脑电标志物在意识障碍评估中的应用  

Applications of EEG Biomarkers in The Assessment of Disorders of Consciousness

作　　者：王仲朋 刘佳[1,2] 陈龙 许敏鹏[1,2] 明东 WANG Zhong-Peng;LIU Jia;CHEN Long;XU Min-Peng;MING Dong(Academy of Medical Engineering and Translational Medicine,Tianjin University,Tianjin 300072,China;Haihe Laboratory of Brain-computer Interaction and Human-machine Integration,Tianjin University,Tianjin 300072,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]天津大学脑机交互与人机共融海河实验室,天津300072

出　　处：《生物化学与生物物理进展》2025年第4期899-914,共16页Progress In Biochemistry and Biophysics

基　　金：国家重点研发计划(2022YFF1202304);国家自然科学基金(62376190);天津市科技计划(22JCYBJC01430)资助项目。

摘　　要：意识障碍(DOC)的传统评估方式主要为行为学量表,存在主观性强、误诊率高等问题,发展客观高效的评价方法成为当前研究的重点。脑电图(EEG)作为一种非侵入性、高时间分辨率的神经电生理监测工具,逐渐成为评估意识水平的关键手段。本文围绕现有的评估意识水平的脑电标志物,包括静息态、任务态脑电特征以及基于经颅磁刺激-脑电图的特征,探讨了各类脑电标志物的特点、有效性、局限性与发展前景。研究表明,静息态、任务态及经颅磁刺激(TMS)-EEG脑电标志物已被证明能够区分不同意识水平并预测患者临床结局,具有重要的临床应用潜力。尽管这些标志物展示出独特优势,但仍缺乏具有高鲁棒性和广泛泛化能力的标准化脑电标志物。本文旨在为未来挖掘更精确和广泛适用的脑电标志物提供参考,使脑电标志物在DOC患者的诊断与预后上有新的突破。Disorders of consciousness(DOC)are pathological conditions characterized by severely suppressed brain function and the persistent interruption or loss of consciousness.Accurate diagnosis and evaluation of DOC are prerequisites for precise treatment. Traditional assessment methods are primarily based on behavioral scales,which are inherently subjective and rely on observable behaviors. Moreover, traditional methods have a highmisdiagnosis rate, particularly in distinguishing minimally conscious state (MCS) from vegetative state/unresponsive wakefulness syndrome (VS/UWS). This diagnostic uncertainty has driven the exploration ofobjective, reliable, and efficient assessment tools. Among these tools, electroencephalography (EEG) has garneredsignificant attention for its non-invasive nature, portability, and ability to capture real-time neurodynamics. Thispaper systematically reviews the application of EEG biomarkers in DOC assessment. These biomarkers arecategorized into 3 main types: resting-state EEG features, task-related EEG features, and features derived fromtranscranial magnetic stimulation-EEG (TMS-EEG). Resting-state EEG biomarkers include features based onspectrum, microstates, nonlinear dynamics, and brain network metrics. These biomarkers provide baselinerepresentations of brain activity in DOC patients. Studies have shown their ability to distinguish different levels ofconsciousness and predict clinical outcomes. However, because they are not task-specific, they are challenging todirectly associate with specific brain functions or cognitive processes. Strengthening the correlation betweenresting-state EEG features and consciousness-related networks could offer more direct evidence for thepathophysiological mechanisms of DOC. Task-related EEG features include event-related potentials, event-relatedspectral modulations, and phase-related features. These features reveal the brain’s responses to external stimuliand provide dynamic information about residual cognitive functions, reflecting neurophysiological

关 键 词：意识障碍 脑电图 脑电标志物 诊断评估 

分 类 号：R318[医药卫生—生物医学工程] R741[医药卫生—基础医学]