Новый подход к изучению сознания с позиции теории интегрированной информации (обзор)

Л.А. Легостаева, Э.А. Змейкина, А.Г. Пойдашева, Д.В. Сергеев, Д.О. Синицын, Е.И. Кремнева, А.В. Червяков, Ю.В. Рябинкина, Н.А. Супонева, М.А. Пирадов

Ключевые слова: функционирование сознания; состояние минимального сознания; вегетативное состояние сознания; теория интегрированной информации; нейрональная система; транскраниальная магнитная стимуляция.

Непрерывное увеличение численности пациентов с хроническими нарушениями сознания обусловливает все бóльшую потребность в объективном методе оценки уровня сознания у данной категории пациентов в клинической практике невролога и реаниматолога. Один из современных подходов основан на теории интегрированной информации (IITC; Tononi, 2004, 2012, 2014). Согласно этой теории механизмы, определяющие состояние сознания, являются непрерывно связанными с определенными концептуально скоординированными структурами, которые в наибольшей степени взаимосвязаны друг с другом и выделяются вне зависимости от качества внешнего воздействия. Основываясь на данной теории, Casali и соавт. (2013) разработали подходы к количественной оценке интегрированной информации в нейрональной системе в зависимости от причинно-следственных связей между ее элементами. Применительно к сознанию был введен индекс пертурбационной сложности (pertrubational complexity index, PCI). Он позволяет измерить комплексность и пространственно-временную структуру паттерна детерминированного коркового возбуждения, которое вызывается неинвазивной стимуляцией коры головного мозга, и описать, насколько распространение электрического сигнала в головном мозге является сложным. Значения индекса отличаются при различных состояниях сознания (например, бодрствование, глубокий сон, наркоз, вегетативное состояние и т.д.), что создает предпосылки для его использования у пациентов с хроническими нарушениями сознания в качестве нового стандарта диагностики.

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