忧郁型与非忧郁型抑郁症患者事件相关电位对比研究

A comparative study of event-related potentials in melancholic and non-melancholic depression patients

目的:探究忧郁型(MEL)与非忧郁型抑郁症(NMEL)患者事件相关电位(ERPs)的差异及其与临床特征的关系。方法:根据17项汉密尔顿抑郁量表(HAMD-17)和蒙哥马利抑郁评定量表(MADRS)将2011年12月至2014年10月昆明医科大学第一附属医院精神科门诊118例首发未治疗抑郁症患者分为MEL组(60例)和NMEL组(58例);对两组患者进行ERPs检测,比较两组患者Fz、Cz、Pz位点N1、N2、P2、P3潜伏期和P3波幅的差异,并分析有差异ERPs指标与患者临床特征的关系。结果:MEL组Fz点P3波幅明显低于NMEL组(t=-2.582,P=0.011)。MEL组和NMEL组Fz点P3波幅与患者病程、MADRS总分、HAMD-17总分以及各因子分的相关无统计学意义。结论:MEL患者认知资源投入和大脑活跃性较NMEL患者下降,Fz点P3波幅下降可能是MEL认知功能损害的特征性指标之一。

Objective:To explore the differences of event-related potentials(ERPs)between melancholic(MEL)and non-melancholic depression(NMEL)patients,and to evaluate the correlation between ERPs and clinical characteristics.Method:According to the Hamilton depression scale-17 item(HAMDA-17)and Montgomery-Asberg depression rating scale(MADRS),118 first-episode untreated depressive disorder patients in the First Affiliated Hospital of Kunming Medical University from December 2011 to October 2014 were divided into the MEL group(60 cases)and the NMEL group(58 cases).All patients were tested for ERPs.The differences in latency of N1,N2,P2,P3 and amplitude of P3 from Fz,Cz and Pz between the two groups were compared.And the relationship between the ERPs indexes with differences and clinical characteristics was examined.Results:The amplitude of P3 from Fz was significantly lower in the MEL group than in the NMEL group(t=2.582,P=0.011).The amplitude of the P3 from Fz were not correlated with patients’disease duration,the total score of MADRS and HAMD-17,and each factor score of HAMD-17 in two groups.Conclusion:The cognitive resource engagement and brain activity are decreased in patients with melancholic depression compared to those with non-melancholic depression,and the decreased amplitude of the P3 from Fz may be one of the characteristic indicators of cognitive impairment in MEL.