失匹配负波在意识障碍评估中的临床价值探讨

自失匹配负波(MMN)于20世纪70年代被发现以来,我们对规律性声音被打破后所诱发的前注意检测有了进一步认识,而MMN成为了开启认知大门的钥匙。至今为止,MMN的研究范围从产生机制发展到神经精神疾病相关的临床试验,特别是对于急性脑损伤(ABI)昏迷以及进展后的慢性意识障碍(DoC)患者,MMN被认为是一个可靠的预后预测指标。然而,由于MMN难以用于个体评估,目前在临床实践中的应用仍十分有限,广大临床医师对MMN的了解甚少。因此,本文就MMN的产生机制、在意识障碍中的临床意义、判读方法及其影响因素做一综述。

The discussion of clinical value of mismatch negativity in the evaluation of disorders of consciousness

Since the discovery of mismatch negativity(MMN)in the 1970s,we have got a further understanding of pre-attention detection evoked by regular sound breaking,which has become the key to open the door of cognition.To date,studies of MMN have ranged from the mechanism of MMN generation to clinical trials related to neuropsychiatric disorders,particularly in comatose patients with acute brain injury(ABI)and in patients with prolonged disorders of consciousness(DoC)subsequently,where MMN is considered as a reliable prognostic predictor.However,MMN is difficult to be used for individual evaluation,its application in clinical practice is still limited and the majority of clinicians have little understanding of MMN so far.In this article,we have reviewed the mechanism of MMN generation,its clinical significance in disorders of consciousness,waveform interpretation and affecting factors.