意识障碍包括三种不同状态:昏迷,植物状态(vegetative state ,VS)和最小意识状态(minimally conscious state,MCS)。近年来,随着各类意识评定量表的应用和神经影像学、电生理技术的快速发展,人们对意识障碍的认识以及诊断水平得到了极大提高。但迄今为止,仍缺乏对意识障碍的有效治疗手段,有关药物、电刺激等促醒的治疗手段均处于探索研究阶段[1]。
[1]Georgiopoulos M, Katsakiori P, Kefalopoulou Z,et al.Vegetative state and minimally conscious state: a review of the therapeutic interventions[J].Stereotact Funct Neurosurg,2010,88(4):199-207.
[2]Lombardi F,Taricco M,De Tanti A,et al.Sensory stimulation of brain-injured individuals in coma or vegetative state: results of a Cochrane systematic review [J].Clin Rehabil,2002,16(5):464-472.
[3]Gerber C S.Understanding and managing coma stimulation are we doing everything we can?[J].Crit Care Nurs Q,2005,28(2):94-108.
[5]Gelling L, Shiel A, Elliott L, et al.Commentary on Oh H and Seo W.(2003) Sensory stimulation programme to improve recovery in comatose patients.Journal of Clinical Nursing 12[J].J Clin Nurs, 2004 ,13(1):125-127.
[6]Boly M, Balteau E, Schnakers C,et al. Baseline brain activity fluctuations predict somatosensory perception in humans[J].Proc Natl Acad Sci USA,2007,104 (29):12187-12192.
[7]Karma D, Rawat A K.Effect of Stimulation in Coma [J].Indian Pediatr,2006 ,43(10):856-860.
[8]Urbenjaphol P , Jitpanya C, Khaoropthum S. Effects of the sensory stimulation program on recovery in unconscious patients with traumatic brain injury[J].J Neurosci Nurs,2009,41(3 ) :E10-E16.
[9]Oh H, Seo W.Sensory stimulation programme to improve recovery in comatose patients[J]. Clin Nurs,2003,12(3):394-404.
[11]Vanhaudenhuyse A, Schnakers C, Brédart S, et al. Assessment of visual pursuit in post-comatose states: use a mirror[J].J Neurol Neurosurg Psychiatry,2008,79 (2):223.
[12]Boly M, Faymonville M E, Schnakers C, et al.Perception of pain in the minimally conscious state with PET activation: an observational study[J]Lancet Neurology,2008,7 (11) :1013-1020.
[13]Hotz G A, Castelblanco A, Lara I M, et al. A controlled multi-sensory stimulation therapy for children recovering from severe brain injury[J].Brain Inj, 2006,20(8):879-888.
[14]Schnakers C, Chatelle C, Vanhaudenhuyse A, et al. The Nociception Coma Scale: A new tool to assess nociception in disorders of consciousness - supplementary online material (doc file)[J].Pain ,2010,148 (2):215-219.
[15]Schnakers C, Vanhaudenhuysel A , Giacino J, et al.Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment[J].BMC Neurol,2009,21(9):35.
[16]Wijnen V J,Heutink M,van Boxtel G J,et al.Autonomic reactivity to sensory stimulation is related to consciousness level after severe traumatic brain injury[J]. Clin Neurophysiol, 2006 ,117(8):1794-1807.
[17]American Congress of Rehabilitation Medicine, Brain Injury-Interdisciplinary Special Interest Group, Disorders of Consciousness Task Force, et alAssessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research [J].Arch Phys Med Rehabil, 2010 ,91(12):1795-1813.
[18]Bruno M A, Landsness E, Noirhomme Q, et al.Electrophysiological correlates of behavioural changes in vigilance in vegetative state and minimally conscious state[J].Brain, 2011,134(8):2222-2232.
[19]Bagnato S, Boccagni C, Prestandrea C , et al.Prognostic value of standard EEG in traumatic and non-traumatic disorders of consciousness following coma [J]Clin Neurophysiol,2010 ,121(3):274-280.
[20]Perrin F, Maquet P, Peigneux P, et al.Neural mechanisms involved in the detection of our first name: a combined ERPs and PET study[J].Neuropsychologia,2005,43(1) :12-19 .
[21]Qin P, Di H, Yan X,et al.Mismatch negativity to the patient’s own name in chronic disorders of consciousness[J].Neurosci Lett,2008,448(1) :24–28.
[22]Di H B, Yu S M, Weng X C, et al.Cerebral response to patient’s own name in the vegetative and minimally conscious states [J].Neurology ,2007,68(12):895–899.
[23]Cooper E B, Scherder E J, Cooper J B.Electrical treatment of reduced consciousness: experience with coma and Alzheimer’s disease [J]Neuropsychol Rehabil ,2005,15(3-4): 389–405.