失匹配负波MMN对不同部位脑卒中患者认知功能的评价研究

Evaluation of Cognitive Function of Patients with Stroke in Different Areas of the Brain by Mismatched Negative MMN

目的探讨事件相关电位失匹配负波MMN对不同部位脑卒中患者认知功能的评估价值。方法按照入排标准纳入脑卒中患者157例,根据患者责任病灶的解剖部位,分为基底节组、丘脑组、颞叶组、额叶组、脑干组。采用简易智能状态检查量表(MMSE)评估认知功能,并检测失匹配负波MMN,比较不同部位脑卒中患者的MMSE评分与MMN潜伏期、波幅,探讨MMN与MMSE评分的相关性。结果与对照组相比:颞叶组、额叶组、丘脑组、基底节组患者MMSE评分减低,MMN波幅减低,MMN潜伏期延长;脑干组MMN波幅减低,MMN潜伏期延长,差异均有统计学意义(P<0.05)。组间比较(采用LSD法):脑干组与颞叶组、额叶组患者比较,MMSE评分增加,MMN波幅增加,MMN潜伏期缩短;基底节组、丘脑组与颞叶组、额叶组患者比较,MMSE评分增加,MMN潜伏期缩短,差异均有统计学意义(P<0.05)。MMSE评分和MMN潜伏期呈负相关关系(r=-0.689,P<0.001),MMSE评分和波幅呈正相关关系(r=0.341,P<0.001)。结论不同部位的脑卒中认知障碍的发生及程度有一定差异,MMN与认知功能障碍有较高的相关性,能够为认知功能障碍的诊断和评估提供客观依据,有助于临床准确诊断。

Objective To explore the value of event-related potential mismatch negative wave MMN in the evaluation of cognitive function in patients with different parts of stroke. Methods 157 stroke patients were included according to the entry and discharge criteria. According to the anatomical location of the responsible focus, they were divided into the basal ganglia group, the thalamus group,the temporal lobe group, the frontal lobe group and the brainstem group. MMSE was used to evaluate cognitive function, and mismatch negative wave MMN was detected. MMSE score, MMN latency and amplitude were compared in different parts of stroke patients, the correlation between MMN and MMSE score was explored. Results Compared with the control group, the MMSE score of patients in temporal lobe group, frontal lobe group, thalamus group and basal ganglia group decreased, MMN amplitude decreased, MMN latency prolonged;MMN amplitude decreased, MMN latency prolonged in brainstem group, the difference was statistically significant(P < 0.05).Comparison among groups(LSD method): compared with patients in temporal lobe group and frontal lobe group, MMSE score increased,MMN amplitude increased and MMN latency shortened in brainstem group;compared with patients in temporal lobe group and frontal lobe group, MMSE score increased and MMN latency shortened in basal ganglia group and thalamus group(P < 0.05). There was a negative correlation between MMSE score and MMN latency(r =-0.689,P < 0.001), and a positive correlation between MMSE score and amplitude(r=0.341,P<0.001). Conclusion There are some differences in the occurrence and degree of cognitive impairment in different parts of stroke. MMN has a high correlation with cognitive impairment. MMN can provide objective basis for the diagnosis and evaluation of cognitive impairment, and it is helpful for clinical accurate diagnosis.