Boly Mélanie, Faymonville Marie-Elisabeth, Peigneux Philippe, Lambermont Bernard, Damas Pierre, Del Fiore Guy, Degueldre Christian, Franck Georges, Luxen André, Lamy Maurice, Moonen Gustave, Maquet Pierre, Laureys Steven
Cyclotron Research Center, University of Liège, Liège, Belgium.
Arch Neurol. 2004 Feb;61(2):233-8. doi: 10.1001/archneur.61.2.233.
The minimally conscious state (MCS) is a recently defined clinical condition; it differs from the persistent vegetative state (PVS) by the presence of inconsistent, but clearly discernible, behavioral evidence of consciousness.
To study auditory processing among patients who are in an MCS, patients who are in a PVS, and healthy control subjects.
By means of (15)O-radiolabeled water-positron emission tomography, we measured changes in regional cerebral blood flow induced by auditory click stimuli in 5 patients in an MCS, 15 patients in a PVS, and 18 healthy controls.
In both patients in an MCS and the healthy controls, auditory stimulation activated bilateral superior temporal gyri (Brodmann areas 41, 42, and 22). In patients in a PVS, the activation was restricted to Brodmann areas 41 and 42 bilaterally. We also showed that, compared with patients in a PVS, patients in an MCS demonstrated a stronger functional connectivity between the secondary auditory cortex and temporal and prefrontal association cortices.
Although assumptions about the level of consciousness in severely brain injured patients are difficult to make, our findings suggest that the cerebral activity observed in patients in an MCS is more likely to lead to higher-order integrative processes, thought to be necessary for the gain of conscious auditory perception.
最低意识状态（MCS）是最近定义的一种临床状态；它与持续性植物状态（PVS）的区别在于存在不一致但明显可辨的意识行为证据。
研究处于最低意识状态的患者、处于持续性植物状态的患者和健康对照者的听觉处理情况。
通过（15）O放射性标记水正电子发射断层扫描，我们测量了5例最低意识状态患者、15例持续性植物状态患者和18例健康对照者在听觉点击刺激下引起的局部脑血流变化。
最低意识状态患者和健康对照者在听觉刺激下均激活了双侧颞上回（布罗德曼区41、42和22）。在持续性植物状态患者中，激活仅限于双侧布罗德曼区41和42。我们还表明，与持续性植物状态患者相比，最低意识状态患者在次级听觉皮层与颞叶和前额叶联合皮层之间表现出更强的功能连接。
尽管很难对重度脑损伤患者的意识水平做出假设，但我们的研究结果表明，在最低意识状态患者中观察到的大脑活动更有可能导致更高层次的整合过程，而这被认为是获得有意识听觉感知所必需的。
