摘要
目的观察不同认知功能评分的帕金森病（PD）患者之间，厦其与正常对照之间事件相关电位（ERPs）P300波的潜伏期和波幅有无差别，为PD患者认知功能障碍的早期诊断提供一种客观、可靠方法。方法参与实验者分为实验靶刺激内容设计者、第一评估者（检测并收集资料者）及第二评估者（有丰富工作经验脑电生理诊断医生）。32名非痴呆PD病患者和与其年龄、性别、受教育程度均匹配的25名身体健康志愿者被纳入研究，采用熟悉和不熟悉人名作为谤发ERPs的任务，仪器设备使用德国EMS-32导脑电地形图处理系统，并记录30导ERPs。第一评估者与第二评估者在双盲的条件下通过分析记录的ERPs来判定出受试者熟悉的名字。结果①第一评估者与第二评估者对人名刺激正确判断率差异无统计学意义（P〉0．05），第一评估者与第二评估者对正常对照组人名刺激的正确判断率均明显高于PD患者组；②在认知熟悉人名时，PD患者组和正常对照组N2-P3波幅明显高于不熟悉人名者（P〈0．05；P〈0．01）；与正常对照组相比，PD患者组N2、P3潜伏期延长，N2-P3波幅下降，但差异均无统计学意义（P〉0．05）；③在N2、P3潜伏期方面，24～26分PD患者组均较正常对照组（熟悉：P〈0．01，P〈0．01；不熟悉：P〈0．01。P〈0．01）和27～30分PD患者组（熟悉；P〈0．05，P〈0．01）不熟悉：P〈0．05，P〈0．01）有显著延长。在N2-P3波幅方面，24～26分PD患者组、27～30分PD患者组和正常对照组之间则差异均无统计学意义（P〉0．05）。结论以识别熟悉与不熟悉人名字作为靶刺激的ERPs，可早期发现PD患者的认知功能损害；PD患者P300潜伏期延长早于波幅的降低，提示P300潜伏期延长是反映早期亚临床认知功能障碍的敏感指标。
Objective To observe whether the event-related potentials（ERP） P300 latency and amplitude has difference between parkinson disease（PD） patients with various cognitive scale score, or between PD patients and the control subjects. So as to explore a kind of objective and reliable method for the early diagnosis of cognitive impairment in patients with PD. Methods The study personals were divided into the designer, observer and data collector, and examiner. Thirty-two cases of non-demented patients with PD were selected as patients group, 25 healthy volunteers were collected as control group, matched by age, sex and education with the patients group. ERPs were recorded from 30 scalp electrodes in the patients and control subjects during the tasks of familiar and unfamiliar names. The experiment instrument is EMS 32 lead of the brain electricity topography system made in Germany. The name, which was familiar to the examiners, was determined by the observer through analyzing the ERP records during the doubleblind condition. Results ①Regardless of the evaluation made by the observer and data collector or the examiner, the correct rates of judgment on control subjects were obviously higher than those on PD patients. ②The wave amplitudes of N2-P3 evoked by familiar names were higher than those evoked by unfamiliar names in both patients and control groups （P〈0.05; P 〈0.01）. Compared with control subjects, the latencies of N2- P3 were longer, and wave amplitudes were lower in the patients with PD. But there were no statistical difference between both groups（ P 3〉 0.05）. ③Compared with control subjects, the latencies of N2- P3 were significant prolonged in PD patients with MMSE 24 26 scores（familiar： P〈0.01, P〈0.01; unfamiliars P〈0.01, P〈0.01）. The latencies of N2-P3 were also significant longer in PD patients with MMSE 24- 26 points scores than those of patients with MMSE 27 - 30 points scores （familiar： P 〈0.05, P 〈0.01;unfamiliar： P 〈0.05, P 〈0.01）. The wave amplitudes of N2- P3 showed no significant difference among the patients with MMSE 24 26 points scores, patients with MMSE 27-30 points scores, and control subjects （ P 〈0.05）. Conclusion PD patients have difficulty in distinguishing one thing from another by identifying the different characters of things. The method of distinction person names （familiar or unfamiliar） as ERPs target stimulation can identify the cognitive function impairment in PD patients in an early stage; the P300 latency prolongation occurs before the amplitude declines, So the prolongation of P300 latency is a marker that can sensitively reflect subclinical cognitive impairment.
出处
《临床荟萃》
CAS
北大核心
2006年第9期612-616,共5页
Clinical Focus
关键词
帕金森病
事件相关电位
P300
认知障碍
人名
双盲法
parkinson disease
event-related potentials,P300
cognitive disorders
names
double-blind method
