焦虑型与忧郁型抑郁障碍患者事件相关电位N170比较  

A comparative study of event-related potential N170 in patients with anxious-somatizing depression and melancholic depression

作　　者：都业铭 闵雪 张云巧 崔雅莲 王宗琦 韩敏 王彦芳[4] DU Yeming;MIN Xue;ZHANG Yunqiao;CUI Yalian;WANG Zongqi;HAN Min;WANG Yanfang(Department of Psychiatry,The First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]上海市松江区精神卫生中心,上海201617 [2]山西医科大学基础医学院 [3]山西医科大学第一临床医学院 [4]山西医科大学第一医院精神卫生科

出　　处：《中国神经精神疾病杂志》2022年第9期538-543,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：山西省自然基金(编号:2022140);山西省136兴医工程项目;山西省自然基金(编号:201801D121345);国家重点研发计划(编号:2016YFC1307103)。

摘　　要：目的探究不同亚型重性抑郁障碍(major depressive disorder,MDD)患者事件相关电位(event-related potential,ERP)N170差异。方法纳入MDD患者和健康对照,采用30项抑郁症状量表(30-item inventory of depressive symptomatology,IDS-30)、17项汉密尔顿抑郁量表(17-item Hamilton depression rating scale,HAMD-17)将患者分为焦虑型、忧郁型、混合型。对所有受试者评估重复性成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status,RBANS),采集中性面孔刺激任务下N170波幅与潜伏期。结果共纳入74例焦虑型(anxious-somatizing depression,ASD)、40例忧郁型(melancholic depression,MD)、66例混合型MDD患者,以及38名对照。焦虑型、混合型HAMD-17总分、焦虑分比忧郁型高(P<0.05)。焦虑型、混合型RBANS总分低于对照组[中位数及四分位数:449(419,488)vs.481(419,500)vs.507.5(474,542),P<0.05]。事件相关电位N170经重复测量方差分析显示,分组和电极点对波幅有交互作用(P<0.05),其中在Pz电极点,混合型波幅比对照组低[(2.96±4.61)μV vs.(4.75±5.00)μV],差异有统计学意义(P<0.05)。结论焦虑型与混合型MDD患者抑郁症状及认知功能损害比忧郁型严重。在中性情绪面孔刺激下,混合型患者存在面孔认知功能障碍。Objective To explore the differences of event-related potential(ERP)components N170 among different subtypes of major depressive disorder(MDD).To provide objective electrophysiological basis for subtypes classification of depression.Methods The patients with MDD and healthy controls were included.The 30-item inventory of depressive symptomatology and 17-item Hamilton depression rating scale were used to classify the patients into anxiety-somatizing depression,melancholic depression and mixed type.The repeatable battery for the assessment of neuropsychological status(RBANS)were assessed in all subjects and N170 amplitude and latency in neutral face stimulation were collected.Result A total of 74 cases of anxiety-somatizing depression(ASD),40 cases of melancholic depression(MD),66 cases of mixed type and 38 cases of healthy control(HC)were enrolled.The HAMD-17 total scores and anxiety scores of patients with anxious-somatizing depression and patients with mixed type depression were higher than those of patients with melancholic depression(P<0.05).The total scores of RBANS in patients with anxious-somatizing depression and patients with mixed type depression were lower than those in HC group[449(419,488)vs.481(419,500)vs.507.5(474,542),P<0.05].Repeated measures ANOVA showed that the group and electrode point have an interaction effect on the amplitude of N170(P<0.05).The amplitude of mixed type was significantly lower than that of HC group at the Pz electrode point[(2.96±4.61)μV vs.(4.75±5.00)μV,P<0.05].Conclusion Patients with anxious-somatizing depression and patients with mixed type depression had more depressive symptoms and cognitive impairment than those with melancholic depression.Under neutral emotional face stimulation,mixed type patients have face recognition disorder.

关 键 词：重性抑郁障碍 亚型 焦虑型 忧郁型 事件相关电位 N170 认知功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]