Lei Ling, Liu Kehong, Yang Yong, Doubliez Alice, Hu Xiaohua, Xu Ying, Zhou Yixing
College of Automation, Hangzhou Dianzi University, Hangzhou, Zhejiang 310018, China.
Wu Jing Hospital, Rehabilitation Center, Hangzhou, Zhejiang 310051, China.
Clin Neurophysiol. 2022 Jan;133:135-144. doi: 10.1016/j.clinph.2021.08.027. Epub 2021 Oct 22.
As consciousness recovery is not only dynamic but also involves interactions between various brain regions, elucidating the mechanism of recovery requires tracking cortical activity in spatio-temporal dimensions.
We tracked the cortical activities of 40 patients (mean age: 54.38 years; 28 males; 21 patients with minimally conscious states) with disorders of consciousness, and collected a total of 156 electroencephalographic signals. We investigated the longitudinal changes in EEG nonlinear dynamic features (i.e., approximate entropy, sample entropy, and Lempel-Ziv complexity) and relative wavelet energy along with consciousness recovery.
Global EEG features showed a non-monotonic trend during consciousness recovery (P < 0.05). When the level of consciousness of patients was transferred to a minimally conscious state from an unresponsive wakefulness syndrome/ vegetative state, an inflection point appeared in the EEG features. The EEG feature change trends between the injured and uninjured areas were dissimilar (P < 0.05). Importantly, the degree of dissimilarity increased non-monotonically across the levels of consciousness (P < 0.05).
EEG recovery was non-monotonic and dissimilar in spatio-temporal dimensions, with an inflection point.
These findings further clarify the process of consciousness recovery and provide assistance in exploring the mechanism of consciousness recovery.
由于意识恢复不仅是动态的，还涉及不同脑区之间的相互作用，阐明恢复机制需要在时空维度上追踪皮层活动。
我们追踪了40例意识障碍患者（平均年龄：54.38岁；男性28例；21例处于最低意识状态）的皮层活动，共收集了156份脑电图信号。我们研究了脑电图非线性动态特征（即近似熵、样本熵和莱姆尔-齐夫复杂度）以及相对小波能量随意识恢复的纵向变化。
在意识恢复过程中，脑电图整体特征呈非单调趋势（P<0.05）。当患者意识水平从不反应性觉醒综合征/植物状态转变为最低意识状态时，脑电图特征出现一个拐点。受伤区域和未受伤区域之间的脑电图特征变化趋势不同（P<0.05）。重要的是，不同程度在意识水平上呈非单调增加（P<0.05）。
脑电图恢复在时空维度上是非单调且不同的，存在一个拐点。
这些发现进一步阐明了意识恢复过程，并为探索意识恢复机制提供了帮助。
