高速肌电诱发电位仪诱发的非匹配负波与阿尔茨海默病患者认知功能的关系

Association between event-related potential mismatch negativity and cognitive function in patients with Alzheimer disease

目的:探讨非匹配负波在阿尔茨海默病病情监测及认知水平评估中的价值。方法:①阿尔茨海默病组为2005-01/10重庆医科大学附属第一医院收治,参照NINCDS-ADRDA诊断标准,由两名专科医师诊断为可能为阿尔茨海默病的患者30例。消除性别、年龄和受教育水平差异,配以健康老年人30例作为对照组。阿尔茨海默病组按简易智力状态检查表评分分为轻度组(≥21分)9例、中度组(10～20分)12例和重度组(≤9分)9例。②应用KEYPOINTR高速肌电诱发电位仪对受试者进行非匹配负波检查,所用电极为氯化银针状电极,极间阻抗小于2kΩ,刺激频率为0.3～1.0Hz,记录峰潜伏期和波幅。结果:60例受试者进入结果分析。①阿尔茨海默病组峰潜伏期长于对照组[(270.90±42.96),(211.27±19.17)ms,P<0.01],波幅低于对照组[(2.72±1.24),(5.18±1.99)μV,P<0.01]。②重度组和中度组峰潜伏期长于轻度组[(301.89±35.57),(282.92±20.61),(223.89±32.52)ms,F=17.57,P<0.01];波幅低于轻度组[(1.79±0.98),(2.48±1.08),(3.97±0.47)μV,F=13.76,P<0.01];中度组与重度组间比较差异不显著(P>0.05)。结论:非匹配负波可反映阿尔茨海默病患者的认知水平,还能反映和监测认知过程的改变。

AIM： To explore the value of mismatch negativity （MMN） to appraise the Alzheimer disease （AD） patient＇s cognition and monitor AD condition. METHODS：① Thirty patients fulfilling the NINCDS-ADRDA criteria of probable AD were diagnosed by two specialized doctors in the First Affiliated Hospital of Chongqing University of Medical Science between January and October 2005. And 30 healthy elders who matched in sex, age and education were chosen as controls. AD patients were divided into three groups according to the score of Mini-Mental State Examimation （MMSE）： 9 cases in mild group （≥ 21 scores）, 12 cases in moderate group （10-20 scores） and 9 cases in severe group （≤ 9 scores）.②The MMN was inspected by using KEYPOINT myoelectricity and evoked potentials inducer in AgCI needle electrode, the impedance between the electrodes was less than 2 kΩ, the stimulation frequency was 0.3-1.0 Hz, Then the peak latency （PL） and wave amplitude （Amp） were both recorded. RESULTS： All 60 subjects were involved in the result analysis.①The MMN PL of AD patients were significantly prolonged compared with control group [（270.90±42.96）, （211.27±19.17） ms, P 〈 0.01], and Amp of AD patients were decreased compared with control group [（2.72±1.24）, （5.18±1.99） μV, P 〈 0.01].②The MMN PL of AD patients with severe and moderate dementia were significantly prolonged compared with that of mild group [（301.89±35.57）, （282.92±20.61）, （223.89±32.52） ms, F =17.57, P 〈 0.01], and Amp were decreased compared with mild group [（1,79±0.98）, （2.48±1.08）, （3.97±0.47） μV, F =13.76, P 〈 0.01]. There was no significant difference of MMN between moderate group and severe group （P 〉 0.05）. CONCLUSION： MMN can reflect the cognition level of AD patients and monitor the alteration of cognition process.