A case of post-traumatic minimally conscious state reversed by midazolam: Clinical aspects and neurophysiological correlates
A case of post-traumatic minimally conscious state reversed by midazolam: Clinical aspects and neurophysiological correlates
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DOI：
10.3233/rnn-140426
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发表时间：
2014-01-01
影响因子：
2.8
通讯作者：
Bonfiglio, Luca
中科院分区：
文献类型：
--
作者：
Carboncini, Maria Chiara;Piarulli, Andrea;Bonfiglio, Luca
目的：我们描述的情况下，受试者在创伤后最低意识状态（MCS）谁检索与环境的充分相互作用后，咪达唑仑输注。我们研究了在不同的频率，时间和皮层地形的EEG相关的“觉醒反应”，沿着内在的连接在两个任务的积极和语言的network.Methods：脑电图记录前和后咪达唑仑管理已提交频谱功率分析，sLORETA分析和内在的连接分析在两个功能网络。咪达唑仑给药后观察到功率谱曲线的关键变化：a）1 - 12 Hz之间的功率降低，在约7 Hz时达到与输注前的最大差异，和B）12 - 30 Hz之间的功率增加，在约15 Hz时达到最大差异。同时，咪达唑仑在两个功能网络中诱导了显著的连接变化，尤其是这两个频段。我们提出了一些关于从MCS恢复的某些方面的假设，包括解剖功能相关性和功能性脑系统，并且我们推断了某种“紧张性”症状可能在确定和/或恢复过程中发挥的作用。或者保持这种特殊的临床状态。
Purpose: We describe the case of a subject in a post-traumatic Minimally Conscious State (MCS) who retrieved full interaction with the environment after midazolam infusion. We studied EEG correlates of the "awakening reaction" in the different domains of frequency, time and cortical topography, along with the intrinsic connectivity within both the task-positive and the linguistic network.Methods: EEG recorded before and after midazolam administration has been submitted to spectral power analysis, sLORETA analysis and intrinsic connectivity analysis within both functional networks.Results: A critical change in the power spectrum profile was observed after midazolam: a) the power between 1 and 12 Hz decreased, reaching its maximum difference with respect to pre-infusion at about 7 Hz and b) the power between 12 and 30 Hz increased, with a maximum difference at about 15 Hz. At the same time, midazolam induced significant connectivity changes, especially for these two frequency bands, within both functional networks.Conclusions: We advance some hypotheses about certain aspects of the recovery from the MCS both in terms of anatomo-functional correlations and functional brain systems and we make inferences about the role that some kind of 'catatonic' symptoms might play in determining and/or maintaining this peculiar clinical state.