Division of Applied System Neuroscience, Department of Advanced Medical Science, Nihon University School of Medicine, 30-1 Ohyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
Eur J Neurosci. 2010 Oct;32(7):1145-51. doi: 10.1111/j.1460-9568.2010.07412.x.
One hundred and seven patients in vegetative state (VS) were evaluated neurologically and electrophysiologically over 3 months (90 days) after the onset of brain injury. Among these patients, 21 were treated with deep brain stimulation (DBS). The stimulation sites were the mesencephalic reticular formation (two patients) and centromedian-parafascicularis nucleus complex (19 cases). Eight of the patients recovered from VS and were able to obey verbal commands at 13 and 10 months in the case of head trauma and at 19, 14, 13, 12, 12 and 8 months in the case of vascular disease after comatose brain injury, and no patients without DBS recovered from VS spontaneously within 24 months after brain injury. The eight patients who recovered from VS showed desynchronization on continuous EEG frequency analysis. The Vth wave of the auditory brainstem response and N20 of the somatosensory evoked potential could be recorded, although with a prolonged latency, and the pain-related P250 was recorded with an amplitude of > 7 μV. Sixteen (14.9%) of the 107 VS patients satisfied these criteria in our electrophysiological evaluation, 10 of whom were treated with DBS and six of whom were not treated with DBS. In these 16 patients, the recovery rate from VS was different between the DBS therapy group and the no DBS therapy group (P < 0.01, Fisher's exact probability test) These findings indicate that DBS may be useful for the recovery of patients from VS if the candidates are selected on the basis of electrophysiological criteria.
107 例处于植物状态（VS）的患者在脑损伤后 3 个月（90 天）进行神经和电生理评估。这些患者中有 21 例接受了深部脑刺激（DBS）治疗。刺激部位为中脑网状结构（2 例）和中央中缝旁核复合体（19 例）。8 例患者从 VS 中恢复过来，在颅脑损伤后昏迷 13 个月和 10 个月、脑血管病后 19 个月、14 个月、13 个月、12 个月、12 个月和 8 个月时能够听从口头命令，而没有接受 DBS 的患者在脑损伤后 24 个月内均未自发从 VS 中恢复。从 VS 中恢复的 8 例患者在连续脑电图频率分析中显示去同步化。可以记录到听觉脑干反应的 Vth 波和体感诱发电位的 N20，尽管潜伏期延长，并且可以记录到与疼痛相关的 P250，其幅度>7μV。在我们的电生理评估中，107 例 VS 患者中有 16 例（14.9%）符合这些标准，其中 10 例接受了 DBS 治疗，6 例未接受 DBS 治疗。在这 16 例患者中，DBS 治疗组和未接受 DBS 治疗组的 VS 恢复率不同（P<0.01，Fisher 确切概率检验）。这些发现表明，如果根据电生理标准选择候选者，DBS 可能对 VS 患者的恢复有用。
