p300

P300
  • 文章类型: Journal Article
    Although many studies document the role of propositional truth-value in human psychological reading behavior, there is a relative paucity of research examining the role of differential propositional truth-value in processing Chinese counterfactual conditionals. This study is to investigate the role of differential propositional value in processing Chinese counterfactual conditionals by means of ERPs (event-related potentials). The study is based on comprehending two types of Chinese counterfactual conditionals, which is propositional truth value introduced by two different markers of conditional conjunctions in the protasis and apodosis, such as true counterfactual conditional markers jiaru (if) & jiu (so) in the sentence wo xiang yu jiaru you tui jiu keyi zai shuixia zhixi (I think if fish had legs so they could stifle under water), and false counterfactual conditional markers ruguo (if) & namo (then) in the sentence wo xiang gou ruguo you lin namo keyi zai shuixia huxi (I think if dogs had scales, then they could breathe under water). Two counterfactual propositional values (i.e. true and false propositional values) are constructed through manipulating sentence counterfactuality between the true and false counterfactual conditional markers in the protasis and the apodosis. Twenty-four full-time Chinese college students participated in the ERP study. The results demonstrated that processing the true counterfactual propositional sentences with conditional markers jiaru (if) & jiu (so) elicited the N400 effect relative to false propositional sentences with conditional markers ruguo (if) & namo (then). Moreover, the counterfactual sentences with true propositional conditions varied from the elicitation of the N400 effect in the protasis and absence of the N400 effect in the apodosis, showing that semantic roles may gradually disappear under the impact of truth value of propositional counterfactual condition, and/or the roles of semantic anomaly was eliminated in the accumulated sentence processing. While for the false counterfactual conditional sentences, elicitations of P300 in the protasis and robust N400 effect in the apodosis were shown, indicating the increasing semantic role in the processing. Interestingly, there was the absence of the P600 effect for processing sentences with syntactic violation, suggesting little extra syntactic cost in processing sentences with false propositional condition.
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  • 文章类型: Journal Article
    对听觉输入的选择性注意通过称为P3b振幅的电振幅反映在大脑中,这是使用脑电图测量的。先前的研究表明,自闭症儿童和青少年在必须听特定声音而忽略其他声音时,P3b振幅会减弱。然而,尚不清楚自闭症儿童和青少年的P3b振幅降低是否与他们的自闭症特征有关,日常功能和/或认知功能。本研究旨在研究这些问题。因此,我们评估了57名年龄在7~14岁的自闭症儿童和57名神经发育型对照儿童对听觉输入的选择性关注,同时用脑电图测量他们的大脑活动.参与者进一步接受认知评估,父母报告了自闭症特征和日常功能。不出所料,自闭症儿童的P3b波幅低于神经系统典型的同龄人.重要的是,P3b振幅减弱与更多的父母报告的社交沟通问题和日常功能困难相关.自闭症儿童进一步降低了视觉输入的处理速度,这也耦合到较低的P3b振幅。总之,我们发现自闭症儿童执行听觉选择性注意任务时P3b振幅减弱,这与处理视觉输入和分配对社会和日常功能至关重要的注意力资源的困难有关。结果表明,当环境充满相互矛盾的感觉输入时,自闭症儿童更容易受到干扰。
    UNASSIGNED: Selective attention to auditory input is reflected in the brain by an electric amplitude called the P3b amplitude, which is measured using electroencephalography. Previous research has shown that children and adolescents with autism have an attenuated P3b amplitude when they have to attend specific sounds while ignoring other sounds. However, it is unknown whether a reduced P3b amplitude in autistic children and adolescents is associated with their autism features, daily functioning and/or cognitive functions. This study aimed to examine these questions. Therefore, we assessed selective attention to auditory input in 57 children with autism aged 7-14 years and 57 neurotypically developing controls while measuring their brain activity with electroencephalography. Participants further underwent cognitive assessment, and parents reported on autistic traits and daily functioning. As expected, children with autism had lower P3b amplitude compared to their neurotypical peers. Importantly, an attenuated P3b amplitude was associated with more parent-reported social-communication problems and difficulties with daily functioning. Children with autism further had reduced processing speed of visual input, which also was coupled to a lower P3b amplitude. In conclusion, we found attenuated P3b amplitude in children with autism performing an auditory selective attention task, which was related to difficulties with processing visual input and allocating attentional resources critical for social and daily functioning. The results suggest that autistic children are more vulnerable to being disturbed when the environment is filled with conflicting sensory input.
