title: The P300 in middle cerebral artery strokes or hemorrhages: Outcome predictions and source localization.
abstract: OBJECTIVE
  There are no reliable outcome predictors for severely impaired patients suffering from large infarctions or hemorrhages within the territory of the middle cerebral artery. This study investigated whether the amplitude of the event-related potential (ERP) component P300 predicts if a patient will be transferred to the next stage of rehabilitation (positive outcome) or to a nursing home (negative outcome). The second goal was to look for lesion locations determining the generation of the P300 amplitude.
  
  
  METHODS
  Forty-seven patients performed an auditory oddball task to elicit the P300 and were assessed with different scores for activities of daily living (ADL). Patients were divided in two groups according to their outcome. P300 amplitudes were compared between these groups controlling for age and gender. Post-hoc analyses were performed to analyse the relationship between P300 amplitude and neurological outcome scores. In addition, lesion overlaps were created to detect which lesion pattern affects P300 generation.
  
  
  RESULTS
  Patients with a positive outcome showed higher P300 amplitudes at frontal electrode sites than those with a negative outcome. P300 amplitude correlated with ADL score difference. Lesions in the superior temporal gyrus, middle and inferior frontal and prefrontal regions led to visibly diminished P300 amplitudes.
  
  
  CONCLUSIONS
  The findings suggest that an impairment of attention (P300 amplitude reduction) negatively influences successful neurological rehabilitation. Left superior temporal lobe and the left premotor/prefrontal areas are essential brain areas for the generation of the P300.
  
  
  CONCLUSIONS
  P300 amplitude may be used as an outcome predictor for severely impaired patients suffering from middle cerebral artery strokes or hemorrhages.
authors.affiliation: Klinikum Bremen-Ost, Department of Neurology, Züricher Str. 40, 28325 Bremen, Germany; University of Bremen, Center for Cognitive Sciences, 28359 Bremen, Germany; University of British Columbia, Department of Psychology, Vancouver, BC V6T 1Z4, Canada.
authors.forename: Mana R
authors.initials: MR
authors.lastname: Ehlers
authors.affiliation: Klinikum Bremen-Ost, Department of Neurology, Züricher Str. 40, 28325 Bremen, Germany.
authors.forename: Carmen
authors.initials: C
authors.lastname: López Herrero
authors.affiliation: Klinikum Bremen-Ost, Department of Neurology, Züricher Str. 40, 28325 Bremen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kastrup
authors.affiliation: Klinikum Bremen-Ost, Department of Neurology, Züricher Str. 40, 28325 Bremen, Germany; University of Oldenburg, Institute of Psychology, 26111 Oldenburg, Germany. Electronic address: helmut.hildebrandt@uni-oldenburg.de.
authors.forename: Helmut
authors.initials: H
authors.lastname: Hildebrandt
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001288:Attention / Q000502:physiology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D002543:Cerebral Hemorrhage / Q000503:physiopathology* / Q000534:rehabilitation; D004569:Electroencephalography; D018913:Event-Related Potentials, P300 / Q000502:physiology*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000503:physiopathology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D011930:Reaction Time / Q000502:physiology; D016896:Treatment Outcome
keywords: Early rehabilitation; Lesion localization; Outcome prediction; P300; Severe impairment; Stroke