Quantitative assessment of visual behavior in disorders of consciousness
Quantitative assessment of visual behavior in disorders of consciousness
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DOI：
10.1007/s00415-012-6435-4
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发表时间：
2012-09-01
影响因子：
6
通讯作者：
Estraneo, A.
中科院分区：
文献类型：
--
作者：
Trojano, L.;Moretta, P.;Estraneo, A.
对眼睛行为的研究在意识障碍(Doc)的鉴别诊断中至关重要。尽管如此，对植物人状态(VS)或最小意识状态(MCS)患者的眼动模式的评估仅依赖于临床评估。在这项研究中，我们的目的是提供对DOC患者对运动刺激的反应的视觉跟踪行为的定量评估。9名VS患者和9名MCS患者被纳入慢性DOC患者神经康复室；11名匹配的健康人作为对照组。所有参与者都通过计算机红外线眼球跟踪系统对眼球跟踪模式进行了定量评估；刺激由一个红色圆圈或在PC显示器上缓慢移动的小彩色图片表示。在MCS和VS中，靶上或靶外注视的比例有显著差异。最重要的是，在所有VS患者中，目标上或目标外的注视分布处于或低于机会水平，而在MCS组中，9名患者中有7人的目标上注视比例显著高于机会水平。固定长度在三组间无显著差异。目前对跟踪任务中视觉行为的定量评估表明，MCS和VS患者在目标注视的比例上存在差异。这些结果可能具有重要的临床意义，因为视觉行为的定量分析可能在DOC的鉴别诊断中提供额外的元素。
The study of eye behavior is of paramount importance in the differential diagnosis of disorders of consciousness (DoC). In spite of this, assessment of eye movement patterns in patients with vegetative state (VS) or minimally conscious state (MCS) only relies on clinical evaluation. In this study we aimed to provide a quantitative assessment of visual tracking behavior in response to moving stimuli in DoC patients. Nine VS patients and nine MCS patients were recruited in a Neurorehabilitation Unit for patients with chronic DoC; 11 matched healthy subjects were tested as the control group. All participants underwent a quantitative evaluation of eye-tracking pattern by means of a computerized infrared eye-tracker system; stimuli were represented by a red circle or a small color picture slowly moving on a PC monitor. The proportion of on- or off-target fixations differed significantly between MCS and VS. Most importantly, the distribution of fixations on or off the target in all VS patients was at or below the chance level, whereas in the MCS group seven out of nine patients showed a proportion of on-target fixations significantly higher than the chance level. Fixation length did not differ among the three groups significantly. The present quantitative assessment of visual behaviour in a tracking task demonstrated that MCS and VS patients differ in the proportion of on-target fixations. These results could have important clinical implications since the quantitative analysis of visual behavior might provide additional elements in the differential diagnosis of DoC.