PDF(Pubmed)
Abstract：
Treating prolonged disorders of consciousness (pDoC) is challenging. Thus, accurate assessment of residual consciousness in patients with pDoC is important for the management and recovery of patients. Functional near-infrared spectroscopy (fNIRS) can be used to detect brain activity through changes of oxygenated hemoglobin/deoxygenated hemoglobin (HbO/HbR) concentrations changes and has recently gained increasing attention for its potential applications in assessing residual consciousness. However, the number of fNIRS studies assessing residual awareness in patients with pDoC is still limited. In this study, fNIRS was used to evaluate the brain function in 18 patients with pDoC, including 14 vegetative states (VS) and 4 minimally conscious states (MCS), and 15 healthy controls (HC). All participants accepted two types of external stimuli, i.e., active stimulation (motor imagery, MI) and passive stimulation (subject\'s own name, SON). The results showed that the mean concentrations of HbO/HbR in the prefrontal cortex of the HC during the passive stimulation were significantly lower than those of the active stimulation, and the fitting slope was high. However, the hemodynamic responses of the patients with pDoC were opposite to those of the HC. Additionally, the mean concentrations of HbO/HbR increased as the level of consciousness decreased during passive stimulation. Our findings suggest that the residual level of consciousness in pDoC patients can be assessed by measuring brain responses to different stimulations using fNIRS. The present study further demonstrates the feasibility and reliability of fNIRS in assessing residual consciousness in patients with pDoC, providing a basis for its expanded clinical application.
摘要：
治疗长期意识障碍（pDoC）具有挑战性。因此，pDoC患者残余意识的准确评估对患者的管理和恢复具有重要意义。功能近红外光谱（fNIRS）可用于通过氧合血红蛋白/脱氧血红蛋白（HbO/HbR）浓度变化来检测大脑活动，并且最近因其在评估残余意识方面的潜在应用而受到越来越多的关注。然而,评估pDoC患者残余知晓率的fNIRS研究数量仍然有限.在这项研究中,fNIRS用于评估18例pDoC患者的脑功能，包括14种植物状态(VS)和4种最低意识状态(MCS)，和15个健康对照（HC）。所有参与者都接受了两种类型的外部刺激，即，主动刺激(运动想象，MI)和被动刺激(受试者自己的名字，SON).结果表明,被动刺激时HC前额叶皮层HbO/HbR的平均浓度明显低于主动刺激,拟合坡度很高。然而,pDoC患者的血流动力学反应与HC相反。此外,在被动刺激期间，随着意识水平的降低，HbO/HbR的平均浓度增加。我们的发现表明，可以通过使用fNIRS测量大脑对不同刺激的反应来评估pDoC患者的意识残留水平。本研究进一步证明了fNIRS评估pDoC患者残余意识的可行性和可靠性。为其扩大临床应用提供依据。
