基于多模态磁共振脑影像技术探索植物状态患者的残存脑功能和意识的纵向研究

Vegetative state is a special type of consciousness disorder,which is an important model to study the biological basis of human consciousness. Exploration of cognitive functions recovery with vegetative state (VS) becoming minimally conscious state (MCS) would contribute not only to the knowledge on changes of human consciousness state, but also to the relations between the brain activity and consciousness. Recently, investigations on the brain mechanism of patients in a VS/MCS have been intensively discussed in cognitive neuroscience, brain science and clinical application. However, longitudinal studies which observe neural mechanism changes based on multimodal magnetic resonance imaging (MRI) and data analysis about large sample VS/MCS patients are very limited, and the brain network analysis also has not been applied in the VS/MCS patients though it has been widely used in studies on the relationships between brain function-structure-behavior, and in studies of different brain disorders. Accordingly, the current project will collect multimodal brain MRI data (task fMRI, resting state fMRI, and diffusion-weighted imaging) of large sample VS/MCS patients longitudinally, combine imaging data analysis, refer to the testing results of clinical scale, and detect the dynamic changes of brain local and global characteristics on VS/MCS patients at different time points, to reveal neuroimaging markers of VS/MCS consciousness recovery. This project will provide significant evidence on the brain plasticity and treatment prediction of VS/MCS patients, as well as neural mechanism changes of different consciousness states.

植物状态（VS─Vegetative State）是一种特殊类型的意识障碍，对其进行研究是探究人类意识生物基础的重要途径。对植物状态（VS）转为最小意识状态（MCS）的脑机制的探索，有助于增进人类对人脑意识状态变化的理解。近年来，对VS/MCS患者脑机制的研究，受到了认知神经科学、脑科学、临床应用的极大关注。但基于大样本VS/MCS患者的多模态影像数据探测大脑神经机制变化的纵向研究却非常有限；尽管脑网络分析已用于'脑功能-结构-行为'及多种脑疾病的研究中，但对VS 患者脑网络的研究还未见报道。据此，本项目拟采集VS/MCS患者大样本的纵向多模态脑影像，结合数据分析，参照临床量表的测评，探测VS/MCS在不同时间点上的脑局部特性、全脑网络特性的动态变化，以揭示VS患者意识恢复进程中的影像学标记。本项目将为VS 患者的大脑神经可塑性及愈后预测、不同意识状态的脑机制的变化提供重要的影像学证据。

意识障碍（Disorders of consciousness, DOC）主要由重度脑损伤导致，对其进行研究有利于我们探讨意识的奥秘。近年来，对意识障碍患者的大脑研究有着日益增长的趋势，然而意识障碍的神经生理脑基础还未完全被探明。本项目利用多模态大脑成像方法，探讨意识障碍中“脑功能-结构-行为”关系，为意识障碍患者大脑神经可塑性及预测、不同意识状态的脑机制的变化提供重要的影像学证据。.作为四年期的资助项目，目前我们已经用磁共振成像系统扫描了超过一百名意识障碍患者和40名健康对照被试，用PET技术扫描了60多名病人和20名健康被试，已建立了华南地区最大的意识障碍患者脑成像数据库。人才培养方面，我们在四年来已培养25名硕士和1名博士，他们都较好的完成了学位攻读期间的学习任务，并完成学位论文撰写和答辩。.在论文撰写和发表上，我们已利用脑功能网络、脑结构网络、机器学习技术等对DOC患者脑成像数据进行了分析。我们获得了较为可靠和稳定的结果，并将结果发表至国际会议和SCI期刊上，另外还有部分稿子正准备发表，今后我们将利用这批数据进行进一步的数据挖掘与文章的挖掘。