老年帕金森病患者事件相关电位检测与认知功能障碍的临床研究

The clincal study of event-related potential and cognitive impairment in aged patients with Parkinson disease

目的：探讨老年帕金森病（PD）患者事件相关电位（ERP）与认知功能障碍的关系，并对其相关因素进行分析。方法：PD患者45例，根据年龄分组，≥60岁为PD老年组，〈60岁为PD非老年组。对所有入选患者进行ERP检测和韦氏成人智力量表中国修订版（WAIS-RC）检查，测定患者的ERP的N2、P3波潜伏期、波幅和患者的语言智商（VIQ）、操作智商（PIQ）、全智商（FIQ）等。结果：老年组PD患者ERP的N2、P3波潜伏期的异常率为73％，非老年组PD患者相应为33％，二者比较差异有极显著意义（P〈0．001）；老年组PD患者WAIS-RC测试异常率为60％，非老年组PD患者为20％，二者比较差异有统计学意义（P〈0．05）。患者的病程、受教育年限、运动功能障碍程度与ERP异常无相关性（P〉0．05）；病程与患者的VIQ、PIQ、FIQ无相关性（P〉0．05）；运动功能障碍程度与VIQ、PIQ、FIQ呈负相关（P〈0．05）；受教育年限与VIQ、PIQ、FIQ呈正相关（P〈0．05）。结论：老年组PD患者的认知功能障碍异常率明显高于非老年组PD患者。PD患者的认知功能障碍（VIQ、PIQ、FIQ）不仅与年龄有关，而且与运动功能障碍程度、受教育年限相关。ERP的检测对认知功能障碍测试比WAIS-RC更敏感，且不受患者的病程、受教育年限、运动功能障碍程度的影响，能客观反映出PD患者认知功能的损害。

Objective：To explore the relationship between event-related potential （ERP） and cognitive impairment in aged patients with Parkinson＇s disease （PD）, and analyze their correlative factors. Methods： Forty-five patients with PD were divided into two groups by their age： the aged group （260 years old） and the non aged group （〈60 years old）. Through the examination of ERP and Wechsler Adult Intelligence Scale-Revised China （WAIS-RC）, the latency and amplitude of N2 and P3, the Verbal Intelligence Quotient （VIQ）, the practical intelligence quotient （PIQ） and the full intelligence quotient （FIQ） of all the subjects were recorded. Results： The abnormality rate of the latency of N2 and P3 in the aged group （70%） was remarkably higher than that of the non-aged group （33%） （P〈0. 001）. The abnormality rate of scale of WAIS-RC in the aged group （60 % ） was higher than that of the non-aged group （20 %） （P〈0.05）. The differences in the abnormality rate of N2 and P3 latency and WAIS-RC between both groups were statistically significant. The abnormaI rate of ERP didn＇t correlate with the patients＇ duration of the disease, education years and movement dysfunction （P〉0. 05）. .The patients＇duration of the disease didn＇t correlate with their VIQ, PIQ and FIQ （P〉0.05）. Their movement dysfunction negatively correlated with their VIQ, PIQ and FIQ （P〈0.05）. Their education years positively correlated with their VIQ,PIQ and FIQ （P〈0.05）. Conclusion： The cognitive impairment of aged patients with PD is much higher than that of the non-aged. The cognitive impairment （VIQ, PIQ and FIQ） correlated with their age as well as their movement dysfunction and education years. The examination of ERP is more sensitive than WAIS-RC. Additionally, it isn＇t influenced by their duration of the disease, education years and movement dysfunction. So it objectively reflects patients＇cognitive impairment.