[Long-latency components (N100, N200 and P300) of acoustic evoked potentials in prediction of mental recovery in severe traumatic brain injury].

: The authors analyzed correlations of amplitude and latency levels of N100, N200 and P300 components of acoustic evoked potentials (AEP) registered during sonic stimulation and counting of target-oriented stimuli in 22 patients in vegetative state and mutism as an outcome of traumatic brain injury. Results were analyzed with association of electrophysiological findings with data of diffusion-tensor MRI. 55 healthy volunteers were included into control group. It is described that patients in vegetative state with formal recovery to the level of clear consciousness develop all three components of AEP in response to target-oriented tone. The instruction "to counts" leads to their better development. Patients with restoration to minimal level of consciousness produce all components during audition of sounds and only N100 and N200 in response to standard tone after instruction "to count". It is discovered that levels of amplitude have bigger correlation according to Spearman's criterion with outcome in comparison to latency. There changes are more prominent in N100 and N200 components rather in P300. In addition, after instruction "to count sounds" the registered changes between stages of vegetative state and mutism are significant for leads of left hemisphere, and during audition of sounds--for sagittal leads. The study showed correspondence of acquired changes with MRI data. Chronic unconscious state is associated with changes in corpus callosum (degeneration fibers) and corticospinal tracts in the brainstem. The data are discussed in light of hypothesis of the role of morphofunctional disconnections (brainstem-thalamus and interhemispheric) in impairment of attention and in genesis of different forms of posttraumatic unconscious state.