军人创伤后应激障碍患者认知性电位变化及其与精神症状的关系

The relationship between cognitive evoked potentials and symptoms in army men with post-traumatic stress disroder

目的 探讨军人创伤后应激障碍(PSTD)患者认知性电位(CEP)的特征和治疗缓解后变化及其与精神症状的关系。方法 应用美国Nicolet Bravo型脑诱发电位仪,对 66 例发病期及其 60 例康复期 PTSD患者进行关联性负变(CNV)、视觉诱发电位(VEP)和听觉诱发电位(AEP)测定,并进行症状自评量表(SCL -90)和事件影响量表(IES)评定。结果 患者组发病期与对照组比较,CNV/M1、VEP/P2 和 AEP/N2 潜伏期延迟(P<0.01或0.05),CNV/M2 和AEP/P3 波幅增高(P<0.01),命令信号后负变化(PINV)出现率增高(P<0.01),SCL-90和IES总分及其部分因子分升高(P<0.01),且 CEP指标与 SCL 90 及 IES总分及其部分因子分显著相关(P<0.01 或 0.05)。患者组康复期 CNV/M1、VEP/P2 和 AEP/N2 潜伏期,CNV/M2、AEP/P3 波幅,PINV出现率以及SCL- 90和IES总分及其部分因子分均恢复至正常值内(与发病期比较P<0.01或0.05,与对照组比较 P>0.05)且治疗前后 CEP指标差值与 SCL 90 及 IES总分及其部分因子减分率显著相关(P<0.01或0.05)。结论 CNV、VEP与AEP的变化可能是PTSD的状态标志。

Objective To investigate the features of cognitive evoked potentials(CEP)in patients with post-traumatic stress disorder(PTSD),the changes of CEP between the duration of episode and remission,and the relationship between CEP and the psychiatric symptoms.Methods Sixty-six episodic patients with PTSD were evaluated with Nicolet Bravo brain evoked potential equipment,symptoms Check List-90(SCL-90)and Impact of Event Scale(IES) and 60 of them were retsted when their psychiatric symptoms remitted.Results The episodic patients showed significantly longer latencies in M 1 of contingent negative variation(CNV),P 2 of visual evoked potential(VEP)and N 2 of auditory evoked potential(AEP,P<0.01 or 0.05);higher amplitudes in M 2 of CNV and P 3 of AEP(P<0.01);higher PINV rate(P<0.01);and higher scores of SCL-90 and IES(P<0.01).The follow-up study revealed that when the psychiatric symptoms remitted,the waveform of CEP became steady;the latencies in M 1 of CNV,P 2 of VEP and N 2 of AEP shorted;the amplitudes in M 2 of CNV and P 3 of AEP,and the scores of SCL-90 and IES decreased to the normal range.The changes of CEP were significantly related to psychiatric symptoms.Conclusion The changes of CNV,VEP and AEP may be state markers of patients with PTSD.