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  • 文章类型: Journal Article
    目的:迄今为止,视觉神经科学中的绝大多数研究都被迫采用视觉系统的高度约束视角,在视觉系统中,刺激以开环反应方式进行处理(即,突然的刺激表现,然后是诱发的神经反应)。虽然这样的约束使神经科学研究具有很高的结构效度,主要结果是采用简化方法来分离视觉感知的组成部分过程。在电生理学中,在这个主题下研究的许多神经过程中,最著名的是,可以说,P300引起的反应。有,然而,在视觉刺激以闭环方式与神经功能相连的自由观看范式中,对该组件的现实推论知之甚少。虽然越来越多的证据表明,类似于P300的神经活动确实发生在这样的范例中,当这种反应发生时,以及可以使用什么行为或环境因素来分离这种成分,这是一个悬而未决的问题。
    方法:当前的工作使用卷积网络在开放世界虚拟环境中以闭环范式的自由观看视觉搜索任务期间解码神经信号。从解码的活动中,我们构建了固定锁定的响应曲线,可以估计固定时刻附近任何P300类似物的可变延迟。然后,我们使用这些估计来调查哪些因素最好地减少可变延迟,因此,预测反应的开始时间。我们认为是可衡量的,与搜索相关的因素包括自上而下(即,目标驱动)和自下而上(即,刺激驱动)过程,如固定持续时间和显着性。我们还认为扫视大小是反映这两个系统集成的中间因素。
    结果:结果表明,在这些因素中,只有扫视大小可靠地决定了P300类似活动的开始时间。具体来说,我们发现,对于大型扫视,响应发作的变异性足够小,可以使用传统的集合平均方法进行分析。
    结论:结果表明,P300类似活动确实发生在闭环过程中,免费观看视觉搜索,同时突出显示该响应的开环版本与其真实世界模拟之间的明显差异。结果还进一步建立了扫视,和扫视大小,作为现实世界视觉处理的关键因素。
    OBJECTIVE: To date the vast majority of research in the visual neurosciences have been forced to adopt a highly constrained perspective of the vision system in which stimuli are processed in an open-loop reactive fashion (i.e., abrupt stimulus presentation followed by an evoked neural response). While such constraints enable high construct validity for neuroscientific investigation, the primary outcomes have been a reductionistic approach to isolate the component processes of visual perception. In electrophysiology, of the many neural processes studied under this rubric, the most well-known is, arguably, the P300 evoked response. There is, however, relatively little known about the real-world corollary of this component in free-viewing paradigms where visual stimuli are connected to neural function in a closed-loop. While growing evidence suggests that neural activity analogous to the P300 does occur in such paradigms, it is an open question when this response occurs and what behavioral or environmental factors could be used to isolate this component.
    METHODS: The current work uses convolutional networks to decode neural signals during a free-viewing visual search task in a closed-loop paradigm within an open-world virtual environment. From the decoded activity we construct fixation-locked response profiles that enable estimations of the variable latency of any P300 analogue around the moment of fixation. We then use these estimates to investigate which factors best reduce variable latency and, thus, predict the onset time of the response. We consider measurable, search-related factors encompassing top-down (i.e., goal driven) and bottom-up (i.e., stimulus driven) processes, such as fixation duration and salience. We also consider saccade size as an intermediate factor reflecting the integration of these two systems.
    RESULTS: The results show that of these factors only saccade size reliably determines the onset time of P300 analogous activity for this task. Specifically, we find that for large saccades the variability in response onset is small enough to enable analysis using traditional ensemble averaging methods.
    CONCLUSIONS: The results show that P300 analogous activity does occur during closed-loop, free-viewing visual search while highlighting distinct differences between the open-loop version of this response and its real-world analogue. The results also further establish saccades, and saccade size, as a key factor in real-world visual processing.
