Correlation of cognitive function with acetylcholinesterase activity and P300 event-related potential of patients with type 2 diabetes mellitus

BACKGROUND： At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE＂ To comparatively observe the intelligence quotient （IQ）, latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase （ACHE） in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN： Correlation analysis of contrast observation SETTING： Department of Endocrinology, Affiliated Hospital of Binzhou Medical College PARTICIPANTS： Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS： ① Evaluation,on IQ： The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian （WAIS-RC）. WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ （VlQ）, performance IQ （PIQ） and full scale IQ （FIQ）. FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave： P300 wave was detected with evoked potential instrument （MYTOPRO, Italian）, and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid： Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer.④Correlation analysis： Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed, t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES： ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS： Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ①Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups： The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were （97.4±10.4）. （92.6±8.4） and （95.2±9.7） scores, respectively; and those of patients with non-diabetes mellitus were （104.7±9.6）, （102.5±8.5）and（102.7±8.9） scores, respectively, and P 〈 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was （370.8±41.8）.（371.5±39.1）and （375.1±43.1） ms, respectively, and that of patients with non-diabetes mellitus was （ 332.1 ±28.3 ）, （335.7 ±29.4）and （339.7 ±27.3） ms, respectively, and P 〈 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was （8.6±4.1）,（8.6±4.0） and （7.7±4.0） μV, respectively and that of patients with non-diabetes mellitus was （11.9±4.1）,（11.5±4.4） and （10.9±5.0） μV, respectively , and P 〈 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was （235.61 ±50.34）and （17.89±4.46） μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [（205.03±44.15）and （14.63±0.48） μkat /L, respectively], and P 〈 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave： The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid （r=-0.588 1, P 〈 0.01 ）, significantly negatively correlated with the latent period at points Fz. C and Pz of P300 wave （r= -0.700 5, -0.689 4, -0.688 5, P 〈 0.01 ）, and significantly positively correlated with the amplitude at points Fz . Cz and Pz of P300 wave（r= 0.607 4,0.616 1,0.592 0,P 〈 0.01 ）. CONCLUSION： ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ②Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.

Characterization of event-related potentials in obsessive compulsive disorder patients: Comparison with depression and generalized anxiety disorder patients

BACKGROUND： Study results of event-refated potential in obsessive compulsive disorder （OCD） remain controversial, potentially as a result of different instruments utilized and their differing technical characteristics. OBJECTIVE： To investigate the differences in several common event-related potentials, Le. contingent negative variations, P300, and mismatch negativity （MMN）, in OCD patients, depression patients, generalized anxiety disorder （GAD） patients, and healthy controls. DESIGN, TIME AND SETTING： A case-control study was performed in the Department of Electrophysiology, Shanghai Mental Health Center from May 2002 to December 2005. PARTICIPANTS： A total of 38 OCD patients, 20 depression patients, and 18 GAD patients, who were diagnosed according to the criteria of Chinese Classification of Mental Disorders （Version 3）, formulated by the Chinese Psychiatry Association, were selected from the Outpatient Department of Shanghai Mental Health Center. Patients with two or more the above diseases were excluded. In addition, 28 healthy people, gender and age matched, were selected as controls. METHODS： Contingent negative variations, P300, and MMN were recorded by a Nicolet Spirit Instrument. All electrodes were attached at Cz according to the Intemationa11020 system, with the mastoid leads as reference and Fpz as ground. MAIN OUTCOME MEASURES： Amplitude and latency of contingent negative variations, P300, and MMN. RESULTS： The contingent negative variations, P300, and MMN were different （P 〈 0.01）. OCD patients showed an increased MI amplitude compared with controls, depression, and GAD patients （P 〈 0.01）. Target P300 amplitudes were significantly lower in OCD, depression, and GAD patients compared with controls （P 〈 0.01）. Moreover, N2 latency and latency of MMN were prolonged in OCD and depression groups compared with controls （P 〈 0.05）. CONCLUSION： Event-related potentials were different in depression, GAD, and OCD patients and healthy controls. In particular, OCD patients exhibited unique characteristics.

