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在昏迷的时候大脑在干什么呢? – 译学馆
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在昏迷的时候大脑在干什么呢?

What Happens in the Brain During a Coma?

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[♪ INTRO ]
电视上 或是小说中 昏迷的病人通常被描述成一种状态:像睡着了一样
On TV, or in novels, patients in comas areusually described the same way: like they’re sleeping.
表面上看是这样
On the outside, that makes sense.
毕竟 他们都是
After all, they ’ ll have the
闭着眼睛 呼吸减弱
same closed eyes and maybe even slower breathing or a
一派安静祥和的表现
peaceful expression.
但是 一个睡着的人和一个昏迷的人
But while a sleeping person and a coma
虽然外表看起来没什么区别
patient might look the same on the outside, on the
但内里 尤其是他们的大脑中 是相当不同的
inside — especially inside their heads — they’revery different.
对于大脑 昏迷基本上一点都不像在沉睡
For the brain, being in a coma is almost nothing like being asleep.
事实上更像被全身麻醉时的状态
It’s actually more like being under generalanesthesia.
但是 大脑中发生了什么 非常有趣
But what’s happening in there is prettyfascinating.
昏迷 医生称其为意识障碍
Comas are what clinicians call disorders ofconsciousness.
包括几种类型
There are a few of them,
比如昏迷 植物状态 都是由
including comas and vegetative states, and they ’ re caused by
大脑的某些损害引起
some sort of damage to the brain.
可由像中风
This could come from something like a stroke,
缺氧 或是车祸中的头部重击
oxygen deprivation, or a major hit to the head,
之类的事件引起
like in a car accident.
引起这些损害的特定机制还在争论中
The specific mechanism that causes these disorders is still up
但不管怎样
for debate, but regardless, some
一些损害引发的深度昏迷可持续数日甚至数月
damage triggers a deep unconsciousness that can last for days or months.
从哲学层次上看 意识的定义也未有定论
On a philosophical level, what it means to be conscious is debatable.
但从医学上来说 醒着的人都有两种特征 清醒且有意识
But medically speaking, a conscious personis generally two things: awake and aware.
清醒的定义很简单
Being awake is pretty simple:
比如说像睁眼这样的反射活动
It ’ s having the reflexes to do things like open your eyes.
有意识意味着
Being aware means
你可以对周遭发生的做出反应
that you can respond to something happening around you — like by
比如 应别人的要求抓住谁的手
squeezing someone’s hand if they ask,
或是举起几只手指
or holding up a certain number of fingers.
而当某人发生意识障碍时
When someone has a disorder of consciousness,
这两个特征中的一项或两个会中断
one or both of these things is disrupted.
对于昏迷来说 是两者皆会
And with comas, it’s both.
昏迷的病人会有些基本的
A coma patient will have some basic,
自动的反应 这表示他们的大脑
automatic responses that show their brain is somewhat
还具备功能 比如扩瞳
functional — like pupil dilation — but they
但是别人拨动时 他们不会睁眼
won ’ t open their eyes if someone pokes them,
即使受到疼痛刺激
even painfully.
同样 他们也无法对周遭事物做出回应
And they can’t respond to what’s goingon around them. Now,
现在 即使听上去像是
even though that might sound like you
熬夜学习了一晚上
after your last all-night study session, comas
昏迷的人也不像是在沉睡中的样子
are nothing like being in a heavy sleep.
其一 昏迷时大脑耗能减少
For one, the brain is using a lot less energy
就算和深度睡眠相比
during a coma — about 10 to 20 % less than
也会少10~20%
even the deepest part of sleep,
与清醒时比 会减少50~60%
and 50 to 60 % less than when you ’ re awake.
这是全脑活动大大降低的标志
This is a sign of significantly lowered activity all
其表现
across the brain, and it plays out in
有以下几种
a few ways.
其一 昏迷中的大脑没有
One is that the comatose brain doesn ’ t go
睡眠时常规的周期
through the regular cycles of sleep. Normally,
正常情况下 睡眠中
during sleep,
大脑会经过几个阶段的快速动眼期 即REM睡眠
brain goes through periods of rapid eye movement, or REM sleep.
在这些阶段中
During these times,
大脑产生的电活动水平实际上
your brain is actually generating electrical activity at a similar
类似于清醒状态
level that it does when it’s awake.
但昏迷中的大脑不会产生这样高水平的活动
But the comatose brain doesn ’ t produce those high levels
从大脑扫描中可知
of activity, so, as far as we
并没有经历快速眼动睡眠
can tell from brain scans, it doesn’t gothrough REM cycles.
REM睡眠时期关系到你精彩纷呈的梦境
Since REM is the phase of sleep associated with vivid dreams,
所以 这也意味着 昏迷的病人
this also means that coma
很可能不会做梦
patients probably don ’ t dream,
同样 尽管很多人汇报说 他们没有昏迷
either — although many have reported them on their way out of a coma.
或许 昏迷和其他状态最大的区别在于
