I-Coma yimeko enzulu yokungabikho zingqondweni enxulunyaniswa nokusilela kwengqondo. Izigulana ze-Comatose aziphenduli ngendlela yokuziphatha. Oku kuphazamiseka kwengqondo kuhlala kudlula kodwa kunokuhlala ixesha elingenammiselo ngamanye amaxesha. Ngeenjongo zeklinikhi, kubalulekile ukuqikelela ukuba izigulane ezinjalo ziya kuphinda zibuyele nini kwaye ziphume kwi-coma.
Ngokumalunga ne-25% yezigulane ezingaphenduliyo ngaphandle kwempendulo ebonakalayo kwimiyalelo yomlomo okanye nayiphi na indlela ebonakalayo yokulandela imiyalelo ebonisa iqondo elithile lokuqonda elifihliweyo kubabukeli. Xa inikwe imisebenzi yokuqonda efana nemiyalelo yemifanekiso yemoto, izigulana ezingaphenduliyo ezinomonzakalo wamva nje wobuchopho zibonisa umsebenzi wobuchopho kwi-Functional magnetic resonance imaging (fMRI) okanye electroencephalography (EEG). Le yinto eyenzeka kwi-cognitive motor dissociation (CMD).
Kuyaziwa ukuba izigulane ezine-comatose ezine-cognitive motor dissociation (CMD) okanye i-consciousness efihliweyo inamathuba angcono okufumana ukubuyiswa kwexesha elide ngenxa yoko kunyanzelekile ukuchonga izigulane ezingaphenduliyo zokulimala kwengqondo kunye ne-cognitive motor dissociation (CMD) okanye ukuqonda okufihliweyo.
Ukurekhodwa kwe-EEG njengoko isigulane sinikwa imiyalelo sinokuhlalutywa ukuze kubonwe umsebenzi wobuchopho obonisa ukuqonda okufihliweyo kodwa ukuphumeza i-EEG esekelwe kumsebenzi kunzima. Kwakhona, oku kunika iziphumo zobuxoki-negative. Ukurekhodwa kwe-EEG yamaza obuchopho anxulunyaniswa neepateni eziqhelekileyo zokulala kunokuba luncedo kuba imijikelezo yobuchopho efanayo phakathi kwethalamus kunye necortex (uthungelwano lwethalamocortical) zibalulekile ekwazini nasekulawuleni ubuthongo. Kwakhona, ukurekhoda amaza engqondo yokulala kulula kakhulu kwaye akufuni kungenelela. Ngapha koko, i-spindles yokulala (okungukuthi, ukugqabhuka okufutshane komsebenzi wamaza obuchopho ngexesha lokulala) kunokubonisa ukubuya kokwazi kunye nokusebenza kwengqondo, njengoko uphando lwangaphambili lubonisa. Umbono kukukhangela umceli mngeni ongaphantsi kobuchwephesha oncedisayo wokuchacha othe waphononongwa kuphononongo lwakutsha nje lweqela labangama-226 abalimele kakhulu ebuchotsheni.
Abaphandi bafumanise ukuba ezinye izigulana zibonise uqhushululu olufutshane olucwangcisiweyo lomsebenzi we-brainwave ngexesha lokulala. Kwigrafu ye-EEG, oku kugqabhuka komsebenzi wombane ebuchotsheni kuchazwa njengemibhobho yokulala. I-Sleep Spindles (WFSS) eyakheke kakuhle yabonwa malunga ne-33% yezigulane ezingaphenduliyo ekuziphatheni emva kokulimala okubukhali kwengqondo. Phantse isiqingatha sezigulane ezine-cognitive motor dissociation (CMD) zibonise i-spindles yokulala ehlala yandulela ukufunyanwa kwe-CMD. Kwakhona, izigulana ezine-WFSS zinexesha elifutshane lokubuyela kwingqondo ebonisa ukuba ukuphuculwa kokulala kunokuba luncedo.
Ngokubanzi, zombini i-CMD kunye nee-spindles zokulala ezenziwe kakuhle (WFSS) zibonakale zinxulumene namathuba angcono okubuyisela ingqondo nangona kunjalo malunga ne-14% yezigulane azizange zibonise i-WFSS okanye i-CMD kodwa ziphinde zabuyela ezingqondweni. Ke, nangona i-CMD kunye ne-WFSS ziziqikelelo zokubuyiswa, azizoziqikelelo ezigqibeleleyo.
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Iingxelo:
- UBodien YG, et al 2024. Ukwahlukaniswa kweMoto yengqondo kwiDisorders of Consciousness. Ipapashwe nge-14 ka-Agasti 2024. N Engl J Med 2024; 391:598-608. DOI: https://doi.org/10.1056/NEJMoa2400645
- Urakami Y. 2012. Ubudlelwane phakathi kweeSpindles zokulala kunye nokuBuyiswa kweKliniki kwizigulane ezinokulimala kwengqondo ebuhlungu: I-EEG kunye ne-MEG Study. I-EEG yonyango kunye ne-Neuroscience. 2012;43(1):39-47. DOI: https://doi.org/10.1177/1550059411428718
- UCarroll, EE, Shen, Q., Kansara, V. et al. I-spindles yokulala njenge-predictor ye-cognitive motor dissociation kunye nokubuyisela ingqondo emva kokulimala kwengqondo. UNat Med (2025). Ipapashwe: 03 Matshi 2025. DOI: https://doi.org/10.1038/s41591-025-03578-x
- IYunivesithi yaseColumbia. Iindaba zoPhando-Iipateni zokuLala zinokutyhila izigulana eziComatose ezinoLwazi olufihlakeleyo. 3 Matshi 2025. Iyafumaneka e https://www.cuimc.columbia.edu/news/sleep-patterns-may-reveal-comatose-patients-hidden-consciousness
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