Cognitive processing in completely paralyzed patients with amyotrophic lateral sclerosis
Cognitive processing in completely paralyzed patients with amyotrophic lateral sclerosis
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DOI：
10.1046/j.1468-1331.2003.00647.x
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发表时间：
2003-09-01
影响因子：
5.1
通讯作者：
Birbaumer, N
中科院分区：
文献类型：
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作者：
Kotchoubey, B;Lang, S;Birbaumer, N
以前从未研究过完全瘫痪患者的认知功能，可能是因为缺乏适当的方法。在这项研究中，检查了三名肌萎缩侧索硬化症(ALS)末期的男性患者。他们完全被锁定，也就是说，无法做出任何自愿反应，包括眼球运动。鉴于这种完全缺乏运动表达的情况，我们使用了事件相关脑电位(ERPs)的方法。在患者床边进行事件相关电位记录。在一名患者中，获得了包括足够的语言理解在内的认知能力保留的迹象。第二例患者的数据也显示复杂认知功能高度完整，但一些ERP现象始终异常，这可能是疾病相关退行性过程的结果。在第三名患者中，没有发现可能表明皮质加工程度较高的皮层反应。这项首次对完全瘫痪患者进行的ERP研究表明，在长时间的严重静止和人工呼吸后，他们中的一些人可以拥有很高的，甚至是正常的信息处理能力。
Cognitive functions have never been studied before in completely paralyzed patients, probably due to the lack of the appropriate method. In this study, three male patients in the last stage of amyotrophic lateral sclerosis (ALS) are examined. They were totally locked-in, i.e., incapable of any voluntary response including eye movements. Given this complete lack of motor expression, the method of event-related brain potentials (ERPs) was used. The ERP recording was carried out at the patients' bedside. In one patient indications of preserved cognitive abilities including adequate language comprehension were obtained. The data of the second patient also demonstrate a high degree of intactness of complex cognitive functions, but some ERP phenomena were consistently abnormal, which may be interpreted as a consequence of disease-related degenerative processes. In the third patient no electrocortical response which might indicate higher cortical processing was found. This first ERP study of totally paralyzed patients shows that some of them can possess high, perhaps even normal, information processing capacity after a long period of severe immobility and artificial ventilation.