定量脑电图在老年脑梗死患者认知功能评估中的研究

Value of quantitative EEG for assessing cognitive function in elderly cerebral infarction patients

目的分析老年首发脑梗死患者的定量脑电图特点,评估其在脑卒中后认知功能的应用价值。方法连续纳入我院神经内科收治的65岁以上首发急性脑梗死患者64例为试验组。依据受教育年限矫正后的蒙特利尔认知评估基础量表(MoCA-B)结果将试验组患者分为脑卒中后认知功能障碍(PSCI)组42例和脑卒中后认知功能正常(PSN)组22例。另选择同期我院体检科年龄、性别等相匹配的35例为对照组。采集各组头皮脑电图数据进行定量分析,总结数据特点,评估其与MoCA-B的相关性。结果对照组、PSN组、PSCI组定量脑电图θ波绝对功率/α波绝对功率比值(TAR)分别为1.48(1.04,2.10)、1.82(1.44,2.16)、2.52(2.13,3.80),呈递增趋势,且PSCI组显著高于PSN组和对照组(P<0.01)。TAR与MoCA-B评分呈负相关(r=-0.703,P=0.000)。TAR评估老年PSCI的最佳切点为2.11,ROC曲线下面积为0.809(95%CI:0.697~0.921,P=0.001)。结论定量脑电图TAR在老年首发脑梗死后认知障碍的评估中可提供一定的客观依据。

Objective To study the value of quantitative EEG for assessing poststroke cognitive impairment by analyzing its characteristics in elderly first-ever cerebral infarction patients.Methods Sixty-four>65 years old first-ever acute cerebral infarction(ACI)patients admitted to our hospital were divided into poststroke cognitive impairment(PSCI)group(n=42)and normal poststroke cognitive function(PSCF)group(n=22)according to their MoCA scale score after adjustment for education time(years)with 35 age-and gender-matched persons who underwent physical examination in our hospital during the same period served as a control group.Their scalp EEG parameters were quantitatively analyzed.The characteristics of their scalp EEG parameters were summarized.The relationship bettwen the characteristics of scalp EEG parameters and MOCA scale score was assessed.Results The TAR of quantitative EEG was 1.48(1.04,2.10),1.82(1.44,2.16),2.52(2.13,3.80)respectively in PSCI group,normal PSCF group,control group and was significantly higher in PSCI group than in normal PSCF group and control group(P<0.01).The TAR of quantitative EEG was negatively related with the MOCA scale score(r=-0.703,P=0.000).The optimal cut-off value of TAR for assessing PSCI in elderly first-ever ACI patients was 2.11.The AUC for TAR in assessing PSCI in elderly first-ever ACI patients was 0.809(95%CI:0.697-0.921,P=0.001).Conclusion The TAR of quantitative EEG can provide a certain basis for assessing the cognitive impairment in elderly first-ever ACI patients.