Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, China.
Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China.
Brain Res. 2024 Nov 15;1843:149133. doi: 10.1016/j.brainres.2024.149133. Epub 2024 Jul 29.
The progress in neuroimaging and electrophysiological techniques has shown substantial promise in improving the clinical assessment of disorders of consciousness (DOC). Through the examination of both stimulus-induced and spontaneous brain activity, numerous comprehensive investigations have explored variations in brain activity patterns among patients with DOC, yielding valuable insights for clinical diagnosis and prognostic purposes. Nonetheless, reaching a consensus on precise neuroimaging biomarkers for patients with DOC remains a challenge. Therefore, in this review, we begin by summarizing the empirical evidence related to neuroimaging biomarkers for DOC using various paradigms, including active, passive, and resting-state approaches, by employing task-based fMRI, resting-state fMRI (rs-fMRI), electroencephalography (EEG), and positron emission tomography (PET) techniques. Subsequently, we conducted a review of studies examining the neural correlates of consciousness in patients with DOC, with the findings holding potential value for the clinical application of DOC. Notably, previous research indicates that neuroimaging techniques have the potential to unveil covert awareness that conventional behavioral assessments might overlook. Furthermore, when integrated with various task paradigms or analytical approaches, this combination has the potential to significantly enhance the accuracy of both diagnosis and prognosis in DOC patients. Nonetheless, the stability of these neural biomarkers still needs additional validation, and future directions may entail integrating diagnostic and prognostic methods with big data and deep learning approaches.
神经影像学和电生理技术的进展在改善意识障碍（DOC）的临床评估方面显示出了巨大的潜力。通过检查刺激诱导和自发性脑活动，许多综合研究探索了 DOC 患者脑活动模式的变化，为临床诊断和预后目的提供了有价值的见解。然而，对于 DOC 患者的确切神经影像学生物标志物达成共识仍然是一个挑战。因此，在这篇综述中，我们首先总结了使用各种范式（包括主动、被动和静息状态方法）的神经影像学生物标志物的实证证据，这些范式使用了基于任务的 fMRI、静息态 fMRI（rs-fMRI）、脑电图（EEG）和正电子发射断层扫描（PET）技术。随后，我们对研究 DOC 患者意识神经相关的文献进行了综述，这些研究结果对 DOC 的临床应用具有潜在价值。值得注意的是，先前的研究表明，神经影像学技术有可能揭示常规行为评估可能忽略的潜在意识。此外，当与各种任务范式或分析方法相结合时，这种组合有可能显著提高 DOC 患者的诊断和预后的准确性。然而，这些神经生物标志物的稳定性仍需要进一步验证，未来的方向可能需要将诊断和预后方法与大数据和深度学习方法相结合。
