Patients with severe traumatic brain injury (TBI) often experience disorders of consciousness (DoC) and motor impairments, which pose challenges to the implementation of conventional intervention approaches. As one of the relatively preserved sensory pathways in these patients, the auditory system holds considerable potential for assessing consciousness and facilitating its recovery. Therefore, this review systematically examines the mechanisms of verbal and nonverbal stimuli in consciousness recovery, focusing on analyzing the synergistic effects and limitations of language stimuli in emotional arousal and semantic integration. Based on this, a complementary mechanism leveraging the respective strengths of both approaches has been explored to establish a new intervention paradigm. Furthermore, integrating advancements in brain-computer interface (BCI) technology, it proposes a closed-loop intervention approach that combines multi-type auditory stimuli with real-time neural feedback. This framework emphasizes individual differences and dynamic regulation, providing theoretical foundations and developmental directions for constructing precision-oriented, mechanism-driven auditory intervention paradigms for severe TBI.
ObjectiveTo explore the clinical features and prognostic factors of diffuse brain stem glioma in children. MethodsA retrospective analysis was conducted on pediatric diffuse brain stem glioma diagnosed by pathology in West China Hospital of Sichuan University between January 2016 and May 2019. The demographic data, clinical manifestations, MRI findings, pathological results, and treatment were included in the prognosis study.ResultsA total of 39 cases of pediatric diffuse brain stem glioma confirmed by pathology were enrolled, including 21 males and 18 females aged between 3 and 14 years with an average of (8.1±2.8) years and mostly between 5 and 10 years (29 cases). The mean maximum diameter of gliomas was (4.46±0.81) cm. Among the 39 cases, there were 15 cases complicated with hydrocephalus and 16 cases whose tumors completely surrounded the basilar artery. The median survival time was 6 months. The one-year survival rate was 15.4%, and the two-year survival rate was 5.1%. Univariate analyses showed that the tumor enhancement and completely enclosed basilar artery had significant impact on the prognosis (P<0.05). Multiple Cox regression analysis showed that whether the basilar artery was completely wrapped was related to the prognosis [hazard ratio=4.596, 95% confidence interval (1.839, 11.488), P=0.001]. ConclusionsPediatric diffuse brain stem gliomas are common in children aged 5-10 years with poor prognosis. Whether the tumor completely surrounds the basilar artery is closely related to the short overall survival time.