Brain potentials in human patients with extremely severe diffuse brain damage

To test higher cortical functions of neurological patients, oddball tasks are often used in which a frequent and a rare stimulus are randomly presented and a P3 brain wave is recorded to the rare stimulus. We examined 33 patients with extremely severe brain injury. Three oddball conditions were used: with two sine tones (ST), with two complex tones (CT) and with vowels 'o' and 'i'. Across all patients, CT elicited P3 more often than ST, and the occurrence of the P3 after vowels was intermediate. However, among patients who showed a distinct P3 wave, its amplitude in the subgroup with traumatic brain injury was larger to vowels than to CT. In patients with non-traumatic etiology, CT and vowels elicited a P3 of a nearly equal amplitude. Stimuli of sufficient complexity should be used when the P3 technique is applied for assessment of cortical functions in severely impaired patients.