The use of event-related potential (P300) and neuropsychological testing to evaluate cognitive impairment in mild traumatic brain injury patients
Puneet Nandrajog1, Zamzuri Idris2, Wan Nor Azlen3, Alwani Liyana3, Jafri Malin Abdullah2
1 Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan; Department of Neurosurgery, Kuala Lumpur Hospital, Kelantan, Malaysia
2 Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan; Center for Neuroscience Services and Research, University of Science Malaysia, Jalan Sultanah Zainab 2, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
3 Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan
Source of Support: None, Conflict of Interest: None
Background: The aim of the study is to compare the amplitude and latency of the P300 event-related potential (ERP) component between a control group and patients after mild traumatic brain injury (mTBI) during 1-7 days (short duration) and 2-3 months (long duration), and to compare the outcome of neuropsychological tests between the long duration postinjury and control study groups.
Materials and Methods: We studied responses to auditory stimulation in two main and one subgroups, namely the control healthy group (19 patients, both ERP and neuropsychology test done), the mTBI 1 group (17 patients, only ERP done within 7 days after injury), and the mTBI 2 subgroup (the 17 mTBI 1 patients in whom a repeated ERP together with neuropsychological testing was done at 2-3 months postinjury). Auditory evoked responses were studied with two different stimuli (standard and target stimuli), where the P300 amplitude and latency were recorded from three midline sites and results were compared between the groups, as were the neuropsychological test results.
Results: There was a significant prolongation of the target P300 latency values shown by the MBI 1 group measured at the central electrode when compared to the control group, which was also seen when the mTBI 1 and mTBI 2 groups were compared. The results of the P300 amplitude values measured at the frontal electrode showed the control group to have higher readings during the presentation of standard tones when compared to the mTBI 1 group. The mTBI 2 group performed better on some neuropsychological tests.
Conclusion: The latency of P300 was significantly prolonged in early mTBI patients who improved over time, and the neuropsychological testing on mTBI 2 patients showed them to be comparable to the control group. The study indicates that ERP should be used as an additional modality of investigation in mTBI patients.