体感诱发电位应用于Tourette综合征的临床探讨

Clinical Study of Application of Somatosensory Evoked Potentials in Tourette Syndrome

目的基于体感诱发电位（SEP）评估感觉-运动皮层功能的理论,探讨SEP评价Tourette综合征的可行性。方法选取2014年3月-2015年4月本院神经内科门诊符合纳入标准的33例Tourette综合征患儿作为试验组,另取30名健康对照者作为正常组。两组均采用耶鲁综合抽动严重程度量表（YGTSS）进行评定,测量SEP。结果两组SEP的N20峰潜伏期、峰-峰波幅无显著性差异（P〉0.05）;试验组P22峰潜伏期较正常组延长（t=2.356,P〈0.05）,峰-峰波幅降低（t=2.507,P〈0.05）;YGTSS评分较正常组明显升高（t=3.012,P〈0.01）。SEP的P22峰潜伏期与YGTSS评分呈正相关（r=0.402,P〈0.001）,P22波幅峰-峰波幅与YGTSS评分呈负相关（r=-0.180,P〈0.001）。结论 Tourette综合征患儿存在皮质-纹状体-丘脑-皮质调节环路对感觉/运动冲动的抑制缺陷。可考虑将SEP作为Tourette综合征患儿的客观检测指标。

Objective To explore the feasibility of somatosensory evoked potentials（SEP） evaluating Tourette syndrome, based on the theory of SEP evaluating sensory-motor cortical function. Methods 33 cases of Tourette syndrome in our hospital from March 2014 to April2015 were as the experiment group and 30 healthy participants were as the normal control group. Both groups were evaluated with Yale Global Tic Severity Scale（YGTSS） and SEP. Results There was no significant difference in N20 leak latency and leak-leak amplitude of SEP between 2 groups（P〉0.05）. The P22 leak latency prolonged（t=2.356, P〈0.05） and the leak- leak amplitude decreased（t=2.507, P〈0.05） in the experiment group compared with the normal control group. The YGTSS score was higher in the experiment group than in the normal control group（t=3.012, P〈0.01）. The P22 leak latency was positively（r=0.402, P〈0.001）, and the P22leak- leak amplitude was negatively（r=-0.180, P〈0.001） correlated with YGTSS score. Conclusion Children with Tourette syndrome are disordered in inhibiting sensory or motor impulse through cortex-striatum-thalamus-cortex regulation circuit. SEP is considered as the objective indicator of patients with Tourette syndrome.