不同意识状态下的大脑功能评估

Murat Ozgoren, Onur Bayazit, Sibel Kocaaslan, Necati Gokmen, Adile Oniz
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摘要

背景:研究大脑功能是神经科学领域的一大挑战,因为人脑具有动态和不断变化的信息处理能力。如果大脑在所谓的不同意识状态下发生重大变化,情况就会更加严重。尽管意识的确切定义是一个难题,但在某些情况下,对意识的描述已达成共识。睡眠和麻醉是不同的状态,它们可以相互区分,也可以与清醒状态区分开来。我们小组的目标是通过为这三种意识状态设定类似的研究条件来解决大脑功能问题:为了实现这一目标,我们设计了一个听觉刺激电池,在 40 通道脑电图测谎仪(Nuamps)会话期间记录不断变化的条件。在手术室和睡眠实验室都通过我们实验室开发的嵌入式交互式刺激装置进行了刺激(改良失配、听觉诱发等)。整个研究为三个意识领域提供了一些结果。为了能够监测这些变化,我们在睡眠和麻醉状态下都加入了双谱指数监测:第一阶段的结果让我们对这些改变状态有了基本的了解,例如在浅睡眠和深睡眠阶段都能成功处理听觉刺激。麻醉会突然改变大脑的反应能力,因此,根据剂量进行麻醉证明是有用的。听觉处理以 N1 波为例,从频谱图到 sLORETA 进行了全面分析。观察到频率成分在整个阶段都在变化。服用异丙酚和深度睡眠阶段都会导致 N1 成分的减少。sLORETA 显示睡眠中 BA7 的活动类似(BIS 70),目标异丙酚浓度为 1.2 微克/毫升:目前的研究采用了类似的刺激和记录系统,并纳入了与 BIS 相关的数值,以验证睡眠和麻醉的通用方法。因此,大脑具有复杂的行为模式,会根据刺激和状态动态地改变其反应能力。
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Brain function assessment in different conscious states.

Background: The study of brain functioning is a major challenge in neuroscience fields as human brain has a dynamic and ever changing information processing. Case is worsened with conditions where brain undergoes major changes in so-called different conscious states. Even though the exact definition of consciousness is a hard one, there are certain conditions where the descriptions have reached a consensus. The sleep and the anesthesia are different conditions which are separable from each other and also from wakefulness. The aim of our group has been to tackle the issue of brain functioning with setting up similar research conditions for these three conscious states.

Methods: In order to achieve this goal we have designed an auditory stimulation battery with changing conditions to be recorded during a 40 channel EEG polygraph (Nuamps) session. The stimuli (modified mismatch, auditory evoked etc.) have been administered both in the operation room and the sleep lab via Embedded Interactive Stimulus Unit which was developed in our lab. The overall study has provided some results for three domains of consciousness. In order to be able to monitor the changes we have incorporated Bispectral Index Monitoring to both sleep and anesthesia conditions.

Results: The first stage results have provided a basic understanding in these altered states such that auditory stimuli have been successfully processed in both light and deep sleep stages. The anesthesia provides a sudden change in brain responsiveness; therefore a dosage dependent anesthetic administration has proved to be useful. The auditory processing was exemplified targeting N1 wave, with a thorough analysis from spectrogram to sLORETA. The frequency components were observed to be shifting throughout the stages. The propofol administration and the deeper sleep stages both resulted in the decreasing of N1 component. The sLORETA revealed similar activity at BA7 in sleep (BIS 70) and target propofol concentration of 1.2 microg/mL.

Conclusions: The current study utilized similar stimulation and recording system and incorporated BIS dependent values to validate a common approach to sleep and anesthesia. Accordingly the brain has a complex behavior pattern, dynamically changing its responsiveness in accordance with stimulations and states.

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