血管性痴呆患者事件相关电位P300改变与认知功能障碍的关系

Relationship between changes of event-related potential P300 and cognitive function disorder in patients with vascular dementia

目的:评价事件相关电位P300作为血管性痴呆患者认知功能障碍客观指征的临床价值。方法:对30例缺血性血管性痴呆患者、30例无痴呆的脑梗死患者和30例正常对照者,采用电生理技术检测事件相关电位P300,应用简明精神状态量表(MMSE)、痴呆简易筛查量表(BSSD)和瑞文标准智力测验(RSPM)评价认知功能,采用MRI技术测定脑叶和海马体积。结果:①血管性痴呆组P300峰潜伏时(435.57±89.95)ms较脑梗死组(367.77±29.14)ms和正常对照组(341.90±29.27)ms明显延长(F=5.16,P<0.01)。②血管性痴呆患者P300峰潜伏时与MMSE,BSSD评分呈负相关(r=-0.87,-0.89,t=6.89,7.05,P<0.01)。③血管性痴呆组额叶和颞叶体积犤(15.19±1.51)%,(4.57±0.51)%犦比正常对照组犤(16.72±1.46)%,(4.92±0.50)%犦显著较小(T=2.85,P<0.01;T=2.21,P<0.05)。④血管性痴呆患者P300峰潜伏时与额叶和颞叶体积呈负相关(r=-0.56,-0.62,t=5.53,6.65,P<0.01)。结论:血管性痴呆患者P300峰潜伏时的延长反映与认知功能相关脑区的病理改变,客观反映认知功能障碍程度。

AIM: To evaluate the clinical value of event related potential P300 as assessment of cognitive function disorder in the patients with vascular dementia(VD). METHODS:Event related potential P300 was tested with electrophysiological technique, cognitive functions were assessed with mini mental state examination(MMSE), brief screening scale for dementia(BSSD) and Raven's standard progressive matrices(RSPM),and volumes of cerebral lobes and hippocampal formation were measured with MRI method in 30 ischemic VD patients, 30 cerebral infarction(CI) patients without dementia and 30 normal controls. RESULTS:①P300 peak latency in VD patients[(435.57±89.95) ms] was obviously longer than that of CI patients[(367.77±29.14) ms] and normal controls[(341.90±29.27) ms](F=5.16,P< 0.01).②P300 peak latency was negatively correlated with the scores of MMSE and BSSD(r=-0.87,-0.89,t=6.89,7.05,P< 0.01) in VD patients.③The volumes of frontal and temporal lobes in VD patients[(15.19±1.51) %,(4.57±0.51) %] were smaller than those of normal controls[(16.72 ±1.46) %, (4.92±0.50) %] respectively(T=2.85,P< 0.01;T=2.21, P< 0.05).④P300 peak latency was negatively correlated with the volumes of frontal and temporal lobes in vascular dementia patients(r=-0.56,-0.62,t=5.53,6.65,P< 0.01). CONCLUSION:The prolongation of P300 peak latency reflects the pathological changes of brain areas associated with cognitive function and the degree of cognitive function disorder in VD patients.