事件相关电位P300在颅脑损伤司法鉴定中的伪装识别研究  

Research on camouflage identification of event related potential P300 in forensic appraisal of craniocerebral injury

作　　者：叶锋 杨园 熊典樟 兰胜作 李小芬 YE Feng;YANG Yuan;XIONG Dianzhang(The Third People's Hospital of Yichun,Yichun 336000,China)

机构地区：[1]宜春市第三人民医院,江西宜春336000

出　　处：《精神医学杂志》2024年第6期601-604,共4页Journal of Psychiatry

基　　金：江西省卫生健康委科技计划项目(编号:20241092)。

摘　　要：目的研究事件相关电位P300对颅脑外伤后司法鉴定中的伪装识别。方法选取颅脑外伤治疗终结后进行精神伤残鉴定的患者60例,由鉴定专家结合二项必选数字记忆测验(BFDMT)、韦氏智力量表评分将患者分为伪装组与非伪装组各30例,另选取一般资料相匹配的30名健康人为对照组。通过高低音听觉刺激高低概率范式(oddball)引发P300,监测比较三组间蒙特利尔认知评估量表(MoCA)评分、P300潜伏期和波幅,并同步记录三组判断高低音(500 Hz和1500 Hz)、图像的正确率。结果伪装组MoCA评分高于非伪装组(P<0.05),P300潜伏期、P300波幅均低于非伪装组和对照组(P<0.05)。伪装组判断高低音、图像的正确率均低于非伪装组和对照组(P<0.05)。与鉴定专家评定的结果相比,P300评定的假阴性为6.7%,假阳性率为3.3%;总准确率为95.0%。结论事件相关电位P300对伪装认知功能损伤的诊断能够提供间接的神经电生理学佐证依据,可作为颅脑损伤后司法鉴定中伪装识别的参考指标。Objective To explore the camouflage identification of event related potential P300 in forensic appraisal of craniocerebral injury.Methods A total of 60 patients with craniocerebral injury who underwent psychiatric disability assessment after treatment were selected and divided into camouflage group and non-camouflage group with 30 cases in each group by the appraisal experts in combination with Binomial Forced-choice Digit Memory Test(BFDMT)and Wechsler Intelligence Scale.30 healthy controls with matched age,gender,and educational level were selected as control group.P300 was triggered through oddball paradigm,and to monitor and compare the Montreal Cognitive Assessment(MoCA)scores,P300 latencies and amplitudes among the three groups,and synchronously record the accuracy of judging high and low frequencies(500,1500 Hz)and images in the three groups.Results The MoCA score of camouflage group was significantly higher than that of non-camouflage group(P<0.05).The P300 latency and P300 amplitude of camouflage group were significantly lower than those of non-camouflage group and control group(P<0.05).The accuracies of detecting high and low frequencies and images in camouflage group were significantly lower than those in non-camouflage group and control group(P<0.05).Compared to expert evaluations,P300-based assessment yielded 6.7%false-negative and 3.3%false-positive rates,with 95%overall accuracy.Conclusion P300 provides indirect neuroelectrophysiological evidence for identifying malingered cognitive impairment,serving as a supplementary indicator in forensic craniocerebral injury evaluations.

关 键 词：事件相关电位 颅脑损伤 伪装 司法鉴定 

分 类 号：D919.4[医药卫生—法医学]