Volume 29, Issue 4, 2020


DOI: 10.24205/03276716.2020.820

Short-latency somatosensory-evoked potentials have prognostic value in patients with acute cerebral infarction


Abstract
Background Cerebral infarction (CI), especially acute severe cerebral infarction, has high disability and fatality rates. Thus, efficient methods for evaluating brain function, implementing medical measures, distributing medical resources and selecting the treatment regimens are of great importance. Short-latency somatosensory-evoked potential (SLSEP), which can be assessed beside the bed, is an ideal tool for assessing brain function because it is unaffected by sedative drugs and state of consciousness. As one of its main parameters, N20 amplitude can directly reflect the number of reservations in medial lemniscus, whose relative integrity is an important influencing factor for CI. Therefore, it has become the focus of studies on the prognosis of brain injury. Aims The aims of this study are as follows: to evaluate the Judson grading standard of SLSEP and the predictive value of affected side N20 amplitude in the prognosis of patients with acute cerebral infarction and establish the ROC curve of the N20 amplitude of the affected side and Judson grading standard in assessment of CI. Methods A total of 50 patients with acute cerebral infraction who are admitted to the intensive care unit of the neurology department of Zhongda Hospital affiliated to Southeastern China University from January 2017 to September 2018 were included in the study. All of them were tested using SLSEP in one week. The NIHSS score and Rankin score (Modified Rankin Scale) were recorded on the first day and after 3 months, respectively. SPSS22.0 and MedCalc15.1 software were adopted for statistical analysis. Results 1) A significant negative correlation between SLSEP N20 amplitude in the affected side and NIHSS score (p<0.05) and a significant positive correlation between Judson grading standard and NIHSS score are observed (p<0.05). 2) The sensitivity, specificity and accuracy of the N20 amplitude in the affected side predicting the prognosis of patients with acute cerebral infarction are 95.7%, 73.2% and 84%, respectively. Its forecast cutoff is 1.08 uV. The sensitivity, specificity and accuracy of Judson grading predicting the CI patients’ prognosis are 95.7%, 74.1% and 82%, respectively. 3) The prognostic values of N20 amplitude and Judson grading standard have no significant differences (p=0.9324). Conclusion 1) The SLSEP N20 amplitude in the affected side and the Judson grading standard may be used for assessing prognosis in patients with acute cerebral infarction after 3 months. No significant differences between the two methods in predicting prognosis. 2) The cutoff value of N20 amplitude of the affected side in predicting the prognosis of patients with CI is 1.085uV after 3 months.

Keywords
short-latency somatosensory-evoked potentials, N20 amplitude, Judson grading standard, cerebral infarction, prognosis.

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