中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (11): 1900-1906.doi: 10.4103/1673-5374.238622

• 原著:颅神经损伤修复保护与再生 • 上一篇    下一篇

听觉刺激对意识障碍患者的作用：一项定量脑电图研究

  

  • 收稿日期:2018-06-21 出版日期:2018-11-15 发布日期:2018-11-15
  • 基金资助:

    浙江省医学技术计划项目（2014RCA007），浙江省与卫计委联合医学科技项目（2016152769）

Effect of acoustic stimuli in patients with disorders of consciousness: a quantitative electroencephalography study

Min Wu1, Wang-Xiao Bao1, Jie Zhang1, Yang-Fan Hu2, Jian Gao3, Ben-Yan Luo1   

  1. 1 Department of Neurology & Brain Medical Centre, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
    2 Department of Computer Science, Zhejiang University, Hangzhou, Zhejiang Province, China
    3 Department of Rehabilitation, Hangzhou Hospital of Zhejiang Armed Police Corps, Hangzhou, Zhejiang Province, China
  • Received:2018-06-21 Online:2018-11-15 Published:2018-11-15
  • Contact: Ben-Yan Luo, PhD,luobenyan@zju.edu.cn
  • Supported by:

    This study was supported by grants from the General Project Plan of Zhejiang Medical Technology of China, No. 2014RCA007; the Medical Science and Technology Project Co-founded by Zhejiang Province and the Ministry of Health of China, No. 2016152769.

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摘要：

听觉刺激被认为是一种对意识障碍患者有效的神经康复疗法，但目前尚无何种听觉刺激唤醒意识障碍患者更为有效的验证。中国浙江武警总队杭州医院神经康复科招募了14例意识障碍患者，其中无反应性觉醒综合征7例(5男2女，45.7 ± 16.8岁)，最小意识状态7例(6男1女，42.3 ± 20.8岁)，并同时招募了14名健康对照(10男4女，51.7 ± 9.7岁)，进行病例对照试验，使用定量脑电图观察静息状态和声刺激条件下音乐、自己名字和白噪声对大脑活化，并探索定量脑电图在不同脑区的预测价值。结果显示以自己名字刺激时，各组受试者大脑的激活程度较高，其中意识障碍患者的颞叶和对照者的额叶最为明显。此外，意识障碍患者在休息和刺激时，定量脑电图指数（δ+θ/α+β值）与昏迷恢复量表(修订版)分数呈负相关。由此推测受试者自己名字可能是意识障碍患者的有效唤醒疗法，且特定刺激状态下的定量脑电图指数可被视为意识障碍的预后指标（敏感性75％，特异性50％）。The clinical study has been registered at clinicaltrials.gov with NCT03385291，版本号1.0。

orcid:0000-0002-9892-5778(Ben-Yan Luo)

关键词: 听觉刺激, 意识障碍, 额叶, 神经可塑性, 定量脑电图, 昏迷恢复量表(修订版), 唤醒, 音乐, 自己的名字, 白噪声, 神经再生

Abstract:

Auditory stimuli are proposed as beneficial neurorehabilitation methods in patients with disorders of consciousness. However, precise and accurate quantitative indices to estimate their potential effect remain scarce. Fourteen patients were recruited from the Neuro-Rehabilitation Unit of Hangzhou Hospital of Zhejiang Armed Police Corps of China. Altogether, there were seven cases of unresponsive wakefulness syndrome (five males and two females, aged 45.7 ± 16.8 years) and seven cases of minimally conscious state (six males and one female, aged 42.3 ± 20.8 years). Simultaneously, fourteen healthy controls (10 males and 4 females, aged 51.7 ± 9.7 years) also participated in this case-control experiment. Brain response to music, subjects’ own name, and noise was monitored by quantitative electroencephalography (QEEG) in the resting state and with acoustic stimulation. Predictive QEEG values in various brain regions were investigated. Our results show that cerebral activation was high in subjects stimulated by their own name, especially in the temporal lobe in patients with disorders of consciousness, and the frontal lobe in the control group. Further, during resting and stimulation, QEEG index (δ + θ/α + β ratio) negatively correlated with the Coma Recovery Scale-Revised score in traumatic disorders of consciousness patients. Hence, we speculate that a subject’s own name might be an effective awakening therapy for patients with disorders of consciousness. Moreover, QEEG index in specific stimulation states may be used as a prognostic indicator for disorders of consciousness patients (sensitivity, 75%; specificity, 50%). This clinical study has been registered at ClinicalTrials.gov (identifier: NCT03385291).

Key words: nerve regeneration, auditory stimulation, disorders of consciousness, frontal lobe, neuroplasticity, quantitative electroencephalography, Coma Recovery Scale-Revised, awakening, music, subjects&rsquo, own name, white noise, neural regeneration