Late auditory and event-related potentials can be useful to predict good functional outcome after coma.
OBJECTIVE
To investigate whether late auditory and event-related potentials, and in particular N100 and mismatch negativity, together with clinical parameters, can help to predict good functional outcome in comatose patients.


METHODS
Prospective cohort study.


METHODS
Hospital.


METHODS
Consecutively sampled comatose patients (N=346) whose etiologies of coma were stroke (125 patients), brain injury (96 patients), anoxia (64 patients), complication of neurosurgery (54 patients), and encephalitis (7 patients).


METHODS
Not applicable.


METHODS
Glasgow Outcome Scale score at 1 year postonset. Patients in a minimally conscious state and those who awoke and died during the follow-up period were classified separately.


RESULTS
Univariate analysis showed that all variables studied, except brainstem auditory evoked potentials, correlated significantly with functional outcome. Mismatch negativity showed the highest positive predictive value for good outcome. A validated model was obtained with multivariate logistic analysis, including pupillary light reflex, N100, mismatch negativity, etiology, and age.


CONCLUSIONS
Late auditory and event-related potentials, and particularly N100 and mismatch negativity, provide strong prognostic factors for good functional outcome. Furthermore, these components may enhance the accuracy of prognosis when associated with other clinical parameters available at the early stage of coma.
Luauté
Jacques
J
Rééducation Neurologique, Pavillon Delore, Hôpital H. Gabrielle, Hospices Civils de Lyon, France. jacques.luaute@chu-lyon.fr
Fischer
Catherine
C
Adeleine
Patrice
P
Morlet
Dominique
D
Tell
Laurence
L
Boisson
Dominique
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003128:Coma / Q000503:physiopathology*; D005071:Evoked Potentials / Q000502:physiology*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012025:Reflex, Pupillary / Q000502:physiology