Effect of variable number of tandem repeats polymorphism in the human dopamine transporter gene on conflict information processing according to event-related potential

The dopamine transporter （DAT） is responsible for dopamine reuptake from the synaptic cleft. A variable number of tandem repeats polymorphism in the DAT gene is related to DAT availability and has been associated with cognition. With the advantage of high-time resolution, event-related potential is an important method to study the time course of human information processing. Previous results have suggested that dopamine exhibits a close relationship with conflicting information processing. Therefore, the present study assumed that conflicting information processing could be influenced by DAT variable number of tandem repeats polymorphism. To confirm this, the present study analyzed the influence of DAT genotypes on N270, which is presumed to reflect neural activity of conflict information processing in young healthy adults. A S1-S2 matching task was performed in healthy adults with 10/10 genotype （n = 14） and 10/9 genotypes （n = 14）, respectively, when event-related potentials were recorded. Results demonstrated that subjects with the 10/10 genotype exhibited shorter N270 latency and quicker reaction times compared with subjects with the 10/9 genotype. There were no differences in N270 amplitude between the two genotypes. These results suggested that 10/10 genotype subjects more efficiently processed conflict information.

Relationships among Event-Related Potentials, Memory, and Schizophrenic Symptoms in College Students with Schizotypal-Traits

The present study investigated the relationships among event-related potentials (ERPs), memory, and schizophrenic symptoms in college students with schizotypal-traits. Scores on the Schizotypal Personality Questionnaire (SPQ) were used to categorize the participants into schizotypal-trait (n = 30) and normal control (n = 37) groups. ERPs were assessed using an auditory oddball paradigm, in which a series of standard tones (1000 Hz) and target tones (1500 Hz) were presented;participants were asked to count the number of presented target tones. The verbal memory and visual memory of the participants were evaluated using the Korean version of the California Verbal Learning Test (K-CVLT) and the Rey-Osterrieth Complex Figure Test (RCFT), respectively. The schizotypal-trait and control groups did not differ in terms of age, educational level, IQ score, accuracy on the auditory oddball task, or performance on the K-CVLT and RCFT measures. However, the schizotypal-trait group exhibited significantly smaller P300 amplitudes than the control group. Additionally, the P300 amplitudes measured at Cz and Pz were negatively correlated with the cognitive-perceptual factor scores on the SPQ. Thus, the present results indicate that reduced P300 amplitudes may represent a biological marker of schizophrenia.

精神分裂症患者事件相关电位P300及其与发病次数的关系

目的探讨首发与复发精神分裂症患者的电生理机制差异。方法对28例精神分裂症首次发作患者(首发组)、32例复发精神分裂症患者(复发组)进行事件相关电位P300的测定,测量其错误数和反应时,潜伏期和波幅,并与30名健康志愿者的结果进行比较。结果①患者组的反应时显著长于对照组(t=8.25,P<0.05);正确率差异无统计学意义;②与对照组相比,患者组在C3、C4电极处,潜伏期均显著延迟(t=2.47,2.56;P<0.05);Fz、Cz、C3、C4点波幅均显著降低(t=3.12,4.14,4.27,3.08;P<0.05);③与首发组相比,复发组在C3、C4、Fz点的潜伏期显著延迟(t=2.58,3.07,6.78;P<0.05);C3、C4、Fz、Cz点波幅均显著降低(t=5.13,4.55,8.35,4.70;P<0.05)。结论首发、复发精神分裂症患者认知功能均受损,且复发患者受损程度大于首发患者。提示患者认知功能受损是一个累积下降的过程。

精神分裂症患者血清同型半胱氨酸水平与P300的相关

目的探讨精神分裂症患者血清同型半胱氨酸水平(Hcy)与事件相关电位P300的关系。方法随机将年龄在18~65岁之间符合CCMD-3精神分裂症诊断标准患者45例作为试验组,选择45例健康者作为对照组。同时采用酶联免疫法检测血清Hcy水平及以P300评定认知功能,并将结果加以分析、比较。结果与对照组相比,研究组CZ、PZ点N1、P2、N2、P3潜伏期均明显延长(t=2.36~3.86,P<0.05或0.01),研究组CZ、PZ点N2、P3波幅明显降低(t=3.06~5.27,P<0.01);研究组血清Hcy水平高于对照组(t=2.76,P<0.01);CZ、PZ点P300潜伏期与血清Hcy水平呈正相关(r=0.36~0.49,P<0.05或0.01),CZ、PZ点P300波幅与血清Hcy水平则呈负相关(r=-0.47^-0.51,P<0.01)。结论精神分裂症患者血清Hcy水平升高,其认知功能损害可能与血清Hcy代谢异常有关。

