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作者： Yitao Gu Wentao Zeng Gong Cheng lizette heine Xiaohua Hu Shan Jing Steven Laureys Haibo Di Hangzhou Normal University International Vegetative State and Consciousness Science Institute University of Liege and University Hospital of LiegeCyclotron Research Center and Neurology DepartmentComa Science Group Hangzhou Wujing Hospital Department of Rehabilitation

Objective:To determine if pupil near response(PNR) can be added into Coma Recovery Scale Revised[CRS-R]as an index of consciousness to improve CRS-R’s diagnostic accuracy in patients with disorders of consciousness(DOC) by removing the influence of patients’ motor impairment and assessor’s personal ***:PNR was evaluated in 20 patients who had been diagnosed as UWS(by means of CRS-R).The outcome was assessed by CRS-R 3 months later to determine the prognosis value of the ***:4 of 20 patients showed PNR(PNR+ group) in this *** was better in these patients than in PNR-patients(4/4 versus 5/16 recovered to MCS at follow up,p=0.026).The detection of conscious visual behaviors at follow-up was more frequent among PNR+ patients than in PNR-patients(4/4 versus 2/16,p=0.003).Conclusions:The significant difference between PNR+ patients and PNR-patients’ outcome suggests that PNR could be considered as a sign of good prognosis for consciousness ***,PNR’s presence requires no motor function and the assessment of PNR by ratio of pupillary constriction(pupil diameter change/original pupil diameter before PNR test)needs no personal *** 2 features of PNR remove the influence of motor impairment and personal interpretation on the diagnostic accuracy of CRS-R in DOC patients,making it can be used as a supplementary index of CRS-R that improves its diagnostic accuracy.

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Measuring consciousness in coma and related states

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World Journal of Radiology 2014年第8期6卷 589-597页

作者： Carol Di Perri Aurore Thibaut lizette heine Andrea Soddu Athena Demertzi Steven Laureys Neuroradiology National Neurological Institute C Mondino 27100 Pavia Italy Cyclotron Research Center and Neu-rology Department Coma Science Group University of Liège Physics and Astrono-my Department Western University London Ontario N6A 3K7 Canada

Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into consciousness can be drawn. A number of recent studies highlight the difficulty in making a diagnosis in patients with DOC based only on behavioral assessments. Here we aim to provide an overview of how neuroimaging techniques can help assess patients with DOC. Such techniques are expected to facilitate a more accurate understanding of brain function in states of unconsciousness and to improve the evaluation of thepatient's cognitive abilities by providing both diagnostic and prognostic indicators.

关键词： Disorders of consciousness Neuroimaging Magnetic resonance imaging Transcranial magnetic stimulation/electroencephalography Minimally conscious state Vegetative state/unresponsive wakefulness syndrome

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