经皮耳迷走神经刺激改善意识障碍患者的脑连接活动：一项初步研究。
Transcutaneous auricular vague nerve stimulation improved brain connection activity on patients of disorders of consciousness: a pilot study.
机构信息
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100700, Beijing, China.
出版信息
J Tradit Chin Med. 2022 Jun;42(3):463-471. doi: 10.19852/j.cnki.jtcm.2022.03.012.
OBJECTIVE
To evaluate the clinical effect of transcutaneous auricular vagus nerve nerve stimulation (taVNS) on disorders of consciousness (DOC) patients with Coma Recovery Scale-Revised (CRS-R) and cerebral cortex activity by electroencephalogram (EEG) detection.
METHODS
Randomized controlled methods were used to evaluate the clinical effect of taVNS on patients with DOC. Twelve patients with initial CRS-R of 6-10 were randomly divided into the treatment group of taVNS and control group of transcutaneous non-auricular vague nerve stimulation (tnVNS). According to clinical diagnosis, the treatment group was divided into vegetative state (VS) group and minimally conscious state (MCS) group.
RESULTS
The energy of delta and beta bands is positively correlated with the brain activity of patients. taVNS has different regulatory effects on patients with different conscious States. In taVNS group, the energy of delta band in local brain regions changed significantly. Significant changes in brain connection activity were limited to local brain regions. While in patients with MCS in the taVNS group, delta and beta band energy significantly changed in multiple brain regions and cross-brain connection activity also changed significantly.
CONCLUSION
These findings suggest that taVNS may be a related extra method for arousing patients' awakening by improving brain connection activity. And the effect is remarkable in MCS patients.
目的
通过脑电图（EEG）检测，评估经皮耳甲迷走神经刺激（taVNS）对昏迷恢复量表修订版（CRS-R）和大脑皮层活动评估的意识障碍（DOC）患者的临床疗效。
方法
采用随机对照方法评估 taVNS 对 DOC 患者的临床疗效。将 12 例初始 CRS-R 为 6-10 分的患者随机分为 taVNS 治疗组和经皮非耳甲迷走神经刺激（tnVNS）对照组。根据临床诊断，治疗组分为植物状态（VS）组和最小意识状态（MCS）组。
结果
δ和β波段的能量与患者的大脑活动呈正相关。taVNS 对不同意识状态的患者有不同的调节作用。在 taVNS 组中，局部脑区的δ带能量变化明显。大脑连接活动的显著变化仅限于局部脑区。而在 taVNS 组的 MCS 患者中，δ和β波段能量在多个脑区明显变化，跨脑连接活动也明显变化。
结论
这些发现表明，taVNS 可能通过改善大脑连接活动成为一种唤醒患者觉醒的相关辅助方法，且在 MCS 患者中的效果更为显著。
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