Use of event related potential markers in patients with traumatic brain injury

Abstract

ObjectiveTo investigate whether event related potentials (ERP) could improve diagnosis and management of traumatic brain injury (TBI) patients in an outpatient setting.BackgroundThough important progress has been made in our understanding of how traumatic brain injury (TBI) affects the brain, diagnosis remains suboptimal, especially in the mild stages of the disease. A real time physiologic measure of brain cortical synaptic function such as event related potentials (ERP) can measure the sensory and cognitive deficits that follow TBI even at the subclinical stages of the disease. Even though the potential of ERP as a diagnostic tool for TBI has been known for several years, the impracticality of running ERP tests in clinical environments on real patients has limited widespread clinical application in the past. Recently, advances in electronics and analysis algorithms have made it practical for ERP tests to be administered in outpatient settings on real patients, thus creating an opportunity to evaluate ERP as an index of functional pathophysiology for TBI in clinical environments.Design/methodsThree patients with acute mild TBI were administered an auditory oddball ERP paradigm in conjunction with standard clinical evaluation.ResultsERPs were an informative measure for understanding covert deficits in cognition. Several ERP components revealed selective dysfunction following sport concussion. ERP testing in this case series increased confidence in diagnosis and prognosis for this population of sport-related concussion, thus leading to better patient management. Through this data, we are now equipped with better insight on which TBI patients would benefit most from the addition of ERP testing to the standard clinical workup.ConclusionsAnalysis of ERP data provides valuable information in patients with TBI, especially in mild cases where neuroimaging studies are non-revealing.