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  • 文章类型: Journal Article
    EB病毒(EBV)传染性单核细胞增多症的病原体,持续感染超过90%的成年人,并与几种人类癌症有关。为了建立终身感染,EBV干预宿主中I型干扰素(IFNI)依赖性抗病毒免疫的诱导。各种EBV基因如何帮助协调这一关键策略还没有完全定义。这里,我们揭示了EBV核抗原3A(EBNA3A)可能抑制IFNβ诱导的机制。使用邻近生物素化,我们鉴定了组蛋白乙酰转移酶P300,IFNβ转录复合物的成员,作为EBNA3A的结合伴侣。我们进一步表明,EBNA3A还与激活的IFN诱导转录因子IRF3相互作用,该因子与细胞核中的P300协作。这两个事件均由EBNA3A的N末端结构域介导。我们建议EBNA3A限制IRF3与IFNβ启动子的结合,从而阻碍下游IFNI信号传导。总的来说,我们的发现提示了一种新的EBV免疫逃避机制,受其潜伏期基因EBNA3A的影响。
    Epstein-Barr virus (EBV), the causative agent of infectious mononucleosis, persistently infects over 90% of the human adult population and is associated with several human cancers. To establish life-long infection, EBV tampers with the induction of type I interferon (IFN I)-dependent antiviral immunity in the host. How various EBV genes help orchestrate this crucial strategy is incompletely defined. Here, we reveal a mechanism by which the EBV nuclear antigen 3A (EBNA3A) may inhibit IFNβ induction. Using proximity biotinylation we identify the histone acetyltransferase P300, a member of the IFNβ transcriptional complex, as a binding partner of EBNA3A. We further show that EBNA3A also interacts with the activated IFN-inducing transcription factor IRF3 that collaborates with P300 in the nucleus. Both events are mediated by the N-terminal domain of EBNA3A. We propose that EBNA3A limits binding of IRF3 to the IFNβ promoter, thereby hampering downstream IFN I signaling. Collectively, our findings suggest a new mechanism of immune evasion by EBV, affected by its latency gene EBNA3A.
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  • 文章类型: Journal Article
    我们先前的研究确定,在广泛的肿瘤细胞中升高SOX2会导致肿瘤生长停滞的可逆状态。了解肿瘤细胞生长如何被抑制的努力导致SOX2:MYC轴的发现,当SOX2升高时,该轴负责下调c-MYC(MYC)。虽然我们已经确定提高SOX2下调MYC转录,责任机制尚未确定。鉴于临床上针对MYC的挑战,我们着手确定如何提高SOX2下调MYC转录。在这项研究中,我们关注MYC启动子区和MYC基因座的上游区域,该区域含有包含5个MYC增强子的MYC超增强子,并且与几种癌症相关.在这里,我们报告了BRD4和p300与上游MYC超增强子以及MYC启动子区域中的每个MYC增强子相关联,并且升高SOX2会减少BRD4和p300对这些位点的募集。此外,我们确定,升高SOX2会导致MYC超增强子和MYC启动子区域中SOX2和H3K27me3的关联增加。重要的是,我们得出的结论是,MYC超级增强子中SOX2的增加会导致一系列事件,最终导致MYC转录的抑制。一起,我们的研究确定了一种新的分子机制,能够在两种截然不同的肿瘤类型中调节MYC转录,并为两种主要调节因子之间的分子相互关系提供了新的机制见解。SOX2和MYC,广泛参与多种癌症。
    Our previous studies determined that elevating SOX2 in a wide range of tumor cells leads to a reversible state of tumor growth arrest. Efforts to understand how tumor cell growth is inhibited led to the discovery of a SOX2:MYC axis that is responsible for downregulating c-MYC (MYC) when SOX2 is elevated. Although we had determined that elevating SOX2 downregulates MYC transcription, the mechanism responsible was not determined. Given the challenges of targeting MYC clinically, we set out to identify how elevating SOX2 downregulates MYC transcription. In this study, we focused on the MYC promoter region and an upstream region of the MYC locus that contains a MYC super-enhancer encompassing five MYC enhancers and which is associated with several cancers. Here we report that BRD4 and p300 associate with each of the MYC enhancers in the upstream MYC super-enhancer as well as the MYC promoter region and that elevating SOX2 decreases the recruitment of BRD4 and p300 to these sites. Additionally, we determined that elevating SOX2 leads to increases in the association of SOX2 and H3K27me3 within the MYC super-enhancer and the promoter region of MYC. Importantly, we conclude that the increases in SOX2 within the MYC super-enhancer precipitate a cascade of events that culminates in the repression of MYC transcription. Together, our studies identify a novel molecular mechanism able to regulate MYC transcription in two distinctly different tumor types and provide new mechanistic insights into the molecular interrelationships between two master regulators, SOX2 and MYC, widely involved in multiple cancers.
