头针治疗脑外伤后认知障碍的临床效果

目的观察头针治疗脑外伤后认知障碍的临床疗效。方法 42例脑外伤后认知障碍患者随机分为治疗组(n=23)和对照组(n=19)。对照组予认知功能训练及盐酸多奈哌齐治疗,治疗组在此基础上予头针治疗,共3个月。分别于治疗前、治疗1个月后、治疗3个月后应用蒙特利尔认知功能评定(Mo CA)及事件相关电位P300进行评估。结果治疗3个月后,两组患者P300和MoCA评分均较治疗前显著改善(P<0.001),治疗组均显著优于对照组(P<0.001)。结论头针对改善脑外伤后认知障碍有一定疗效。

伪装与非伪装认知功能损伤事件相关电位P_(300)比较研究

目的探讨检测认知功能损伤的神经电生理技术。方法以年龄、性别、文化程度及脑损伤程度基本匹配的伪装与非伪装认知功能损伤各10例脑外伤患者为研究对象,并以上述条件相匹配的10例正常人作对照。通过高低音听觉刺激高低概率范式(oddball)引发P_(300),并同步记录被试判断高低音和简单图片的正确率。结果①伪装组、非伪装组及正常对照组三组听觉高低音和简单图片判断的正确率的差异均有显著性,伪装组显著低于非伪装组和正常对照组(P<0.01);伪装组高低音判断的正确率仅为34.7%,图片判断的正确率为45.8%;而非伪装组和对照组的正确率均在90%以上。②三组在额点(Fz)、中央点(Cz)、顶点(Pz)三个导联上的P_(300)潜伏期及低、高概率事件的P300幅值差值的差异均无显著性(P>0.05)。结论事件相关电位P_(300)潜伏期及幅值差值对伪装认知功能损伤的诊断能够提供间接的神经电生理学佐证依据。

轻型颅脑外伤患者事件相关电位的研究

目的：研究事件相关电位（ＥＲＰ） 对轻型颅脑外伤患者脑认知功能变化的评估作用。方法：用听觉ｏｄｄｂａｌｌ 刺激序列ＥＲＰ检测２２ 例轻型颅脑外伤患者并和２０ 位正常人对照。结果：病例组ＥＲＰ 的Ｐ３ 峰潜伏期较正常对照组明显延长（Ｐ＜０－０１） ；随着病情的好转，Ｐ３ 潜伏期逐渐缩短，波幅亦逐渐增高。结论：ＥＲＰ是测定轻型颅脑外伤患者脑认知功能变化的一项客观指标。

闭合性颅脑外伤患者事件相关电位的研究

目的：研究ERP对闭合性颅脑外伤患者脑认知功能变化的评估作用。方法：应用Medicid-03E脑诱发电位仪测定168例闭合性颅脑外伤患者的视觉（图像）、听觉诱发的P3波之潜伏期和波幅，并与正常对照组作比较，54例患者进行复测比较。结果：病人组P3潜伏期较正常对照组明显延长（P＜0．001），波幅降低；P3波潜伏期、波幅与患者病情严重程度相关；有原发昏迷者改变尤为突出；随着病情的好转，P3潜伏期逐渐缩短，波幅亦逐渐增高。结论：ERP是测定闭合性颅脑外伤患者脑认知功能变化的一项客观指标。

颅脑损伤后所致癫痫患者的事件相关电位P_(300)特征

目的探讨颅脑外伤所致癫痫患者的认知功能特点及事件相关电位P300的临床应用价值。方法对53例颅脑外伤所致精神障碍患者、52例颅脑外伤不伴癫痫患者和50例健康对照组分别进行了P300电位测定,采用韦氏成人智力测验修订版测定智商,将三组测定结果进行相关分析。结果颅脑外伤所致癫痫患者组与颅脑外伤组事件相关电位成分中N2、P3波潜伏期延长和P3波幅降低,言语智商、操作智商、总智商得分均降低均较对照组显著,差异均有极显著性(P均<0.01);而颅脑外伤伴癫痫组P300电位成分中N2、P3波潜伏期延长和P3波幅降低及言语智商、操作智商、总智商得分降低均较颅脑外伤组显著,差异均有极显著性(P均<0.01)。相关分析显示,颅脑外伤伴癫痫组P300潜伏期与言语智商、操作智商和总智商分呈显著负相关(r=-0.33～-0.29,P<001),波幅则呈显著正相关(r=0.31～0.36,P<0.01)。结论P300电位是评价颅脑外伤所致癫痫患者认知状况的重要指标。

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.