事件相关电位和脑电图在痴呆早期诊断中的意义

The value of Event-related potentials and electroencephalorgraphy in the early stage of dementia

目的研究血管性痴呆(vascular dementia,VD)患者ERP和EEG的变化特征,并与神经心理学及痴呆程度进行相关性分析。方法测定68例VD患者及37例健康志愿者的事件相关电位(ERP:N100,P300)、脑电图(EEG),同时采用MMSE进行认知功能评定,并进行相关性分析。结果68例VD组患者的P300潜伏期明显延长,波幅明显降低,与正常对照组比较有明显差异性(P<0.01,P<0.05),N100潜伏期。波幅变化不是很大(P>0.05),脑电图异常率,VD组94%,正常对照组18%,2组比较有明显差异性(P<0.01)。VD组患者ERP异常程度与EEG异常程度经相关性分析无相关性。VD组MMSE与正常对照组比较有明显差异(P<0.05),VD组MMSE评分与P300PL呈负相关(r=-0.57,P<0.05),与P300AMP呈正相关(r=0.37,P>0.05)。结论ERP与认知功能存在明显相关性,提示了ERP是反映其认知功能障碍程度的客观指标之一,可作为检测高危人群普查的手段之一,ERP在判断认知功能方面敏感于其他检查手段,客观性强。

Objective To investigate the feature of ERP and EEG parameter in vascular dementia （VD） patients, and analyze their correlation to the degree of dementia of patients. Methods Evaluate the event--related potentials （ERP） and electroencephalorgraphy （EEG） of 68 VD patients and 37 healthy volunteers, at the same time analyse and value the cognition functions using the mini mental state examination （MMSE）. Results Compared with the control group, the peak latencies（PL） of P300 were significantly delayed and the amplitude（AMP） of P300 was significantly decreased （P 〈 0.01, P 〈 0.05） . The peak latencies and amplitude of N100 had no significant changes （P 〉 0.05） ; the abnormal rate of electroencephalography： 94% for VD group, 18% for the control group; the comparison between the two groups is significant （P 〈 0.01） ; there is no relationship between the ERP and EEG abnormal degree of the VD group. The total MMSE score for VD group is 16.52±4.28, significantly below the control group 25.04±5.03 （P 〈 0.05） ; the MMSE evaluation of VD group is negatively related to P300PL （r= -0.57, P〈0.05） , is postively related to P300AMP （r=0.37, P〉0.05）. Conclusions ERPis an objective, sensitive, special index to evaluate the cognition function of the brain, EEG can be used as a consulted index for the change of the VD group＇s electrophysiology. There is a significant relationship between P300 and the cognition function, registering that P300 is a more sensitive, objective method than others when evaluating the cognition functions; it is an objective index to evaluate the obstacles for the cognition function, it can be a method to generally test the high risk group of people.