Developmental studies and clinical application of mismatch negativity: problems and prospects

There is wide interest in the clinical application of mismatch negativity (MMN) to assess discriminative capabilities in individuals whose auditory capacities are difficult to determine, including infants, young children and those with severe cognitive impairment. Before MMN can be used as a clinical electrophysiologic measure, it is necessary to establish that it can be reliably elicited in normal individuals. This chapter describes a detailed analysis of MMN recorded in a group of healthy 8-yr-old children to assess intrasubject and intersubject reliability of the response. We conclude that although statistically reliable results can be obtained with group data, and perhaps even in individuals when large numbers of stimuli can be delivered, the unfavorable signal to noise ratio of individual MMN data currently limits its clinical applicability. Suggestions for approaches to surmount these difficulties are presented for its eventual clinical usefulness.