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在患有急性意识障碍的儿童中,对新的听觉刺激的认知处理

Brian L Appavu^1,2,3, Sarah Wykhoff⁴, Brian Burrows⁵

¹Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA. bappavu@gmail.com.

Neurocritical care

|February 11, 2026

概括

在重症儿童中检测隐藏的意识是具有挑战性的. 与事件相关的潜力 (ERP),如不匹配的消极性 (MMN) 和P300b,可以预测不响应儿科患者的更好的长期结果.

科学领域:

神经科学是一个神经科学.
儿科重症监护儿科重症监护
电子生理学电子生理学

背景情况:

预测急性昏迷症的重症儿童是很困难的.
通过脑电图 (EEG) 的事件相关潜能 (ERP) 提供了对隐藏意识的非侵入性检测.
关键的ERP包括不匹配的负面性 (MMN) 和P300b反应.

研究的目的:

使用一个奇怪的范式来研究听觉ERP,以评估重病,不反应的儿童的皮质处理.
确定ERP是否能区分注意力和不注意力处理.
将ERP的发现与长期的功能结果联系起来.

主要方法:

未来的儿科重症监护室 (PICU) 患者的招生,格拉斯哥昏迷表得分小于8,接受连续EEG.
听觉局部-全球奇怪模式,以引起MMN类和P300b类的响应.
基于集群的 permutation 测试用于 ERP 显著性和 Mann-Whitney U 测试用于结果关联 (格拉斯哥结果尺度扩展 - 儿科).

主要成果:

在29名儿童中,有6名 (20.7%) 患有可复制ERP:有2名 (6.9%) 患有MMN样反应,4名 (13.8%) 患有P300b样反应.
任何可检测的ERP响应的存在与更有利的长期功能结果有关 (较低的GOSE-Peds得分,p=0.029).

结论:

在重病,不反应的儿童中,ERP有效地检测出不注意的和注意的皮质处理.
可复制的MMN或P300b反应表明可能有更好的长期功能恢复.
这种非侵入性EEG方法有助于对这种脆弱的儿科患者群体的预后.

关键词:

严重的脑损伤是急性脑损伤.意识意识意识意识意识意识意识意识意识意识意识与事件相关的潜力与事件相关的潜力不匹配的消极性不匹配的消极性在P300b中,它是P300b.儿科儿科儿科

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