非人灵长类动物意识水平量表评估工具现状分析

Analysis of the current status of tools for assessing the level of consciousness scale in non-human primates

近年来,随着脑损伤、神经系统功能障碍等重症疾病的诊疗取得巨大突破,越来越多患者转归为意识障碍。在临床工作中,准确评估意识障碍对其治疗起着关键作用,患者经过治疗后如何评估意识水平及预后也成为了近几年的研究热点。意识缺失与恢复模型是理解意识神经机制的理想工具,临床试验易受伦理等诸多因素限制,因此常用动物模型作为临床前基础实验,而非人灵长类动物(non-human primates,NHP)与人类亲缘关系近,是研究人类疾病的理想模型。目前针对NHP意识水平的评估实验较多,方法也各异,均具有一定的优点及局限性。该文特对NHP意识水平量表评估工具现状的研究文献进行梳理后发现其评估主要分为麻醉实验后基于刺激反应的意识水平评估、刺激-奖赏实验后基于行为任务完成度的意识水平评估以及多指标综合评估NHP意识水平。因此,该文就当前各NHP意识水平量表评估工具现状及其优缺点进行综述,以期从动物模型角度为评估意识水平提供新的思考,以望寻找更加合适的评估工具。

In recent years,with the great breakthroughs in the treatment of brain injury,neurological dysfunction and other serious diseases,more and more patients have been referred to disorders of consciousness(DOC).In clinical work,accurate assessment of DOC is critical to its treatment,and how to assess the level of consciousness and prognosis of patients after treatment has become a hot research topic in recent years.The model of consciousness loss and recovery is an ideal tool to understand the neural mechanism of consciousness,but clinical trials are easily restricted by many factors such as ethics,so animal models are often used as preclinical basic experiments,while non-human primates(NHP)are closely related to humans and are ideal models for studying human diseases.Currently,there are many tests to assess the level of consciousness of NHP,and there are different methods,all of which have certain advantages and limitations.This article reviews the current literature on the current status of the NHP consciousness scale assessment tool,and find that the assessment of NHP consciousness is mainly divided into stimulus response-based assessment after anesthesia experiments,behavioral task completion-based assessment after stimulus-reward experiments,and comprehensive multiindicator assessment of NHP consciousness level.Therefore,this article provides an overview of the current status of each NHP consciousness scale assessment tool and its advantages and disadvantages in order to provide new thoughts on assessing consciousness from the perspective of animal models in the hope of finding a more appropriate assessment tool.