脑血管性痴呆关联性负变的研究

A Clinical Study of Contingent Negative Variation in Patients with Vascular Dementia

目的探讨脑血管性痴呆 (VD)患者关联性负变 (CNV)的变化特点及其临床应用价值。 方法使用美国NicoletSpirit脑电生理仪 ,采用声和光成对刺激以及反应时间 (RT)技术 ,对 2 4例VD患者和 2 2名正常老年人的CNV进行对照研究。 结果VD组命令信号后负变化 (PINV)出现率增多 (VD组 79% ,NC组 32 % ,χ2 值 10 .47,P <0 .0 1)。与NC组相比 ,VD组CNV早成分M1、晚成分M2 潜伏期延长 ,反应时间延迟 ,且与其认知功能评定 (MMSE评分 )相关。VD组早成分M1波幅下降 (P <0 .0 1)。 结论本组VD患者CNV改变可能与疾病所致的脑实质损害有关 ,血管性病变后的心理应激也可影响CNV。PINV增多对临床诊断VD患者有一定参考价值。RT延迟可以辅助评定痴呆认知功能损害程度。

Objective This study is to evaluated the changes and the clinical value of contingent negative variation (CNV) in patients with vascular dementia (VD). Methods CNV, post-imperative negative variation (PINV) and reaction time (RT) were recorded from 24 VD patients and 22 agd- and gender-matched healthy volunteers, using an American Nicolet Spirit instrument. Mini-mental state exa mination (MMSE) was used to obtain congnitive function scores in patiens. Results The VD group showed significantly decreased amplitude of early CNV (M 1) (P<0.01) and higher occurrence of PINV (P<0.01) as compared to healthy controls. A poor cognitive function score was correlated with prolonged latency of early CNV(M 1) and late CNV (M 2) and slowed RT. Conclusion The changes of CNV may assess brain malfunction of VD, and its clinical application was suggested. Increase in occurrence of PINV might contribute to diagnose VD and reduction in RT might reflect the severity of cognitive function.