Ammermann Heidi, Kassubek Jan, Lotze Martin, Gut Ernst, Kaps Michael, Schmidt Joachim, Rodden Frank A, Grodd Wolfgang
Section for Experimental Magnetic Resonance of the CNS, Department of Neuroradiology, University of Tübingen, Hoppe-Seyler-Str. 3, D-72076 Tübingen, Germany.
J Neurol Sci. 2007 Sep 15;260(1-2):65-70. doi: 10.1016/j.jns.2007.03.026. Epub 2007 May 9.
The object of this study was to analyze magnetic resonance imaging data from patients with disorders of consciousness who were suffering from non-traumatically induced brain lesions with respect to the pattern of vulnerability and to examine the associations between the sizes of these lesions and the clinical outcome of the patients. To this end, T1- and T2-weighted brain images were examined in twelve patients in the post-anoxic vegetative state after a median of 21 days after the causative event. Predominant in the characteristic lesion patterns were regions of pathological white matter signals within the frontal and occipital lobes and in the periventricular regions. The total volumes of the lesions were found to be associated with the severity of the patients' clinical outcomes as measured by the Ranchos Los Amigos Cognitive Scale after a median of 25 months. These lesion patterns demonstrated damage to cerebral networks critical to higher cognitive processes ("consciousness") in both white and gray matter. The relevance of these findings for patients in anoxia-induced decreased levels of consciousness is discussed.
本研究的目的是分析患有非创伤性脑损伤的意识障碍患者的磁共振成像数据，以了解其易损模式，并研究这些病变大小与患者临床结局之间的关联。为此，对12例处于缺氧后植物状态的患者进行了T1加权和T2加权脑图像检查，这些患者在致病事件发生后中位21天接受检查。特征性病变模式中主要是额叶、枕叶及脑室周围区域的病理性白质信号区域。在中位25个月后，发现病变总体积与通过Rancho Los Amigos认知量表测量的患者临床结局严重程度相关。这些病变模式显示，对高级认知过程（“意识”）至关重要的脑网络在白质和灰质中均受到损害。本文讨论了这些发现对于缺氧导致意识水平下降患者的相关性。
