帕金森病患者事件相关电位和抑郁的相关因素

Correlated factors of depression and event related potential in patients with Parkinson diseases

目的:探讨帕金森病(Parkinson'sdisease,PD)患者抑郁的发生和事件相关电位(eventrelatedpotential,ERP)的变化,并对其相关因素进行分析。方法:采用汉密顿抑郁量表(HAMD)及Zung抑郁自评量表(SDS)对45例PD患者(PD组)和30例对照组进行测试,检测事件相关电位的潜伏期及P3的波幅,并与年龄、病程、受教育年限、运动功能障碍、脑萎缩等因素进行相关性分析。结果:PD组抑郁发生率49%,对照组抑郁发生率17%,两者差异有显著性意义(χ2=11.01,P<0.01)。病程>5年的PD患者抑郁的发生明显高于病程≤5年的患者(χ2=28.96,P<0.01);运动功能障碍越重的患者越易发生抑郁(χ2=5.17,P<0.05);有脑萎缩的PD患者中抑郁的发生高于无脑萎缩的PD患者(χ2=13.55,P<0.01)。PD患者中有27例(60%)N2,P3的潜伏期异常率,显著高于对照组(χ2=9.80,P<0.01);PD组N2,P3的潜伏期较对照组明显延长(t=7.78,P<0.001),PD组P3的波幅较对照组降低(t=10.69,P<0.05)。脑萎缩、长时间应用抗胆碱药与N2,P3的潜伏期成正相关(r=0.2839～0.2879,P<0.05),与P3的波幅成负相关(r=-0.321,P<0.05),年龄、病程、运动功能障碍、受教育年限与P3的潜伏期及P3的波幅无相关性。结论:PD患者事件相关电位的异常主要表现N2,P3的潜伏期延长和P3波幅降低,脑萎缩和长时间应用抗?

AIM:To explore the occurrence of depression and changes of event related poten tial (ERP) in patients with Parkinson's disease (PD),and to analyze Their relate d factors. METHODS:Totally 45 patients with PD(PD group)and 30 controls were tested by us ing Hamilton rating scale for depression (HAMD) and Zung's self-rating depressi on scale (SDS).The latency of all the waves of ERP and the amplitude of P3 wer e measured,and the correlation analysis was performed with the factors of age,du ration,motor dysfunction, education level and brain atrophy etc. RESULTS:The incidence of depression was 49% in the PD group, significantly different from that in the control group (17%)(χ2=11.01, P< 0.01); that of PD patients with the duration >years was obviously higher than that of PD patien ts with the duration ≤ 5 years (χ2=28.96,P< 0.01). The serious motor dysfunc tion, the higher the occurrence of depression(χ2=5.17, P< 0.05).The incidence rate of depression was higher in PD patients with brain atrophy than those witho ut brain atrophy (χ2=13.55,P < 0.01).ERP abnormality occurred in 27 PD patients (60%),significantly more than that in the control group(χ2=9.80,P< 0.01).The latencies of N2 and P3 were significantly prolonged (t=7.78,P< 0.001) and the a mplitude of P3 markedly lowered (t=10.69,P< 0.05) in the PD group as compared wi th those in the control group.Brain atrophy and long-term application of antich olinerlgic were positively correlated with the latencies of N2 and P3 (r=0.283 9 -0.287 9,P< 0.05), but negatively correlated with the amplitude of P3(r=-0.321 ,P< 0.05).The age, the course of PD,motor dysfunction and the education level ha d no correlations with latencies of P3 and amplitude of P3. CONCLUSION:The elongation of N2 and P3 and the decrease of P3 amplitude are th e main abnormalities of ERP in PD patients, and the important factors of N2 and P3 abnormality are brain atrophy and long-term application of anticholinerlgic. The occurrence of depression in PD patients is higher, and the intrinsic factor plays an important role. The damage of cerebral function and subcortical struct ures may be one of the important factors for the occurrence of depression in PD patients.