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Журнал высшей нервной деятельности им. И.П. Павлова, 2023, T. 73, № 3, стр. 291-310

Выявление феномена “скрытого сознания” у пациентов с хроническими нарушениями сознания: обзор данных фМРТ с парадигмами

А. Н. Черкасова 1, 2, *, К. А. Яцко 2, 3, М. С. Ковязина 1, 2, 4, Н. А. Варако 1, 2, 4, Е. И. Кремнева 2, Ю. В. Рябинкина 2, Н. А. Супонева 2, М. А. Пирадов 2

1 Московский государственный университет имени М.В. Ломоносова, факультет психологии
Москва, Россия

2 ФГБНУ “Научный центр неврологии”
Москва, Россия

3 Московский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины
Москва, Россия

4 ФГБНУ “Психологический институт РАО”
Москва, Россия

* E-mail: cherka.sova@mail.ru

Поступила в редакцию 03.08.2022
После доработки 21.11.2022
Принята к публикации 27.02.2023

Аннотация

В последние десятилетия диагностика проявлений сознательной деятельности у пациентов с хроническими нарушениями сознания (ХНС) существенно расширилась за счет использования инструментальных методов. С их помощью был описан феномен “скрытого сознания”. В данном обзоре освещены исследования по выявлению “скрытого сознания” у пациентов с ХНС с помощью метода функциональной магнитно-резонансной томографии. Проанализировано и систематизировано большинство вариантов пассивных и активных парадигм, применяющихся для этой цели. Отдельное внимание уделено комплексному подходу с сочетанием различных парадигм и методов исследования. Подчеркивается значимость выявления феномена “скрытого сознания” для нейрореабилитации пациентов с ХНС.

Ключевые слова: сознание, хронические нарушения сознания, вегетативное состояние, синдром ареактивного бодрствования, состояние минимального сознания, “скрытое сознание”, когнитивно-моторное разобщение, функциональная магнитно-резонансная томография

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