基于互样本熵脑网络的脊髓电刺激下微意识状态患者脑功能评估  

Brain function evaluation in the minimally conscious state using cross-sample entropy based on brain network measure under the spinal cord stimulation

作　　者：梁振虎[1,2] 任娜 王勇 李佳妮[1,2] 白洋 李小俚 何江弘 Zhenhu LIANG;Na REN;Yong WANG;Jiani LI;Yang BAI;Xiaoli LI;Jianghong HE(Institute of Electrical Engineering,Yanshan University,Qinhuangdao 066004,China;Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province,Qinhuangdao 066004,China;Department of Basic Medical Science,School of Medicine,Hangzhou Normal University,Hangzhou 310000,China;State Key Laboratory of Cognitive Neuroscience and Learning,Beijing Normal University,Beijing 100875,China;The Seventh Medical Center to Chinese PLA General Hospital,Coma and Encephalopathy Control Center,Beijing 100053,China)

机构地区：[1]燕山大学电气工程学院,秦皇岛066004 [2]河北省智能康复及神经调控重点实验室,秦皇岛066004 [3]杭州师范大学医学院基础医学系,杭州310000 [4]北京师范大学认知神经科学与学习国家重点实验室,北京100875 [5]中国人民解放军第七医学中心昏迷与脑病调控中心,北京100053

出　　处：《中国科学：信息科学》2021年第6期940-958,共19页Scientia Sinica(Informationis)

基　　金：国家自然科学基金(批准号:61673333,81230023,81771359);河北省自然科学基金优秀青年基金(批准号:F2018203281)资助项目。

摘　　要：脊髓电刺激作为一种有效的意识促醒手段已经在临床上得到了较为广泛的应用,但是其内在机制仍不完全明确.本文将正常人静息态脑电作为对照组,利用样本熵对微意识状态患者的脊髓电刺激前后的脑电信号进行计算,并分析了基于互样本熵构造的脑网络在刺激前后的变化.结果表明,脊髓电刺激提高了微意识状态患者额叶和中央区内的脑电信号复杂度;还提高了患者在额叶内、中央区内以及额叶与其他脑区间的高频段(α~γ,8~45 Hz)的耦合模式复杂度,表明通道间信息交互作用的显著增强;同时,患者高频段脑网络平均聚类系数增加,平均特征路径长度减少,小世界特性显著提升(在α,β,和γ均为p<0.001).相对于健康对照组,这些指标变化的方向趋向于正常人静息态的脑功能.样本熵和互样本熵在脊髓电刺激后与健康对照组在某些脑区内或脑区间上无显著差异(比如,β和γ频段的样本熵值在额叶和中央区(p>0.05)),但是高频段的脑网络参数仍有显著差异(比如,高频段小世界网络特征p<0.001).因此,我们认为这些变化是脊髓电刺激对大脑产生了一个"短时程效应".我们推测脊髓电刺激对脑功能的重塑有一定的促进作用.本研究对脊髓电刺激的内在机理提供了新的解释,同时也为微意识状态患者的脑功能评估提供了新的思路.Although spinal cord stimulation(SCS),as an effective method for consciousness modulation,has been applied in MCS,the underlying mechanism is still not clear.In this study,the resting-state EEG signals recorded from healthy volunteers were employed as a control group for comparison.The sample entropy,as well as the brain networks characteristics derived from the cross-sample entropy,were used to investigate the neural responses between the states of the pre-SCS and post-SCS.The results showed that the complexity of EEG signals increased in the frontal and central regions after the SCS.The SCS also enhanced the coupling mode in intra-region of pairwise channels within the frontal region and central region,as well as the inter-region channels between the frontal region with other regions in high frequency bands(α8~13 Hz,β13~30 Hz,γ30~45 Hz).This indicated that the information integration increased after SCS.Also,compared with the pre-SCS state,the average clustering coefficient increased and the average path length decreased in the post-SCS state in high frequency band(fromαtoγ).Also,the small-world network characteristics of the patients in the high frequency band are significantly enhanced after SCS(p<0.001 inα,β,andγ).Compared with the healthy control group,the change directions of these indices tend to the brain function indices of resting states in normal subjects.There was no significant difference between pre-SCS in MCS patient state and the resting state in healthy control subjects in the sample entropy and cross sample entropy of some regions,such as the sample entropy of theβandγfrequency bands in the frontal and the central regions(p>0.05).However,the parameters of brain networks still exist significant differences between the post-SCS and resting state.Therefore,we think that these indices changes after SCS may be induced from the"short-range effect"of SCS.We speculate that the SCS has the ability to remodeling brain function through the"short-range effect".This study provided a new interpreta

关 键 词：微意识状态 脑电 脊髓电刺激 互样本熵 脑网络 

分 类 号：R741.05[医药卫生—神经病学与精神病学]