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[Mismatch negativity and conscience level in severe traumatic brain injury].

D Zarza-Luciáñez1, S Arce-Arce, H Bhathal

  • 1Unidad Asistencial San Vicente, Neurologia, Neurofisiologia y Rehabilitacion Cerebral, Madrid, Spain. dzarza@hotmail.com

Revista De Neurologia
|April 25, 2007
PubMed
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Mismatch negativity (MMN) effectively distinguishes vegetative state from minimally conscious state in severe traumatic brain injury (TBI) patients. This auditory evoked potential aids in accurate diagnosis and improves patient management.

Area of Science:

  • Neuroscience
  • Clinical Neurophysiology
  • Brain Injury Research

Context:

  • Severe traumatic brain injury (TBI) can lead to disorders of consciousness, including vegetative state (VS) and minimally conscious state (MCS).
  • Accurate diagnosis is crucial for prognosis and therapeutic management, but differentiating VS from MCS can be challenging.
  • The mismatch negativity (MMN) is an auditory evoked potential reflecting automatic attentional processing.

Purpose:

  • To assess the diagnostic utility of MMN in distinguishing between VS and MCS in patients with severe TBI during the subacute phase.
  • To evaluate MMN as a tool for improving diagnostic accuracy in patients with altered consciousness post-TBI.

Summary:

  • MMN was recorded in 19 patients (8 VS, 11 MCS) with severe TBI, more than two months post-injury.

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  • 100% of MCS patients exhibited MMN, while 87.5% of VS patients did not.
  • The single VS patient who showed MMN later improved to MCS, suggesting MMN's predictive value.

    • Impact:

    • MMN serves as a valuable tool for differentiating VS from MCS in severe TBI, aiding clinical evaluation.
    • Utilizing MMN can reduce diagnostic errors, positively impacting therapeutic strategies, family decisions, and healthcare costs.
    • MMN may also be applicable for assessing other conditions involving altered consciousness.