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Background <p>The objective of this study was to evaluate the relationship between the N20-P25 amplitude of short-latency somatosensory evoked potentials (SSEPs) and neurologic outcomes in patients in a coma state.</p> Methods <p>We retrospectively enrolled neurocritical patients who were older than 18&#xa0;years; were admitted to the Department of Critical Medicine, Xiangya Hospital, Central South University, from January 2017 to January 2021 for 1–3&#xa0;days; had a Glasgow Coma Scale score ≤ 8; had a body temperature ≥ 35&#xa0;°C; and had SSEP records. Good outcome was defined as Cerebral Performance Category scores 1–3 at 1&#xa0;year. The specificity and sensitivity of different SSEP patterns and amplitudes were calculated.</p> Results <p>A total of 457 patients were included in this study. The N20-P25 amplitude can be used for predicting awakening for traumatic brain injury (TBI) (area under the curve [AUC] 0.70, <i>p</i> = 0.0077), aneurysmal subarachnoid hemorrhage (SAH) (AUC 0.69, <i>p</i> = 0.005), intracerebral hemorrhage (ICH) (AUC 0.69, <i>p</i> = 0.005), and cardiac arrest (CA) (AUC 0.72, <i>p</i> = 0.0077). An N20-P25 amplitude &gt; 1.6&#xa0;μV predicted awakening in CA, with a sensitivity of 100% (95% confidence interval [CI] 81.6–100%) and specificity of 46.7% (95% CI 30.9–60.9%). In SAH, an N20-P25 amplitude &gt; 0.74&#xa0;μV predicted the sensitivity and specificity of awakening were 100% (95% CI 93.8–100%) and 16% (95% CI 8.3–28.5%), respectively. In TBI, an N20-P25 amplitude &gt; 1.20&#xa0;μV predicted awakening with a sensitivity of 100% (95% CI 86.2–100%) and a specificity of 34.2% (95% CI 21.2–50.1%). An N20-P25 amplitude &gt; 0.65&#xa0;μV predicted the sensitivity and specificity of awakening in ICH were 100% (95% CI 91.0–100%) and 14.3% (95% CI 5.7–31.5%), respectively.</p> Conclusions <p>N20-P25 amplitude can predict awakening in patients in a coma state at 1&#xa0;year. Different diseases have different cutoff values for predicting awakening.</p>

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N20-P25 Amplitude can Predict Awakening from Coma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月11日

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  • Li Huang,
  • Zhi-han Li,
  • Mei-lin Ai,
  • Qi Liu,
  • Qian-yi Peng,
  • Mi-lin Peng,
  • Chun-guang Zhao,
  • Li-na Zhang

摘要

Background

The objective of this study was to evaluate the relationship between the N20-P25 amplitude of short-latency somatosensory evoked potentials (SSEPs) and neurologic outcomes in patients in a coma state.

Methods

We retrospectively enrolled neurocritical patients who were older than 18 years; were admitted to the Department of Critical Medicine, Xiangya Hospital, Central South University, from January 2017 to January 2021 for 1–3 days; had a Glasgow Coma Scale score ≤ 8; had a body temperature ≥ 35 °C; and had SSEP records. Good outcome was defined as Cerebral Performance Category scores 1–3 at 1 year. The specificity and sensitivity of different SSEP patterns and amplitudes were calculated.

Results

A total of 457 patients were included in this study. The N20-P25 amplitude can be used for predicting awakening for traumatic brain injury (TBI) (area under the curve [AUC] 0.70, p = 0.0077), aneurysmal subarachnoid hemorrhage (SAH) (AUC 0.69, p = 0.005), intracerebral hemorrhage (ICH) (AUC 0.69, p = 0.005), and cardiac arrest (CA) (AUC 0.72, p = 0.0077). An N20-P25 amplitude > 1.6 μV predicted awakening in CA, with a sensitivity of 100% (95% confidence interval [CI] 81.6–100%) and specificity of 46.7% (95% CI 30.9–60.9%). In SAH, an N20-P25 amplitude > 0.74 μV predicted the sensitivity and specificity of awakening were 100% (95% CI 93.8–100%) and 16% (95% CI 8.3–28.5%), respectively. In TBI, an N20-P25 amplitude > 1.20 μV predicted awakening with a sensitivity of 100% (95% CI 86.2–100%) and a specificity of 34.2% (95% CI 21.2–50.1%). An N20-P25 amplitude > 0.65 μV predicted the sensitivity and specificity of awakening in ICH were 100% (95% CI 91.0–100%) and 14.3% (95% CI 5.7–31.5%), respectively.

Conclusions

N20-P25 amplitude can predict awakening in patients in a coma state at 1 year. Different diseases have different cutoff values for predicting awakening.