P300评估抑郁症的病程与认知功能障碍的相关性

目的 采用事件相关电位P300的改变来研究抑郁症患者的病程与认知功能障碍的相关性.方法 对40～ 50岁年龄段的115例抑郁症患者,以病程＞2年为标准分为两组进行事件相关电位研究.结果 ＞2年抑郁症患者组P300潜伏期较＜2年组延长（U=3.15,P＜0.05）,P300波幅较＜2年组降低（U=4.79,P＜0.001）.结论 抑郁症患者的病程越长、认知功能损害程度越严重.

P300 change and cognitive behavioral therapy in subjects with Internet addiction disorder A 3-month follow-up study

Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.

Connecting the P300 to the diagnosis and prognosis of unconscious patients

The residual consciousness of unconscious patients can be detected by studying the P300, a wave among event-related potentials. Previous studies have applied tones, the subject＇s name and other names as stimuli. However, the results were not satisfactory. In this study, we changed the constituent order of subjects＇ two-character names to create derived names. The subject＇s derived names, together with tones and their own names, were used as auditory stimuli in event-related potential experiments. Healthy controls and unconscious patients were included in this study and made to listen to these auditory stimuli. In the two paradigms, a sine tone followed by the subject＇s own name and the subject＇s derived name followed by the subject＇s own name were used as standard and deviant stimuli, respectively. The results showed that all healthy controls had the P300 using both paradigms, and that the P300 in the second paradigm had a longer latency and two peaks. All minimally conscious state patients had the P300 in the first paradigm and the majority of them had the P300 in the second paradigm. Most vegetative state patients had no P300. Patients who showed the P300 in the two paradigms had more residual consciousness, and patients with the two-peak P300 had a higher probability of awakening within a short time. Our experimental findings suggest that the P300 event-related potential could reflect the conscious state of unconscious patients.

Progress in the application of P300 in depression

Depression is a common mental disor-der with low mood,loss of interest and pleasure as main symptoms.Because of depending on the subjective diag-nosis of psychiatrists,its diagnosis is no reliable objective basis.P300 research findings can be used as an objective diagnostic indicator for patients.This paper mainly intro-duces the current research status of event-related poten-tials for depression and introduces the scientific research and clinical significance of P300 for depression.

Combined Effects of Electroacupuncture and Behavioral Training on Learning-Memory Ability and Event-Related Potential P300 in Rats with Mid/Advanced Cerebral Infarction

Background： The effectiveness of the combination of electroacupuncture （EA） and behavioral training （BT） for mid/advanced cerebral infarction （M/ACI） and related mechanisms remains unclear. This study aimed to investigate the combined effects on the learning-memory ability and event-related potential P300 in rats with M/ACI. Methods： Eighty rats with M/ACI were divided into Group Model （M）, Group EA, Group BT, and Group EA-BT （n = 20） according to the random number with five healthy rats in Group Control （CON）. On the 6th week after modeling, EA, BT, and EA-BT were given to Group EA, Group BT, and Group EA-BT, respectively, whereas Group M and Group CON were not given any intervention. Y-maze test and P300 were recorded before and after the intervention. Results： After intervention, the P300 latency was lower and the amplitude was higher in the Group EA-BT, Group EA, and Group BT than before （for latency, t = -7.638, -4.334, and -5.916; for amplitude, t = 8.125, 3.846, and 5.238; P 〈 0.01 ）, with Group EA-BT superior to Group EA （for latency, t = -3.708; for amplitude, t = 3.653; P 〈 0.01） and Group BT （for latency, t = -2.067; for amplitude, t = 2.816; P 〈 0.05）, with no significant difference between Group BT and EA （for latency, t = -1.439; for amplitude, t = 1.075; P 〉 0.05）. While the performances of Y-maze tests in the Group EA-BT, Group EA, and Group BT were all better than before （t = 10.359, 4.520, and 7.791, P 〈 0.01）, with Group EA-BT better than Group EA （t = 5.627, P 〈 0.01 ） and Group BT （t = 2.913, P 〈 0.01 ） respectively, and Group BT better than Group EA （t = 2.912, P 〈 0.01）. Conclusion： EA or BT can affect P300 in rats with M/ACI, and the combination of these two methods can significantly improve the learning-memory ability.

