双相障碍抑郁发作与单相抑郁症失匹配负波的对照研究

Mismatch negativity components of event-related potentials in bipolar and unipolar depressive disorder

目的:比较双相障碍I型抑郁发作与单相抑郁症失匹配负波(MMN)的差异及其与各自临床特征的相关性。方法:对55例双相障碍I型抑郁发作患者(双相组)、55例单相抑郁患者(单相组)以及50名正常对照者(正常对照组)进行MMN检测;采用大体功能评定量表(GAF)评定各组总体功能水平,汉密尔顿抑郁量表(HAMD)评估患者组病情严重程度。在控制性别、年龄、教育年限后,偏相关分析患者组MMN与临床特征及功能的相关性。结果:患者组较正常对照组GAF评分降低(F=53.96,P<0.01);患者组较正常对照组MMN潜伏期延长(F=44.31,P<0.01)、MMN波幅降低(F=5.39,P<0.01);双相组与单相组MMN潜伏期及MMN波幅差异无统计学意义(P均>0.05)。双相组MMN潜伏期与HAMD评分和发作次数呈正相关(r=0.51,0.46;P<0.01);MMN波幅与HAMD评分和发作次数呈负相关(r=-0.35,-0.39;P<0.01);单相组MMN潜伏期与HAMD评分呈正相关(r=0.52,P<0.01),MMN波幅与HAMD评分呈负相关(r=-0.47,P<0.01)。结论:双相障碍I型抑郁发作与单相抑郁症患者的异常MMN可能是抑郁发作的状态性标记。

Objective：To detect the mismatch negativity （MMN） in bipolar I and unipolar depressive disorder and the relationship with clinical variables. Method： Fifty-five patients with bipolar I disorder （BPD） ,55 patients with unipolar depression （UPD） ,and 50 unrelated healthy controls （HC） were included in this study. MMN was measured by brain evoked potentiometer and the functioning status was assessed using gen- eral function rating scale （GAF） among the three groups. The clinical status of patients with BPD and UPD were determined using Hamilton depression scale （HAMD）. Partial correlations were computed to explore associa- tions among the MMN and the clinical data when controlling for gender, age and education level in BPD and UPD. Results： Compared to HC, both patients groups showed significantly lower GAF （ F = 53. 96, P 〈 0.01 ）, significantly delayed MMN latency （ F = 44.31, P 〈 0.01 ） and decreased MMN amplitude （ F = 5.39, P 〈 0.01 ）. No significant differences between the patients groups in MMN latency and amplitude （ all P 〉 0.05 ）. MMN latency correlated positively with HAMD score and number of onsets （ r = 0.51,0.46 ;P 〈 0.01 ）, whereas, MMN amplitude correlated negatively with HAMD score and number of onsets （ r = - 0.35, - 0.39 ; P 〈 0.01 ） in BPD. MMN latency correlated positively with HAMD score （ r = 0.52, P 〈 0.01 ）, however, MMN amplitude correlated negatively with HAMD score （r= -0.47,P〈0.01） in UPD. Conclusion：Generalized abnormalities of MMN existed in bipolar I and unipolar depression. MMN changes may represent the state mark- er of depression episode.