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音乐在长期意识障碍患者的诊断、治疗及预后中的作用

Music in the diagnosis, treatment and prognosis of people with prolonged disorders of consciousness.

作者信息

Magee Wendy L

机构信息

a Boyer College of Music and Dance , Temple University , Philadelphia , PA , USA.

出版信息

Neuropsychol Rehabil. 2018 Dec;28(8):1331-1339. doi: 10.1080/09602011.2018.1494003. Epub 2018 Jul 16.

Abstract

Using music with people with prolonged disorders of consciousness (PDOC) has progressed considerably in recent years. Using both imaging and behavioural measures has revealed music's potential for enhancing arousal and awareness, boosting cognition and improving behavioural outcomes when compared to non-music conditions. Furthermore, music may have prognostic potential with this population. Explanations for these effects draw on music's potential to simultaneously excite the networks implicated in internal self-referential awareness and external awareness. A music-based protocol and measure for PDOC has been standardised that demonstrates particular sensitivity to assessment of auditory responsiveness, an important factor with a population where visual impairment is prevalent. Such measures can now contribute to interdisciplinary assessment of awareness in people with PDOC. Reviewing the latest research on this topic, priorities for research are identified. These include examining music's potential for prognosis of recovery, as well as its influence on the rate of emergence from PDOC, particularly its capacity to elicit heightened responsiveness across sensory domains when compared to non-music interventions. Research comparing the efficacy of live versus recorded music will help to inform evidence-based protocols. Lastly, its potential as a modality for assessment and treatment with paediatric PDOC populations should also be explored.

摘要

近年来,针对患有长期意识障碍(PDOC)的人群使用音乐的情况有了显著进展。运用成像和行为测量方法均已揭示,与无音乐的情况相比,音乐在增强唤醒和意识、提升认知以及改善行为结果方面具有潜力。此外,音乐对于这一人群可能具有预后潜力。对这些效应的解释基于音乐能够同时激发与内部自我参照意识和外部意识相关的神经网络的潜力。一种针对PDOC的基于音乐的方案和测量方法已经标准化,该方法对听觉反应性评估具有特别的敏感性,而视觉障碍在这一人群中普遍存在,听觉反应性是一个重要因素。此类测量方法现在有助于对PDOC患者的意识进行跨学科评估。回顾关于这一主题的最新研究,确定了研究重点。这些重点包括研究音乐在恢复预后方面的潜力,以及其对从PDOC中苏醒速度的影响,特别是与无音乐干预相比,其在跨感觉领域引发更高反应性的能力。比较现场音乐与录制音乐疗效的研究将有助于为基于证据的方案提供信息。最后,还应探索其作为儿科PDOC人群评估和治疗方式的潜力。

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