多发性硬化患者的抑郁情绪及其事件相关电位研究

A study on depression and event-- related potential in patients with multiple sclerosis

目的探讨多发性硬化（MS）患者的抑郁情绪和事件相关电位（ERP）特征，为多发性硬化的病情判定寻找更多的依据。方法对63例多发性硬化患者和60例正常对照分别进行了抑郁量表（HAMD）评定和ERP测定，并将结果加以比较。结果MS组中ERP测定的异常率为85．7％（54／63），ERP中N2、P3波潜伏期较对照组延长，P3波幅降低，差异具有统计学意义（P〈0．01）；HAMD评定中躯体化、体质量变化、认知障碍、昼夜变化、迟缓、睡眠及绝望感等因子分和总分值与对照组相比，差异具统计学意义（P〈0．01）。ERP成分中P3波潜伏期与HAMD评定中躯体化、体质量变化、认知障碍、昼夜变化、迟缓、睡眠及绝望感等因子分呈呈正相关（r＝0．32～0．48，P〈0．01），而P3波幅与其呈负相关（r=-0．29～-0．42，P〈0．01）。结论MS患者的抑郁情绪及认知障碍明显，ERP测定可作为MS患者认知功能的判定指标应用于临床。

Objective To explore the features of depression and event--related potential （ERP） in patients with multiple sclerosis （MS） and provide more basis for judgement of pathogenetic condition of these patients. Methods HAMD and ERP test were used to analyse 63 patients with multiple sclerosis, and compared to 60 health volunteers （normal controls）. Results The abnormal rate of ERP in MS patients was 85.7%0 （54/63）, The latency of N2 and P3 of ERP and the amplitude of P3 in MS patients were longer and lower compared to controls. There were significant difference between in the two groups （P 〈 0.01）. The scores of factors in somatization, body weight, cognitive handicap, diurnal variation, retardation, sleep and feeling of despair of HAMD in MS group were significantly higher than those in the control group （P 〈 0.01）. Correlation analysis indicated a remarkable positive correlation between latency of P3 of ERP and the scores of factors of HAMD in MS group （r=0.32～0.48, P 〈 0.01）, and a significant negative eorrelation with P3 amplitude （r=-0. 29～-0. 42, P 〈 0.01）. Conclusions MS patients have obvious depression and cognitive handicap, ERP can be used a clinical index to appraise cognition with MS patients.