Level of consciousness as a conditioning factor of F wave generation in stroke patients

Objective The current study aimed to investigate whether the level of consciousness influenced the F wave generation, as an independent factor. Methods Forty three patients with acute stroke were divided according to their level of consciousness in two groups; to those with Glasgow scale (GCS) score 3–7 indicating coma (group I) and those with GCS score 8–15 (group II). A series of 40 electrical stimuli were delivered to the ulnar nerve bilaterally in order to obtain F waves. The following variables were estimated and then compared between groups: F persistence, F wave latency, amplitude and duration. All studies were performed within 3 days from the onset of the stroke symptoms. Results The main finding to emerge was the significantly reduced F wave persistence in the group of patients with low GCS score as opposed to patients allocated in the group with GCS score 8–15. This result is referred to F waves obtained from both the affected and unaffected limb. F wave minimum latency was also prolonged in the group with low GCS score, whilst the comparison of all other F wave variables revealed no significant differences between groups I and II. F wave persistence measurements did not differ between the affected and unaffected sides. Stroke location and type (ischemic or hemorrhagic) were not associated with alterations of F wave measurements. Conclusions Our results on stroke patients suggest that generation of F waves, expressed by the F wave persistence is associated with the level of consciousness. Significance F wave study may be useful as an objective measure in documenting the severity of consciousness impairment.