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  • 文章类型: Journal Article
    识别与问题赌博相关的大脑活动的特定模式可能会更深入地了解其潜在机制,强调神经生理学研究的重要性,以更好地了解发展和持续的赌博行为。已通过基于近赢/近错过(NW)效应的脑电图(EEG)研究研究了认知功能的模式。本研究的主要目标是通过对反馈事件引起的事件相关电位(ERP)研究的系统回顾,评估NW的神经生理学基础及其对赌博问题的调节。审查遵循了系统审查和荟萃分析方案(PRISMA)的首选报告项目的建议。共纳入15项研究,图12包括非问题赌徒(NPG)和三个将问题赌徒(PG)与匹配的对照进行比较。对于P300组件,获胜结果比其他结果(西北和失利)引起更大的振幅,紧随其后的是西北结果,在一些研究中,这引起了比损失更大的振幅。对于反馈相关的消极性(FRN),在几项研究中,损失结果引起了更负的振幅,尽管在其他人中引发了与NW结果相似的幅度。对于PG,NW结果引起的P300振幅高于损失,而NPG显示与两个结果相似的振幅。本综述从不同来源收集了信息,并提供了不同研究的一致观点。然而,研究缺乏系统和健壮的方法,导致结果不一致,难以得出任何明确的结论。
    Identification of specific patterns of brain activity related to problem gambling may provide a deeper understanding of its underlying mechanisms, highlighting the importance of neurophysiological studies to better understand development and persistence of gambling behavior. The patterns of cognitive functioning have been investigated through electroencephalography (EEG) studies based on the near-win/near-miss (NW) effect. The main goal of the present study was to evaluate the neurophysiological basis of NWs and their modulation by gambling problems through a systematic review of event-related potentials (ERP) studies elicited by feedback events. The review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA). A total of 15 studies were included, 12 comprising non-problem gamblers (NPGs) and three comparing problem gamblers (PGs) with matched controls. For the P300 component, the win outcome elicited a larger amplitude than the other outcomes (NW and loss), followed by the NW outcome, which elicited a larger amplitude than loss in some studies. For feedback-related negativity (FRN), the loss outcome evoked a more negative amplitude in several studies, despite eliciting a similar amplitude to NW outcomes in others. For PGs, the NW outcome evoked a higher amplitude of P300 than loss, while NPGs showed a similar amplitude to both outcomes. The present review gathered information from different sources and provides a consistent view of the different studies. However, studies lack systematic and robust methodologies, leading to inconsistent results and making it difficult to reach any definitive conclusions.
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  • 文章类型: Journal Article
    BACKGROUND: Studies suggest that the components of brain-evoked potentials (EPs) may serve as biomarkers of the post-traumatic stress disorder (PTSD) caused by participation in combat operations; however, to date, research remains fragmented, with no studies that have attempted to combine different paradigms. In addition, the mismatch negativity component has not been studied in a Russian sample of veterans with PTSD.
    OBJECTIVE: To identify objective neurophysiological markers of combat-related PTSD using the method of auditory-evoked potentials in active and passive listening paradigms.
    METHODS: The study included a recording of auditory EPs in an oddball paradigm in three settings: 1) directed attention to auditory stimuli, 2) passive listening while viewing a neutral video sequence, and 3) viewing a video sequence associated with a traumatic event. Combatants diagnosed with PTSD (18 people) were compared with mentally healthy civilian volunteers (22 people).
