Daltrozzo Jerôme, Wioland Norma, Mutschler Veronique, Lutun Philippe, Calon Bartholomeus, Meyer Alain, Pottecher Thierry, Lang Simone, Jaeger Albert, Kotchoubey Boris
Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
Cogn Behav Neurol. 2009 Mar;22(1):53-62. doi: 10.1097/WNN.0b013e318192ccc8.
To evaluate cortical information processing (particularly, semantic processing) in acute nontraumatic coma by means of event-related brain potentials (ERPs).
The tests included measures of obligatory auditory processing (N100), automatic (Mismatch Negativity) and controlled (P300) detection of stimulus deviance, and semantic processing (ERP effects in word pairs and sentences). The tests were presented to 20 healthy participants and 42 coma patients with Glasgow Coma Scale <9.
Responders (ie, patients whose ERP data indicate that their brain was able to process the corresponding stimuli) were found in each ERP test, and their distribution was statistically different from that expected by chance. Particularly, 7 responders were found in the word pair paradigm and 3 responders in the sentence paradigm. The P300 responsiveness highly correlated with other ERP responses, with Glasgow Coma Scale and with the future development of coma (ie, P300 on day 4 was related to the clinical state on day 20).
Results suggest a wide range of cortical information processing in coma, including semantic processing. The question is discussed of whether, and to what extent, these processing operations are related to conscious awareness of stimuli.
通过事件相关脑电位（ERP）评估急性非创伤性昏迷患者的皮质信息处理（尤其是语义处理）。
测试包括对强制性听觉处理（N100）、刺激偏差的自动检测（失匹配负波）和控制性检测（P300）以及语义处理（词对和句子中的ERP效应）的测量。测试对象为20名健康参与者和42名格拉斯哥昏迷量表评分<9的昏迷患者。
在每项ERP测试中均发现了有反应者（即ERP数据表明其大脑能够处理相应刺激的患者），其分布与随机预期有统计学差异。特别是，在词对范式中发现7名有反应者，在句子范式中发现3名有反应者。P300反应性与其他ERP反应、格拉斯哥昏迷量表以及昏迷的未来发展高度相关（即第4天的P300与第20天的临床状态相关）。
结果表明昏迷患者存在广泛的皮质信息处理，包括语义处理。文中讨论了这些处理操作是否以及在多大程度上与对刺激的意识觉知相关的问题。
