Williams Shawniqua T, Conte Mary M, Goldfine Andrew M, Noirhomme Quentin, Gosseries Olivia, Thonnard Marie, Beattie Bradley, Hersh Jennifer, Katz Douglas I, Victor Jonathan D, Laureys Steven, Schiff Nicholas D
Department of Neurology and Neuroscience, Weill Cornell Medical College, New York, United States.
Elife. 2013 Nov 19;2:e01157. doi: 10.7554/eLife.01157.
Zolpidem produces paradoxical recovery of speech, cognitive and motor functions in select subjects with severe brain injury but underlying mechanisms remain unknown. In three diverse patients with known zolpidem responses we identify a distinctive pattern of EEG dynamics that suggests a mechanistic model. In the absence of zolpidem, all subjects show a strong low frequency oscillatory peak ∼6-10 Hz in the EEG power spectrum most prominent over frontocentral regions and with high coherence (∼0.7-0.8) within and between hemispheres. Zolpidem administration sharply reduces EEG power and coherence at these low frequencies. The ∼6-10 Hz activity is proposed to arise from intrinsic membrane properties of pyramidal neurons that are passively entrained across the cortex by locally-generated spontaneous activity. Activation by zolpidem is proposed to arise from a combination of initial direct drug effects on cortical, striatal, and thalamic populations and further activation of underactive brain regions induced by restoration of cognitively-mediated behaviors. DOI: http://dx.doi.org/10.7554/eLife.01157.001.
唑吡坦可使部分重度脑损伤患者的言语、认知和运动功能出现反常恢复，但其潜在机制仍不清楚。在三名已知对唑吡坦有反应的不同患者中，我们识别出一种独特的脑电图（EEG）动力学模式，该模式提示了一种机制模型。在未使用唑吡坦时，所有受试者的脑电图功率谱中均显示出一个强烈的低频振荡峰值，约为6 - 10赫兹，在额中央区域最为突出，且半球内和半球间具有高相干性（约0.7 - 0.8）。使用唑吡坦后，这些低频处的脑电图功率和相干性急剧降低。据推测，约6 - 10赫兹的活动源于锥体神经元的内在膜特性，这些特性被局部产生的自发活动被动地带动穿过皮层。据推测，唑吡坦的激活作用源于药物对皮层、纹状体和丘脑群体的初始直接作用，以及认知介导行为恢复所诱导的未充分激活脑区的进一步激活。DOI: http://dx.doi.org/10.7554/eLife.01157.001
