抑郁症患者脑诱发电位的变异特点:2个月随访观察

Characteristics of variation of brain evoked potentials in patients with depression: two month follow up observation

目的:探讨抑郁症患者脑诱发电位的变异特点及临床应用价值。方法:实验于2001-08/2003-10在解放军一六○医院精神疾病防治中心完成。使用美国NicoletBravo脑电生理仪对符合中国精神障碍分类与诊断标准第三版(CCMD-3)中抑郁症诊断标准的46例患者(抑郁症组)以及42名健康志愿者(对照组),进行听觉诱发电位(auditorye-vokedpotential,AEP)、事件相关电位P300(eventrelatedpotentialP300,P300)的检测。同时抑郁症组完成汉密顿抑郁量表(HAMD)评定。并于治疗2个月时对抑郁症组进行了相同项目的随访。结果:治疗前与对照组相比,抑郁症组P300靶N2和P3潜伏期均延迟(t=2.15,4.22,P<0.05和0.01),靶P3和非靶P2波幅均降低(t=8.24,6.48,P均<0.01);AEP双峰P2波的出现率增高(χ2=17.68,P<0.01)。治疗后与治疗前比较,抑郁症组P300大部分变异指标明显变化(t=2.52～9.06,P<0.05～0.01),与对照组比较差异均无显著性意义(t=0.83～1.75,P均>0.05);P300非靶P2波幅与AEP双峰P2波的出现率变化不明显,与对照组相比仍有显著性差异(t=6.03,χ2=13.91,P均<0.01);HAMD总分及大部分因子评分明显下降,差异有显著性意义(t=2.56～9.61,P<0.05～0.01)。治疗前后,P300主要指标的差值与部分精神症状的变化之间有显著相关性(r=0.224～0.342,P<0.05?

AIM: To investigate the features of variation of brain evoked potentials (BEP) and its value on clinical application in patients with depression.METHODS: The trial was complete in the Center of Prevention and Treatment for Mental Diseases, the 160 Hospital of Chinese PLA during August 2001 to October 2003. The auditory evoked potential (AEP) and event related potential P300 (P300) were determined in 46 patients with depression(depressive group), who were in accordance with the depressive diagnostic criteria of the third edition of the Chinese Classification and Diagnostic Criteria of Mental Disorders (CCMD 3), and 42 healthy volunteers (control group) with the Nicolet Bravo instrument (America). At the same time, patients in the depressive group were scored with the Hamilton Depression scale (HAMD), and were retested 2 months after treatment. RESULTS: Compared with the control group, the patients in the depressive group had delayed latencies of target N2 and P3(t=2.15, 4.22,P< 0.05 and 0.01), decreased amplitudes of target P3 and non target P2 (t=8.24, 6.48, P< 0.01)), and the occurrence rates of double AEP peak of P2 were increased(χ2=17.68, P< 0.01). Most of the P300 indicators of variation in the depressive group were changed obviously before and after treatment(t=2.52 to 9.06,P< 0.05 to 0.01), insignificantly different from those in the control group(t=0.83 to 1.75,P >0.05).The changes of latency of P300 non target P2 and occurrence rates of double AEP peak of P2 in the depressive group was not obvious, but still significantly different from those in the control group(t=6.03,χ2=13.91,P< 0.01).The total score and most factor scores of HAMD were obviously decreased with significant differences in the depressive group (t=2.56 to 9.61, P< 0.05 to 0.01). There were significant correlations between the difference of most P300 indicators and part changes of the psychiatric symptoms (r=0.224 to 0.342, P< 0.05 to 0.01).CONCLUSION: The BEP of the depressive patients has their own characteristics of variation, and it has certain value in assistant diagnosis and evaluation of depression.