帕金森病认知功能障碍患者睡眠期脑电波特征分析

QUANTITATIVE ELECTROENCEPHALOGRAM (EEG) ASSESSMENT OF NIGHTTIME SLEEP IN PATIENTS WITH COGNITIVE DYSFUNCTION IN PARKINSON’S DISEASE

目的采用定量脑电图对帕金森病认知功能障碍患者睡眠期脑电波特征进行定量分析,从而评定睡眠时脑电波变化对帕金森病认知功能障碍患者的预测价值。方法共有42例帕金森病(PD组)患者及38例志愿者(对照组)进行夜间多导睡眠监测检查。采用简易智力状态检查(MMSE)评分,将帕金森病患者分为认知障碍组及非认知障碍组;详细分析各组的临床资料,并应用定量脑电分析技术分析各组非快速眼动睡眠2期(N2期)及快速眼动睡眠期(REM期)各频率段脑电波的振幅变化。结果 PD认知功能障碍患者的delta、theta波振幅显著增加,N2期在额叶部位Delta、theta、(D+T)/(A+B)与对照组比较差异有统计学意义,Theta、(D+T)/(A+B)与非认知障碍组比较差异有统计学意义。PD认知功能障碍组REM期在枕叶部位(D+T)/(A+B)与非认知障碍组和对照组比较差异有统计学意义。结论帕金森病认知功能障碍患者睡眠期出现delta、theta波的特征性变化。NREM2及REM睡眠期各相应部位的脑电波振幅变化有望成为预测帕金森病认知功能障碍的新方法。

Objective Quantitative electroencephalogram(EEG) was used to quantitatively analyze the characteristics of brain wave during sleep in patients with cognitive dysfunction in Parkinson’s disease,so as to evaluate the predictive value of brain wave changes during sleep in patients with cognitive dysfunction in Parkinson’s disease.Methods A total of forty-two patients with Parkinson’s disease(PD group) and 38 volunteers(control group) were examined by polysomnography at night.The patients with Parkinson’s disease were divided into cognitive impairment group and non-cognitive impairment group by MMSE score.The clinical data of each group were analyzed in detail,and the amplitude of each frequency EEG in non-rem sleep stage 2(N2 stage) and REM sleep stage was analyzed by quantitative electroencephalography.Results The amplitude of delta and theta waves increased significantly in PD patients with cognitive dysfunction.There was a statistically significant difference in N2 stage different from the control group in Delta,theta,(D+T)/(A+B) of the frontal lobe,and Theta,(D+T)/(A+B) were statistically different from the non-cognitive impairment group.There were statistically significant differences in the occipital lobe(D+T)/(A+B) in the PD cognitive impairment group compared with the non-cognitive impairment group and the control group in the REM phase.Conclusion Patients with cognitive dysfunction in Parkinson’s disease show characteristic changes of delta and theta waves during sleep.The amplitude changes of brain wave in different parts during NREM2 and REM sleep period are expected to be a new and promising method to predict cognitive dysfunction in Parkinson’s disease.