双相障碍抑郁发作与单相抑郁症患者听觉事件相关电位P300的对照研究

P300 components of auditory event-related potentials in bipolar and unipolar depressive disorder

目的:探讨双相障碍I型抑郁发作与单相抑郁患者听觉事件相关电位P300的差异及与各自临床特征相关性。方法:对60例双相障碍I型抑郁发作患者(双相组)、50例单相抑郁患者(单相组)以及50名正常对照者(对照组)进行P300检测;偏相关分析患者组P300与其临床特征及功能相关性。结果:患者组较对照组N1、P2、N2、P3a和P3b潜伏期显著延长(分别F=9.17,F=8.74,F=15.27,F=7.98,F=10.64;P均<0.01);3组间N2-P3b潜伏期差异无统计学意义(F=0.46,P>0.05);患者组较对照组N1、P2、N2、P3a、P3b和N2-P3b波幅显著降低(分别F=12.23,F=7.27,F=14.16,F=6.96,F=8.58,F=5.36;P均<0.01);患者组较对照组按键反应时间显著延长(F=55.37,P<0.01);单相组较双相组N1、N2波幅降低、N2潜伏期延长(P均<0.05),双相组较单相组按键反应时间延长(P<0.01)。双相组N1波幅与其HAMD评分负相关(P<0.01),N2潜伏期与其HAMD评分正相关(P<0.01),按键反应时间与其病程和HAMD评分正相关(P均<0.05);单相组N2波幅与其HAMD评分负相关(P<0.01),按键反应时间与其HAMD评分正相关(P<0.05)。结论:双相障碍I型抑郁发作与单相抑郁患者听觉事件相关电位P300均存在异常,但损害有差异;P300异常在二者可能均为状态与素质性并存。

Objective： To detect the P300 components of auditory event-related potentials in bipolar I and unipolar depressive disorder and the relationship with clinical variables. Method ：60 patients with bipolar I disorder（BPD） ,50 patients with unipolar depression （UPD）, and 50 unrelated healthy controls （HC） were included. P300 was measured by brain evoked potentiometer. Partial correlations were computed to explore asso- ciations among the P300 and the clinical data when controlling for gender, age and education level in BPD and UPD. Results：When compared to HC, both Patients groups showed significantly delayed N1, P2, N2, P3a and P3b latency（ F = 9.17, F = 8.74, F = 15.27, F = 7.98, F = 10.64, respectively, all P 〈 0.01 ）. But no signifi- cant differences among the three groups in N2-P3b latency（ F = 0. 46, P 〉 0.05 ）. When compared to HC, both patients groups showed significantly reduced N1, P2, N2, P3a, P3b and N2-P3b amplitude （ F = 12. 23, F = 7.27, F = 14. 16, F = 6. 96, F = 8. 58, F = 5.36, respectively, all P 〈 0.01 ）. When compared to HC, both pa- tients groups showed significantly delayed mean reaction time（MRT） （ F = 55.37 ,P 〈 0.01 ）. While compared to BPD, UPD showed significantly reduced N1 amplitude and delayed N2 latency （all P 〈 0.05 ）. Whereas, when compared to UPD,BPD showed significantly delayed MRT（P 〈 0.01 ） and reduced N2 amplitude（ P 〈0.05 ）. N1 amplitude correlated negatively with HAMD score（P 〈 0.01 ）, N2 latency correlated positively with HAMD score （ P 〈 0.01 ） and MRT correlated positively with course and HAMD score （ all P 〈 0.05 ） in BPD. N2 ampli- tude correlated negatively with HAMD score （ P 〈 0.01 ） MRT correlated positively with HAMD score （ P 〈 0.05 ） in UPD. Conclusion ： Generalized abnormalities of P300 existed in bipolar I and unipolar depression, but the abnormalities are different. Abnormalities of P300 may represent the state and trait marker in both bipolar I and unipolar depression.