中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (3): 473-480.doi: 10.4103/1673-5374.153699

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

对意识障碍患者意识状态采用创新事件相关电位P300刺激源判断预后

  

  • 收稿日期:2015-02-03 出版日期:2015-03-20 发布日期:2015-03-20
  • 基金资助:

    国家自然科学基金(81371194)

Connecting the P300 to the diagnosis and prognosis of unconscious patients

Ran Li, Wei-qun Song, Ju-bao Du, Su Huo, Gui-xiang Shan   

  1. Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
  • Received:2015-02-03 Online:2015-03-20 Published:2015-03-20
  • Contact: Wei-qun Song, M.D., songwq66@vip.163.com
  • Supported by:

    This work was supported by grants from the National Natural Science Foundation of China, No. 81371194.

摘要:

事件相关电位P300客观准确地探测意识障碍患者的残余意识。以往研究使用纯音、受试者名字、他人名字作为刺激进行此类研究,结果均不理想。我们创新性地将受试者名字调换顺序得到受试者衍生名字,并结合纯音、受试者名字一起作为听觉刺激进行事件相关电位实验。纳入的正常健康者和意识障碍患者,均接受以下听觉刺激:在两个范式中,纯音-受试者名字,受试者衍生名字-受试者名字分别作为标准刺激和偏差刺激。结果显示,所有正常健康者在两个范式中都出现P300,第二个范式中的P300为双峰且潜伏期更长。所有最小意识状态患者在第一个范式中出现了P300,大部分在第二个范式中出现了P300,植物状态患者则大部分未引出P300。同时在两个范式中出现P300者意识水平较高,且第二个范式中P300为双峰者会在短期内苏醒。结果说明,事件相关电位P300波可以反映意识障碍患者的意识状态。

关键词: 神经再生, 脑损伤, 认知神经科学, 事件相关电位, P300, 电生理, 营养状态, 微意识状态, 意识, 意识障碍, 无意识, 评价, 预后, 国家自然科学基金

Abstract:

The residual consciousness of unconscious patients can be detected by studying the P300, a wave among event-related potentials. Previous studies have applied tones, the subject’s name and other names as stimuli. However, the results were not satisfactory. In this study, we changed the constituent order of subjects’ two-character names to create derived names. The subject’s derived names, together with tones and their own names, were used as auditory stimuli in event-related potential experiments. Healthy controls and unconscious patients were included in this study and made to listen to these auditory stimuli. In the two paradigms, a sine tone followed by the subject’s own name and the subject’s derived name followed by the subject’s own name were used as standard and deviant stimuli, respectively. The results showed that all healthy controls had the P300 using both paradigms, and that the P300 in the second paradigm had a longer latency and two peaks. All minimally conscious state patients had the P300 in the first paradigm and the majority of them had the P300 in the second paradigm. Most vegetative state patients had no P300. Patients who showed the P300 in the two paradigms had more residual consciousness, and patients with the two-peak P300 had a higher probability of awakening within a short time. Our experimental findings suggest that the P300 event-related potential could reflect the conscious state of unconscious patients.

Key words: nerve regeneration, brain injury, cognitive neuroscience, event-related potential, P300, electrophysiology, nutritional state, minimally conscious state, consciousness, disorders of consciousness, unconsciousness, evaluation, prognosis, NSFC grants, neural regeneration