Auditory ERP Differences in the Perception of Anticipated Speech Sequences in 5 - 6 Years Old Children and Adults

The perception of complex auditory information such as complete speech sequences develops during human ontogeny. In order to explore age differences in the auditory perception of predictable speech sequences we compared event-related potentials (ERPs) recorded in 5- to 6-year-old children (N = 15) and adults (N = 15) in response to anticipated speech sequences as successive and reverse digital series with randomly omitted digits. The ERPs obtained from the omitted digits significantly differed in the amplitude and latency of the N200 and P300 components between adults and children, the N400 and LPC components were more pronounced in children in the right frontal area for the digits presentation. These findings indicate that the perception of a successive speech structure is less automated in children and requires a detailed analysis of the successive structure and error detection. These differences in auditory ERPs reflect developmental changes in the auditory perception of speech sequences and can serve as indicators of the maturity of cognitive functions in children.

女性抑郁症首次发病患者认知事件相关电位P300与脑灰质体积的相关分析

目的 探讨首次发病未服药女性抑郁症患者脑灰质体积变化特点,以及与认知事件相关电位P300的相关分析.方法 对25例18 ～58岁首次发病未服药女性抑郁症患者（患者组）和28名健康对照者（对照组）行头部3D结构MRI扫描,并对患者组进行P300检查.结果 患者组较对照组右侧额下回岛盖部、右侧中央前回灰质体积减小.患者组中P3、N2潜伏期均与双侧壳核、右侧颞中回体积呈正相关（均P ＜0.01）;P3潜伏期与左侧颞中回、左侧额中回、左侧梭状回体积呈正相关（均P＜0.01）,而P3波幅与左侧角回、右侧额上回体积呈负相关（均P＜0.01）;N2潜伏期与左侧后扣带回、右侧梭状回、枕叶、左侧小脑体积呈正相关（均P＜0.01）;患者组P300潜伏期和波幅与汉密尔顿抑郁量表的总分和各因子分无相关性.结论 首次发病未服药女性抑郁症患者存在特征性脑灰质体积异常,其P300可能与多个脑灰质区域相关,尤其与颞叶、基底神经节的关系最明显.

药物滥用性头痛患者认知功能及事件相关电位P300的研究

目的探讨药物滥用性头痛(MOH)患者认知功能及认知电位的变化情况。方法MOH患者(观察组)及对照组各30例,两组均进行P300、简易精神状态量表(MMSE)检测。采用SPSS 10.0软件进行数据处理,P300潜伏期、波幅比较采用t检验。结果两组P300靶刺激中P3潜伏期、波幅比较均差异有统计学意义:观察组P3潜伏期[分别为(393.70±42.60)ms]较对照组[(331.05±22.35)ms]延长,差异有统计学意义(t=7.13,P<0.05);观察组P3波幅[(3.40±2.30)u V]较对照组[(6.20±2.40)u V]明显降低,差异也有统计学意义(t=4.59,P<0.05)。两组MMSE评分比较,观察组总分、定向力、记忆力、计算力、回忆力、语言能力[(24.00±2.21)分,(8.15±0.86)分,(2.88±0.23)分,(3.07±1.04)分,(1.72±0.89)分,(8.42±1.33)分]低于对照组[分别为(27.07±2.06)分,(9.28±1.03)分,(3.01±0.26)分,(3.25±1.20)分,(1.92±0.90)分,(9.69±1.44)分],总分、定向力、语言能力评分差异有统计学意义(t=3.66,3.19,3.34;P<0.05)。结论 MOH患者存在轻度的认知功能障碍,认知电位P300为MOH患者认知功能障碍的诊断提供一客观指标。

