Alzheimer病的脑诱发电位初步探讨

A preliminary study of brain evoked potentials in patients with Alzheimer's disease

目的探讨Ａｌｚｈｅｉｍｅｒ病（ＡＤ）脑诱发电位变异及临床应用价值。方法记录３９例ＡＤ患者和４０例健康老年人的脑干听觉反应（ＡＢＲ）、听觉诱发电位（ＡＥＰ）、视觉诱发电位（Ｆ－ＶＥＰ）以及事件相关电位Ｐ３００。结果与健康对照组相比，ＡＤ组的脑诱发电位变异为：（１）波幅下降（ＡＢＲ－Ⅴ，ＡＥＰ－Ｐ２，Ｆ－ＶＥＰ－Ｐ２，靶Ｐ３００－Ｐ２、Ｐ３，非靶Ｐ３００－Ｐ２）；（２）潜伏期延长（ＡＢＲ－Ⅲ，ＡＥＰ－Ｐ１、Ｎ１、Ｐ２）；（３）部分潜伏期提前（靶和非靶Ｐ３００－Ｎ１）。相关分析提示：除靶Ｐ３００－Ｎ１潜伏期外，以上指标均与ＡＤ的认知功能评定（ＣＡＳＩ分）有显著线性相关，部分指标同时又与被试者的教育年限显著相关。Ｋ－Ｍｅａｎｓ聚类分析表明：与ＣＡＳＩ和教育年限皆相关的脑诱发电位指标（ＢＥＰｓ）区分两类被试者的特异性高（１００．０％）而敏感性低（５１．７％）；仅与ＣＡＳＩ评分相关的ＢＥＰｓ指标则敏感性高（９３．６％）而特异性低（５５．６％）。结论ＡＤ患者的脑诱发电位指标变异程度基本上与其认知功能受损程度相平行；

Objective To investigate the variation of brain evoked potentials(BEPs) and their clinical applications in patients with Alzheimer's disease(AD). Methods Four kinds of BEPs (auditory brainstem response, ABR; auditory evoked potentials, AEP; flash visual evoked potentials, F VEP; event related potentials, ERPs P300) were recorded from 39 patients diagnosed as AD according to DSM III R and 40 age matched normal controls(NC), using a Dantec Concerto SEEG 16 instrument. Results The AD patients presented lower amplitudes(ABR V, AEP P2,F VEP P2, P300 P2 & P3),prolonged latencies( ABR III, AEP P1, N1 & P2 ) and shortened latencies ( N1 of both target and nontarget P300), as compared to NC group. All the above mentioned BEP indexes except N1 latency of target P300 were found significantly correlated with one cognitive assessment (CASI score), and some of them were also significantly correlated with the years of education(ED) received by the subjects. K Means cluster analysis revealed that, the indexes correlated with both CASI and ED, could differentiate the subject groups with a better specificity (100 0%); and the ones correlated only with CASI could do so with a better sensitivity (93 6%). Conclusions The variation of BEP in AD is essentially parallel with the degree of impaired cognition. Some BEP indexes might be developed into the tool for cognitive assessment, and of their potentials the clinical application were suggested.