基于EEG-fNIRS响应特性的意识障碍个性化音乐治疗机制研究

急危重症救治技术的发展挽救众多生命的同时也造就了大量后ICU(post-ICU)慢性危重症患者，尤其是意识障碍(disorders of consciousness, DOC)患者，临床处理十分困难。近年来临床实践与基础研究表明音乐治疗有助于DOC患者的康复，并提出了个性化音乐(patient-preferred music)能够同步激活反映自我觉知的内在网络和反映认知功能的外在网络这一假说。我们在国内较早地将规范化的音乐治疗应用于DOC患者，观察到患者存在明显的情绪和行为反应。本项目拟在此基础上采用医学-生物信息工程-音乐学多学科交叉模式，探讨个性化音乐治疗、同步EEG-fNIRS响应信号、神经行为学反应三者之间的关系，多尺度分析被激活的内在网络与外在网络以验证上述假说，研究音乐治疗促进DOC患者康复的可能神经机制，并探究可用于诊疗评估的生物学标志物，研究个性化音乐治疗的优化方案。

The advancement of modern emergence medicine has saved many lives, meanwhile, caused more post-ICU patients with chronic critical illness, especially disorders of consciousness (DOC), which has been a great medical challenge. Recent clinical practice and basic research have shown the benefit of music therapy (MT) to DOC patients‘ recovery, and proposed the hypothesis that patient-preferred music can simultaneously activate the two anti-correlated brain networks for internal and external engagement. The former reflects awareness of self, and the latter represents external awareness on behalf of cognitive functions. Being the pioneer in applying standardized MT to DOC patients in China, we have observed they had obvious emotional and behavioral responses to music. This project intends to investigate the possible mechanisms underlying MT for DOC patients by making sense of the correspondence between individualized MT, brain responsiveness measured using EEG-fNIRS, and clinical effects, through a multi-disciplinary approach (medicine, bioinformatics engineering and Musicology). Multi-scale analysis is used to explore the internal and external network activated by MT in order to verify the hypothesis. We also discuss the neurobiomarkers which could be used for diagnosis, assessment, and the best individual MT protocol for DOC patients.