【摘要】：目的觀察皮質下缺血性血管性認知損害(subcortical ischemic vascular cognitive impairment,SIVCI)患者關聯(lián)性負變(contingent negative variation,CNV)變化特征及其與計算機輔助測驗-持續(xù)操作任務(continuous performance task,CPT)的相關性,探求反映SIVCI早期注意損害的神經電生理指標,促進診斷水平的提高。方法應用意大利EB-Neuro事件相關電位工作站,對15例皮質下缺血性血管性癡呆(subcortical ischemic vascular dementia,SIVD)患者,30例皮質下缺血性血管性認知損害非癡呆型(subcortical ischemic vascular cognitive impairment no dementia,SIVCIND)患者和15名正常對照(normal control,NC)檢測CNV命令信號前期待波(expectancy wave,EW)的潛伏期、波幅和面積。結果①與正常對照相比,SIVCI患者CNV波形欠規(guī)則;SIVCIND患者CNV EW波幅降低(9.98±4.10μV vs.16.13±2.75μV,P0.05),平均面積減少(14848.10±3199.16μV·ms vs.20058.87±1025.95μV·ms(P0.05),潛伏期差異無統(tǒng)計學意義(F(2,57)=1.90,P0.05);SIVD患者較SIVCIND患者EW波幅進一步降低(6.25±1.52μV vs.9.98±4.10μV,P0.05),平均面積進一步減少(8474.00±3511.94 vs.14848.10±3199.16μV·ms,P0.05);②EW潛伏期與CPT反應時呈正相關(R=0.748,P0.01),與CPT漏報率無相關性(R=0.22,P0.05);EW波幅與CPT反應時呈負相關(R=-0.616,P0.01),與CPT漏報率無相關性(R=-0.191,P0.05);EW平均面積與CPT反應時呈負相關(R=-0.718,P0.01);與CPT漏報率呈負相關(R=-0.829,P0.01)。結論 SIVCI患者早期可能即存在注意保持等認知異常;CNV EW平均面積可能為一個較好反映持續(xù)注意損害的神經電生理指標。
[Abstract]:Objective to observe the change of (contingent negative variation,CNV in patients with subcortical ischemic vascular cognitive impairment (subcortical ischemic vascular cognitive impairment,SIVCI) and its correlation with computer-assisted test (continuous performance task,CPT). To explore the neurophysiological indexes reflecting the early attention damage in SIVCI and to improve the diagnostic level. Methods EB-Neuro event-related potential workstation was used in Italy. The latent period of CNV signal Pre-expectation Wave (expectancy wave,EW) was measured in 15 patients with subcortical ischemic vascular dementia (subcortical ischemic vascular dementia,SIVD) and 30 patients with subcortical ischemic vascular cognitive impairment (subcortical ischemic vascular cognitive impairment no dementia,SIVCIND) and 15 normal controls (normal control,NC). Amplitude and area. Results 1Compared with the normal control, the amplitude of CNV EW and the average area of CNV in the patients with SIVCI were decreased (9.98 鹵4.10 渭 V vs.16.13 鹵2.75 渭 V P 0.05), and the mean area was decreased (14848.10 鹵3199.16 渭 V ms vs.20058.87 鹵1025.95 渭 V ms (P 0.05). There was no significant difference in the latency between the two groups. The EW amplitude in the patients with SIVCI was further lower than that in the patients with SIVCIND (6.25 鹵1.52 渭 V, P 0.05 鹵4.10 渭 V, P 0.05), and the mean area of EW in the patients with SIVCI was significantly lower than that in the patients with SIVCIND (6.25 鹵1.52 渭 V, P 0.05 鹵4.10 渭 V, P 0.05). Further reduction of (8474.00 鹵3511.94 vs.14848.10 鹵3199.16 渭 V ms,P0.05) 2EW latency was positively correlated with CPT response time (RP0. 748% P0.01), but not correlated with CPT underreporting rate (R0. 22% P05). EW amplitude was negatively correlated with CPT response time (RP0. 616, P0.01), but not with CPT underreporting rate (RP05-0. 191). EW mean area was negatively correlated with CPT reaction time (R0. 718, P0.01). The rate of missing report was negatively correlated (RV-0. 829, P0.01). Conclusion the average area of EW in patients with SIVCI may be an early neurophysiological index reflecting the impairment of sustained attention.
【作者單位】： 第三軍醫(yī)大學新橋醫(yī)院神經內科;
【分類號】：R749.13

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