Brain response to one's own name in vegetative state, minimally conscious state, and locked-in syndrome.
BACKGROUND
A major challenge in the management of severely brain-injured patients with altered states of consciousness is to estimate their residual perception of the environment.


OBJECTIVE
To investigate the integrity of detection of one's own name in patients in a behaviorally well-documented vegetative state (VS), patients in a minimally conscious state (MCS), and patients with locked-in syndrome.


METHODS
We recorded the auditory evoked potentials to the patient's own name and to 7 other equiprobable first names in 15 brain-damaged patients.


RESULTS
A P3 component was observed in response to the patient's name in all patients with locked-in syndrome, in all MCS patients, and in 3 of 5 patients in a VS. P3 latency was significantly (P<.05) delayed for MCS and VS patients compared with healthy volunteers.


CONCLUSIONS
These results suggest that partially preserved semantic processing could be observed in noncommunicative brain-damaged patients, notably for the detection of salient stimuli, such as the subject's own name. This function seems delayed in MCS and (if present) in VS patients. More important, a P3 response does not necessarily reflect conscious perception and cannot be used to differentiate VS from MCS patients.
Perrin
Fabien
F
Laboratoire de Neurosciences & Systèmes Sensoriels, UMR-5020, Université Claude Bernard Lyon 1-CNRS, 50 avenue Tony Garnier, 69366 Lyon CEDEX 07, France. fabien.perrin@univ-lyon1.fr
Schnakers
Caroline
C
Schabus
Manuel
M
Degueldre
Christian
C
Goldman
Serge
S
Brédart
Serge
S
Faymonville
Marie-Elisabeth
ME
Lamy
Maurice
M
Moonen
Gustave
G
Luxen
André
A
Maquet
Pierre
P
Laureys
Steven
S
D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D018913:Event-Related Potentials, P300 / Q000502:physiology*; D005072:Evoked Potentials, Auditory / Q000502:physiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011782:Quadriplegia / Q000175:diagnosis* / Q000503:physiopathology; D013067:Speech Perception / Q000502:physiology