Detecting awareness in the vegetative state
Detecting awareness in the vegetative state
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DOI：
10.1196/annals.1417.018
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Coleman, Martin R.
中科院分区：
文献类型：
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作者：
Owen, Adrian M.;Coleman, Martin R.
在植物人状态下，对残余脑功能的评估是极其困难的，并且经常依赖于对观察到的自发和意志行为的主观解释。对于那些保留外周运动功能的患者，由结构成像和电生理学支持的严格的行为评估通常足以确定患者的觉醒和意识水平。然而，越来越明显的是，在一些患者中，外周运动系统的损伤可能会阻止对命令的明显反应，即使感知和理解这些命令的认知能力可能保持不变。功能性神经影像学的进展为这个问题提供了一个新的解决方案;在最近的几个案例中，所谓的“激活”研究被用来识别被认为是植物人的患者的残余认知功能，甚至是有意识的意识，但保留了使用标准临床方法逃避检测的认知能力。
The assessment of residual brain function in the vegetative state, is extremely difficult and depends frequently on subjective interpretations of observed spontaneous and volitional behaviors. For those patients who retain peripheral motor function, rigorous behavioral assessment supported by structural imaging and clectrophysiology is usually sufficient to establish a patient's level of wakefulness and awareness. However, it is becoming increasingly apparent that, in some patients, damage to the peripheral motor system may prevent overt responses to command, even though the cognitive ability to perceive and understand such commands may remain intact. Advances in functional neuroimaging suggest a novel solution to this problem; in several recent cases, so-called "activation" studies have been used to identify residual cognitive function and even conscious awareness in patients who are assumed to be vegetative, yet retain cognitive abilities that have evaded detection using standard clinical methods.