脑电近似熵、失匹配负波在检测帕金森病患者认知功能障碍中的评估作用

The effect of electroencephalographic approximate entropy and mismatch negativity on screening cognitive impairment in Parkinson＇s disease patients

目的：对比帕金森病（PD）患者与对照组的脑电近似熵（ApEn）、失匹配负波（MMN）检查结果，分析两种方法在帕金森病患者认知功能障碍中的评估作用。方法：病例组15例、对照组36例受试对象均接受常规16信道脑电图检查，选用脑电非线性指数近似熵对安静闭眼、闭眼心算、安静睁眼三种状态下的原始脑电数据进行分析；并收集简易智力状态检查量表（MMSE）得分、MMN的潜伏期和波幅相关数据，运用统计学方法对两组结果进行分析。结果：①病例组与对照组MMN在Cz、Fz点的潜伏期差异虽然没有统计学意义，但从数值上可见病例组的潜伏期有延长趋势；两组在Cz、Fz点的波幅比较差异无统计学意义；②病例组与对照组脑电ApEn对比，只在闭眼心算时，两组于中央感觉运动区（C3）、顶叶（P3）、枕叶（O2）点的脑电ApEn差异有统计学意义，病例组较对照组测值降低。结论：脑电ApEn和MMN潜伏期都可作为认知功能的评价措施。并且闭眼心算状态的脑电ApEn评价效果的敏感性较MMN潜伏期强。三种状态下，闭眼心算的脑电ApEn评价效果最好。

Objective： To compare the result of electroencephalogram approximate entropy （EEG ApEn） and mismatch negativity （MMN） between Parkinson＇s disease （PD） group and health control （HC） group, and analyze their effect of screening cognitive impairment in PD patients. Methods： 15 sub- jects in PD group and 36 subjects in HC group were collected data from tests： MMSE score, MMN and EEG. The data from EEG is derived after nonlinear analysis with the parameter ApEn, as well as the la- tency and amplitude of MMN. llesults： （1） Although, latencies at electrode positions Cz and Fz show no significant difference between HC and PD groups, the extended trend can be revealed from the value. The amplitudes at electrode positions Cz and Fz have no significant difference between HC and PD groups. （2） Comparing EEG ApEn between PD and HC groups, only in the state of mental arithmetic, there are significant differences at central sensorimotor region （Ca）, parietal lobe （P3） and occipital lobe （（）2）, with lower value in PD group. Conclusion：This study suggests that ApEn as one of nonlinear EEG analysis parameters and the latency of MMN may contribute to objectively screen PD patients with CI. Moreover, the effect of EEG ApEn is more sensitive and objective than the latency of MMN. Among the 3 states, EEG ApEn in the state of mental arithmetic with eyes closed is the most effective.