精神发育迟滞患儿的事件相关电位视觉P300的特征及与智商的相关性

目的 探讨精神发育迟滞（MR）患儿的事件相关电位视觉P300的特征以及智商与视觉P300的潜伏期和波幅的关系.方法 选择2012年10月至2013年4月本院康复科门诊就诊及住院行康复治疗的MR患儿30例为MR组,另选同期本院儿童保健科体检的性别、年龄相匹配正常健康儿童30例为正常对照组.两组对象均在本院儿童保健科的智力测试室行韦氏智力测试,同时进行视觉P300的检测,比较两组P300的潜伏期和波幅的变化,并行P300的潜伏期和波幅值与言语智商（VIQ）、操作智商（PIQ）及总智商（FIQ）相关分析.结果 与正常对照组相比,MR组儿童事件相关电位视觉P300波的潜伏期延长,波幅降低,其差异有统计学意义（P＜0.05）.MR组儿童事件相关电位视觉P300的潜伏期与智商呈负相关（P＜0.05）.P300的波幅与IQ无相关（P＞0.05）.结论 事件相关电位视觉P300的潜伏期和波幅可客观地反映精神发育迟滞儿童认知功能的变化,可作为评价MR患儿认知功能的客观指标之一,具有协助诊断的意义.

精神分裂症患者认知功能、听觉事件诱发电位P300和脑灰质体积的相关分析

目的 分析经抗精神病药治疗后病情基本稳定但仍残留部分症状的非急性期精神分裂症患者认知功能、听觉事件诱发电位P300和脑灰质体积的相关性.方法 采用听觉事件诱发电位P300、神经心理认知测验对18例非急性期精神分裂症患者（患者组）和18名健康对照者（对照组）进行认知功能检测;采用PANSS和临床总体印象量表（Clinical Global Impression Scale-Severity,CGI-S）评定患者的精神症状,锥体外系副反应量表（Extrapyramidal Side Effects Scale,SAS）、不自主运动量表（Abnormal Involuntary Movement Scale,AIMS）和静坐不能量表（Barnes Akathisia Rating Scale,BARS）评定既往使用抗精神病药的不良反应情况.利用磁共振和脑诱发电位仪分别对患者和对照者进行脑部影像学、神经电生理检查.结果 神经心理认知功能测验中持续性操作测验（Continuous Performance Test,CPT）两位数和三位数测验患者组（2.5±1.2、2.1±1.2）较对照组（3.5±0.6、2.9±0.8）评分低（t=-3.088、-2.563,均P＜0.05）;Stroop色词干扰测试的单词、颜色和色词测试总分患者组（77.1 ±16.6、32.4±7.3和32.4±7.3）均较对照组（89.3±8.9、41.8±6.8、41.8±6.8）评分低（t=-2.733、-4.015、-4.015,均P＜0.05）;沟槽钉板测验利手和非利手患者组（69.9±10.9、77.3±11.4）较对照组（56.7±7.1、68.7±10.8）完成测试时间延长（t=-4.015、2.313,均P＜0.05）;颜色连线2患者组（46.3±18.1）较对照组（37.4±10.6）测试完成时间长（=4.638,P＜0.05）;范畴流利测验患者组（11.8±5.1）较对照组（15.6±3.5）评分低（t=-2.593,P＜0.05）,2组间比较差异有统计学意义.患者组的P300潜伏期N2（237.1±19.6）与对照组（217.6±26.6）比较延长（=2.966,P＜0.05）,波幅差异无统计学意义.P300波幅与迷宫测试、颜色连线及威斯康星卡片分类测验（Wisconsin Card Sorting Test,WCST）正确数呈正相关（r=0.493、0.527、0.512,均P＜0.05）,与沟槽钉板、WCST错误数呈负相关（r=-0.571、-0.512,均P＜0.05）.患者组的内侧前额叶、右侧颞叶和小脑部分区域的灰质体积较对照组下降,差异有统计学意义,P300潜伏期与局部脑灰质体积（右颞叶的颞上回和颞中回、右后叶小脑扁桃体、右侧小脑后叶、下半小叶）呈负相关（均P＜0.01）.结论 非急性期精神分裂症患者的认知功能存在广泛损害.患者内侧前额叶、颞叶、小脑灰质体积异常,且右侧颞叶、右侧小脑局部灰质体积与P300潜伏期相关,提示颞叶、小脑等区域可能是P300异常的脑结构和功能基础.

