首页|P300与慢性意识障碍患者经颅直流电刺激响应的相关性研究

P300与慢性意识障碍患者经颅直流电刺激响应的相关性研究

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  • NETL
  • NSTL
  • 万方数据
目的:利用两组加工深度递增式变化的事件相关电位(ERP)Oddball范式探讨经颅直流电刺激(tDCS)响应慢性意识障碍患者的电生理学特征.方法:研究纳入17例无反应觉醒综合征(UWS)和30例微意识状态(MCS)患者,对其进行两组加工深度递增式变化范式的ERP检查,后在连续10个工作日内接受20次左侧前额叶背外侧(DLPFC)区域tDCS治疗,根据改良昏迷恢复量表(CRS-R)评估结果分为响应者和非响应者,分析干预响应者一般情况特征及电生理学特征.结果:在UWS患者中,性别、年龄、病程、接受手术情况、CRS-R评分、P300出现情况均与tDCS响应性无关(P＞0.05);而在MCS患者中,CRS-R评分(P=0.015)和反名-正名(DO)范式中P300出现情况(P=0.005)与tDCS响应性相关,而性别、年龄、病程、接受手术情况、纯音一正名(TO)范式中P300出现情况与响应性无关(P＞0.05).结论:更高的CRS-R评分和分层听觉ERP范式中P300的存在,特别是DO范式中的P300成分与MCS患者的tDCS响应性有关,推测是由于DO范式中P300成分代表患者残存的语义加工处理能力,因此具有优先恢复的能力.
The correlation between P300 and tDCS response in patients with prolonged disorders of consciousness
Objective:To explore the electrophysiological characteristics of patients with prolonged disorders of conscious-ness responded to transcranial direct current stimulation(tDCS)intervention by a hierarchical auditory event-re-lated potential(ERP)Oddball pattern.Method:A hierarchical auditory ERP pattern was applied to seventeen unresponsive wakefulness syndrome(UWS)and thirty-one minimally conscious state(MCS)patients who subsequently received 20 anodal tDCS sessions of the left dorsolateral prefrontal cortex(DLPFC)over 10 consecutive working days.The patients were divided into responders and non-responders according to the Coma Recovery Scale-Revised(CRS-R)be-havioral evaluation,and the differences in general conditions and electrophysiological characteristics were com-pared.Result:Univariable analysis showed that the responders and non-responders did not differ for gender,age,time since onset,operation,CRS-R score and the proportion of P300(P＞0.05)in UWS patients.In MCS pa-tients,CRS-R score(P=0.015)and P300 in DO paradigm(P=0.005)were independently associated with tDCS response,while gender,age,time since onset,operation and P300 in TO paradigm were not associated with responsiveness(P＞0.05).Conclusion:Higher CRS-R total score and presence of P300 in the hierarchical auditory ERP pattern,especial-ly P300 in the DO paradigm,are associated with tDCS response in MCS patients.P300 in the DO paradigm may indicate that these patients possess higher levels of preserved semantic processing capabilities,and had a priority to recover.

prolonged disorders of consciousnessevent-related potentialtranscranial direct current stimula-tionP300coma recovery scale-revised

张晔、李瑞、万小萍、霍仁超、宋为群

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首都医科大学宣武医院康复医学科,北京市,100053

慢性意识障碍 事件相关电位 经颅直流电刺激 P300 改良昏迷恢复量表

科技部科技创新项目国家自然科学基金资助项目国家自然科学基金资助项目北京市自然科学基金资助项目北京市医院管理中心"青苗"计划专项经费资助项目

2030+2021ZD020430082102658818737237204267QML20230813

2024

10.3969/j.issn.1001-1242.2024.07.004

中国康复医学杂志
中国康复医学会

中国康复医学杂志

CSTPCD北大核心
影响因子：2.026
ISSN：1001-1242
年,卷(期)：2024.39(7)