老年期抑郁症患者认知功能损害与听觉诱发电位P300的特征变化  

Character of cognitive functional lesion and auditory evoked potential P300 in patients with senile depression

作　　者：周振和[1] 朱红梅[1] 李恒芬[2] 侯永华[2] 

机构地区：[1]无锡市精神卫生中心精神科,江苏省无锡市214151 [2]河南省精神病医院老年精神科,河南省新乡市453002

出　　处：《中国临床康复》2005年第20期12-14,共3页Chinese Journal of Clinical Rehabilitation

基　　金：河南省教育厅科技公关项目(20023200017)~~

摘　　要：目的:探讨反映老年期抑郁症患者认知功能损害的客观指标听觉诱发电位P300的特征。方法:应用配对设计,对2002-02/2003-12河南省精神病医院经老年认知功能量表筛查的58例老年期抑郁症患者(实验组)及58例正常老年人(对照组)采用意大利产安培MK-15诱发电位系统完成听觉P300检测。针状电极产自丹麦ECI公司。电极位置参照国际脑电图学会10/20标准,记录电极置于中央中线Cz点,参考电极置于右耳M2点,前额FPz点接地,电极间阻抗小于5kΩ,分析时间为1000ms。被检者接受双耳的短音刺激,刺激频率为1次/s,刺激持续时间10ms,灵敏度为5μV,带通低频滤波0.1Hz,高频滤波50Hz,叠加200次。采用两套触发和刺激系统、两个完全独立的时间窗口来进行听觉诱发电位P300检测。非靶刺激(NT)强度为85dB,频率为1000Hz,占80%。靶刺激(T)频率为2000Hz,强度为95dB,随机出现,串插在非靶刺激中,占20%。两者次序关系的范例如下:NTNTNTTNTNTNTNTTTNTNTNTNTNTTNTNTNT。受试者对靶刺激作按键反应,每例重复2次,取平均值。在听觉诱发电位P300检查的当日,采用汉密顿抑郁量表及老年认知功能量表分别评价抑郁情绪及认知功能。主要观察靶刺激时听觉诱发电位P300的成分N1,P2,N2,P3潜伏期及波幅和反应时间。N2,P2为内源性成分,N1,P2为外源性成分,N2,P3为潜伏期及反应时间代表大脑皮质的觉醒态度,大脑激活水平或兴奋性水平。P2,P3的波幅与注意、记忆有关,即与认知资源容量及对认知资源容量的分配能力有关。应用配对样本t检验及直线相关分析进行数据处理。结果:两组各58例均进入结果分析。①靶刺激实验组P2,N2,P3潜伏期比对照组明显延长犤P2(205±32),(184±29)ms,t=3.266,P<0.01;N2(281±26),(230±24)ms,t=4.054,P<0.01;P3(358±19),(321±17)ms,t=9.767,P<0.01犦。P2,P3波幅比对照组明显降低犤P2(2.51±1.49),(3.39±2.09)μV,t=3.101,P<0.01;P3(2.03±1.53),(8.09±1.28)μV,tAIM：To study the characters of objective marker of the auditory evoked potential （AEP） P300 in patients with cognitive functional lesion and senile depression.METHODS：By paired design, fifty-eight senile depression patients with cognitive impairment were selected by functional scale from Henan Psychosis Hospital from February 2002 to December 2003 （experiment group）, and fifty-eight healthy old people were selected （controlled group）.Two groups were measured auditory P 300 by Ampere MK-15 evoked potential system made in Italy. The needle eleetrodes were used made in ECI Company Denmark. According to International Electroencephalology Association 10-20 system criteria placed electrodes： record electrode was placed in Cz; conference electrode was placed in M2; ground wire was lined in FPz. The impedance between two electrodes was less than 5 kΩ.1 000 milliseconds were analyzed. Subjects were received short tone stimulus through two ears. Frequency of stimulation was one time per second;persistence time was 10 milliseconds ; susceptibility was 5μV; band-pass　low frequency transduction smoothing was 0.1Hz; high-frequency smoothing　was 50 Hz; stratum super stratum 200 times. Two evoked and stimulated　systems and two independent time windows were applied to measure　potential P 300. Nontarget （NT）（intensity 85 dB; frequency 1 000 Hz ）occupied 80 percent. Target （T） （frequency 2 000 Hz; intensity 95 dB）occupied 20 percent and appeared randomly among non-target stimulations.The sequence paradigm between non-target and target was as followings： NT NT NT T NT NT NT NT T T NT NT NT NT NT T NT NT NT. All subjects knobbed response to target stimulations two times and averaged value were received as outcome. When AEP P 300 was examined, depression emotion and function were evaluated by HAMD and old-aged cognition functional scale. Main outcome measures： Auditory evoked potential P300 component N1, P2, N2, P3 latency and amplitude and reactive time changes. N2 and P2 were endogenet

关 键 词：抑郁症 老年人 诱发电位 听觉 

分 类 号：R749.057[医药卫生—神经病学与精神病学]