在taVNS之后的自主反应预测了DoC患者意识水平的变化
Yan Li1,2, Francesco Riganello3, Jing Yu2
1International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China.
Scientific reports
|March 2, 2025
概括
通过皮肤进行的耳膜迷走神经刺激 (taVNS) 在区分意识障碍 (DoC) 和通过分析心率变化 (HRV) 预测患者康复方面表现有前途. 这种非侵入性方法为评估和潜在治疗DoC提供了一种新的方法.
科学领域:
- 神经科学和神经病学 神经科学和神经病学
- 心脏病学和自主神经系统研究
- 生物医学工程和信号处理.
背景情况:
- 在严重获得性脑损伤 (sABI) 中,改善的生存率增加了意识障碍 (DoC) 的患病率,包括不反应性清醒综合征 (UWS) 和最小意识状态 (MCS).
- 由于主观行为评估和高误诊率,DoC的临床诊断面临挑战.
- 了解大脑心脏动态对于DOC评估和治疗策略至关重要.
研究的目的:
- 通过心率变化 (HRV) 调节自主反应,研究通过皮肤进行的耳耳道迷走神经刺激 (taVNS) 的实用性.
- 为了区分健康对照 (HC) 和DoC患者.
- 区分MCS和UWS状态,并预测患者的预后.
主要方法:
- 一项前性随机临床试验,涉及26名HC和36名DoC患者 (17名MCS,19名UWS/VS).
- 服用taVNS10分钟,同时记录心电图 (ECG) 进行心率变化 (HRV) 分析.
- 支持向量机 (SVM) 建模,使用辐射基函数 (RBF) 内核使用HRV参数 (VLF,LF,SampEn) 进行分类和结果预测.
主要成果:
- 观察到HRV参数 (HF,VLF,SampEn) 的显著调节,表明与HC相比,DoC患者的自主反应发生了变化.
- SVM模型在分类HC与DoC方面取得了86%的准确性,在分类MCS与UWS方面取得了78%的准确性.
- SVM建模预测了患者的结果,在干预后三个月的准确率为86%,在干预后六个月的准确率为71%.
结论:
- 据HRV变化证明,taVNS有效调节自主调节,为DoC评估提供了一个潜在的工具.
- 这项研究表明taVNS在区分DoC状态和预测患者康复方面具有实用性.
- 这些发现突显了脑心动态在DoC中的重要性,并将taVNS作为一个有前途的治疗和预后方法.
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