Wu Min, Bao Wang-Xiao, Zhang Jie, Hu Yang-Fan, Gao Jian, Luo Ben-Yan
Department of Neurology & Brain Medical Centre, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Department of Computer Science, Zhejiang University, Hangzhou, Zhejiang Province, China.
Neural Regen Res. 2018 Nov;13(11):1900-1906. doi: 10.4103/1673-5374.238622.
Auditory stimuli are proposed as beneficial neurorehabilitation methods in patients with disorders of consciousness. However, precise and accurate quantitative indices to estimate their potential effect remain scarce. Fourteen patients were recruited from the Neuro-Rehabilitation Unit of Hangzhou Hospital of Zhejiang Armed Police Corps of China. Altogether, there were seven cases of unresponsive wakefulness syndrome (five males and two females, aged 45.7 ± 16.8 years) and seven cases of minimally conscious state (six males and one female, aged 42.3 ± 20.8 years). Simultaneously, fourteen healthy controls (10 males and 4 females, aged 51.7 ± 9.7 years) also participated in this case-control experiment. Brain response to music, subjects' own name, and noise was monitored by quantitative electroencephalography (QEEG) in the resting state and with acoustic stimulation. Predictive QEEG values in various brain regions were investigated. Our results show that cerebral activation was high in subjects stimulated by their own name, especially in the temporal lobe in patients with disorders of consciousness, and the frontal lobe in the control group. Further, during resting and stimulation, QEEG index (δ + θ/α + β ratio) negatively correlated with the Coma Recovery Scale-Revised score in traumatic disorders of consciousness patients. Hence, we speculate that a subject's own name might be an effective awakening therapy for patients with disorders of consciousness. Moreover, QEEG index in specific stimulation states may be used as a prognostic indicator for disorders of consciousness patients (sensitivity, 75%; specificity, 50%). This clinical study has been registered at ClinicalTrials.gov (identifier: NCT03385291).
听觉刺激被认为是意识障碍患者有益的神经康复方法。然而,用于评估其潜在效果的精确且准确的定量指标仍然匮乏。从中国人民武装警察部队浙江省总队杭州医院神经康复科招募了14名患者。其中,共有7例无反应觉醒综合征(5例男性,2例女性,年龄45.7±16.8岁)和7例最低意识状态(6例男性,1例女性,年龄42.3±20.8岁)。同时,14名健康对照者(10例男性,4例女性,年龄51.7±9.7岁)也参与了这项病例对照实验。通过定量脑电图(QEEG)在静息状态和声音刺激下监测大脑对音乐、受试者自己的名字和噪音的反应。研究了不同脑区的预测性QEEG值。我们的结果表明,受自己名字刺激的受试者大脑激活程度较高,尤其是意识障碍患者颞叶以及对照组额叶。此外,在静息和刺激期间,QEEG指数(δ+θ/α+β比值)与创伤性意识障碍患者的昏迷恢复量表修订版得分呈负相关。因此,我们推测受试者自己的名字可能是意识障碍患者有效的唤醒疗法。此外,特定刺激状态下的QEEG指数可作为意识障碍患者的预后指标(敏感性75%;特异性50%)。这项临床研究已在ClinicalTrials.gov注册(标识符:NCT03385291)。