本文關(guān)鍵詞：腦電非線性分析在阿爾茨海默病早期診斷中的臨床應(yīng)用，由筆耕文化傳播整理發(fā)布。

        目的：探討腦電非線性分析方法對阿爾茨海默�。ˋD）早期診斷的臨床應(yīng)用價值。方法：受試者分為輕度阿爾茨海默病組（輕度AD組=13例）、遺忘型輕度認(rèn)知功能障礙組（aMCI組=9例）、血管性認(rèn)知功能障礙組（VCI組=10例）及正常老年人（NA=10人）組。受試者完成中文版簡易智能狀態(tài)檢查(MMSE)、蒙特利爾認(rèn)知評估量表(MoCA)、總體衰退量表(GDS)、臨床癡呆評定量表(CDR)、Hachinshki缺血指數(shù)(HIS)、漢密爾頓抑郁量表(HDRS)、日常生活活動能力量表(ADL)評定，采集腦電信號并行非線性分析。最后選取有顯著差異的導(dǎo)聯(lián)（P＜0.01）行ROC曲線分析來評估腦電非線性參數(shù)對AD早期診斷的價值。結(jié)果：①非線性參數(shù)D2、PD2、Dm、Cx、ApEn、C-ApEn能夠反應(yīng)認(rèn)知功能障礙程度變化的總體趨勢，其中，D2、PD2、Cx、ApEn差異有顯著的統(tǒng)計學(xué)意義（均P＜0.01）；②輕度AD組與NA組比較，D2、PD2、Dm、LE、KE、Cx、ApEn、C-ApEn差異有統(tǒng)計學(xué)意義（均P＜0.05），其中Cx全腦平均值、除O2外各導(dǎo)聯(lián)均減低且差異有顯著的統(tǒng)計學(xué)意義（均P＜0.01），KE僅O1導(dǎo)聯(lián)減低且差異也有顯著的統(tǒng)計學(xué)意義（P＜0.01），而LE在O1、O2導(dǎo)聯(lián)增高且差異有統(tǒng)計學(xué)意義（P＜0.01，P＜0.05）;aMCI組與NA組比較，D2（P4、F7）、PD2（P3、T6和全腦平均值）、KE（P4、O1）、Cx（F7、T5）、ApEn（F7、T4、T6）減低且差異有統(tǒng)計學(xué)意義（P＜0.01，P＜0.05）；輕度AD組與VCI組比較，，D2、PD2、Dm、LE、KE、Cx、ApEn、C-ApEn差異有統(tǒng)計學(xué)意義（均P＜0.05）;aMCI組與VCI組比較，LE、KE、Cx、ApEn、C-ApEn差異有統(tǒng)計學(xué)意義（均P＜0.05）而輕度AD組與aMCI組比較，D2、PD2、Dm、LE、KE、Cx、ApEn、C-ApEn差異有統(tǒng)計學(xué)意義（均P＜0.05）。③所選的8種非線性參數(shù)在大多數(shù)差異有顯著意義的導(dǎo)聯(lián)（P＜0.01）診斷價值較高。其中，輕度AD組與NA組相比，Cx15個導(dǎo)聯(lián)中除T5（A=0.885，診斷價值中等）外診斷價值均較高（A＞0.9）；LE僅在O2導(dǎo)聯(lián)敏感性為69.2%，特異性為80%，診斷價值中等（A=0.788）；KE僅在O1導(dǎo)聯(lián)敏感性為84.6%，特異性為90%，診斷價值中等（A=0.838）。而aMCI組與NA組相比，Cx在F7導(dǎo)聯(lián)敏感性為88.9%，特異性為70%，診斷價值中等（A=0.817）而ApEn在T6敏感性為77.8%，特異性為90%，診斷價值較高（A=0.917）。結(jié)論：腦電非線性分析能夠較早客觀判斷腦功能的改變，對輕度AD敏感性和特異性要優(yōu)于aMCI，有助于AD的早期診斷。

    Objective: To investigate the clinical application value of EEGnonlinear analysis in early diagnosis ofAlzheimer’s disease.Method:Mini-mental State Examination(MMSE),Montreal CognitiveAsswssment Scale(MoCA),Global deterioration Scale(GDS),Clinicaldementia rating scale(CDR),Hachinski ischemic index(HIS),Hamiltondepression rating scale(HDRS),activity of daily living(ADL)were completedand EEG were recorded from13mild Alzheimer’s disease patients(MildAD),9amnestic mild cognition impairment patients(aMCI),10vasular cognitiveimpairment patients(VCI) and10normal aged (NA) subjects.Electrodes withsignificance(P＜0.01)were slected to investigate the value of EEG nonlinearanalysis in early diagnosis of Alzheimer’s disease using receiver operatingcharacteristic(ROC)curves.Results:①Nonlinear parameters D2,PD2,Dm,LE,Cx,ApEn,C-ApEn canreflect the overall trend of cognition impairment,in which D2,PD2,Cx,ApEnshowed highly statistical significant differences(P＜0.01);The AD patientshad significantly lower Cx values except at the O2(P＜0.01),lower KE valuesonly at the O1(P＜0.01),and higher values of LE at the O1,O2~electrodes(P＜0.01~,P＜0.05)compared with NA subjects. D2(P4,F7), PD2(P3,T6and thewhole brain mean value),KE(P4,O1),Cx(F7~,T5), ApEn (F7,T4,T6~) weresignificantly lower for aMCI group in contrast to NA subjects(P＜0.01~,P＜0.05). Compared with VCI group,all D2, PD2,Dm,LE,KE,Cx,ApEn,C-ApEn in mildAD group had significant difference(P＜0.05).The LE,KE,Cx,ApEn,C-ApEn values of the EEGs for the aMCI patients were different from thoseof VCI patients(P＜0.05) and significant differences of D2,PD2,Dm,LE,KE,Cx,ApEn,C-ApEn were also found(P＜0.05) when contrastedaMCI patients with mildAD ones.③The diagnosis values of8selectednonlinear parameters are higher at the most electrodes where P＜0.01.Compared with NA group, the diagnosis values of Cx were higher except T5for mildAD. The sensitivity and specificity of LE were69.2%,80%respectively with the moderate diagnosis value only at O2.And84.6%,90%respectively for KE with the moderate diagnosis value only at O1. On theother hand,between aMCI group and NA group, the sensitivity and specificityof Cx were88.9%,70%respectively only at F7with the moderate diagnosisvalue.And77.8%,90%separately for ApEn at T6with the higher diagnosisvalue.Conclusion: Nonlinear analysis of EEG can objectively evaluate thebrain function changes, albeit the sensitivity and specificity for mildAD aresuperior to aMCI, which may contribute to AD early diagnosis.

腦電非線性分析在阿爾茨海默病早期診斷中的臨床應(yīng)用

致謝4-5摘要5-7Abstract7-8前言10-13對象與方法13-19結(jié)果19-39討論39-51結(jié)論51結(jié)語與展望51-53參考文獻(xiàn)53-56綜述：阿爾茨海默病生物學(xué)標(biāo)志物的研究進(jìn)展56-95    參考文獻(xiàn)86-95附錄95-104個人簡歷104

  本文關(guān)鍵詞：腦電非線性分析在阿爾茨海默病早期診斷中的臨床應(yīng)用，由筆耕文化傳播整理發(fā)布。