轻度认知障碍患者听觉范式诱发脑电P300电位的病例对照研究

Auditory Paradigm Evoked P300 Potentials in Patients with Mild Cognitive Impairment (MCI): A Case-Control Study

摘要: 背景：轻度认知障碍(Mild Cognitive Impairment, MCI)的早期识别是获得理想治疗效果及延缓其进展为痴呆的关键。本研究利用事件相关电位(Event Related Potentials, ERPs)脑电技术检测MCI受试的听觉范式诱发P300电位，发现可能用于临床早期识别MCI的脑电电位指标。方法：研究主要在深圳市康宁医院记忆门诊和社区使用临床痴呆评定量表(Clinical Dementia Rating, CDR)的访谈评分作为标准招募MCI患者和对照受试，在完成人口统计学资料收集及相关神经心理测量问卷后采用ERP脑电技术的方法检测受试的听觉范式诱发P300电位，同时在Fz，Cz和Pz采集P300潜伏期和波幅。结果：研究一共招募受试51位受试完成听觉范式诱发P300电位采集，其中MCI受试24位，对照受试27位。MCI受试在简易智能检查量表(Min-Mental State Examination, MMSE)及蒙特利尔认知评估(Montreal Cognitive Assessment, MoCA)的认知测评上得分均低于对照受试(分别为27.6 ± 2.0比29.0 ± 1.2和22.6 ± 2.2比26.9 ± 2.0，P ≤ 0.01)，其P300诱发电位在Fz部位波幅低于对照受试者(3.6 ± 4.8比7.9 ± 6.3，P = 0.01)，并且受试Fz部位波幅的降低与MoCA的测评得分存在正相关(相关系数为0.30，P = 0.04)。结论：MCI患者P300诱发电位在Fz部位的波幅降低可能成为临床早期识别MCI脑电指标。

Abstract: Background: Early recognition of mild cognitive impairment (MCI) is the key to obtain the ideal therapeutic effect and delay its progression to dementia. This study used event-related potentials (ERPs) technology to detect the auditory paradigm evoked P300 potentials of MCI patients, and expected to prove that ERPs indicators might be used to identify MCI in the early clinical stage. Methods: The study mainly used the Clinical Dementia Rating (CDR) interview scores both in the memory clinic of Shenzhen Kangning Hospital and in the community as the standard to recruit MCI patients and control subjects, respectively. After completing the collection of demographic data and neuropsychological assessments, the ERPs technique was used to detect the auditory paradigm evoked P300 potential, which latency and amplitude were collected at Fz, Cz and Pz. Results: The study recruited a total of 51 subjects to complete the auditory paradigm evoked P300 potential acquisition, of which 24 were MCI subjects and 27 were control subjects. The scores of MCI subjects on the cognitive assessment of Min-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were lower than those of control subjects (27.6 ± 2.0 vs. 29.0 ± 1.2, 22.6 ± 2.2 vs. 26.9 ± 2.0, respectively, P ≤ 0.01). At the Fz site, the P300 amplitude of MCI patients was lower, when compared to the P300 amplitude of control subjects (3.6 ± 4.8 vs. 7.9 ± 6.3, P = 0.01). The reduction in the amplitude of the Fz site was positively correlated with the MoCA score in MCI patients (r = 0.30, P = 0.04). Conclusion: The reduced amplitude of P300 evoked potential at Fz site in MCI patients may be an indicator of early clinical identification of MCI.