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神经刺激“唤醒”昏迷15年的植物人

2017-09-26 10:16:54   新华网

新华社华盛顿9月25日电(记者 林小春)科学家25日说,在胸腔植入迷走神经刺激器后,一名因车祸而处于植物人状态15年之久的35岁男子呈现出意识苏醒迹象,颠覆了学术界有关人持续昏迷超过12个月就无法唤醒的既有认识。

负责研究的法国里昂马克·让纳罗认知科学研究所的安杰拉·西里古在新一期美国《当代生物学》杂志上说:“通过刺激迷走神经,我们发现能够增强(植物人)患者在这个世界的存在。”

迷走神经连接着人脑与身体的许多其他部位,包括肠道。迷走神经对保持清醒、警觉性和许多其他基本功能具有重要作用。迷走神经刺激器是一种微型可植入式器件,此前已被用来辅助治疗药物难治性癫痫和抑郁症。

为检验迷走神经刺激器恢复意识的能力,研究人员希望寻找一个很难用巧合来解释被“唤醒”的植物人病例,最终找到了一个昏迷了十多年、没有苏醒迹象的车祸受害者。

研究结果显示,在开展迷走神经刺激一个月后,患者的注意力、动作和脑活动显著改善,能响应以前不响应的一些简单命令。例如,他的眼睛能跟着目标移动,并根据要求转头。他的母亲报告说,在听人给他读书时,他保持清醒的能力有提高。

此外,研究人员还观测到这名患者对“威胁”重新有了反应。例如,当医生的头突然靠近他的脸时,他会睁大眼睛,表现出惊讶。

研究人员认为,在多年处于植物人状态后,这名患者进入了“最小意识状态”。

大脑活动记录也显示,这名患者脑中涉及运动、感觉和意识的区域活动明显增强,大脑功能连接性改善,脑皮层和下皮层的代谢活动也同样增加。

研究人员指出,这项工作表明,即使在病情最严重的临床病例中,正确的干预措施也可能带来意识变化的产生。西里古说:“哪怕希望看似已经消失,大脑仍有可能被修复。”

目前,研究人员正计划开展一项大型合作研究,以确认并进一步挖掘迷走神经刺激对处于植物人或最小意识状态患者的治疗潜力。

一些专家表示,这是一项令人激动的新发现,但由于很难从单一病例了解一个疗法的真正效果,需谨慎解读,这项研究的结果尚需在更多患者身上得到验证,才能获推荐使用。

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