiCTR2400083798。
方法：我们对42例DOC患者进行了MMN和P300，平均起效时间为40.21±19.43天。这些患有DOC的患者被归类为昏迷，反应迟钝的觉醒综合征（UWS），最小意识减去(MCS-)，根据神经行为评估和昏迷恢复量表修订评分，以及最低意识加（MCS）组。主要结果是DOC患者在6个月时意识的改善。我们评估了MMN和P300在6个月时定量预测预后的功效以及MMN和P300参数区分DOC的能力。
结果：在DOC组中显示出至少一个MMN或P300参数的显着差异，但在MCS-组和MCS+组之间没有(显著性水平:0.05)。MMN和P300振幅在6个月时均显示出理想的预测准确性，曲线下面积（AUC）分别为0.859和0.856。MMN和P300振幅的最佳阈值为2.044和1.095μV。然而,组合的MMN-P300振幅显示出更好的6个月预测准确性（AUC0.934，95％置信区间0.860-1.000），灵敏度为85%，特异性为90.9%。
结论：MMN和P300可能有助于区分昏迷，UWS,MCS,但不是在MCS患者和MCS+患者之间。MMN振幅，P300振幅,尤其是6个月时的MMN-P300振幅组合可能是DOC患者6个月时意识改善的有趣预测因子。
背景：中国临床试验注册标识符ChiCTR2400083798。
