事件相关电位P300在颅脑损伤患者认知功能障碍评定中的应用

Application of event-related potential P300 in the evaluation of cognitive dysfunction in patients with traumatic brain injury

目的探讨事件相关电位P300在颅脑损伤患者认知功能障碍评定中的应用价值。方法选取2021年1月-9月在绵阳市第三人民医院神经外科保守治疗、并符合诊断标准的颅脑损伤患者36例作为研究组,同期在医院其他患者家属和护工中招募健康对照组共36名。采用Oddball范式对受试者进行事件相关电位P300检测,采用蒙特利尔认知评估量表(MoCA)和简易精神状态评价量表(MMSE)评定受试者的认知功能。比较两组P300的潜伏期、波幅以及MoCA和MMSE评分,比较P300潜伏期、MoCA和MMSE对颅脑损伤患者认知功能障碍的检出率。结果研究组MoCA和MMSE评分均低于对照组[(18.08±4.29)分vs.(27.36±1.20)分,(22.53±3.54)分vs.(28.11±1.09)分,t=-12.510、-9.041,P均<0.05];研究组P300潜伏期高于对照组[(406.08±26.95)ms vs.(367.08±22.50)ms,t=6.665,P<0.05],波幅低于对照组[(7.76±0.90)μV vs.(9.87±0.99)μV,t=-9.459,P<0.05]。在研究组中,P300潜伏期阳性检出率和MoCA对认知功能障碍的检出率均高于MMSE对认知功能障碍的检出率(χ^(2)=5.675、7.604,P均<0.05)。结论事件相关电位P300或许可作为评估颅脑损伤患者认知功能障碍的客观临床指标。

Objective To explore the application value of event-related potential P300 in the evaluation of cognitive dysfunction in patients with traumatic brain injury.Methods From January to September 2021,a total of 36 patients with traumatic brain injury who were conservatively treated in the Neurosurgery Department of the Third Hospital of Mianyang and met the diagnostic criteria were selected as the experimental group.And 36 participants were recruited from the family members and carers of other patients in the hospital as the control group.Oddball paradigm was used to measure the event-related potential P300.Montreal Cognitive Assessment(Mo CA)and Mini-Mental State Examination(MMSE)were used to assess the cognitive function of the subjects.The latency and amplitude of P300,Mo CA and MMSE scores were compared between two groups.The detection rates of P300 latency,Mo CA and MMSE on cognitive dysfunction in patients with traumatic brain injury were compared.Results Mo CA and MMSE scores in experimental group were lower than those in control group[(18.08±4.29)vs.(27.36±1.20),(22.53±3.54)vs.(28.11±1.09),t=-12.510,-9.041,P<0.05].The latency of P300 in experimental group was higher than that in control group[(406.08±26.95)ms vs.(367.08±22.50)ms,t=6.665,P<0.05],and the amplitude was lower than that in control group[(7.76±0.90)μV vs.(9.87±0.99)μV,t=-9.459,P<0.05].In experimental group,the positive detective rate of P300 latency and Mo CA on cognitive dysfunction were higher than that in MMSE(χ^(2)=5.675,7.604,P<0.05).Conclusion Event-related potential P300 can be used as an objective clinical indicator for evaluating cognitive dysfunction in patients with traumatic brain injury.