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生死攸关:静息脑电图对处于植物状态和最小意识状态患者生存预后的预测价值。

Life or death: prognostic value of a resting EEG with regards to survival in patients in vegetative and minimally conscious States.

机构信息

BM-Science - Brain and Mind Technologies Research Centre, Espoo, Finland.

出版信息

PLoS One. 2011;6(10):e25967. doi: 10.1371/journal.pone.0025967. Epub 2011 Oct 5.

Abstract

OBJECTIVE

To investigate the potentially prognostic value of a resting state electroencephalogram (EEG) with regards to the clinical outcome from vegetative and minimally conscious states (VS and MCS) in terms of survival six months after a brain injury.

METHODS

We quantified a dynamic repertoire of EEG oscillations in resting condition with eyes closed in patients in VS and MCS. The exact composition of EEG oscillations was assessed by analysing the probability-classification of short-term EEG spectral patterns.

RESULTS

Results demonstrated that (a) the diversity and the variability of EEG for Non-Survivors were significantly lower than for Survivors; and (b) a higher probability of mostly delta and slow-theta oscillations occurring either alone or in combination were found during the first assessment for patients with a bad outcome (i.e., those who died) within six months of an injury compared to patients who survived. At the same time, patients with a good outcome (i.e., those who survived) after six months post-injury had a higher probability of mostly fast-theta and alpha oscillations occurring either alone or in combination during the first assessment when compared to patients who died within six months of an injury.

CONCLUSIONS

Resting state EEGs properly analysed may have a potentially prognostic value with regards to the outcome from VS or MCS in terms of survival six months after a brain injury.

SIGNIFICANCE

This work may have implications for clinical care, rehabilitative programmes and medical-legal decisions for patients with impaired consciousness states after being in a coma due to acute brain injuries.

摘要

目的

研究静息状态脑电图(EEG)在脑损伤后 6 个月的生存预后方面对植物状态和最小意识状态(VS 和 MCS)临床结果的潜在预后价值。

方法

我们通过分析短期 EEG 频谱模式的概率分类,来量化静息状态下闭眼时 VS 和 MCS 患者 EEG 振荡的动态范围。

结果

结果表明:(a)非幸存者的 EEG 多样性和可变性明显低于幸存者;(b)与幸存者相比,在损伤后 6 个月内死亡的患者中,第一次评估时,单独或组合出现高概率的 delta 和慢 theta 振荡的情况更为常见;而在损伤后 6 个月存活的患者中,第一次评估时,单独或组合出现高概率快 theta 和 alpha 振荡的情况更为常见。

结论

适当分析的静息状态 EEG 可能具有潜在的预后价值,可预测脑损伤后 6 个月的 VS 或 MCS 生存结果。

意义

这项工作可能对急性脑损伤导致昏迷后意识状态受损的患者的临床护理、康复计划和医疗法律决策产生影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e784/3187816/6f89d65a4a56/pone.0025967.g001.jpg

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