Department of Basic Medical Science, School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang 311121, China; International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 311121, China.
Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China.
Clin Neurophysiol. 2019 Aug;130(8):1235-1242. doi: 10.1016/j.clinph.2019.04.710. Epub 2019 May 13.
The objective of this study was to explore the role for quadratic phase coupling within electroencephalography (EEG) oscillations in the diagnosis of consciousness and consciousness restoration for disorders of consciousness (DOC).
Fifty-one DOC patients were enrolled in this study. For each patient, a Coma Recovery Scale-Revised (CRS-R) score and 20-min resting-state EEG were recorded. Consciousness recovery was assessed with a CRS-R score at a three-month follow-up. Twenty healthy subjects were included as controls. General harmonic wavelet transform-based bicoherence was used to quantify the quadratic phase coupling characteristics of the EEG oscillations.
Quadratic phase self-coupling (QPSC) at the delta (QPSC_delta), theta (QPSC_theta) and alpha (QPSC_alpha) bands were closely correlated with patient CRS-R scores. Particularly, the QPSC_theta value could significantly differentiate between vegetative state (VS) patients, minimally conscious state (MCS) patients and healthy control subjects. As compared to VS patients, patients with MCS had a lower QPSC_theta value on the left as well as a higher QPSC_alpha value in right frontal regions. The frontal QPSC_theta value showed significant differences between recovered and unrecovered patients.
QPSC characteristics could differentiate between consciousness states and show a predictive ability for the recovery of consciousness in DOC patients.
Changes in QPSC accompany consciousness injury and restoration in DOC patients. A QPSC assessment is helpful in the diagnosis and prognosis of DOC patients.
本研究旨在探讨脑电（EEG）振荡中的二次相位耦合在意识障碍（DOC）患者的意识诊断和意识恢复中的作用。
本研究纳入了 51 名 DOC 患者。对每位患者进行 Coma Recovery Scale-Revised（CRS-R）评分和 20 分钟静息状态 EEG 记录。在三个月的随访中，使用 CRS-R 评分评估意识恢复情况。20 名健康受试者作为对照组。采用基于广义谐波小波变换的双谱分析来量化 EEG 振荡的二次相位耦合特征。
Delta（QPSC_delta）、theta（QPSC_theta）和 alpha（QPSC_alpha）频段的二次相位自耦合（QPSC）与患者的 CRS-R 评分密切相关。特别是，theta 频段的 QPSC 值可以显著区分植物状态（VS）患者、最小意识状态（MCS）患者和健康对照组。与 VS 患者相比，MCS 患者的左侧 QPSC_theta 值较低，右侧额区的 QPSC_alpha 值较高。额叶 QPSC_theta 值在恢复和未恢复患者之间存在显著差异。
QPSC 特征可区分意识状态，并对 DOC 患者的意识恢复具有预测能力。
QPSC 的变化伴随着 DOC 患者的意识损伤和恢复。QPSC 评估有助于 DOC 患者的诊断和预后。
