Quantified EEG and cortical evoked responses in patients with chronic traumatic frontal lesions

Eighteen frontal trauma patients and 17 age-matched control subjects had quantified EEGs and measurements of sensory (SEP) and auditory evoked potentials (P300) using a Biologic Brain Atlas III system. The findings were compared to the conventional paper EEG, and to the frontal lesion volumes, severity of head injury, and outcome variables. The quantified EEG confirmed the pathological findings detected by visual inspection, but some regional abnormalities were more easily detected by topographic mapping. The regional distribution of pathological slowing corresponded well with the morphological lesions in most patients. The modal frequency of EEG correlated both with lesion volume and injury severity and with the outcome variables. There were no pathological findings in the SEPs, and all but one patient had clearly distinguishable P300 responses. There was a significant reduction in P300 amplitude in the frontal patients at the anterior, but not at the posterior electrodes. The topographical distribution of the P300 changes corresponded well with the morphological lesions. Our findings indicate that the P300 potential is, in part, dependent upon the prefrontal cortical areas. The present study thus supports P300 investigations which have shown amplitude reduction in other disorders (e.g., schizophrenia) with a presumed prefrontal dysfunction.