Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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The assessment of the level of anesthesia is a very hard task, since no gold standard has stood out in the past three decades. Middle Latency Auditory Evoked Potential (MLAEP) is one of the most popular neurophysiological tools for anesthesia monitoring. Recently, Spectral Entropy (SpEn) has been introduced: it provides two different parameters, State Entropy (SE) and Response Entropy (RE). The aim of this prospective study is to check SpEn end-point, comparing it to MLAEPs in neurosurgical anesthesia. ⋯ Our results show that SpEn is able to discriminate between the levels of wakefulness and surgical anesthesia. However, the meaning of data showing a discrepancy between AAI and SpEn is not yet clear and calls for further study.
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Meta Analysis
Predicting coma and other low responsive patients outcome using event-related brain potentials: a meta-analysis.
A meta-analysis was performed to estimate the predictive power (odd ratio, OR) for awakening of auditory event-related potential (ERP) components in low responsive patients with stroke or hemorrhage, trauma, anoxic, post-operative, and metabolic encephalopathy etiologies. ⋯ The prognostic assessment of low responsive patients with auditory ERP should take into account both MMN and P300.
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Comparative Study
The pattern of auditory brainstem response wave V maturation in cochlear-implanted children.
Maturation of acoustically evoked brainstem responses (ABR) in hearing children is not complete at birth but rather continues over the first two years of life. In particular, it has been established that the decrease in ABR wave V latency can be modeled as the sum of two decaying exponential functions with respective time-constants of 4 and 50 weeks [Eggermont, J.J., Salamy, A., 1988a. Maturational time-course for the ABR in preterm and full term infants. Hear Res 33, 35-47; Eggermont, J.J., Salamy, A., 1988b. Development of ABR parameters in a preterm and a term born population. Ear Hear 9, 283-9]. Here, we investigated the maturation of electrically evoked auditory brainstem responses (EABR) in 55 deaf children who recovered hearing after cochlear implantation, and proposed a predictive model of EABR maturation depending on the onset of deafness. The pattern of EABR maturation over the first 2 years of cochlear implant use was compared with the normal pattern of ABR maturation in hearing children. ⋯ Changes in EABR wave V latency over the first 2 years of cochlear implant use were found to be well fitted by the sum of two decaying exponential functions in children with early-onset deafness. This is in line with the maturation of ABR wave V latency in normal-hearing children over the first two years of life. Further studies are needed to assess whether the differences observed in terms of auditory pathways maturation are associated with consistent differences in terms of language development.
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Editorial Comment
Event-related potentials predict the outcome of the vegetative state.