视神经脊髓炎谱系疾病事件相关电位研究  

Cerebral event-related potentials in neuromyelitis optica spectrum disorder

作　　者：周嫔婷[1] 曾秋明[1] 杨欢[1] 董晓华[1] ZHOU Pinting;ZENG Qiuming;YANG Huan;DONG Xiaohua(Department of Neurology,XiangYa Hospital of Central South University,87 XiangYa Road,Changsha,Hunan 410008,China)

机构地区：[1]中南大学湘雅医院,长沙410008

出　　处：《中国神经精神疾病杂志》2021年第9期523-528,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金资助项目(编号:81801203)。

摘　　要：目的探讨视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)认知功能损害的神经电生理特点,加深对NMOSD的理解,从而为更好地管理NMOSD患者提供理论依据。方法本研究共纳入13例NMOSD患者(NMOSD组)及13名年龄、性别、受教育程度相匹配的健康对照者(对照组),采用听觉Oddball模式进行事件相关电位(event-related potential,ERP)检测,分别记录Cz、Fz及Pz处的N1,P2,N2,P3波及失匹配负波(mismatch negativity,MMN),对两组间的各成分峰潜伏期及基线-峰波幅进行对比研究。结果与对照组相比,NMOSD患者所有记录点的P3潜伏期[NMOSD组:Fz(346.15±19.56)ms,Cz(340.23±17.13)ms,Pz(339.62±24.37)ms;对照组:Fz(310.38±17.52)ms,Cz(312.31±16.20)ms,Pz(320.54±20.35)ms;P<0.05]及Fz、Cz记录点的N2潜伏期[NMOSD组:Fz(238.23±36.55)ms,Cz(226.85±28.45)ms;对照组:Fz(207.31±13.43)ms,Cz(206.23±19.12)ms;P<0.05]均延长,Cz记录点的P3波幅显著下降[NMOSD组(11.05±5.78)μV,对照组(20.39±9.50)μV;P<0.05]。而两组间各记录点的N1、P2及MMN的潜伏期、波幅无统计学差异(P>0.05)。结论NMOSD患者存在ERPs异常,其中内源性成分(N2及P3)显著异常,而外源性成分(N1及P2)无明显改变,表明ERPs可作为检测NMOSD患者认知功能损害的有效客观手段。Objective Central nervous system involvement and its relationship with cognitive function in patients with neuromyelitis optica spectrum disorder(NMOSD)have recently become more widely appreciated.However the objective tools of monitoring such function is lack.The objective of this study was to characterize electrophysiologically the basis of the cognitive dysfunction in NMOSD to provide a theoretical basis for better management of NMOSD patients.Methods Thirteen NMOSD patients and 13 age-,gender-matched healthy controls(HCs)were assessed with event-related potentials(ERPs)elicited by an auditory oddball paradigm,with one(1,000 Hz)occurring during 80%of the trials(frequent tone)and the other(2,000 Hz)occurring during 20%of the trials(rare tone).The latencies and amplitudes of N1,P2,N2,P3,mismatch negativity(MMN)components were measured at Cz,Fz and Pz electrode sites.Results The peak latencies of the P3 at all recording sites[NMOSD:Fz(346.15±19.56)ms;Cz(340.23±17.13)ms;Pz(339.62±24.37)ms;HCs:Fz(310.38±17.52)ms;Cz(312.31±16.20)ms;Pz(320.54±20.35)ms;P<0.05]and the N2 at Cz,Fz[NMOSD:Fz(238.23±36.55)ms;Cz(226.85±28.451)ms;HCs:Fz(207.31±13.43)ms;Cz(206.23±19.12)ms;P<0.05]were delayed in patients with NMOSD compared with the healthy control subjects.The amplitude of the P3 was significantly lower[NMOSD(11.05±5.78)μV;HCs(20.39±9.50)μV;P<0.05]in the NMOSD group at Cz.No significant differences were found between the two groups in regarding to N1,P2 and MMN components at all recording sites.Conclusion The present study has decumented that the endogenous ERPs(P3 and N2)are significantly affected in patients with NMOSD,compared to exogenous ERPs(N1 and P2),indicating a neurocognitive abnormality in NMOSD.The recording of ERPs may thus provide a useful tool as an objective measure of cognitive function in patients with NMOSD.

关 键 词：视神经脊髓炎谱系疾病 事件相关电位 认知障碍 N2 P3 失匹配负波 

分 类 号：R744.5[医药卫生—神经病学与精神病学]