采用不同范式ERP联合推断重型颅脑外伤后WAIS智商  

Establishment of regression model of intelligence quotient in patients after severe traumatic brain injury by using different paradigms of ERP

作　　者：刘子龙[1] 程珞 孙婷怡[1] 赵丽丽[1] 陈晓瑞[1] 赵小红[1] 饶广勋[1] 刘良[1] 

机构地区：[1]华中科技大学同济医学院法医学系,湖北武汉430030 [2]监利县人民医院神经内科,湖北荆州433300

出　　处：《中国法医学杂志》2014年第3期214-217,221,共5页Chinese Journal of Forensic Medicine

基　　金：中央高校基本科研业务费资助项目(2012QN001);湖北省自然科学基金资助项目(2009CDB415)

摘　　要：目的探讨联合应用视觉Oddball、数字计算和图片再认范式引出的事件相关电位(ERP)特征性成分推断重型颅脑外伤(sTBI)患者智商的可行性。方法采用3种ERP范式检测122名交通事故所致sTBI患者,同时测查韦氏成人智力量表(WAIS),建立回归模型。结果 3种刺激范式在sTBI患者中均能记录到稳定的ERP波形,无明显性别差异,其中图片再认P500潜伏期最长,数字计算P3c次之,视觉VP300最短(P<0.01),3者的波幅与WAIS总智商无明显相关(P>0.05),P500潜伏期均值与总智商的相关性(r=-0.67,P<0.01)高于P3c(r≈-0.57,P﹤0.05)和VP300(r≈-0.43,P<0.05);采用VP300、P3c、P500潜伏期建立的模型分别只能解释伤后WAIS智商方差变异的18%、33%、45%,3个指标联合可达56%;推断模型均不存在明显共线性。结论视觉VP300、数字计算P3c和图片再认P500的潜伏期均可用于推断脑损伤后的智能状态,增加刺激材料复杂性或联合多个ERP指标推断脑外伤后WAIS智商结果更为可靠。Objective To establish regression model for estimating intellectual status using the paradigms of visual Oddball, digital calculation and pictures recognition of event-related potentials （ERP） in patients with severe traumatic brain injury （sTBI）. Methods Visual Oddball, digital calculation and pictures recognition of ERP were recorded in 122 traffic accident-induced sTBI patients with the complaint of intelligence impairment, and their intelligence quotient （IQ） was measured using the Weehsler Adult Intelligence Scale （WAIS）, then the regression model was established. Results Stable ERP waveforms were recorded when using these paradigms. The mean latency of visual VP300 was the shortest, then was that of P3c, and the mean latency of PS00 was the longest （P 〈 0. 01 ）. No significant gender difference was found. The mean amplitudes of VP300, P3 c and PSO0 were not significantly correlated with FIQ of WAIS （ P 〉 0. 05）, but their mean latency were negatively correlated with FIQ （ P 〈 0. 01 each）, and the correlation coefficient was ranged from 0.43 to 0. 67. However, no significant colinearity was found between these regression equations. The regression models based on VP300, P3c and P500 only accounted for 18%, 33% and 45% of the variance of FIQ, respectively, and it was increased to 56% when combining the three indices. Conclusion The latency of Visual VP300 Visual oddbal, P3c of digital calculation and PS00 of pictures recognition could be used to estimate intellectual status of sTBI patients. The efficiency of estimation will be improved by increasing the complexity of stimulus materials or combining visual P300, P3c and P500.

关 键 词：法医精神病学 重型颅脑损伤 智商 事件相关电位 回归模型 

分 类 号：D919[医药卫生—法医学]