Wang Pingzhi, Xiang Jie, Niu Yan, Wei Jing, Lan Caiqin, Li Xiangping, Xu Liying, Yin Yajie, Wang Hongxiong, Zhang Tao, Yang Lei, Xing Hao, Fan Shasha, Niu Qing, Kang Huicong, Liang Ying
Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Tongji Shanxi Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China.
College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan, China.
Front Neurosci. 2024 Sep 16;18:1443478. doi: 10.3389/fnins.2024.1443478. eCollection 2024.
How to conduct objective and accurate individualized assessments of patients with disorders of consciousness (DOC) and carry out precision rehabilitation treatment technology is a major rehabilitation problem that needs to be solved urgently.
In this study, a multi-layer brain network was constructed based on functional magnetic resonance imaging (fMRI) to analyze the structural and functional brain networks of patients with DOC at different levels and to find regulatory targets (imaging markers) with recovery potential for DOC. Then repeated transcranial magnetic stimulation (rTMS) was performed in DOC patients to clinically validate.
The brain network connectivity of DOC patients with different consciousness states is different, and the most obvious brain regions appeared in the olfactory cortex and precuneus. rTMS stimulation could effectively improve the consciousness level of DOC patients and stimulate the occipital lobe (specific regions found in this study) and the dorsolateral prefrontal cortex (DLPFC), and both parts had a good consciousness recovery effect.
In clinical work, personalized stimulation regimen treatment combined with the brain network characteristics of DOC patients can improve the treatment effect.
如何对意识障碍(DOC)患者进行客观准确的个体化评估并开展精准康复治疗技术是亟待解决的重大康复问题。
本研究基于功能磁共振成像(fMRI)构建多层脑网络,分析不同意识水平DOC患者的脑结构和功能网络,寻找具有DOC恢复潜力的调控靶点(影像标志物)。然后对DOC患者进行重复经颅磁刺激(rTMS)以进行临床验证。
不同意识状态的DOC患者脑网络连通性不同,最明显的脑区出现在嗅觉皮质和楔前叶。rTMS刺激可有效提高DOC患者的意识水平,刺激枕叶(本研究发现的特定区域)和背外侧前额叶皮质(DLPFC),且这两部分均有良好的意识恢复效果。
在临床工作中,结合DOC患者的脑网络特征进行个性化刺激方案治疗可提高治疗效果。