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.

Differential cognitive responses to guqin music and piano music in Chinese subjects： an event-related potential study

Objective To compare the cognitive effects of guqin （the oldest Chinese instrument） music and piano music. Methods Behavioral and event-related potential （ERP） data in a standard two-stimulus auditory oddball task were recorded and analyzed. Results This study replicated the previous results of culture-familiar music effect on Chinese subjects： the greater P300 amplitude in frontal areas in a culture-familiar music environment. At the same time, the difference between guqin music and piano music was observed in NI and later positive complex （LPC： including P300 and P500）： a relatively higher participation of right anterior-temporal areas in Chinese subjects. Conclusion The results suggest that the special features of ERP responses to guqin music are the outcome of Chinese tonal language environments given the similarity between Guqin＇s tones and Mandarin lexical tones.

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.

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.

2型糖尿病病人事件相关电位P_(300)的研究

目的通过对2型糖尿病患者进行事件相关电位(ERP)的检测,早期发现病人认知功能异常程度及相关因素。方法用Nicolet Viking Ⅳ型肌电图/诱发电位仪对30例2型糖尿病患者和30例年龄、性别、教育程度相匹配的健康人进行事件相关电位P300检测。对两组间ERP各参数的差异进行方差分析、t检验及Poisson分析,观察病例组ERP各参数变化与糖基血红蛋白、血脂之间的关系。结果(1)不同性别及文化程度的正常人中P300的波峰潜伏期无显著性差异(P>0.05)。(2)与正常对照组相比,2型糖尿病患者P300波峰潜伏期显著延长(P<0.01),波幅显著下降(P<0.05)。(3)2型糖尿病患者P300波峰潜伏期的延长与糖基血红蛋白、血脂的增高相关(P<0.05)。结论ERP是检测2型糖尿病患者认知功能障碍的敏感指标,有助于早期发现糖尿病患者的潜在性痴呆。

儿童癫癎患者认知功能和事件相关电位P_(300)的研究

目的 探讨儿童癫患者认知功能状况和P3 0 0 特点及二者关系。方法 对 38例儿童癫采用odd ball刺激序列检测P3 0 0 ,采用中国修订韦氏儿童智力量表 (WISC -RC)测定智商。结果 1.癫儿童智商低于正常 6 5 .8% ,智力损害 2 8.9% ;2 .P3 0 0 潜伏期和波幅较对照组明显延长和降低 (P <0 .0 1) ,且智力正常的癫组P3 0 0 潜伏期和波幅较对照组也明显延长和降低 (P <0 .0 5 ) ;3.相关分析显示P3 0 0 潜伏期与各智商间均呈显著负相关 (r =- 0 .2 76～ - 0 .32 7 P均 <0 .0 5 ) ,波幅与语言智商、总智商呈显著正相关。结论 癫儿童存在不同程度的认知障碍 ,智商和P3 0 0 有密切关系 ,但二者又不完全等同 。

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.

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.

Clinical study on Jin's three-needle therapy for post-stroke cognitive impairment

Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table,with 30 cases in each group.The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy.The treatment for both groups lasted four weeks.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores as well as amplitude and latency of potential 300(P300)were adopted to compare the between-group results before and after treatment.Results:Before treatment,there were no significant differences(all P>0.05)in MMSE and MoCA scores,P300 latency and P300 amplitude between the two groups.After 4 weeks of treatment,the MMSE and MoCA scores and P300 amplitudes were improved in both groups,and the P300 latencies became shorter.The results showed significant intra-group and between-group differences(all P<0.05).Conclusion:Based on the routine treatment,Jin's three-needle therapy is effective for PSCI.The mechanism is probably through its regulation on the patients'neuroelectrophysiology.

Therapeutic Efficacy Observation on Acupuncture Treatment for Vascular Cognitive Disorder Following a Cerebral Infarction

Objective：To observe the event related potential 300 （P300） after scalp acupuncture treatment in patients with cognitive disorder due to cerebral infarction,and evaluate its therapeutic effect.Methods：Sixty-six patients aged below 70 years old with cognitive disorder after initial onset of cerebral infarction were randomized into a treatment group and a control group.Conventional neurological drugs and physical trainings were prescribed to both groups.In addition,the treatment group received scalp acupuncture.The two groups were compared by evaluating the latency and amplitude of P300 before and after the 3-month treatment.Results：After treatment,the latency of P300 was shortened by 39.1 ms in the treatment group,versus 16.7 ms in the control group,and the difference was statistically significant （P0.05）.Conclusion：P300 can objectively evaluate the therapeutic effect of scalp acupuncture in treating the patients with cognitive disorder due to cerebral infarction.Scalp acupuncture has positive effect in treating this group of patients.

