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Issue title: Life-Sustaining Treatments in Vegetative State: Scientific Advances and Ethical Dilemmas
Guest editors: Gian Luigi Giglix and Nathan D. Zaslery
Article type: Research Article
Authors: Schoenle, Paul W.; * | Witzke, W.
Affiliations: University of Konstanz and Neurological Rehabilitation Center NRC, Gustav-Ricker-Str. 4, D-39102 Magdeburg, Germany. Tel.: +49 391 610 1101; Fax: +49 391 610 1166; E-mail: paul.schoenle@uni-konstanz.de | [x] Department of Neurosciences, Ospedale “Santa Maria della Misericordia”, Udine, Italy | [y] Concussion Care Center of Virginia, Inc., Ltd., Tree of Life Services, Inc., Pinnacle Rehabilitation, Inc., Glen Allen, VA, USA
Correspondence: [*] Corresponding author.
Note: [1] See also [14].
Abstract: Event-related potentials (ERPs) can provide valuable information about cognitive capabilities in severely brain-damaged patients. This study examined 120 patients with severe brain damage using event related potentials ERPs (N 400) to gain information about their remaining semantic processing capabilities and to contribute to differential diagnosis. Patients were classified into three diagnostic groups: patients in vegetative state (VS), patients in near vegetative state (NEVS) and patients not in vegetative state (NOVS). N400 ERPs were analyzed on an individual basis. All three groups could be differentiated by N400. While VS-patients as a group were least likely to show N400, some VS-patients (approx. 12%) showed clear semantic N400 potentials as an indication of semantic processing capabilities. Patients in NEVS showed significantly more intact semantic capabilities (76.74%) than the VS-group despite little clinical differences between the two groups. Thus, ERPs provide valuable information about patients with brain injury whose clinical conditions often do not allow a true assessment of their cognitive capabilities. Given these findings, we would espouse that both ethical and legal debate should take into account results of ERP studies of such patients.
Keywords: N400, semantic processing, vegetative state, minimally conscious state, severe brain injury
DOI: 10.3233/NRE-2004-19409
Journal: NeuroRehabilitation, vol. 19, no. 4, pp. 329-334, 2004
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