Correlation Between Brain Stem Auditory Evoked Potential And Behavioral Assessment In Patients With Prolong Disorders Of Consciousness

Objective:To investigate the correlation between brain stem auditory evoked potential and behavioral assessment in patients with prolong disorders of consciousness,provide more objective and accurate diagnostic results of consciousness level for patients with prolong disorders of consciousness,and reduce the misdiagnosis rate of individual behavioral assessment for patients with prolong disorders of consciousness.Methods:103 patients with prolong disorders of consciousness who were hospitalized in the Department of Rehabilitation Medicine of the First Affiliated Hospital of Nanchang University from November 2021 to January 2023 and who met the diagnostic criteria for prolong disorders of consciousness were selected as the subjects of this study.BAEP test and behavioral evaluation were carried out within 1week after admission and 4 weeks after treatment,including the full outline of unresponsiveness(FOUR),the coma recovery scale-revised scale(CRS-R).The behavioral evaluation was conducted continuously on the day of BAEP testing and 4days after treatment,and the best of the 5 evaluations was selected as the final result of the behavioral evaluation,Correlation analysis was performed on the evaluation results of BAEP,FOUR scale,and CRS-R scale after 1 week of admission and 4weeks of treatment.Results:An ordered multiple factor logistic regression was performed between the Cant grading and the sub item scores and total scores of the FOUR scale.The analysis results showed that there was a negative correlation between Cant grading and FOUR sub item scores and total scores at admission(p<0.01),with the largest regression coefficient between Cant grading and respiration(β=-12.564);After 4 weeks,there was a negative correlation between Cant grading and FOUR eye response,motor response,brainstem reflexs scores,and total score in the total score change group(p<0.01),with the largest regression coefficient between Cant grading and motor response(β=-2.122);In the group with no change in total score after 4weeks,there was a negative correlation between Cant grading and FOUR eye reaction and total score(p<0.01),with the largest regression coefficient between Cant grading and eye response(β=-18.614),there was no statistically significant correlation between motor response and brainstem reflexs.An ordered multiple factor logistic regression was performed between the Cant grading and the sub item scores and total scores of the CRS-R scale.The analysis results showed that there was a negative correlation between the Cant grading and the scores of auditory,visual,motor,oromotor and total scores of CRS-R at admission(p<0.01),and the regression coefficient between the Cant grading and the total score of CRS-R was the largest(β=-5.338);In the total score change group after 4 weeks,there was a negative correlation(p<0.05)between the Cant grading and the scores and total scores of all sub items of CRS-R,with the largest regression coefficient between the Cant grading and CRS-R communication(β=-4.227),there was a negative correlation between Cant rating and CRS-R vision,arousal processes sub item scores,and total score in the group with no change in total score after 4 weeks(p<0.01),with the largest regression coefficient between Cant grading and CRS-R vision(β=-20.228),and there was no statistically significant correlation with motor and oromotor subprojects.After stepwise linear regression analysis using the sub item scores and total scores of the two scales as independent variables and the Cant grading as dependent variables,it was found that the total FOUR score,brainstem reflexs,and CRS-R score were the main factors affecting the Cant grading.Conclusion:The Cant grading of BAEP in patients with PDOC was correlated with both the FOUR scale and the CRS-R scale,and the correlation coefficient with the CRS-R scale was greater than that with the FOUR scale.The Cant grading and FOUR scale were the most sensitive to changes in motor response and brainstem reflexs scores,while the CRS-R scale was the most sensitive to changes in auditory,motor,and oromotor scores;The total score of FOUR,brainstem reflexs,and total score of CRS-R are the main factors that affect the Cant grading of PDOC patients.Therefore,BAEP can dynamically monitor the consciousness level of patients with PDOC in clinical practice by combining behavioral assessments(especially the CRS-R scale),which can reduce the misdiagnosis rate of individual behavioral assessments and improve the accuracy of consciousness level assessment for patients with PDOC.