脑梗死患者认知功能障碍与事件相关电位-失匹配负波的相关性分析

Correlation analysis between the cognitive dysfunction and event-related potential mismatch negativity in patients with cerebral infarction

目的:探讨脑梗死患者认知功能障碍与事件相关电位(ERP)相关性。方法:选取症状性脑梗死患者(SCI组)和无症状性脑梗死患者(ACI组)各43例,及43名健康成人(对照组)。分别采用蒙特利尔评估量表北京版(Mo CA)评价3组的认知功能,并采用诱发电位检测仪检测3组2种ERP:N400和失匹配负波(MMN)。分析MMN、N400与Mo CA评分的相关性,比较不同部位脑梗死患者的MMN与N400。结果:ACI组和SCI组Mo CA评分均显著低于对照组(P<0.01),SCI组Mo CA评分低于ACI组(P<0.05);与对照组比较,SCI组和ACI组MMN、N400均表现为潜伏期延长、波幅降低(P<0.01),SCI组MMN和N400潜伏期均高于ACI组(P<0.01和P<0.05),N400波幅低于ACI组(P<0.05);MMN和N400潜伏期与Mo CA评分均呈负相关关系,MMN和N400波幅与Mo CA评分均呈正相关关系;后循环梗死患者MMN、N400潜伏期均显著高于前循环梗死患者(P<0.01),而波幅显著低于前循环梗死患者(P<0.01)。结论:无症状性脑梗死患者与症状性脑梗死患者均存在认知功能障碍,可通过ERP早期检测,其中MMN与认知功能障碍具有较高的相关性。

Objective： To investigate the correlation between the cognitive dysfunction and event-related potential（ ERP） in patients with cerebral infarction. Methods： Forty-three paitents with symptomatic cerebral infarction,43 patients with asymptomatic cerebral infarction and 43 heathy people were divided into the SCI group,ACI group and control group,respectively. The cognitive function in 3groups were evaluated using Montreal Assessment Scale Beijing edition（ Mo CA）,and 2 kinds of ERP,N400 and mismatch negativity（ MMN） in 3 groups were detected using evoked potential detector,the correlations of MMN,N400 and Mo CA score were analyzed,and the MMN and N400 in different parts of cerebral infarction were compared. Results： The Mo CA scores in ACI group and SCI group were significantly lower than that in control group,and the Mo CA score in SCI group was lower than that in ACI group. Compared with the control group,the extending latency and decreasing amplitude of MMN and N400 in SCI group and ACI group were found（ P〈 0. 01）.The latency of MMN and N400 and amplitude of N400 in SCI group were higher and lower than those in ACI group,respectively（ P〈 0. 01 and P〈 0. 05）. The latency of MMN and N400 were negative correlation with Mo CA score,the amplitude of MMN and N400 were postive correlation with Mo CA score. The latency and amplitude of MMN and N400 in posterior circulation infarction patients were significantly higher and lower than those in the anterior circulation infarction patients,respectively（ P〈 0. 01）. Conclusions： Patients with symptomatic or asymptomatic cerebral infarction have cognitive dysfunction,which can be early detected using ERP,and MMN has a higher correlation with cognitive dysfunction.