轻度颅脑外伤患者提示性持续操作任务行为学及事件相关电位研究

Behavioral and neurophysiological abnormalities during cued continuous performance test in patients with mild traumatic brain injury

目的通过对急性期轻度颅脑外伤（mild traumatic brain injury，mTBI）患者与健康对照者行为学及事件相关电位（event—related potentials，ERPs）比较分析，探索mTBI患者持续注意和执行控制的特征及神经机制。方法选择急性期mTBI患者与健康对照者各17名，采用提示性持续操作测试记录其行为学及ERPs结果。结果1．行为学：mTBI与健康对照者的击中数分别为[（66．76±3．27）分、（69．12±1．41）分]、反应时间分别为[（533．66±144．20）ms、（413．03±94．57）ms]、遗漏错误数分别为[（3．24±3．27）分、（0．88±1．41）分]、虚报错误数分别为[（0．35±1．00）分、（0．53±0．87）分]，其中击中数、遗漏错误数、反应时间差异有统计学意义（P〈0．05），虚报错误数差异无统计学意义（19〉0．05）。2．ERPs：①mTBI组Go与Nogo条件下N2波幅显著低于对照组（P〈0．05）。②N2波幅组别主效应显著（P〈0．05），条件主效应与组别条件的交互效应不显著（P〉0．05）。N2成分潜伏期组别、条件主效应与组别×条件的交互效应均不显著（P〉0．05）。③mTBI组Go条件下P3波幅显著低于对照组（P〈0．05），Nogo条件下两组P3波幅差异无统计学意义（P〉0．05）。④P3波幅组别与条件主效应显著（P〈0．05），组别×条件的交互效应不显著（P〉0．05）。P3潜伏期组别和条件的主效应及交互效应均不显著（P〉0．05）。结论mTBI患者急性期持续注意、冲突监测能力存在损害，而反应抑制功能可能没有损害。

Objective To investigate the features and neural mechanisms of sustained attention and exec- utive function in patients with acute mild traumatic brain injury （mTBI） by comparing and analyzing behavioral and event-related potentials of patients and healthy controls. Methods Seventeen patients with acute mTBI and seventeen healthy controls participated in a cued continuous performance test. Behavioral data and event-related potentials were collected and analyzed. Results 1. There were significant differences between the mTBI group and the control group in hitting number （ （ 66.76±3.27）, （ 69.12± 1.41 ） ）, reaction time（ （ 533.66± 144.20） ms, （413.03±94.57） ms） and the number of errors of omission （ （ 3.24±3.27）, （ 0.88± 1.41 ） ） （P〈0.05）, but no sig- nificant differences in the number of false errors （（0.35±1.00） , （0.53±0.87） ） （P〉0.05）. 2. The amplitude of Go-N2 and Nogo-N2 were significantly smaller in mTBI group than that in control group （P〈0.05）. The main effect of group was significant of N2 amplitude （P〈0.05） ,but main effect of condition and the interaction effect were not significant（P〉0.05）. Group and condition had no significant main effect and interaction effect on the latency of N2 （P〉0.05）. The amplitude of Go-P3 was significantly smaller in mTBI group than that in control group （P〈0.05） , while not on the amplitude of Nogo-P3 （P〉0.05） .The main effect of group and condition were significant on P3 am- plitude （P〈0.05） ,but the interaction effect was not significant（P〉0.05 ）. Group and condition had no significant main effect and interaction effect on the amplitude of P3 （P〉0.05）. Conclusion Patients with mTBI show impair- ments in sustained attention and conflict monitoring, but not in response inhibition.