A pilot study using lactulose in management of minimal hepatic encephalopathy in children with extrahepatic portal vein obstruction

Background:Minimal hepatic encephalopathy(MHE)is not associated with overt neuropsychiatric symptoms but rather with subtle changes in psychometric and/or neurOphysiolOgic tests.We aimed to diagnose MHE in children with extrahepatic portal vein obstruction fEHPV01 and to evaluate the el№ct of lactulose on MHE.Methods:A prospective study was carried out on 30 patients with EHPVO(21 males;mean age 10+2.5 years).The study was carried out in the Pediatric Hepatology Unit.Cairo University Pediatric Hospital,Cairo,Egypt,between 2011 and 2013.AII patients were subjected to clinical and Iaboratory assessment.neuropsychmetric testin2 using the arabic version of Wechsler intelligence tests.neurophysiological testing by visual electroencephalogram and P300 event related potentials(ERP).

Assessment of cognitive dysfunction in traumatic brain injury patients:a review

Traumatic brain injury(TBI)is one of the major causes of human mortality and morbidity in the world.Brain injury could affect the core of a person’s being–their thinking,memory,personality and behaviour.Electrophysiological markers from the human electroencephalogram and brain imaging provide a rich source of data which helps to elucidate specific processing impairments in TBI patients.To assess the cognitive and social function in traumatic brain injury patients,this review will focus on some of methods for assessing the disabling cognitive and social function deficits induced by TBI.There are many new technologies available to address TBI and recognition related questions.Integration of the various techniques will help to facilitate our comprehending of TBI,cognitive function and social function,and improve treatment and rehabilitation.

尼莫地平联合卡巴拉汀治疗老年血管性痴呆的临床疗效与不良反应

目的 观察尼莫地平联合卡巴拉汀治疗老年血管性痴呆的临床疗效与不良反应,为该疾病提供有效的治疗方法.方法 将151例老年血管性痴呆患者采用随机数字表法分为观察组78例和对照组73例.对照组被给予尼莫地平治疗,观察组被给予尼莫地平联合卡巴拉汀治疗.采用简易精神状态检查量表（MMSE）评估认知功能,采用临床痴呆评定量表（CDR）评估痴呆程度,采用日常生活自理能力量表（ADL）评价日常活动能力;在治疗前和治疗12周后进行P300试验,测定P300潜伏期（P300-PL）和波幅（P300-A）;在治疗期间观察两组出现的药物不良反应.结果 治疗12周后,两组的MMSE均高于治疗前,两组的CDR、ADL均显著低于治疗前（t=8.353、18.289、6.627、2.463、10.681、5.201,均P〈0.05）;治疗12周后,观察组的MMSE[（23.17 ±3.95）分]均显著高于对照组[（19.88±4.43）分],观察组的CDR、ADL[（1.47±0.26）分、（39.87 ±7.43）分]均显著低于对照组[（1.80±0.34）分、（41.16 ±6.40）分]（t=4.823、6.725、5.278,均P〈0.05）.治疗12周后,两组的P300-PL均低于治疗前,两组的P300-A均显著高于治疗前（t=12.051、6.429、2.477、2.104,均P〈0.05）;治疗12周后,观察组的P300-PL[（321±39） ms]显著低于对照组[（356 ±44） ms]（t=5.180,P〈0.05）.在治疗过程中,对照组的不良反应发生率为9.59％,观察组的不良反应发生率为11.54％,差异无统计学意义（χ^2=0.151,P〉0.05）.结论 尼莫地平联合卡巴拉汀能有效治疗老年血管性痴呆,改善患者的认知功能、痴呆程度和日常活动能力,且药物不良反应发生率低,具有良好的临床应用价值.