The role of microglia in thalamic reticular nucleus in acupuncture regulating cognitive deficits in insomnia rats

Objective:To explore the mechanism of acupuncture in regulating cognitive deficits in insomnia rats by observing the effect of acupuncture on microglia in thalamic reticular nucleus(TRN).Methods:Thirty rats were randomly divided into a control group,a model group and an acupuncture group,with 10 rats in each group.The insomnia model was established by intraperitoneal injection of para-chlorophenylalanine(PCPA)once a day for 2 d.Rats in the control group were intraperitoneally injected with the same amount of normal saline.Rats in the acupuncture group received acupuncture at Neiguan(PC 6)and Zusanli(ST 36)for 5 consecutive days.The CLOCKLAB 2 data acquisition system was used to dynamically observe the sleep of the rats throughout the experiment.The cognition of rats was evaluated by event-related potentials(ERPs).After intervention,brain tissue was extracted.Immunofluorescence was used to test the fluorescence expression in TRN region.The concentrations of interleukin(IL)-1βand tumor necrosis factor(TNF)-αwere detected by enzyme-linked immunosorbent assay.Results:After intraperitoneal injection of PCPA suspension,the spontaneous activity in light period of rats in the model group and acupuncture group increased significantly compared with the control group(both P<0.01).After acupuncture treatment,the rats in the acupuncture group had much less spontaneous activity during the light period than those in the model group(P<0.01),and the results indicated that acupuncture could effectively improve the sleep quality of insomnia rats.Compared with the control group,rats in the model group showed that the P3 latency,the average optical density of microglia,and the concentrations of IL-1βand TNF-αincreased significantly(all P<0.05),and the P3 amplitude decreased significantly(P<0.01).Compared with the model group,rats in the acupuncture group presented that the P3 latency,the average optical density of microglia,and the concentrations of IL-1βand TNF-αwere significantly decreased(all P<0.05),and the amplitude of P3 was significantly increased(P<0.05).Conclusion:Acupuncture possesses an ability to improve the cognitive state in insomnia rats.The mechanism may be related to inhibiting the microglial activation,diminishing the levels of pro-inflammatory mediators like IL-1βand TNF-α,and promoting the recovery of central nervous system function.

焦虑症患者的听觉事件相关电位P_(300)研究

目的探讨焦虑症听觉事件相关电位P300的特点。方法收集符合中国精神病分类方案第2版(CCMD-2-R)焦虑症诊断标准的30例患者(焦虑症组)以及30名正常人(正常对照组),应用美国NicoletSpirit脑诱发电位仪,采用“听觉靶-非靶刺激序列”为诱发事件,完成听觉P300检测。结果焦虑症组与正常对照组的P300波形均清晰可辨。(1)靶刺激:在Fz、Cz2个电极位置,焦虑症组靶N2潜伏期[分别为(282.7±34.6)ms和(277.9±22.6)ms]较正常对照组[分别为(263.3±18.9)ms和(259.5±13.8)ms]明显延长(P<0.01);焦虑症组靶P3波幅[分别为(3.1±1.2)μV和(3.1±1.4)μV]较正常对照组[分别为(6.4±2.4)μV和(6.2±2.0)μV]明显降低(P<0.01);在Fz、Cz2个电极位置,尽管焦虑症组靶P3潜伏期也较正常对照组延长,但差异无统计学意义(P>0.05)。(2)非靶刺激:在Fz点,焦虑症组非靶P2波幅[(2.3±1.3)μV]较正常对照组[(3.4±1.0)μV]明显降低(P<0.01)。结论P300为反映焦虑症认知功能障碍的客观生理指标,P300中靶N2潜伏期、靶P3波幅有可能成为焦虑症诊断的一个辅助指标,值得进一步跟踪观察。

Effects of Risperidone and Paliperidone on Brain-Derived Neurotrophic Factor and N400 in First-Episode Schizophrenia

