Evaluation of brain function in patients with chronic disorder of consciousness by auditory mismatch negativity

Jun Xia ,Jun Wang ,Li Zhang ,Yang Yi ,Wei Miao ,Yuanyuan Dang ,Lixin Xu ,Xiaoyu Xia ,Jianghong He

doi:10.3760/cma.j.issn.1671-8925.2019.07.012

Abstract

Objective To investigate the application value of auditory mismatch negativity (aMMN) in evaluating the brain function of patients with chronic disorders of consciousness (DOC). Methods Thirty-three patients with DOC or escaped minimally conscious state (eMCS), admitted to our hospital from April to June 2018, were selected in this study. Based on the levels of consciousness assessed by Coma Recovery Scale-Revised (CRS-R), they were divided into vegetative state (VS) group, micro-consciousness state (MCS) group and eMCS group; 14 healthy subjects were included as control group. The differences of aMMN amplitude and latency in patients from different groups, patients with different etiologies and different lateral cerebra were compared. Pearson correlation analysis was used to determine the correlation between CRS-R scores and aMMN. Results (1) There was statistically significant difference in aMMN amplitude between patients from any two groups (P<0.05); as compared with that in the control group, the latency of VS group and MCS group was significantly increased (P< 0.05). (2) According to the etiology, the aMMN amplitude of brain injury group, cerebral hemorrhage group and hypoxic encephalopathy group was significantly lower than that of control group (P<0.05). (3) There was significant difference in the amplitude of aMMN between lesion side and contralateral side in 11 patients (t=5.798, P=0.000). (4) Statistical results showed that CRS-R scores were positively correlated with aMMN amplitude (R=0.876, P=0.000), but not with the latency (r=0.018, P=0.922). Conclusion The amplitude of aMMN is significantly positively correlated with levels of consciousness in DOC patients, which can be used as an important tool to assess the levels of consciousness and dynamically estimate the outcomes of consciousness in DOC patients. Key words: Auditory mismatch negativity; Disorder of consciousness; Brain function; Vegetative state

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