脑干卒中后慢性意识障碍的丘脑-皮层网络电生理活动模式及其调控研究

丘脑-皮层环路的功能失调在慢性意识障碍（pDOC）发生过程中扮演重要角色，对此环路中的中央丘脑区进行脑深部电刺激（DBS）是目前外科治疗pDOC的新兴手段。但对pDOC的丘脑-皮层环路电生理特征缺乏充分了解，DBS程控无法针对异常神经环路电活动进行精准调制，是制约DBS临床治疗发展的关键瓶颈。为此，本研究以脑干卒中后pDOC为切入点，拟通过同步记录丘脑局部场电位与头皮脑电信号，对pDOC的丘脑-皮层网络电生理活动特性及其在DBS调控中的作用进行探究。首先，从自发态到诱发态、从脑区内特征分析到脑区间连接分析，多维度研究pDOC丘脑-皮层网络的病理性电活动特征。在此基础上研究丘脑-皮层网络电活动对不同参数DBS的响应模式，并建立丘脑-皮层网络电生理特征响应与DBS疗效的映射关系。该研究为pDOC的脑网络致病机理及DBS调节机制提供电生理水平证据，并为科学评估及优化DBS治疗方案提供理论依据。

Dysfunction of thalamo-cortical network plays important roles in the pathophysiological mechanisms of prolonged disorders of consciousness (pDOC). Central thalamic deep brain stimulation (DBS) is believed to modulate the neural activities of brain networks and improve the level of consciousness. However, there is still a lack of thorough study on the patterns of electrophysiological activities in thalamo-cortical network, and how DBS regulates the electrophysiological patterns in thalamo-cortical network, which restricts our understanding of the neural mechanisms of prolonged disorders of consciousness and development of advanced neuromodulation technology to improve its therapeutic effect. This project aims to study the neural patterns in thalamo-cortical network and their role in the therapeutic mechanisms of central thalamic DBS in patients with pDOC after brainstem stroke. By recording thalamic local field potential and scalp EEG signals, the electrophysiological patterns in thalamo-cortical network was investigated with time-frequency analysis, phase lag index, phase-amplitude coupling, and Granger causality analysis. Then we further investigate the neural patterns of thalamic-cortical network in response to central thalamic DBS with different stimulation parameters, and explore whether this thalamic-cortical network neural activity response can be used as an electrophysiological biomarker for efficacy evaluation of DBS. This study will elucidate the electrophysiological mechanisms of thalamic-cortical network in the occurrence of prolonged disorders of consciousness and DBS treatment, which would guide clinical assessment and optimization of DBS strategy.