Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, The Second Clinical College of Southern Medical University, Guangzhou, China.
CNS Neurosci Ther. 2024 Feb;30(2):e14388. doi: 10.1111/cns.14388. Epub 2023 Aug 11.
This study investigated the prognostic effect of electroencephalography (EEG) instant effects of single spinal cord stimulation (SCS) on clinical outcome in disorders of consciousness (DOC) and the time-dependent brain response during the recovery of consciousness prompted by SCS.
Twenty three patients with DOC underwent short-term SCS (stSCS) implantation operation. Then, all patients received the postoperative EEG test including EEG record before (T1) and after (T2) single SCS session. Subsequently, 2 weeks stSCS treatment was performed and revised coma recovery scale (CRS-R) and EEG data were collected. Finally, they were classified into effective and ineffective groups at 3-month follow-up (T6).
The parietal-occipital (PO) connectivity and clustering coefficients (CC) in the beta band of the effective group at the 1 week after the treatment (T5) were found to be higher than preoperative assessment (T0). Correlation analysis showed that the change in beta CC at T1/T2 was correlated with the change in CRS-R at T0/T6. In addition, the change in PO connectivity and CC in the beta at T0/T5 were also correlated with the change in CRS-R at T0/T5.
SCS may facilitate the recovery of consciousness by enhancing local information interaction in posterior brain regions. And the recovery can be predicted by beta CC in the EEG test.
本研究旨在探讨脑电(EEG)即时效应预测脊髓刺激(SCS)对意识障碍(DOC)患者临床预后的影响,并探讨 SCS 促意识恢复过程中脑电的时间依赖性反应。
23 例意识障碍患者行短期 SCS(stSCS)植入术。术后所有患者均行 EEG 测试,包括单次 SCS 前后(T1、T2)的 EEG 记录。随后进行 2 周的 stSCS 治疗,并采集修订昏迷恢复量表(CRS-R)和 EEG 数据。最后在 3 个月随访(T6)时将患者分为有效组和无效组。
治疗后 1 周(T5),有效组患者的顶枕部(PO)连接度和 beta 频段的聚类系数(CC)高于术前评估(T0)。相关性分析表明,T1/T2 时 beta CC 的变化与 T0/T6 时 CRS-R 的变化相关。此外,T0/T5 时 PO 连接度和 beta 频段 CC 的变化与 T0/T5 时 CRS-R 的变化也相关。
SCS 可能通过增强后头部区域的局部信息交互来促进意识恢复,EEG 测试中的 beta CC 变化可预测恢复情况。