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意识障碍,而不是完整的锁定综合征,用于末期肌缩侧面硬化症:一个病例系列

Florent Gobert^1,2, Inès Merida³, Emmanuel Maby⁴

¹Hospices Civils de Lyon, Neurological hospital Pierre-Wertheimer, Intensive Care Unit, Lyon, France. florent.gobert01@chu-lyon.fr.

Communications medicine

|November 19, 2025

概括

末期肌缩侧面硬化症 (ALS) 可能涉及一种退行性意识障碍,而不是完全的锁定综合征 (cLIS). 这表明隐蔽的意识可能会消失,影响患者的护理和对ALS进展的理解.

科学领域:

神经科学是一个神经科学.
神经学神经学
认知科学认知科学

背景情况:

肌缩侧面硬化症 (ALS) 末期通常被认为是完整的锁定综合征 (cLIS).
这项研究将重点从cLIS转移到认知运动分离 (CMD),探索潜在的可证明意识.
这项研究调查了末期ALS患者的隐蔽意识.

研究的目的:

用多式联动电池来评估ALS末期病例中隐蔽意识的保护.
在ALS中区分cLIS和潜在的退行性意识障碍.
在明显失去沟通能力的患者中描述大脑功能.

主要方法:

神经生理学测试包括听觉奇特的范式和听觉脑机接口 (BCI).
功能激活任务成像,长期EEG,大脑形态和休息状态新陈代谢分析.
用多模式评估电池对两个末期ALS患者的评估.

主要成果:

一名患者最初遵循命令,但后来失去了命令遵循和认知反应.
第二名患者无法执行命令或控制BCI.
两位患者都表现出改变的清醒状态,大脑缩和全球低代谢,表明有意识障碍.

结论:

研究结果表明,在末期的ALS中,存在的是"退行性意识障碍",而不是cLIS.
这种情况似乎与典型的四肢和无关节症不同,在这种情况下,通信仍然存在.
识别神经成像特征对于了解末期ALS至关重要,需要进一步调查.

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