脑卒中后抑郁患者探究性眼动与事件相关电位的研究

Study of exploratory eye movement and event-related potential in patients with post-stroke depression

目的观察比较脑卒中后抑郁(PSD)及不伴抑郁脑卒中(NPSD)患者的认知功能差异,评价探究性眼动(EEM)和事件相关电位(ERP)对PSD的临床判定价值。方法对50例PSD及50例NPSD患者以及48名正常对照者分别进行了EEM和ERP测定,并将结果进行比较。结果PSD组EEM和ERP测定的异常率分别为96%(48/50)和92%(46/50),NPSD组分别为86%(43/50)和82%(41/50);PSD和NPSD组EEM测定凝视点(NEF)及反应探索评分(RSS)值均较正常对照组减少,D值增加,差异有统计学意义(P<0.01),两病例组相比,NEF、RSS及D值差异有统计学意义(均P<0.01);PSD和NPSD组ERP测定N2及P3波潜伏期较正常对照组延长,P3波幅降低,差异有统计学意义(均P<0.01),两病例组相比,ERP测定N2及P3波测定结果差异有统计学意义(均P<0.01)。结论PSD患者的认知功能损害较NPSD明显,EEM和ERP测定可作为PSD患者认知功能的判定指标。

Objective To observe the cognitive ruction difference between post-stroke depression （PSD） and non-post-stroke depression（NPSD） patients. To evaluate the clinical value of exploratory eye movement （EEM） and event-related potentials（ERP） on PSD. Methods EEM and ERP test were used for 50 PSD, 50 NPSD patients and 48 normal controls. The results were compared. Results The abnormal rate of EEM and ERP test in PSD group were 96% （48/50） and 92% （46/50）respectively,and the abnormal rate of EEM and ERP test in NPSD group were 86% （43/50）and 82% （41/50）respectively. The number of eye fixation （NEF）and the responsive search score （RSS） of PSD and NPSD group were significant lower and the scores of diseriminant （D） were significant higher than those in the normal control group（ all P 〈 0. 01 ）. The in ＇,exes of NEF, RSS and scores of D of EEM had significant difference between the two case groups （ P 〈 0. 01 ）. The latency of N2 , P3 of ERP were significant longer and the amplitude of P3 was obvious lower than those in the normal control group （ all P 〈 0. 01 ）. There were significant differences in indexes of N2 , P3 of ERP between the two case groups （ all P 〈 0. 01 ）. Conclusions There are more obvious cognitive ruction impairment in PSD patients than that in NPSD. EEM and ERP test can be used as the indexes to determine cognition of PSD patients.