帕金森病早期多种诱发电位检测的临床诊断价值

Diagnostic significance of detecting three evoked potentials in early stages of Parkinson's disease

目的 观察帕金森病早期体感诱发电位(SL-SEP)、脑干听觉诱发电位(BAEP)和视觉诱发电位(PR-VEP)的异常特征,寻找敏感可靠的诊断指标。方法 对一组52例Yahr分期为Ⅰ期的帕金森病人和一组40例年龄匹配的健康对照组进行三种诱发电位观测。结果 帕金森病早期SLSEP异常率为69.2％;BAEP的异常率为32.7％;PR-VEP的异常率为30.7％,病例组SL-SEP各主波峰潜伏期、峰间潜伏期、P25和N30波幅与对照组比较差异有显著性意义;病例组BAEPⅠ-ⅢIPL、Ⅲ-VIPL、Ⅰ-Ⅲ/Ⅲ-Ⅴ比值和PR-VEP的P100PL与对照组比较差异无显著性意义。结论 在帕金森病的早期,皮层感觉处理过程已受到干扰;体感诱发电位中央前成份以及顶成份P25是一个敏感的诊断指标。

Objective To observe the abnormal features of somatosensory evoked potentials (SL-SEPs) ,brainstem auditory evoked potentials(BAEPs), visual evoked potentials(PR-VEPs) in early stages of Parkinson' s disease(PD), and to find out the sensitive and reliable diagnostic index. Methods SEPs, BAEPs and VEPs were measured in 52 patients with PD in Yahr stage 1 and 40 age-matched normal controls. Results The abnormality rate of SL-SEPs, BAEPs and PR-VEPs were 69.2%, 32.7% and 30.7% in early stages of PD; the values of peak latency of N20, P22, P25 and N30 cortical SL-SEPs components, of inter-peak latency of N13-N20, N13-P22, and of amplitude of P25 and N30 were significantly different between the experimental and the control groups; no significant difference was found in the values of inter-peak latency of Ⅰ-Ⅲ,Ⅲ - Ⅴ and Ⅰ -Ⅲ/Ⅲ- Ⅴ BAEPs components and ones of peak latency of P100 PR-VEPs components between the two groups. Conclusion The cortical sensory treatment process was interfered in early stages of PD; the pre-central components and parietal components P25 of SL-SEPs are helpful in PD diagnosis.