Ray P G, Meador K J, Smith J R, Wheless J W, Sittenfeld M, Clifton G L
Department of Neurology, Medical College of Georgia, Augusta 30912, USA.
Neurology. 1999 Mar 23;52(5):1044-9. doi: 10.1212/wnl.52.5.1044.
Studies of the mechanisms of conscious perception using direct cortical stimulation and recording techniques are rare. The clinical necessity to implant subdural electrode grids in epilepsy patients undergoing evaluation for surgery offers an opportunity to examine the role of stimulus parameters and evoked potentials in conscious perception.
Subjects included epilepsy patients with grids over somatosensory or occipital cortex. Single pulses (100 microseconds) and stimulus trains were applied to electrodes, and thresholds for perception were found. Evoked potentials were recorded in response to peripheral stimulation at intensities at, above, and below sensory threshold.
During cortical stimulation, sensory threshold changed little for stimulus trains of 250 milliseconds and longer, but increased sharply as TD decreased below this level. Primary evoked activity was recorded in response to peripheral stimulations that were subthreshold for conscious perception.
The results confirm a previous report of the effects of stimulus TD on sensory threshold. However, no motor responses occurred following somatosensory stimulation with short trains, as previously reported. The TD threshold pattern was similar in visual cortex. In agreement with the previous report, early components of the primary evoked response were not correlated with conscious sensory awareness.
1)通过直接刺激体感皮层和视觉皮层,确定刺激串持续时间(TD)对感觉知觉的影响。2)研究对于低于知觉阈值的刺激所产生的诱发电位情况。
使用直接皮层刺激和记录技术对意识知觉机制进行的研究很少见。在接受手术评估的癫痫患者中植入硬膜下电极网格的临床必要性为研究刺激参数和诱发电位在意识知觉中的作用提供了契机。
研究对象包括在体感皮层或枕叶皮层放置有电极网格的癫痫患者。向电极施加单个脉冲(100微秒)和刺激串,并找出知觉阈值。记录在感觉阈值、高于感觉阈值和低于感觉阈值强度下对周围刺激的诱发电位。
在皮层刺激期间,对于250毫秒及更长时间的刺激串,感觉阈值变化不大,但当TD降至该水平以下时,感觉阈值急剧上升。记录到了对低于意识知觉阈值的周围刺激产生的初级诱发电活动。
结果证实了先前关于刺激TD对感觉阈值影响的报道。然而,与先前报道不同的是,短串体感刺激后未出现运动反应。视觉皮层中的TD阈值模式相似。与先前报道一致,初级诱发电反应的早期成分与有意识的感觉觉知无关。