生物谷：英國(guó)科學(xué)家近日研究發(fā)現(xiàn),，某些處于植物狀態(tài)（vegetative state）的病人大腦能顯現(xiàn)出接近于正常人的腦部活動(dòng)。該研究有望幫助醫(yī)生預(yù)測(cè)哪些病人有希望從植物狀態(tài)恢復(fù)過(guò)來(lái)。相關(guān)論文發(fā)表在8月份的《神經(jīng)病學(xué)檔案》（Archives of Neurology）上,。
眾所周知,，植物狀態(tài)比一般的昏迷要嚴(yán)重的多。植物人雖然有反射反應(yīng),，但是沒有任何證據(jù)表明他們有意識(shí),。處于持續(xù)植物狀態(tài)的病人，如果持續(xù)時(shí)間超過(guò)兩年,，事實(shí)上就沒有康復(fù)的希望了,。另外，植物人的反射反應(yīng)往往十分容易讓人誤解,，這就使得針對(duì)植物人的分類和診斷顯得異常困難,。
在最新的研究中，英國(guó)劍橋大學(xué)的Adrian Owen和同事針對(duì)一位因車禍陷入植物狀態(tài)已達(dá)六月之久的病人展開了研究,。研究人員一邊用語(yǔ)言要求該病人設(shè)想自己正在從事某種活動(dòng)，比如打網(wǎng)球或散步回家等,，同時(shí)應(yīng)用功能核磁共振成像（fMRI）技術(shù)觀測(cè)她的實(shí)時(shí)腦部活動(dòng),。結(jié)果令人驚訝，她的大腦活躍起來(lái)了,，在研究人員期望的所有區(qū)域都表現(xiàn)出了活性,。掃描顯示，這些活性與完成同樣任務(wù)的正常人腦部顯示的幾乎一樣,。
Owen稱,，研究過(guò)后六個(gè)月，該病人表現(xiàn)出了初步的好轉(zhuǎn)跡象,。她現(xiàn)在恢復(fù)到了最小意識(shí)狀態(tài)（minimally conscious state）,，間或能對(duì)刺激做出反應(yīng)。Owen表示,，到目前研究為止,，相對(duì)于缺氧導(dǎo)致的意識(shí)喪失，腦外傷導(dǎo)致意識(shí)喪失的病人似乎更容易恢復(fù)知覺,。
目前,，人們沒有任何積極的治療辦法來(lái)幫助這類病人，雖然近來(lái)有報(bào)道稱深度腦刺激能使這類病人好轉(zhuǎn)（見更多閱讀）,。而此次發(fā)現(xiàn)將有助于預(yù)測(cè)哪些植物人有可能恢復(fù)知覺,，無(wú)疑具有重要的價(jià)值。
不過(guò),，Owen也希望人們不要高估了新的研究結(jié)果的意義,。他表示，他和研究小組隨后又針對(duì)另外10名植物人展開了研究，卻只在一個(gè)人身上得到了類似的結(jié)果,。他說(shuō)：“我們不想給人們帶來(lái)錯(cuò)誤的希望,，以為所有這樣的病人都能康復(fù)。老實(shí)說(shuō),，目前尚沒有任何被實(shí)踐檢驗(yàn)過(guò)證明對(duì)這類病人有益的治療或干預(yù),。”（科學(xué)網(wǎng) 梅進(jìn)/編譯）
原始出處:
Arch Neurol, Aug 2007; 64: 1098 - 1102
Using Functional Magnetic Resonance Imaging to Detect Covert Awareness in the Vegetative State
Adrian M. Owen, PhD; Martin R. Coleman, PhD; Melanie Boly, PhD; Matthew H. Davis, PhD; Steven Laureys, MD, PhD; John D. Pickard, MD, PhD
Arch Neurol. 2007;64:1098-1102.
The assessment of patients with disorders of consciousness, including the vegetative state, is difficult and depends frequently on subjective interpretations of the observed spontaneous and volitional behavior. For those patients who retain peripheral motor function, rigorous behavioral assessment supported by structural imaging and electrophysiological findings is usually sufficient to establish a patient's level of wakefulness and awareness. However, it is becoming increasingly apparent that in some patients damage to the peripheral motor system may prevent overt responses to command although the cognitive ability to perceive and understand such commands may remain intact. Recent advances in functional neuroimaging suggest a novel solution to this problem; in several cases, so-called activation studies have been used to identify residual cognitive function and conscious awareness in patients who are assumed to be in a vegetative state yet retain cognitive abilities that have evaded detection using standard clinical methods.
Author Affiliations: Medical Research Council Cognition and Brain Sciences Unit (Drs Owen and Davis) and Impaired Consciousness Study Group, Wolfson Brain Imaging Centre, University of Cambridge (Drs Coleman and Pickard), Cambridge, England; and Cyclotron Research Centre and Neurology Department, University of Liège, Liège, Belgium (Drs Boly and Laureys).
