title: Assessment of nociceptive system in vegetative and minimally conscious state by using laser evoked potentials.
abstract: OBJECTIVE
  The aim of this study is to assess if laser evoked potentials (LEPs) examination should be considered as an objective evidence of potential or residual pain perception capacity in vegetative (VS) and minimally conscious state (MCS) patients and if it could be a feasible methodology in order to differentiate these two clinical entities.
  
  
  METHODS
  This is a cross-sectional observational study focusing on the role of LEP examination, which is an easy and objective neurophysiological approach of the nociceptive system.
  
  
  METHODS
  Thirteen VS and 10 MCS patients were enrolled. All subjects were evaluated clinically by using validated behavioural scales and underwent to upper and lower limbs LEP recording.
  
  
  RESULTS
  Intra-group LEPs analysis in VS patients highlighted significant differences for N2P2 latency (p = 0.036) and amplitude (p = 0.018). Inter-group LEPs analysis showed significant differences in post-anoxic condition for N2P2 latency (p = 0.034), amplitude (p = 0.034) and a trend in N2P2 latency in brain trauma (p = 0.07). Interestingly, correlation analysis showed a significant relationship between N2P2 amplitude and Coma Recovery Scale-Revised scoring in the post-traumatic VS (r = 0.823, p = 0.044).
  
  
  CONCLUSIONS
  The findings lead to detection of potential markers of conscious pain perception in patients with DOC, with important impact on therapeutic and rehabilitative management, and provide new information that may allow a better differential diagnosis.
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.
authors.forename: S
authors.initials: S
authors.lastname: De Salvo
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.
authors.forename: A
authors.initials: A
authors.lastname: Naro
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.
authors.forename: L
authors.initials: L
authors.lastname: Bonanno
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.
authors.forename: M
authors.initials: M
authors.lastname: Russo
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.
authors.forename: N
authors.initials: N
authors.lastname: Muscarà
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.
authors.forename: P
authors.initials: P
authors.lastname: Bramanti
authors.affiliation: a IRCCS Centro Neurolesi 'Bonino-Pulejo' , Messina , Italy and.|b Department of Biomedical Sciences and Morphological and Functional Imaging , University of Messina , Messina , Italy.
authors.forename: S
authors.initials: S
authors.lastname: Marino
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000175:diagnosis; D003128:Coma; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D066331:Laser-Evoked Potentials / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009619:Nociceptors / Q000378:metabolism / Q000502:physiology*; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D018458:Persistent Vegetative State / Q000175:diagnosis*; D020127:Recovery of Function
keywords: Laser evoked potentials; minimally conscious state; outcome evaluation; pain; vegetative state