一个与在深度脑刺激后恢复意识相关的人类大脑网络
Aaron E L Warren1,2, Marina Raguž3,4, Helen Friedrich2,5
1Department of Neurosurgery, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
medRxiv : the preprint server for health sciences
|November 1, 2024
概括
对于意识障碍 (DoC) 的深度大脑刺激 (DBS) 是有前途的. 有效的治疗取决于精确的电极放置在特定的大脑网络,改善患者的兴奋和意识.
科学领域:
- 神经科学是一个神经科学.
- 神经外科 神经外科
- 神经学 神经学
背景情况:
- 意识障碍 (DoC) 涉及到受损的兴奋或意识.
- 深度大脑刺激 (DBS) 是DoC的潜在治疗方法,但结果各不相同.
- 变化可能源于患者因素,电极放置或刺激的大脑网络.
研究的目的:
- 研究DBS准,大脑网络参与和DoC患者意识改善之间的关系.
- 确定最优的电极放置和刺激参数,以在DoC中有效地实现DBS.
主要方法:
- 研究了40名接受DBS的DoC患者,这些患者的DBS准了胸膜中枢-中枢-副筋综合体.
- 灰色物质完整性与临床结果相关,特别是在条形体中.
- 分析了电场的空间分布及其与特定大脑核和网络的接触.
主要成果:
- 更好地保存灰色物质,特别是在条形体中,与良好的意识相关.
- 有效的刺激涉及到电场延伸到膜/膜下核,并参与上升的兴奋网络 (下丘脑,脑干,额叶).
- 连接到网络的最佳DBS站点与普遍缺席发作和获得的大脑病变有关.
结论:
- DBS对于DoC来说具有治疗潜力.
- 对于有效的DBS来说,精确地准胸膜中枢-中枢-副筋综合体和相关网络至关重要.
- 对于DoC而言,有效的DBS与其他影响意识的条件共享网络机制.
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