Background：Risperidone and paliperidone have been the mainstay treatment for schizophrenia and their potential role in neuroprotection could be associated with brain-derived neurotrophic factor （BDNF） and N400 （an event-related brain potential component）.So far,different effects on both BDNF and N400 were reported in relation to various antipsychotic treatments.However,few studies have been conducted on the mechanism ofrisperidone and paliperidone on BDNF and N400.This study aimed to compare the effects ofrisperidone and paliperidone on BDNF and the N400 component of the event-related brain potential in patients with first-episode schizophrenia.Methods：Ninety-eight patients with first-episode schizophrenia were randomly divided into the risperidone and paliperidone groups and treated with risperidone and paliperidone,respectively,for 12 weeks.Serum BDNF level,the latency,and amplitude of the N400 event-related potential before and after the treatment and Positive and Negative Syndrome Scale （PANSS） scores were compared between the two groups.Results：A total of 94 patients were included in the final analysis （47 patients in each group）.After the treatment,the serum BDNF levels in both groups increased （all P 〈 0.01）,while no significant difference in serum BDNF level was found between the groups before and after the treatment （all P 〉 0.05）.After the treatment,N400 amplitudes were increased （from 4.73 ± 2.86 μv and 4.51 ± 4.63 μv to 5.35 ± 4.18 μv and 5.52 ± 3.08 μv,respectively） under congruent condition in both risperidone and paliperidone groups （all P 〈 0.01）.Under incongruent conditions,the N400 latencies were shortened in the paliperidone group （from 424.13 ± 110.42 ms to 4.7.41 ± 154.59 ms,P 〈 0.05）,and the N400 amplitudes were increased in the risperidone group （from 5.80 ± 3.50 μv to 7.17 ± 5.51 μv,P 〈 0.01）.After treatment,the total PANSS score in both groups decreased significantly （all P 〈 0.01）,but the difference between the groups was not significant （P 〉 0.05）.A negative correlation between the reduction rate of the PANSS score and the increase in serum BDNF level after the treatment was found in the paliperidone group but not in the risperidone group.Conclusions：Both risperidone and paliperidone could increase the serum BDNF levels in patients with first-episode schizophrenia and improve their cognitive function （N400 latency and amplitude）,but their antipsychotic mechanisms might differ.

Citric acid reduces the decline in P300 amplitude induced by acute alcohol consumption in healthy adults

Event-related potential (ERP) is a reliable neuroelectric measure of brain activity that helps to confirm the assessment of mental status and cognitive impairment. Many studies have reported that alcoholics show a significantly lower ERP P300 amplitude than the norm. In the present study, ERP P300 waves were measured to evaluate the effect of citric acid on cognitive function during excessive alcohol consumption in healthy adults. Five volunteers were selected through clinical interview, physical examination, and psychiatric assessment for participation in this study. In a double-blind placebo-controlled before-after design, each subject was treated with 5 ml/kg body weight alcohol, 5 ml/kg body weight alcohol and 1 mg citric acid, or a placebo on three separate occasions, one week apart. ERP P300, blood biochemical indicators, blood alcohol concentrations (BACs) and acetaldehyde concentrations were assessed. Repeated measure analysis of variance (ANOVA) with a within-subjects factor was used to evaluate differences in blood biochemical indicators, BACs, blood acetaldehyde concentrations, and ERP P300 in the three sessions of assessments. Several blood biochemical indicators showed significant differences between treatments, including the levels of cholinesterase (CHE), total bile acid (TBA), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), and glycylproline dipeptidyl aminopeptidase (GPDA). BACs after consumption of alcohol alone or citric acid with al- cohol were significantly higher compared to those after placebo treatment (P<0.05). There were no significant dif- ferences in blood acetaldehyde concentrations between the treatments. The P300 amplitudes on the frontal (Fz), central (Cz), and parietal (Pz) regions of the scalp after consumption of alcohol were significantly lower than those after consumption of the placebo or citric acid with alcohol (P<0.05), while there were no significant differences between the latter two treatments. The results of this study suggest that citric acid could reduce the decline in ERP P300 amplitude and cognitive ability induced by acute alcohol consumption. It may also affect some blood biochemical indicators, but the specific mechanisms need further research.

儿童眩晕对认知功能影响的临床研究

目的本研究拟通过比较眩晕患儿与正常儿童的事件相关电位(ERPs),探索眩晕对患儿认知功能的影响,为临床治疗提供理论指导。方法选取2024年1月至8月于听力障碍及眩晕诊治中心就诊的以头晕、眩晕、平衡不稳为主诉症状的6~17岁患儿作为研究对象(眩晕组),另选取同期年龄相仿的正常儿童作为对照组。两组分别采用听觉Oddball范式刺激模式下的ERPs进行认知功能评估,ERPs包括P1、N1、P2、N2和P3共5个波形成分,比较两组间各波形成分的潜伏期和振幅差异。结果眩晕组33例患儿,男14例、女19例,平均年龄(10.2±2.7)岁;对照组16名,男12名、女4名,平均年龄(9.8±2.5)岁。眩晕组患儿的N1和N2振幅显著低于对照组儿童,差异存在统计学意义(P<0.05),余成分的振幅及各波的潜伏期差异均未见统计学意义(P>0.05)。眩晕组和对照组ERPs各波潜伏期、振幅与年龄无显著相关性(P>0.05)。结论儿童眩晕会对患儿的认知功能产生影响,主要表现在早期的感知和认知控制阶段,对高级认知处理的影响不明显;提示眩晕会导致儿童对刺激的感知能力、冲突处理能力和认知控制能力减弱。