轻度认知功能障碍对老年人长潜伏期听觉诱发电位影响的研究  

Effects of mild cognitive impairment on long-latency evoked potentials

作　　者：张景华 李沫[3] 傅新星[1,4] 吕继辉 王媛[1] 王松建[1] 刘怡 王硕 ZHANG Jinghua;LI Mo;FU Xinxing;LYU Jihui;WANG Yuan;WANG Songjian;LIU Yi;WANG Shuo(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China;Department of Otolaryngology,Beijing Geriatric Hospital,Beijing,100095,China;Center for Cognitive Disorders,Beijing Geriatric Hospital,Beijing,100095,China;Ear Science Institute Australia,Subiaco,Western Australia,6008,Australia)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京市耳鼻咽喉科研究所,北京100730 [2]北京老年医院耳鼻咽喉科,北京100095 [3]北京老年医院认知障碍诊疗中心,北京100095 [4]澳大利亚耳科学研究所,珀斯6008

出　　处：《中国耳鼻咽喉头颈外科》2023年第4期212-216,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学基金(81870715、81200754);高层次公共卫生技术人才建设项目(学科骨干-02-42)。

摘　　要：目的本研究拟比较轻度认知功能障碍(mild cognitive impairment,MCI)和正常认知功能(normal cognition,NC)长潜伏期听觉诱发电位(the long-latency auditory evoked potential,LAEP)的差异,以期摸索可用于早期发现认知功能障碍的客观神经电生理指标。方法收集老年受试者29例,采用被动“oddball”范式,分析MCI组和NC组中P1-N1-P2和失匹配负波(mismatch negativity,MMN)的潜伏期和幅值的差异。对组间有差异的指标进行ROC曲线分析,确定最佳诊断截点及灵敏度和特异度。并对蒙特利尔认知评估(Montreal cognitive assessment,MoCA)评分与LAEP中各成分行相关性分析。结果MCI组MMN潜伏期为(267.40±31.02)ms,较NC组(240.30±29.94)ms显著延长(t=3.036,P<0.05);ROC曲线分析显示,最佳诊断截点为259.50ms,AUC=0.734,敏感度为68.00%,特异度为77.27%。MoCA评分与P2幅值(r=-0.440,P=0.028)和MMN(r=-0.422,P=0.040)潜伏期之间呈显著负相关关系(P<0.05)。结论轻度认知障碍对LAEP的影响主要表现为MMN潜伏期的显著延长,在识别早期认知障碍上具有一定诊断价值。OBJECTIVE The purpose of this study was to compare the differences of P1-N1-P2 and mismatch negativity(MMN)in the long-latency auditory evoked potential(LAEP)between mild cognitive impairment(MCI)and normal cognition(NC),in order to explore the objective neuroelectrophysiological indexes that can be used for early detection of cognitive dysfunction.METHODS Twenty-nine elderly subjects were collected,and the differences of latency and amplitude of P1-N1-P2 and MMN between MCI group and NC group were analyzed by passive"oddball"paradigm.Receiver operating characteristic ROC curve analysis was performed on the indicators with differences between groups to determine the optimal diagnostic cut-off point and sensitivity and specificity.The correlation analysis was performed on the Montreal cognitive assessment(MoCA)score and the latency and amplitude of each component of LAEP.RESULTS The latency of mismatch negativity(MMN)in the MCI group was(267.40±31.02)ms,which was longer than that in the NC group(240.30±29.94)ms,and the difference was statistically significant(t-3.036,P<0.05).Based on the ROC curve,the calculated optimal diagnostic cut-off was 259.50 ms,the sensitivity was 68.00%,and the specificity was 77.27%.There was a significant negative correlation between MoCA score and P2 amplitude(r=-0.440,P=0.028)and MMN latency(r=-0.422,P=0.040).CONCLUSION The influence of mild cognitive impairment on LAEP is mainly manifested by the significant prolongation of the latency of MMN,which has certain diagnostic value in identifying early cognitive impairment.

关 键 词：认知功能障碍 诱发电位 听觉 失匹配负波 

分 类 号：R749.1[医药卫生—神经病学与精神病学]