慢性意识障碍相关颅内电生理特征研究进展  

Current progress on characteristics of intracranial electrophysiology related to prolonged disorders of consciousness

作　　者：黄永志 吴佳柔 许敏鹏 何江弘(综述)[3] 明东(审校) HUANG Yongzhi;WU Jiarou;XU Minpeng;HE Jianghong;MING Dong(Academy of Medical Engineering and Translational Medicine,Tianjin University,Tianjin 300072,P.R.China;School of Precision Instrument and Optoelectronics Engineering,Tianjin University,Tianjin 300072,P.R.China;Department of Neurosurgery,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,P.R.China)

机构地区：[1]天津大学医学工程与转化医学研究院,天津300072 [2]天津大学精密仪器与光电子工程学院,天津300072 [3]首都医科大学附属北京天坛医院神经外科,北京100070

出　　处：《生物医学工程学杂志》2024年第4期826-832,共7页Journal of Biomedical Engineering

基　　金：国家自然科学基金(82101274)。

摘　　要：慢性意识障碍(pDOC)是由各类严重脑损伤导致的持续性意识丧失的病理状态。pDOC会严重影响患者的社会生活能力,并对家庭及社会造成巨大负担。探究意识障碍的发生机制、准确评估pDOC患者的意识水平,是制定有效临床诊疗策略的基础。借助功能磁共振、头皮脑电等非侵入脑成像技术的研究已经证实,意识的产生、维持以及意识障碍涉及大脑多个皮质和皮质下脑区及相关的功能网络。颅内神经电生理技术直接记录皮质下或皮质神经元的电活动,信噪比和空间分辨率高,对于深入揭示意识障碍脑功能和疾病机制具有独特优势和重要价值。本综述从反映微观尺度的单神经元活动锋电位和反映宏观尺度的神经元集群活动场电位两类典型的颅内电生理信号分析出发,回顾pDOC相关的颅内电生理特征研究进展,并探讨当前存在的问题和未来发展趋势,以期推动pDOC相关的病理生理机制研究,并为后续pDOC的临床诊疗提供有益启示。Prolonged disorders of consciousness(pDOC)are pathological conditions of alterations in consciousness caused by various severe brain injuries,profoundly affecting patients’life ability and leading to a huge burden for both the family and society.Exploring the mechanisms underlying pDOC and accurately assessing the level of consciousness in the patients with pDOC provide the basis of developing therapeutic strategies.Research of non-invasive functional neuroimaging technologies,such as functional magnetic resonance(fMRI)and scalp electroencephalography(EEG),have demonstrated that the generation,maintenance and disorders of consciousness involve functions of multiple cortical and subcortical brain regions,and their networks.Invasive intracranial neuroelectrophysiological technique can directly record the electrical activity of subcortical or cortical neurons with high signal-to-noise ratio and spatial resolution,which has unique advantages and important significance for further revealing the brain function and disease mechanism of pDOC.Here we reviewed the current progress of pDOC research based on two intracranial electrophysiological signals,spikes reflecting single-unit activity and field potential reflecting multi-unit activities,and then discussed the current challenges and gave an outlook on future development,hoping to promote the study of pathophysiological mechanisms related to pDOC and provide guides for the future clinical diagnosis and therapy of pDOC.

关 键 词：慢性意识障碍 锋电位 局部场电位 颅内电生理 

分 类 号：R741[医药卫生—神经病学与精神病学]