近期的文章顯示使用意向指令,、腦激活模式發(fā)現(xiàn)10%的無反應(yīng)性清醒綜合征（UWS，之前稱為植物狀態(tài)）患者存在意識,。但是也有可能,，無法依從指令的患者（如由于記憶、注意能力受限）能夠感知疼痛和愉悅,，并留有情緒能力,。德國海德堡大學(xué)醫(yī)學(xué)心理學(xué)與行為性神經(jīng)生物研究所的Boris Kotchoubey博士等人進(jìn)行了一項(xiàng)研究，在一個特定的腦結(jié)構(gòu)網(wǎng)絡(luò)（稱為腦的痛感矩陣,，即PM）評估無反應(yīng)性清醒綜合征患者殘存的情感意識能力,，研究結(jié)果在線發(fā)表在2012年12月19日的Neurology雜志上。研究結(jié)果顯示：無反應(yīng)性清醒綜合征患者中有很多能夠?qū)ζ渌税l(fā)出的疼痛信號做出反應(yīng),。猜測“情感意識”能夠在腦部損傷非常嚴(yán)重的患者（已經(jīng)沒有認(rèn)知能力）保留,。
研究人員對2個影像中心中嚴(yán)格診斷的UWS患者進(jìn)行檢查。使用fMRI觀察腦對意向指令和疼痛呼喊聲（相對于中性的人類發(fā)聲）的血液動力學(xué)反應(yīng),。
研究結(jié)果發(fā)現(xiàn)：與其他研究結(jié)果進(jìn)行線性對比發(fā)現(xiàn)：5個患者對意向指令的反應(yīng)是一致的,。相反，24位患者在呼喊聲中出現(xiàn)痛感矩陣的激活,。痛感矩陣由一個感覺亞系統(tǒng)（構(gòu)成疼痛感覺）和一個情感亞系統(tǒng)（構(gòu)成疼痛的特征性厭惡情緒）組成,。前者在34%的患者被激活，后者30%的患者被激活,。
該研究發(fā)現(xiàn)：盡管無反應(yīng)性清醒綜合征患者是否能夠感知疼痛存在爭議,，試驗(yàn)結(jié)果顯示他們中的很多人能夠?qū)ζ渌私o予的疼痛信號做出反應(yīng)。猜測“情感意識”甚至能夠在腦部損傷非常嚴(yán)重的患者（已經(jīng)沒有認(rèn)知能力）保留,。(生物谷Bioon.com)
DOI:10.1212/WNL.0b013e31827f0846
PMC:
PMID:
Patients with unresponsive wakefulness syndrome respond to the pain cries of other people
Yu T, Lang S, Vogel D, Markl A, Müller F, Kotchoubey B.
OBJECTIVE:Recent publications show that using imagery instructions, brain activation patterns indicating consciousness can be found in approximately 10% of patients with unresponsive wakefulness syndrome (UWS; previously called vegetative state). It is possible, however, that patients who cannot follow instructions (because of limited memory/attention capacities, for example) are nevertheless conscious and retain emotional abilities to feel pain and pleasure. The aim of this study was to assess residual affective consciousness in a specific network of brain structures, the so-called pain matrix (PM) of the brain. METHODS:We examined 44 carefully diagnosed UWS patients at 2 imaging centers. fMRI was used to investigate the brain hemodynamic responses to (a) imagery instructions, and (b) pain cries as opposed to neutral human vocalizations. RESULTS:In line with the data of other groups, consistent responses to imagery instructions were obtained in 5 patients. In contrast, the PM was activated by pain cries in 24 patients. The PM consists of a sensory subsystem, which underlies pain sensation, and an affective subsystem, which underlies the characteristic aversive emotional tone of pain. The former was activated in 34% of patients, the latter in 30% of patients. CONCLUSION:Although there is debate about whether patients with UWS can perceive their own pain, our data indicate that many of them respond to the signals of pain in others. One can speculate that "affective consciousness" can remain even in patients with very severe brain damage who have no capacity for cognition.
