卒中急性期非痴呆型血管性认知障碍患者工作记忆的事件相关电位特征研究  

Working memory deficits in post stroke-vascular cognitive impairment no dementia during the acute stroke phase:an ERP study

作　　者：严玉宁[1] 李亚健[1] 魏文石[1] 

机构地区：[1]复旦大学附属华东医院神经内科

出　　处：《老年医学与保健》2015年第3期144-146,152,共4页Geriatrics & Health Care

基　　金：上海市科委科技支撑项目(124119a8802)

摘　　要：目的探索卒中急性期非痴呆型血管性认知障碍（PS—VCIND）患者的工作记忆特点。方法卒中急性期PS—VCIND及卒中后无认知障碍（PS—NCI）患者各13例，行数字n—back（n=0，1）工作记忆任务的ERP实验，记录行为学数据及EEG，离线处理数据，比较两组在不同记忆负荷下的行为表现及ERP成分的差异。结果两组被试1-back较0-back任务反应时均延长（P〈0．001），正确率无变化；不同组别（PS—VCIND和PS—NCI）间正确率与反应时差异均无统计学意义。ERP数据示PS—VCIND组1-back较0-back的P300潜伏期延长（P=0．011）、波幅减小（P=0．001）；且在1-back任务中，PS—VCIND较PS—NCI组潜伏期延长（P=0．047）、波幅减小（P=0．035）。结论卒中急性期PS—VCIND患者存在工作记忆损害，n—back范式诱发的ERP成分可增加卒中后认知障碍早期诊断的客观性。Objective To examine working memory （WM） in post stroke-vascular cognitive impairment no dementia （PS-VCIND） during the acute stroke phase. Methods 13 patients with PS-VCIND and 13 patients with post stroke-no cog- nitive impairment （PS-NCI） performed a digit n-back WM task （0- to 1-back） during the acute stroke phase. Behavioral data and event-related potentials （ERPs） were measured. Results Both the groups exhibited significantly longer reaction times （P〈0.001） from 0- to 1-back task, but no significant difference in accuracy rates. No significant differences were observed in behavioral data between PS-VCIND and PS-NCI groups. For PS-VCIND patients, P300 latency prolonged （P=0.011） and P300 amplitude reduced （P=0.001） significantly as WM load increased （1-back versus 0-back task）. And a significant between group difference in ERPs was evidenced in a high WM load condition. PS-VCIND patients showed significantly prolonged P300 latency （P=0.047） and significantly reduced P300 amplitude （P=0.035） compared with PS-NCI patients in 1-back task. Conclusions These results indicate WM deficits in PS-VCIND after acute stroke, n- back ERPs may reveal WM changes prior to clinical impairment, which may be a potential biomarker for early detection of post stroke cognitive impairment.

关 键 词：卒中后认知障碍 非痴呆型血管性认知障碍 工作记忆 事件相关电位 

分 类 号：R749.1[医药卫生—神经病学与精神病学]