首发抑郁症患者治疗前后认知电位P_(300)和失匹性负波的变化

Changes of P_(300) and Mismatch Negativity in the Treatment of First Episode Depression

目的了解抗抑郁剂治疗对抑郁症首次发病患者的认知电位P300和失匹性负波(MMN)的影响。方法对64例抑郁症首次发病患者于治疗基线和治疗12周采用汉密顿抑郁量表(HAMD)17项评定症状严重程度,采用脑诱发电位仪进行事件相关电位P300和MMN检测,并与36例健康人进行P300和MMN指标对照研究。结果①治疗前抑郁症组患者的P300潜伏期和MMN潜伏期均比对照组延迟,P300和MMN波幅均低于对照组(P<0.01)。②治疗后患者组P300和MMN潜伏期均显著缩短,P300波幅和MMN波幅均明显提高(P<0.05)。③治疗后临床病情缓解组(HAMD总分≤7)P300潜伏期与对照组比较无显著差异(P>0.05),缓解组的P300和MMN波幅均明显低于对照组(P<0.05);MMN潜伏期比对照组明显延长(P<0.01)。结论首发抑郁症治疗后认知电位P300和MMN有明显改善。病情缓解患者的P300波幅、MMN潜伏期和MMN波幅未完全恢复正常。

Objective To study P300 of the first episode depression and mismatch negativity（MMN） changes after antidepressant treatment. Methods Sixty-four patients with first episode depression were evaluated by HAMD 17 , and P300 and MMN tests were performed at the baseline and week 12. The cognitive potentials were compared with those of control group（N =36）. Results Compared with the control group, depressive patients had longer latency of P300 and MMN ,lower amplitude of P300 and MMN before treatment （P 〈 0.01）. After treatment, patients showed improvement in P300 and M MN performance （P 〈 0.05）. Remission patients （HAMD total score ≤7） had no statistical difference in P300 latency with control group, but they had lower P300 amplitude and MMN amplitude and longer MMN latency （P 〈0.05）. Conclusion First episode depression cognitive potential P300 and MMN performance may improve after treatment. The remission patients fail to restore in P300 amplitude, MMN amplitude and MMN latency.