Coma yog qhov tsis nco qab txog lub xeev uas cuam tshuam nrog lub hlwb tsis ua haujlwm. Cov neeg mob Comatose yog tus cwj pwm tsis zoo. Cov teeb meem ntawm kev nco qab no feem ntau yog hloov pauv tab sis yuav kav ntev rau lub sijhawm tsis kawg. Rau lub hom phiaj kho mob, nws yog ib qho tseem ceeb uas yuav tau twv seb thaum twg cov neeg mob no yuav rov qab nco qab thiab tawm ntawm coma.
Kwv yees li 25% ntawm cov neeg mob tsis hnov lus tsis muaj cov lus teb tsis txaus ntseeg rau cov lus txib lossis ib qho kev coj ua raws li kev coj ua qhia tau qee qhov kev nco qab uas tau muab zais rau cov neeg soj ntsuam. Thaum nthuav tawm nrog kev paub txog kev paub zoo li lub cev muaj zog cov lus txib, cov neeg mob tsis hnov mob nrog lub hlwb raug mob tsis ntev los no qhia lub hlwb ua haujlwm ntawm kev ua haujlwm magnetic resonance imaging (fMRI) lossis electroencephalography (EEG). Qhov no yog qhov tshwm sim ntawm kev paub lub cev muaj zog dissociation (CMD).
Nws paub tias cov neeg mob comatose nrog kev paub txog lub cev tsis sib haum xeeb (CMD) lossis kev nco qab zais cia muaj qhov zoo dua ntawm kev ua tiav kev rov qab mus ntev yog li qhov yuav tsum tau txheeb xyuas cov neeg mob tsis hnov mob mob hlwb nrog kev paub lub cev tsis sib xws (CMD) lossis tsis nco qab.
Cov ntaub ntawv teev tseg ntawm EEG raws li tus neeg mob tau nthuav tawm nrog cov lus txib tuaj yeem txheeb xyuas kom pom cov haujlwm hauv lub hlwb qhia tias tsis nco qab tab sis kev ua haujlwm raws li EEG nyuaj. Tsis tas li ntawd, qhov no muab cov txiaj ntsig tsis tseeb-tsis zoo. EEG cov ntaubntawv povthawj siv lub hlwb tsis cuam tshuam nrog kev pw tsaug zog ib txwm tuaj yeem pab tau vim tias lub hlwb zoo sib xws ntawm thalamus thiab cortex (thalamocortical tes hauj lwm) yog qhov tseem ceeb rau ob qho tib si nco qab thiab tswj kev pw tsaug zog. Tsis tas li ntawd, sau cov suab paj nruag pw tsaug zog yog yooj yim dua thiab tsis tas yuav muaj kev cuam tshuam. Tsis tas li ntawd, kev pw tsaug zog spindles (viz., luv luv tawg ntawm lub hlwb ua haujlwm thaum pw tsaug zog) tuaj yeem cuam tshuam txog kev rov qab los ntawm kev nco qab thiab kev txawj ntse, raws li kev tshawb fawb ua ntej. Lub tswv yim yog los nrhiav ib qho kev sib tw tsawg dua qhov kev kwv yees ntawm kev rov qab los uas tau tshawb pom hauv kev tshawb fawb soj ntsuam tsis ntev los no ntawm 226 tus neeg mob mob hlwb raug mob.
Cov kws tshawb fawb tau pom tias qee cov neeg mob tau pom muaj kev sib koom ua ke luv luv ntawm lub hlwb ua haujlwm thaum pw tsaug zog. Ntawm EEG daim duab, cov tawg ntawm hluav taws xob ua haujlwm hauv lub hlwb raug suav hais tias yog pw tsaug zog spindles. Zoo-tsim pw tsaug zog spindles (WFSS) tau pom nyob rau hauv kwv yees li 33% ntawm cov neeg mob uas coj tus cwj pwm tsis zoo tom qab mob hlwb raug mob. Kwv yees li ib nrab ntawm cov neeg mob uas muaj kev paub txog lub cev muaj zog dissociation (CMD) pom tias pw tsaug zog spindles uas nquag ua ntej kev kuaj pom ntawm CMD. Tsis tas li ntawd, cov neeg mob WFSS muaj lub sijhawm luv luv rau kev rov qab los ntawm kev nco qab qhia tias kev pw tsaug zog tuaj yeem pab tau.
Zuag qhia tag nrho, ob qho tib si CMD thiab zoo-tsim pw tsaug zog spindles (WFSS) tau tshwm sim los cuam tshuam nrog txoj hauv kev zoo dua ntawm kev nco qab tab sis li ntawm 14% cov neeg mob tsis qhia WFSS lossis CMD tab sis rov qab nco qab. Yog li, txawm hais tias CMD thiab WFSS yog qhov kev kwv yees ntawm kev rov qab los, lawv tsis yog qhov ua tau zoo tshaj plaws.
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References:
- Bodien YG, thiab al 2024. Cognitive Motor Dissociation in Disorders of Consciousness. Luam tawm 14 Lub Yim Hli 2024. N Engl J Med 2024; 391: 598-608. DOI: https://doi.org/10.1056/NEJMoa2400645
- Urakami Y. 2012. Kev sib raug zoo ntawm Pw Spindles thiab Clinical Recovery in Patients With Traumatic Brain Injury: A Simultaneous EEG and MEG Study. Clinical EEG thiab Neuroscience. 2012; 43(1:39-47. DOI: https://doi.org/10.1177/1550059411428718
- Carroll, EE, Shen, Q., Kansara, V. et al. Pw tsaug zog spindles ua tus kwv yees ntawm kev paub lub cev muaj zog dissociation thiab rov qab nco qab tom qab mob hlwb raug mob. Nat Med (2025). Published: 03 March 2025. DOI: https://doi.org/10.1038/s41591-025-03578-x
- Columbia University. Cov xov xwm tshawb fawb - Cov qauv pw tsaug zog tuaj yeem nthuav tawm cov neeg mob Comatose nrog kev nco qab zais. 3 Lub Peb Hlis 2025. Muaj nyob ntawm https://www.cuimc.columbia.edu/news/sleep-patterns-may-reveal-comatose-patients-hidden-consciousness
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 or electroencephalography (EEG). This is the phenomenon of cognitive motor dissociation (CMD).){kind=link}