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动态功能连接:意识障碍诊断的新视角

Shedding new light on disorders of consciousness diagnosis: The dynamic functional connectivity.

机构信息

IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.

IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.

出版信息

Cortex. 2018 Jun;103:316-328. doi: 10.1016/j.cortex.2018.03.029. Epub 2018 Apr 4.

Abstract

It has been proposed that awareness may depend on the highly-dynamic functional connectivity of large-scale cortico-thalamo-cortical networks. We investigated how brain connectivity changes over time in the resting state in a group of patients with chronic disorders of consciousness (DoC). To this end, we assessed dynamic functional connectivity (DFC) in the resting state by analyzing the time-dependent EEG phase synchronization in five frequency bands (δ, θ, α, β, and γ). Patients in Minimally Conscious State (MCS) showed changes in DFC matrices and topography over time (mainly in the γ range), which were significantly different from those observed in patients with Unresponsive Wakefulness Syndrome (UWS). The degree of DFC significantly correlated with the level of behavioral responsiveness measured using the Coma Recovery Scale-Revised. The analysis of DFC seems promising to differentiate patients with DoC. Moreover, sharpening the current knowledge of DFC by using EEG-based approaches may shed light on the processes of consciousness and their pathophysiology, and may help to design neuromodulation protocols aimed at targeting maladaptive and dysfunctional FC.

摘要

有人提出,意识可能依赖于大规模皮质-丘脑-皮质网络的高度动态功能连接。我们研究了一组慢性意识障碍(DoC)患者在静息状态下大脑连接随时间的变化。为此,我们通过分析五个频带(δ、θ、α、β和γ)中 EEG 相位同步的时间依赖性来评估静息状态下的动态功能连接(DFC)。最小意识状态(MCS)患者的 DFC 矩阵和拓扑结构随时间发生变化(主要在γ范围内),与无反应觉醒综合征(UWS)患者观察到的变化明显不同。DFC 的程度与使用昏迷恢复量表修订版测量的行为反应水平显著相关。DFC 的分析有望区分 DoC 患者。此外,通过使用基于 EEG 的方法来锐化 DFC 的现有知识,可能有助于阐明意识过程及其病理生理学,并可能有助于设计旨在针对适应不良和功能失调的 FC 的神经调节方案。

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