无症状性脑梗死患者近记忆障碍及认知电位P300的特点

Characteristics of recent memory impairment and cognitive P300 in patients with asymptomatic cerebral infarction

目的 探讨无症状性脑梗死 (asymptomaticcerebralinfarction ,ACI)患者近记忆障碍及认知电位P30 0的特点。方法 用《临床记忆量表》和体感刺激诱发的认知电位对 6 7例ACI患者和 6 5例健康人进行检测。结果 ACI患者指向记忆、联想学习、图像自由回忆、人像特点联系回忆测验的成绩和记忆商 (MQ)均显著低于对照组 (P 均 <0 .0 0 1) ,而无意义图形再认测验的成绩两组间比较无统计学意义 (P >0 .0 5 ) ;ACI组认知电位N2 、P30 0波峰的潜伏期分别为 (2 6 9.8± 2 9.5 )ms和 (389.7± 35 .6 )ms,均较对照组 [分别为 (2 14 .6± 2 3.5 )ms和 (32 1.8± 30 .5 )ms]明显延长 ,P30 0波幅 [(3.8± 2 .2 ) μV]较对照组 [(10 .9± 3.6 ) μV]显著降低 (P均 <0 .0 0 1)。多灶脑梗死组指向记忆、联想学习、图像自由回忆、人像特点联系回忆的测验成绩和MQ均明显低于单灶脑梗死组 (P <0 .0 0 1～ 0 .0 1) ;认知电位N2 、P30 0的潜伏期也较单灶脑梗死组明显延长 (P <0 .0 0 1) ,P30 0波幅下降。结论 ACI患者近记忆障碍的特点是再认障碍不明显 ,而主动回忆、抽象概念的记忆和学习能力明显下降 ,梗死灶越多 ,近记忆障碍越重 ;ACI患者确有不同程度的认知功能障碍 ,将记忆检查和认知电位结合起来应用于临床 ,会提高检测的?

Objective To explore the characteristics of recent memory impairment and cognitive P300 in patients with asymptomatic cerebral infarction (ACI).Methods Sixty seven patients without history or sign of cerebral infarction were identified having cerebral infarct loci by CT or MRI (ACI group) and sixty five normal control matched by age,sex and education were also collected.All subjects were tested with Clinical Memory Test and sensory stimulating induced cognitive potentials.Results The scores of directed memory,paired association learning,free recall of pictures,association recall of characters of somebody's picture and memory quotient(MQ) in patients with ACI were significantly less than those in the control group(all P< 0.001 ),but the score of recognition for meaningless shapes in the patients with ACI had no marked difference compared with that in the control group (P> 0.05 ).The latency of cognitive N 2 and P300 in patients with ACI( 269.8 ± 29.5 ) ms and ( 389.7 ± 35.6 ) ms was significantly prolonged and the amplitude of P300 ( 3.8 ± 2.2 ) μV was markedly lowered as compared with the controls [( 214.6 ± 23.5 ) ms,( 321.8 ± 30.5 ) ms and( 10.9 ± 3.6 ) μV,respectively] (all P< 0.001 ).The scores of directed memory,paired association learning,free recall of pictures,association recall of characters of somebody's picture and MQ in the multi infarct cerebral group were significantly less than those in single infarct cerebral group(P< 0.001 0.01 ).The latency of cognitive N 2 and P300 in patients with multi infarct group was also significantly prolonged and the amplitude of P300 was markedly lowered as compared with these in patients with single infarct group(P< 0.01 ).Conclusion The characteristics of recent memory disturbance in patients with ACI is that the ability of active recall,memory and learning of abstract ideas markedly decreased,but the disturbance of recognition was not significant.The more cerebral infarct lesion,the more severe memory impairment.The patients with ACI do have some degrees of cognitive impairment.