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 Friedrich5,6
1Department of Neurosurgery, Mass General Brigham, Harvard Medical School, Boston, MA, USA. awarren15@bwh.harvard.edu.
Nature communications
|July 21, 2025
概括
对于意识障碍的深度大脑刺激在针对特定的胸膜网络时显示出有希望的结果. 有效的治疗需要涉及下侧侧核和腹膜管道,这与灰质的保存有关.
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) 涉及严重的兴奋和意识障碍.
- 深度大脑刺激 (DBS) 是一种潜在的治疗方法,但结果各不相同.
- 变化可能源于患者因素,电极放置或参与的大脑网络.
研究的目的:
- 为了研究DBS的有效性,针对与DoC患者的乳头中枢-中枢-囊综合体.
- 确定DoC的成功DBS治疗的神经解剖学和网络相关性.
- 改进DBS目标和DoC的患者选择标准.
主要方法:
- 对40名DoC患者的分析,这些患者接受了针对thalamic centromedian-parafascicular复合体的DBS治疗.
- 意识改善与灰质完整性的相关性,特别是在条形体中.
- 电场建模以确定最佳的刺激参数和参与路径.
- 外部验证使用具有中风引起的兴奋障碍和引起的意识障碍的独立队列.
主要成果:
- 意识的改善与更好的灰质保存相关,特别是在条形体中.
- 有效的DBS需要下侧侧核和腹部体通道的参与.
- 在独立的DoC队列中,有效的刺激模式重叠与受损的大脑活动.
- 连接大脑干和下丘脑的腹部体通道被确定为一个关键通道.
结论:
- 针对乳头中枢 - 中枢 - 囊综合体的DBS可以改善精选患者的意识.
- 保存的条状灰质可能会预测出更好的结果.
- 优化DBS以吸引下侧侧细胞核和腹膜通道至关重要.
- 结果为患者选择提供信息,精确目标,并确定意识障碍的相关网络.
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