Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Clin Neurophysiol. 2023 Sep;153:46-56. doi: 10.1016/j.clinph.2023.06.012. Epub 2023 Jul 1.
To explore whether the EEG dynamics induced by zolpidem can predict consciousness evolution in patients with prolonged disorders of consciousness (PDOC).
We conducted a prospective explorative analysis on thirty-six patients with PDOC and eleven healthy controls. The EEG power spectrum was analyzed and categorized into 'ABCD' patterns at baseline and one hour after zolpidem administration at 10 mg. The clinical outcome was defined as consciousness improvement and no improvement six months after enrollment using the Coma Recovery Scale-Revised (CRS-R) score.
Zolpidem administration significantly increased the EEG power in the delta & theta bands and decreased EEG power in the beta bands in healthy controls. Further follow-up studies indicated that the increased EEG beta-band power induced by zolpidem can predict an improved consciousness six months after enrollment with an area under the receiver operating characteristic curve (AUC) of 0.829, the sensitivity of 94.38% and an accuracy of 81.48%.
Our work revealed that the specific EEG responses to zolpidem can predict consciousness recovery in PDOC patients.
The zolpidem-induced specific EEG responses could potentially predict the recovery of PDOC patients, which may help clinicians and patients' families in their decision-making process.
探索佐匹克隆诱导的脑电图动力学是否可以预测长时间意识障碍（PDOC）患者的意识演变。
我们对 36 名 PDOC 患者和 11 名健康对照者进行了前瞻性探索性分析。在基线和佐匹克隆给药后 1 小时（10mg）时，对脑电图功率谱进行了分析，并分为“ABCD”模式。使用昏迷恢复量表修订版（CRS-R）评分，将 6 个月后的临床结果定义为意识改善和无改善。
佐匹克隆给药可显著增加健康对照者的 delta 和 theta 波段的脑电图功率，并降低 beta 波段的脑电图功率。进一步的随访研究表明，佐匹克隆诱导的脑电图 beta 波段功率增加可以预测 6 个月后意识改善，其受试者工作特征曲线（ROC）下面积（AUC）为 0.829，灵敏度为 94.38%，准确性为 81.48%。
我们的工作表明，佐匹克隆诱导的特定脑电图反应可以预测 PDOC 患者的意识恢复。
佐匹克隆诱导的特定脑电图反应可能有潜力预测 PDOC 患者的恢复，这可能有助于临床医生和患者家属在决策过程中做出选择。
