肌萎缩侧索硬化患者定量脑电图特点及与认知功能损害的关系  

Features of quantitative EEG in patients with amyotrophic lateral sclerosis and their relationship with cognitive impairment

作　　者：刘晨昱 王亮[1] 祁艺 张策 靳娇婷[1] 胡芳芳[1] 贾蕊[1] 党静霞[1] LIU Chenyu;WANG Liang;QI Yi;ZHANG Ce;JIN Jiaoting;HU Fangfang;JIA Rui;DANG Jingxia(Department of Neurology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061)

机构地区：[1]西安交通大学第一附属医院神经内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2020年第6期837-841,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的探讨肌萎缩侧索硬化(amyotrophic lateral sclerosis,ALS)患者定量脑电图变化,及其与认知功能损害的相关性。方法纳入ALS患者38例,健康对照者26名,均行定量脑电图检查,得到各频段相对功率并计算慢波比例(δ+θ)/(α+β)作为比较指标。其中27例ALS患者通过ECAS(Edinburgh Cognitive and Behavioural ALS Screen)量表评估认知情况,分析慢波比例与量表得分的关系;同时25名健康对照者行ECAS量表检查确定量表得分界值,根据界值对有/无认知损害的ALS患者的定量脑电图差异进行比较。结果ALS患者定量脑电图的δ、θ频段相对功率及慢波比例均显著高于健康对照,α、β频段相对功率无明显差异;在不同脑区的比较中,ALS患者双侧颞、枕区及右侧顶区的慢波比例显著高于健康对照,左侧颞区慢波比例与ALS病程呈正相关(相关系数0.405,P=0.05)。通过ECAS量表检查发现,ALS组存在认知损害的比例为33.3%;存在认知损害的ALS患者的额、颞区慢波比例高于无认知损害的ALS患者;且额、颞区慢波比例与量表总分、ALS特异项得分及ALS非特异项得分呈负相关。结论ALS患者脑电活动的改变主要是慢波活动增加,以颞、顶、枕区为著;患者额、颞区慢波比例与认知损害相关。Objective To investigate the characteristics of quantitative electroencephalogram(EEG)in patients with amyotrophic lateral sclerosis(ALS)and their relationship with cognitive impairment.Methods We recruited 38 patients with ALS and 26 healthy controls.All the patients underwent quantitative EEG examination to obtain the relative power of each frequency band and calculate the slow wave ratio(δ+θ)/(α+β)as comparison indexes.Among them,27 patients with ALS underwent the ECAS scale examination to assess their cognitive function.At the same time,25 healthy controls underwent the Edinburgh Cognitive and Behavioural ALS Screen(ECAS)to determine the cut-off of scale score.We compared the slow wave ratio in ALS patients with and without cognitive impairment according to the cut-off score.Results The relative powers ofδandθbands and slow wave ratios of quantitative EEG in ALS patients were significantly higher than those in healthy controls,and there was no significant difference in relative powers ofαandβbands.In the comparison of slow wave ratios in different brain regions,the proportion of slow waves in the bilateral temporal-occipital regions and the right parietal areas was significantly higher than that in healthy controls.The slow wave ratio in the left temporal area was positively correlated with the course of ALS(correlation coefficient 0.405,P=0.05).The ECAS scale screening revealed that 33.3%of ALS patients had cognitive impairment.ALS patients with cognitive impairment had higher slow wave ratios in the frontal and temporal areas than patients without cognitive impairment.The ALS specific item score,ALS non-specific item score and the total score of ECAS were all negatively correlated with the slow wave ratios in the frontal and temporal areas.Conclusion The changes of EEG activity in patients with ALS are mainly the increase of slow wave activity,which is significant in the temporal,parietal and occipital areas.The slow wave ratios in frontal and temporal areas of ALS patients are correlated with cogni

关 键 词：肌萎缩侧索硬化 定量脑电图 慢波比例 认知损害 

分 类 号：R741[医药卫生—神经病学与精神病学]