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
The correlation between P300 and tDCS response in patients with prolonged disorders of consciousness
张晔 1李瑞 1万小萍 1霍仁超 1宋为群1
作者信息
- 1. 首都医科大学宣武医院康复医学科,北京市,100053
- 折叠
摘要
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.
Abstract
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.
关键词
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Key words
prolonged disorders of consciousness/event-related potential/transcranial direct current stimula-tion/P300/coma recovery scale-revised引用本文复制引用
基金项目
科技部科技创新项目(2030+2021ZD0204300)
国家自然科学基金资助项目(82102658)
国家自然科学基金资助项目(81873723)
北京市自然科学基金资助项目(7204267)
北京市医院管理中心"青苗"计划专项经费资助项目(QML20230813)
出版年
2024
NETL
NSTL
万方数据