    RESULTS: An increase in the latency period of the early components of auditory EP (N100 and P200), an increase in the amplitude of the P200 component to a deviant stimulus, and a decrease to a standard one in the active listening paradigm were established in the PTSD group. There were no significant differences in the parameters of the P300 component. The characteristics of mismatch negativity in the passive paradigm were revealed: an increase in the phenomenon amplitude, both when shown a video sequence associated with a traumatic event and when shown a neutral video sequence. A binary logistic regression model constructed using the selected parameters showed that the identified characteristics can potentially be considered as diagnostic markers of PTSD in combatants, as the classification accuracy stood at 87% (sensitivity - 81%, specificity - 91%).
    CONCLUSIONS: Potential neurophysiological markers of PTSD are the following: the amplitude and latency of early components of auditory EPs in the paradigm of directed attention to stimuli and the amplitude of mismatch negativity during passive attention.
    UNASSIGNED: Исследования показывают, что компоненты вызванных потенциалов головного мозга (ВП) могут являться биомаркерами посттравматического стрессового расстройства (ПТСР) вследствие участия в боевых действиях, однако на сегодняшний день исследования фрагментарны, не представлены исследования, сочетающие различные парадигмы. На русской выборке ветеранов с ПТСР не изучался компонент негативности рассогласования.
    UNASSIGNED: Выявление объективных нейрофизиологических маркеров ПТСР вследствие участия в боевых действиях методом слуховых вызванных потенциалов в парадигмах активного и пассивного слушания.
    UNASSIGNED: Исследование включало регистрацию слуховых ВП в парадигме вероятностного предъявления (oddball) в трех состояниях: 1) направленное внимание на слуховые стимулы; 2) пассивное слушание при просмотре нейтрального видеоряда; 3) при просмотре видеоряда, связанного с травматическим событием. Обследованы комбатанты с диагнозом ПТСР (18 человек) в сравнении с психически здоровыми гражданскими добровольцами (22 человека).
    UNASSIGNED: В группе лиц с ПТСР обнаружено увеличение латентного периода ранних компонентов слухового ВП (N100 и Р200), увеличение амплитуды компонента Р200 на девиантный стимул и снижение на стандартный в парадигме активного слушания. Не выявлено значимых различий в показателях компонента Р300. Выявлены особенности негативности рассогласования в пассивной парадигме: увеличение амплитуды феномена как при предъявлении видеоряда, связанного с травматическим событием, так и при предъявлении нейтрального видеоряда. Построенная с использованием выделенных показателей модель бинарной логистической регрессии показала, что выявленные особенности потенциально можно рассматривать как диагностические маркеры ПТСР у комбатантов — точность классификации составила 87% (чувствительность — 81%, специфичность — 91%).
    UNASSIGNED: Потенциальными нейрофизиологическими маркерами ПТСР являются амплитуда и латентный период ранних компонентов слуховых ВП в парадигме направленного внимания на стимулы, а также амплитуда негативности рассогласования при пассивном внимании.
