重症肌无力患者的注意网络功能研究

The study on attention networks in patients with myasthenia gravis

目的探讨重症肌无力(myasthenia gravis,MG)患者注意功能是否受损及其受损特点,并进一步分析其影响因素,对MG注意缺陷的可能神经机制进行推测。方法选取安徽医科大学第一附属医院门诊及住院的MG确诊患者26例,并选取来自同期健康体检中的健康查体者40名作为对照。比较两组简易精神状态检查量表(mini-mental state examination,MMSE)评分、数字广度(digit span,DS)、词语流畅性(verbal fluency test,VFT)、抑郁自测量表(self-rating depression scale,SDS)评分差异,采用注意网络测验(attention network test,ANT)方法对受试者的注意功能受损情况进行检测。结果 MG和对照组间MMSE、DS、VFT、SDS评分差异无统计学意义(均P>0.05);两组间ANT总平均反应时间(RT)及总平均正确率差异无统计学意义(均P>0.05);MG组的定向网络效率与对照组比较减低(t=-4.198,P<0.01),而两组间警觉网络与执行网络差异比较无统计学意义(均P>0.05)。结论 MG患者存在注意功能损害,表现为定向网络异常,而警觉网络与执行控制网络保留正常,提示患者可能存在中枢胆碱能系统损害,推测MG患者存在认知功能障碍。

ObjectiveTo study the changes of attention function in myasthenia gravis(MG)patients,and further analyze its influencing factors,and speculate on the possible neurological mechanism of MG attention deficit.MethodsTwenty six patients with MG diagnosed and hospitalized from the First Affiliated Hospital of Anhui Medical University and40healthy subjects from the same period were enrolled in this study.The scores of mini mental state examination(MMSE),digit span(DS),verbal fluency test(VFT),self rating depression scale(SDS)were compared between the MG group and the control group.The attention network test(ANT)method was used to detect the damage of the attention function of the subjects.ResultsThere was no significant difference in MMSE,DS,VFT and SDS scores between the MG and the control groups(P>005).There was no significant difference in ANT total mean response time(RT)and total mean accuracy between the two groups(P>005)The directional network efficiency of the MG group was lower than that of the control group(t=-4198,P<001),but the difference between the two groups in alert network and executive network was not statistically significant(P>005).ConclusionsMG patients showed attention functional impairment in the performance of directional network,but alert network and executive control network remained normal,the results suggested that MG patients may have central cholinergic system damage with cognitive dysfunction.