婴儿痉挛症脑干听觉诱发电位的奇异性初步分析

Analysis of the brainstem auditory evoked potential singularity in infantile spasms

目的运用建立在子波变换基础上的Lipschitz指数和模极大值两种奇异性检测方法分析婴儿痉挛症患儿脑干听觉诱发电位,试图解释婴儿痉挛症患儿智能迟滞的原因,从神经电生理的信息传递的角度来证明脑干是责任病灶。方法本实验病例分为2组,正常组12例,平均年龄(6.325±3.210)岁;婴儿痉挛症组13例,平均年龄(4.638±3.986)岁。所有病例均行脑干听觉诱发电位检查,并用建立在子波变换基础上的Lipschitz指数和模极大值两种奇异性检测方法进行分析。结果Lipschitz指数尖峰在正常幼儿0～2ms和5～7ms各出现1次,在婴儿痉挛症患儿尖峰出现在0～2ms和5～7ms之后。正常幼儿模极大值在一定范围内连续性好,而在婴儿痉挛症患儿则中断。结论研究发现在婴儿痉挛症患儿的脑干、尤其是上部脑干对上行传导的信息耦合性差,从而影响患儿的智能发育。

Objective To analyse the brainstem auditory evoked potential (BAEP) in infantile spasms (IS) by singularity detection method with Lipschitz exponential and modulus maximum based on wavelet transform,in order to explain the cause for mental retardation in infantile spasms. Methods Two groups were enrolled:group 1,12 healthy infants with average age (6.325±3.210) years;group 2,13 IS patients with average age(4.638±3.986) years. BAEP was measured in every subject and analysed with Lipschitz exponential and modulus maximum based on wavelet transforming. Results The peaks of lipschitz exponentials were in the ranges of 0～2 ms and 5～7 ms in healthy group- but delayed in IS group. The wavelet transform modulus maximum was a continuous form within certain range in the healthy infants whereas it was an intermittent form in IS patients. Conclusion It is demonstrated that the mental retardation in IS patients results from the malfunction of the brainstem,especially the poor coupling upward-conducting information with the upper brainstem.