不同程度抑郁症患者认知功能及事件相关电位P300的研究

Cognitive function and event related potential P300 among different severity depressive patients

目的:探讨抑郁症患者认知功能损害特点,及其与事件相关电位(ERP)P300的关系。方法:64例诊断符合《国际疾病分类》第10版(ICD-10)的抑郁症患者分为30例中重度抑郁症组(A组)和34例轻度抑郁症组(B组);对其分别进行威斯康星卡片分类测验(WCST)、韦氏成人记忆量表(WMS)和ERP-P300检查,并与30例正常对照者(C组)进行对比,分析WCST、WMS评分与P300指标的关系。结果:A组WCST中完成分类数(Cc)、持续性错误数(Rpe)、随机错误数(NRpe),WMS中长时记忆、短时记忆、瞬时记忆、记忆商数、P300的N2、P3a、P3b潜伏期和波幅与C组间差异有统计学意义(P均<0.05);B组Cc、NRpe、短时记忆、瞬时记忆、记忆商数、P300的N2、P3a、P3b波幅与C组间差异有统计学意义(P均<0.05);A组Cc、Rpe、长时记忆、记忆商数及P300的N2、P3a、P3b潜伏期与B组之间差异有统计学意义(P<0.05),且ERP-N2、P3b潜伏期与长时记忆分呈负相关(r=-0.467,-0.523,P<0.05);P300的N2、P3a、P3b潜伏期与Rpe呈正相关(r=0.657,0.573,0.763,P<0.05);ERP-N2、P3b波幅与短时记忆和瞬时记忆分呈正相关(r=0.478,0.434,0.532,0.541;P均<0.05),与NRpe呈负相关(r=-0.489,-0.532,P均<0.05)。结论:抑郁症患者存在注意转移、记忆、执行功能等方面的认知功能障碍,抑郁程度与其认知功能损害的程度相关,P300指标的异常可反映认知功能损害。

Objective： To explore the characteristic of cognitive impairments in depressive patients and analyze its correlation with the endogenous components of event-related potentials（ ERP） P300. Method： 64 cases patients meeting international classification of diseases（ ICD-10） criteria for the diagnosis of depression were divided into moderate to severe depression group（ group A,n = 30） and 34 cases of mild depression group（ group B,n = 30）. Wisconsin card sorting test（ WCST）,Wechsle memory scale（ WMS） in adults and ERPP300 examinations were conducted to them,and the data were compared with 30 cases of normal control group（ group C,n = 30） to analyze the differences of them and correlation analysis were performed between the former indicators and the endogenous components of ERP-P300. Results： There were statistical significance between group A and C in the complete number of categories（ Cc）,perseverative error（ Rpe）,non-perseverative error（ NRpe） of WCST,long-term memory、short-term memory,immediate memory,memory quotient of WMS,latencies and amplitudes of ERP-N2,P3 a,P3 b（ all P 0. 05）. There were statistical significance between group B and C in Cc,NRpe,short-term memory,immediate memory,memory quotient,the amplitudes of N2,P3 a,P3 b（ all P 0. 05）. There were statistical significance between group A and B in Cc,Rpe,long-term memory,memory quotient,the latencies of CN2,P3 a,P3 b（ P 0. 05）. The latencies of N2、P3 b had negative correlation with the scores of long-term memory（ r =-0. 467,-0. 523,P 0. 05） and the latencies of N2、P3 a、P3 b had positive correlation with Rpe（ r = 0. 657,0. 573,0. 763; all P 0. 05）,the amplitudes of N2、P3 b had positive correlation with the scores of short-term memory and immediate memory（ r = 0. 478,0. 434,0. 532,0. 541; all P 0. 05）and negative correlation with NRpe（ r =-0. 489,-0. 532; all P 0. 05）. Conclusion： depressive patients have cognitive dysfunctions in shifting of attention,memory and executive function. The severity of depressive emotion can affect the degree of cognitive impairment. The endogenous components of P300 can reflect different aspects and levels of cognitive impairment.