帕金森病患者注意缺陷及认知障碍与事件相关电位P300 MMN相关性

Correlation between attention deficit and cognitive impairment and event-related potential P300, MMN in patients with Parkinson's disease

目的探讨帕金森病(PD)患者注意缺陷及认知障碍与事件相关电位P300、多灶性运动神经病的相关性.方法将90例帕金森病患者按蒙特利尔认知评估量表注意测试评分分为两组,评分≥6分者设为PDa组(48例),<6分者设为PDb组(42例).采用简明精神状态检查量表、蒙特利尔认知评估量表评定两组患者认知功能,持续性注意量表评定两组患者持续注意功能,面孔情绪认知量表评定患者面孔情绪;采用诱发电位P300系统测定两组事件相关电位.结果(1)两组简明精神状态检查量表评分比较差异无统计学意义(P>0.05),蒙特利尔认知评估量表总分及注意测试评分比较差异均有统计学意义(P<0.01);(2) PDb组持续性注意量表漏报率、平均反应时间均显著高于PDa组(P<0.01);(3)两组面孔情绪认知量表评分喜、怒、悲、惊、厌、怕维度评分及总分比较差异均有统计学意义(P<0.01);(4)两组面孔情绪认知量表怕、厌维度评分及总分与事件相关电位P300及多灶性运动神经病波幅均呈显著正相关(P<0.01),与P300及多灶性运动神经病潜伏期均呈显著负相关(P<0.01).结论帕金森病患者认知功能障碍可出现注意缺陷,患者面孔情绪识别障碍以怕、厌为主;事件相关电位P300、多灶性运动神经病与情绪识别具有相关性,是检测情绪识别认知障碍的有效电生理指标.

Objective To investigate the correlation between attention deficit and cognitive impairment and event-related potential P300, MMN in patients with Parkinsons disease. Methods 90 patients with Par-kinsons disease were divided into two groups according to the MoCA attention test score. The scores were ≥6 points for the PDa group (48 cases), and <16 points for the PDb group (42 cases). The cognitive func-tion of the two groups was assessed by MMSE and MoCA. CPT was used to assess the continuous atten-tion function of the two groups. The face emotion recognition scale was used to assess the facial emotion of the patients. Two groups of event-related potentials were measured using the evoked potential P300 sys-tem. Results (1) There was no significant difference in MMSE score between the two groups (P>0. 05). There were significant differences in the scores of MoCA and the attention test scores (P<0. 01).(2) The CPT miss report rate and average reaction time of PDb group were significantly higher than th(xse of PDA group (P<0. 01).(3) There were significant differences in the scores of happiness, anger, sadness, hor-ror, disgust, fear dimension and total score between the two groups on the face emotional cognition scale (P<0. 01).(4) The fear and disgust dimension scores and total scores of the two groups' face emotion rec-ognition scale were significantly positively correlated with event-related potential P300 and MMN, and negatively correlated with P300 and MMN latency(P<0. 01). Conclusions Patients with Parkinsons dis-ease may have attention deficits in cognitive dysfunction, and the face emotion recognition disorder is main-ly fear and disgust. Event-related potential P300 and MMN are related to emotion recognition and are effective electrophysiological indicators for detecting emotional recognition of cognitive impairment.