Brain response to one's own name in vegetative state, minimally conscious state, and locked-in syndrome

Arch Neurol. 2006 Apr;63(4):562-9. doi: 10.1001/archneur.63.4.562.

Abstract

Background: A major challenge in the management of severely brain-injured patients with altered states of consciousness is to estimate their residual perception of the environment.

Objective: To investigate the integrity of detection of one's own name in patients in a behaviorally well-documented vegetative state (VS), patients in a minimally conscious state (MCS), and patients with locked-in syndrome.

Design: We recorded the auditory evoked potentials to the patient's own name and to 7 other equiprobable first names in 15 brain-damaged patients.

Results: A P3 component was observed in response to the patient's name in all patients with locked-in syndrome, in all MCS patients, and in 3 of 5 patients in a VS. P3 latency was significantly (P<.05) delayed for MCS and VS patients compared with healthy volunteers.

Conclusions: These results suggest that partially preserved semantic processing could be observed in noncommunicative brain-damaged patients, notably for the detection of salient stimuli, such as the subject's own name. This function seems delayed in MCS and (if present) in VS patients. More important, a P3 response does not necessarily reflect conscious perception and cannot be used to differentiate VS from MCS patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acoustic Stimulation
  • Adult
  • Aged
  • Aged, 80 and over
  • Attention / physiology
  • Brain / pathology
  • Brain / physiopathology*
  • Event-Related Potentials, P300 / physiology*
  • Evoked Potentials, Auditory / physiology
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Persistent Vegetative State / diagnosis*
  • Persistent Vegetative State / physiopathology
  • Predictive Value of Tests
  • Quadriplegia / diagnosis*
  • Quadriplegia / physiopathology
  • Speech Perception / physiology