与认知运动解离相关的受伤模式
Eva Franzova1, Qi Shen1, Kevin Doyle1
1Department of Neurology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, NY, USA.
Brain : a journal of neurology
|August 13, 2023
概括
脑损伤患者的认知运动解离 (CMD) 表明潜在的恢复. 这项研究将特定的脑损伤模式和网络功能障碍与CMD联系起来,这表明前脑前脑中电路集成失败.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 在没有反应的急性脑损伤患者中,认知运动解离 (CMD) 预测功能恢复.
- 通过EEG和机器学习检测CMD具有临床意义,但根本机制尚不清楚.
- 了解CMD机制对于患者护理和治疗指导至关重要.
研究的目的:
- 测试CMD是由于未能将综合的电机命令与电机输出集成而产生的假设.
- 分析CMD和没有CMD的患者的结构性损伤模式和网络功能障碍.
- 为了识别潜在的神经成像标志物用于CMD查.
主要方法:
- 手动分段MRI序列 (T2-FLAIR,DWI) 来量化107名患者的结构损伤.
- 损伤模式分析,以确定CMD (n=21) 和非CMD (n=86) 组中的共同点.
- 使用EEG (ABCD分类,WPPC) 评估thalamocortical和皮层-皮层网络连接.
主要成果:
- 在CMD和非CMD组中确定了不同的病变模式;在CMD患者中没有中脑病变.
- 患有皮下病变的CMD患者表现出保留的甲状腺皮层网络功能,但改变了远程皮层-皮层连接.
- 患有双边皮层病变和CMD的患者显示皮层-皮层网络功能得到保护.
结论:
- 在前脑前半回路水平上,运动指令集成的失败是患有皮下病变的患者中CMD的基础.
- 保持皮层-皮层网络功能与双边皮层病变患者的CMD检测有关.
- 结构性MRI和静止式EEG可以使CMD查成为可能.
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