Probably the biggest difference between comas and other conditions, though,
活动
is the activity
大脑皮层的活动
in the brain ’ s cerebral cortex —
或是其他主要的部分
or what we tend to think of as the main part of the brain
昏迷时 也有些基础的活动
During a coma, there ’ s activation in some basic,
比如感觉区
sensory areas, but they ’ re not being
但那也不是正常的活动
processed normally.
所以 实际大脑无法解读出
So the brain can ’ t actually make sense
感觉信号的意思
of what those sensory signals mean.
举个例子 2000年 Brain期刊上的一项研究
For example, a study done in the journal Brain
展示了5名植物状态以及昏迷中的病人
in 2000 showed that five patients in vegetative
对外界的声音在听觉皮质产生了活动反应
states and comas had some activity in their auditory cortex in response to sound.
但这些信号并未传送至
But those signals weren ’ t sent on to a place
大脑中可以解读它们的区域
in the brain where they could be understood. So,
所以你可能听说过 昏迷中的人能听懂你的话
you might ’ ve heard that someone in a coma can understand you,
即使他无法做出回应
even if they can ’ t
——这个说法不完全正确
respond — but that’s not totally true.
从技术上来说 他们能接收到你的声音
They can technically hear you, but according to most research,
但根据大多数研究结果
they won ’ t be able to
他们无法处理你说的话
process anything you say.
这和你说的那种 在课堂上睡觉
It ’ s different than what happens when you, say,
不一样
fall asleep during lecture.
研究表明 睡眠中的大脑可以处理听到的信息
According to studies, the sleeping brain can process what it hears,
即使你意识不到
even if you don ’ t
也记不住
realize or remember it.
在昏迷中缺少这个过程 是因为
This lack of processing happens because, during a coma,
大脑皮质的两个主要网络被中断
two major networks in the cortex are disrupted:
一个是内部感知 另一个是外部感知
one that covers internal awareness, and one that does external awareness.
内部感知处理内心的天马行空
Internal awareness deals with things like talking inside your head and wandering thoughts.
外部感知则让你展示出如何处理外部的刺激
External awareness is more about how you process external stimuli,
就像摆出什么表情
like what my face looks like
这两张网也可由其他损害中断
These networks can get interrupted in other disorders,
比如 闭锁综合征
too — like locked-in syndrome,
人有意识但是动弹不得
where someone is conscious but can’t movenormally.
但在那种情况下 中断的只有一个网
But in that case, only one network is disrupted.
而昏迷 则是两者
With comas, it ’ s both,
因此 大脑没有进行大量的高层处理
so there ’ s not a ton of higher-level processing happening.
一般来说 与其他状况或者睡眠时相较
In general, the comatose brain is a lot more disconnected
昏迷中的大脑与周遭发生的事情
from the things happening around
处于失联的状态
it than in some other conditions or when you’reasleep.
非要说有什么区别的话 这更像是全麻状态
If anything, it’s actually most similarto being under general anesthesia.
一些医生把麻醉称作“可逆的昏迷”
Some physicians even call anesthesia a “ reversible coma ”,
用于在没有严重危险情况下
and it can be used to study real
学习真实昏迷的状态
comas without putting someone in serious danger. Ultimately,
最后 依据损害的严重程度
depending on the severity of the damage,
昏迷的病人可能痊愈
a coma patient might heal and slowly
逐渐恢复正常意识 醒过来
come back to regular consciousness, becomingboth awake and aware.
一旦恢复
Once they do,
他们可能对这段经历不会有丝毫印象
they probably won ’ t have any memory of the experience — even if they
即使他们能记起醒来过程中的事
do remember the process of waking up.
这可能不是一件坏事
Which probably isn’t such a bad thing.
即使 医生们努力想使病人
Although doctors work to get patients out of comas
尽可能安全并迅速地从昏迷中醒来
as safely and quickly as possible,
但学习其机理也同样重要
studying them and how they work are reallyimportant.
毕竟 昏迷是我们
After all, comas are key ways
了解大脑产生意识的根源的一个关键点
for us to understand the root of consciousness in our brains.
通过揭秘当与外界失去联系时
By untangling the things that are happening
大脑中发生的事
inside our heads when we lose connection with
我们对关系到现实生活的事
the world, we ’ re able to get a better idea
能在第一时间有更好的了解
of the biology that links us to reality in the first place.
那就是值得我们理解的事
And that’s definitely worth understanding.
感谢收看本期科学心理秀
Thanks for watching this episode of SciShowPsych!
如果你喜欢和我们一起探索人类思维
If you ’ d like to keep exploring the human mind with us,
你可以进入此网站并订阅
you can go to youtube.com/scishowpsych and subscribe.
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[♪ OUTRO ]

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