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  • 文章类型: Journal Article
    巨自噬,自噬的主要调节形式,维持细胞稳态并降解运输的货物。它由蛋白激酶复合物启动,通过两个信号通路调节哺乳动物雷帕霉素复合物1(mTORC1)-腺苷5'一磷酸活化蛋白激酶(AMPK)-Unc51样激酶1(ULK1)和ULK1-PI3K-磷脂酰肌醇3-磷酸(PI3P)。目前,自体溶酶体在体外CD8+T细胞的衰老过程中积累,并可能参与诱导衰老细胞的死亡敏化。再生障碍性贫血的主要机制,一种高免疫疾病,T细胞亚群失衡如CD8+T细胞异常活化和功能亢进。因此,自噬在CD8+T细胞中的作用以及某些免疫抑制药物是否诱导细胞自噬死亡以治疗高免疫性疾病成为研究热点。发现再生障碍性贫血患者的乙酰转移酶p300明显升高,并与疾病的严重程度有关。先前的研究已经报道,典型的自噬受mTORC1-p300轴的调节。p300是p300-VPS34轴介导的非经典自噬的关键桥。在CD8+T细胞中存在自噬和乙酰化的缺陷。在免疫抑制药物治疗后,p300的表达也显著降低。我们的发现为理解免疫抑制药物如何影响AA自噬缺乏机制提供了框架,并证明了免疫抑制药物通过p300介导的经典自噬途径和非经典自噬途径负调节CD8+T细胞的功能。
    Macroautophagy, the mainly regulated form of autophagy, maintains the cellular homeostasis and degrades the transported cargoes. It is initiated by the protein kinase complex regulating by two signals pathway Mammalian target of rapamycin complex 1 (mTORC1)-Adenosine 5\' monophosphate activated protein kinase (AMPK)-Unc 51 like kinase 1(ULK1) and ULK1-PI3K- phosphatidylinositol 3-phosphate (PI3P). Currently, autolysosomes are accumulated during the aging process of CD8+T cells in vitro and may participate in inducing death sensitization of senescent cells. The main mechanism of aplastic anemia, a hyperimmune disease, is the T cells subsets imbalance such as CD8+T cells abnormal activation and hyperfunction. Therefore, the role of autophagy in the CD8+T cells and supposed whether some immunosuppress drugs induced the cells autophagic death to treat the hyperimmune diseases were focused. It was decided found that the acetyltransferase p300 obviously increased in the aplastic anemia patients and was related with the severity of disease. Previous studies have reported that canonical autophagy is regulated by the mTORC1-p300 axis. p300 is a critical bridge in the p300-VPS34 axis mediated non-canonical autophagy. There is the deficiency of autophagy and acetylation in the CD8+T cells. The expression of p300 also decreased notably after the immunosuppressive drugs therapy. Our findings provide a framework for understanding how immunosuppressive drugs effect on the AA autophagy deficiency mechanism and proved that immunosuppressive drugs negatively regulated the function of CD8+T cells by p300-mediated canonical autophagy pathway and non-canonical autophagy pathway.
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  • 文章类型: Journal Article
    非侵入性经皮耳迷走神经刺激(taVNS)作为一种神经刺激工具,在调节注意力和记忆等认知过程中具有潜在应用,引起了越来越多的兴趣。可能是通过调节蓝斑去甲肾上腺素系统。研究检查P300大脑相关成分与去甲肾上腺素能活动的相关性,然而,产生了不一致的发现,可能是由于刺激参数的差异,因此需要进一步调查。在这项涉及61名参与者的事件相关潜在研究中,因此,我们检查了taVNS参数的变化,特别是刺激类型(间隔与连续刺激)和持续时间,在视觉新奇怪球任务中影响P300振幅。尽管在P300的整个簇和时间窗口中没有发现刺激的影响,但基于簇的置换测试显示,taVNS对小电极簇的P300反应有明显的影响。以观察到的容易目标的较大振幅为特征(即,与假刺激相比,taVNS后容易从标准品辨别的刺激)。值得注意的是,我们的研究结果表明,刺激类型显着调节taVNS对P300的影响,连续刺激显示更大的P300差异(taVNSvs.假)与间隔刺激相比的硬目标和标准。我们没有观察到刺激持续时间对靶相关P300的交互作用。虽然我们的发现与之前的研究一致,需要进一步研究才能充分阐明taVNS对P300成分的影响及其作为该领域神经调节可靠标志物的潜在效用.
    Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has attracted increasing interest as a neurostimulation tool with potential applications in modulating cognitive processes such as attention and memory, possibly through the modulation of the locus-coeruleus noradrenaline system. Studies examining the P300 brain-related component as a correlate of noradrenergic activity, however, have yielded inconsistent findings, possibly due to differences in stimulation parameters, thus necessitating further investigation. In this event-related potential study involving 61 participants, therefore, we examined how changes in taVNS parameters, specifically stimulation type (interval vs. continuous stimulation) and duration, influence P300 amplitudes during a visual novelty oddball task. Although no effects of stimulation were found over the whole cluster and time window of the P300, cluster-based permutation tests revealed a distinct impact of taVNS on the P300 response for a small electrode cluster, characterized by larger amplitudes observed for easy targets (i.e., stimuli that are easily discernible from standards) following taVNS compared to sham stimulation. Notably, our findings suggested that the type of stimulation significantly modulated taVNS effects on the P300, with continuous stimulation showing larger P300 differences (taVNS vs. sham) for hard targets and standards compared to interval stimulation. We observed no interaction effects of stimulation duration on the target-related P300. While our findings align with previous research, further investigation is warranted to fully elucidate the influence of taVNS on the P300 component and its potential utility as a reliable marker for neuromodulation in this field.
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  • 文章类型: Journal Article
    背景:本研究的目的是探讨错配阴性(MMN)和P300事件相关电位在昏迷和其他意识障碍(DOC)患者6个月时辨别意识状态和预测意识改善的价值。
    方法:我们对42例DOC患者进行了MMN和P300,平均起效时间为40.21±19.43天。这些患有DOC的患者被归类为昏迷,反应迟钝的觉醒综合征(UWS),最小意识减去(MCS-),根据神经行为评估和昏迷恢复量表修订评分,以及最低意识加(MCS)组。主要结果是DOC患者在6个月时意识的改善。我们评估了MMN和P300在6个月时定量预测预后的功效以及MMN和P300参数区分DOC的能力。
    结果:在DOC组中显示出至少一个MMN或P300参数的显着差异,但在MCS-组和MCS+组之间没有(显著性水平:0.05)。MMN和P300振幅在6个月时均显示出理想的预测准确性,曲线下面积(AUC)分别为0.859和0.856。MMN和P300振幅的最佳阈值为2.044和1.095μV。然而,组合的MMN-P300振幅显示出更好的6个月预测准确性(AUC0.934,95%置信区间0.860-1.000),灵敏度为85%,特异性为90.9%。
    结论:MMN和P300可能有助于区分昏迷,UWS,MCS,但不是在MCS患者和MCS+患者之间。MMN振幅,P300振幅,尤其是6个月时的MMN-P300振幅组合可能是DOC患者6个月时意识改善的有趣预测因子。
    背景:中国临床试验注册标识符ChiCTR2400083798。
    BACKGROUND: The objective of this study was to investigate the value of mismatch negativity (MMN) and P300 event-related potentials for discriminating the consciousness state and predicting improvement of consciousness at 6 months in patients with coma and other disorders of consciousness (DOC).
    METHODS: We performed MMN and P300 on 42 patients with DOC with a mean onset time of 40.21 ± 19.43 days. These patients with DOC were categorized into coma, unresponsive wakefulness syndrome (UWS), minimal consciousness minus (MCS-), and minimal consciousness plus (MCS +) groups according to neurobehavioral assessment and the Coma Recovery Scale-Revised score. The primary outcome was the improvement of consciousness at 6 months in patients with DOC. We assessed the efficacy of MMN and P300 in quantitatively predicting the prognosis at 6 months and the capability of MMN and P300 parameters to differentiate between DOC.
    RESULTS: At least one significant difference in either MMN or P300 parameters was displayed among the DOC groups, but not between the MCS- and MCS+ groups (significance level: 0.05). Both MMN and P300 amplitudes showed desirable predictive accuracy at 6 months, with areas under the curve (AUCs) of 0.859 and 0.856, respectively. The optimal thresholds for MMN and P300 amplitudes were 2.044 and 1.095 μV. However, the combined MMN-P300 amplitude showed better 6-month predictive accuracy (AUC 0.934, 95% confidence interval 0.860-1.000), with a sensitivity of 85% and a specificity of 90.9%.
    CONCLUSIONS: MMN and P300 may help discriminate among coma, UWS, and MCS, but not between patients with MCS- and patients with MCS+ . The MMN amplitude, P300 amplitude, and especially combined MMN-P300 amplitude at 6 months may be interesting predictors of consciousness improvement at 6 months in patients with DOC.
    BACKGROUND: Chinese Clinical Trial Registry identifier ChiCTR2400083798.
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