S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, University of Calabria, Cosenza, Italy.
J Neurotrauma. 2011 Oct;28(10):2013-7. doi: 10.1089/neu.2011.1885.
Visual pursuit marks substantial recuperation from a vegetative state and evolution into a minimally-conscious state, but its incidence in different studies suggests some unreliability in contrast with its established prognostic relevance. Subjects in vegetative (n=9) or minimally-conscious (n=13) states were tested for visual pursuit 6 times/day (9:30, 10:30, and 11:30 am, and 2:00, 3:00, and 4.00 pm, for a total of 132 determinations). Visual pursuit was observed at all testing times in 8 minimally-conscious patients, and never in 5 subjects in a vegetative state. Its incidence per subject ranged from 50-100% of testing times in the minimally-conscious state (83±23%), and 0-33% in a vegetative state (7%±12), with spontaneous fluctuations during the day and maximal levels at 10.30 am and 3.00 pm, and was never observed at the post-prandial time point (2:00 pm). The overall chance of observing visual tracking at least once during the day was ∼33% in the vegetative state, whereas that of not observing it in the minimally-conscious state was ∼38%. These percentages are congruent with the reported misdiagnosis rate between the two conditions, and document spontaneous variability possibly related to circadian rhythms.
视觉追踪标志着从植物状态中显著恢复，并向最小意识状态发展，但不同研究中的发生率表明，与既定的预后相关性相比，其存在一定的不可靠性。对处于植物状态（n=9）或最小意识状态（n=13）的受试者进行了 6 次/天（上午 9:30、10:30 和 11:30，以及下午 2:00、3:00 和 4:00，共 132 次测试）的视觉追踪测试。在 8 名最小意识状态患者中，所有测试时间均观察到视觉追踪，而在 5 名植物状态患者中则从未观察到。其在最小意识状态下的受试者发生率范围为测试时间的 50-100%（83±23%），而在植物状态下为 0-33%（7%±12%），白天有自发波动，最高水平在上午 10.30 和下午 3.00，且从未在餐后时间点（下午 2:00）观察到。在植物状态下，白天至少观察到一次视觉追踪的总体机会约为 33%，而在最小意识状态下未观察到的机会约为 38%。这些百分比与这两种状态之间报告的误诊率相符，并记录了可能与昼夜节律有关的自发变异性。
