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事件相关电位神经标志物在重度创伤性脑损伤和长期昏迷后慢性交叉性失语患者评估与治疗中的应用——病例报告

Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma - Case Report.

作者信息

Chantsoulis Marzena, Półrola Paweł, Góral-Półrola Jolanta, Hajdukiewicz Anna, Supiński Jan, Kropotov Juri D, Pachalska Maria

机构信息

Academy of Physical Education, Department of Physiotherapy, Wroclaw, Poland.

Jan Kochanowski University in Kielce, Faculty of Medicine and Health Sciences, Kielce, Poland.

出版信息

Ann Agric Environ Med. 2017 Mar 31;24(1):141-147. doi: 10.5604/12321966.1232770.

Abstract

UNLABELLED

Objective. The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma.

CASE REPORT

An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B.

RESULTS

In the 1st recording, the neuromarker of aphasia was found - an excess of the P2 wave over the left temporal area. There was a cognitive control deficit - an excess of omission errors and an increase of RT variability - all indexes of sporadic ADHD. In the 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally.

CONCLUSIONS

The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes.

摘要

未标注

目的。本研究旨在评估事件相关电位(ERP)神经标志物在重度创伤性脑损伤(TBI)及长期昏迷后慢性交叉性失语患者评估与治疗中的应用。

病例报告

一名29岁的双利手女性患者,在车祸后患有创伤后慢性交叉性失语、重度TBI及长期昏迷。该患者参加了两个不同的神经治疗康复项目,包括20次相对β训练和20次重复经颅磁刺激(rTMS);两个项目均结合了行为训练。患者接受了3次测试:实验前、项目A完成后以及项目B完成后。

结果

在第一次记录中,发现了失语的神经标志物——左颞叶区域P2波过度。存在认知控制缺陷——遗漏错误过多且反应时变异性增加——所有这些都是散发性注意缺陷多动障碍(ADHD)的指标。在第二次记录中,发现认知控制和语言功能有轻微改善。在第三次记录中,rTMS治疗后,她的大多数认知功能障碍,包括语言功能,都得到了解决。需要强调的是,发现了激活情况(尤其是额叶右侧ERP电位增加)。失语的神经标志物没有改变,只是位置略有向前移动。

结论

ERP神经标志物的应用有助于双利手慢性创伤后失语和散发性ADHD患者的诊断、治疗及学业成功。ERP可用于评估神经治疗项目引起的大脑功能变化。

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