轻度认知障碍患者简单加法计算的事件相关电位早成分

目的研究轻度认知障碍(MCI)患者简单加法计算的心算效率及事件相关电位(ERP)早成分改变。方法被试者分为正常老年(对照)组和MCI组,每组16名,均为右利手。使用ERP技术,采集简单计算过程的脑电信号,比较两组行为数据和算式早成分(N1,P1,N170,P2)的波幅和潜伏期的差异。结果 MCI组的反应时长于对照组,差异具有显著性(P<0.01);MCI组的正确率低于对照组,差异具有显著性(P<0.01);MCI组与对照组比较,颞枕区N170以及额中央区P2潜伏期延长(P<0.01),波幅增大(P<0.05);MCI组左侧颞枕区N170波幅低于对照组,差异具有显著性(P<0.01);MCI组右侧颞枕区N170波幅高于对照组,差异具有显著性(P<0.01)。结论 MCI患者简单加法计算的心算效率降低,计算的正确率降低,同时提示大脑在算式早期加工阶段出现异常。     

老年轻度认知功能障碍患者事件相关电位N400

目的 探讨事件相关电位N400在老年轻度认知功能障碍诊断中的临床意义.方法 被试者分为正常老年(NC)对照组和老年轻度认知功能障碍(MCI)组作为观察组,每组各16名.刺激包括40句匹配句和40句不匹配句,要求被试者进行语义违例判定任务,同时记录32导脑电.结果 ①两组均产生较明显的反应语义理解功能的特异性成分N400;②与NC组相比,MCI组N400的潜伏期延长(P＜0.05),平均波幅降低(P＜0.05).结论 事件相关电位N400可为诊断老年轻度认知功能障碍提供客观参考依据.     

轻度认知障碍患者认知功能与事件相关电位N400的临床研究

目的探讨轻度认知障碍(mild cognitive impairment,MCI)患者的认知功能状况与N400表现。方法选择MCI患者20例(MCI组),健康体检者23例(对照组)。使用简易智能状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)对所有受试者进行评定,并做N400检测,分析它们之间的相关性及对MCI的诊断价值。结果与对照组比较,除MoCA语言项外,MCI组MMSE、MoCA评分明显降低,差异有统计学意义(P<0.05,P<0.01);N400潜伏期延长,其中Fz、Pz匹配和非匹配刺激潜伏期,C3、C4非匹配刺激潜伏期,Pz、C4匹配刺激波幅的差异有统计学意义(P<0.05,P<0.01)。N400潜伏期与MMSE总分、MoCA总分呈负相关,N400波幅与MMSE总分、MoCA总分呈正相关(P<0.05,P<0.01)。结论 MCI患者存在N400的异常及认知功能的损害,N400对MCI的诊断具有辅助价值。     

帕金森病患者面孔识别事件相关电位的研究

目的研究事件相关电位(ERP)N170成分在视空间功能障碍帕金森病(PD)患者中的变化,探讨PD早期认知功能障碍的检测手段。方法选择临床诊断为PD的患者50例,进行神经心理学量表评估后,分为2组:视空间功能正常组(正常组)20例和视空间功能受损组(受损组)30例。采用面孔学习-再认试验模式,利用ERP技术,记录10导联脑电数据、正确反应率及反应时间、N170的波幅、潜伏期、行为学指标和神经心理学量表评分,并进行分析。结果受损组蒙特利尔认知评估量表评分明显低于正常组(P0.05),受损组对已学习过面孔识别的正确率低于正常组(51.6% vs 60.0%,P0.05)。受损组仅在T6导联熟悉面孔事件诱发N170的波幅高于正常组(P0.05)。受损组在F7、F8、O1及T5导联N170的潜伏期或波幅在熟悉状态和陌生状态下比较,差异有统计学意义(P0.05)。结论蒙特利尔认知评估量表可用于PD患者早期认知损害的评估,面孔学习再认试验方法对检测PD患者视空间能力损害具有临床价值。ERP N170在面孔再认阶段对于检测PD患者视空间能力损害不敏感。     

N末端脑利钠肽前体与冠脉狭窄程度的关系探讨

目的探讨N末端脑利钠肽前体(NT-proBNP)与冠状动脉狭窄程度的关系。方法对67例稳定型心绞痛(SAP)患者进行分组,根据冠状动脉造影(CAG)结果进行Syntax评分分为轻度病变组(21例)、中度病变组(32例)、重度病变组(14例),另设正常对照组41例。用电化学发光双抗体夹心免疫法测定各组血清N末端脑利钠肽前体浓度。结果 SAP组血清N末端脑利钠肽前体水平与正常对照组比较差异有统计学意义(P<0.05),血清N末端脑利钠肽前体水平与白细胞、C反应蛋白、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板计数、心肌肌钙蛋白I之间无明显相关性。结论 SAP患者血清N末端脑利钠肽前体浓度明显升高,与冠状动脉斑块的病变程度密切相关,提示其有助于冠心病的危险分型,可作为冠心病患者的临床监测指标之一。     

中老年简笔画面孔表情识别事件相关电位的研究

目的观察中老年简笔画面孔表情识别事件相关电位(ERP)的特征。方法采用正性、中性、负性三种表情面孔的简笔画图片作为刺激物,13名中老年受试者(男8名,女5名,年龄40~65岁)和13名青年受试者(男9名,女4名,年龄21~30岁),执行表情面孔隐含识别的ERP,比较两年龄组表情面孔识别的平均反应时间和正确率及N170的潜伏期和波幅的差异。结果中老年组面孔识别平均反应时间、正确率较对照组延长,N170潜伏期和波幅无显著差异(P0.05)。结论对不同表情面孔的简笔画图片识别,中老年人呈现出衰退特征,但中老年人在早期面孔脑加工的结构编码阶段与青年人相比尚无明显的差别。     

2型糖尿病与轻度认知功能损害的相关性

目的对2型糖尿病患者进行认知功能评价,确定轻度认知功能障碍(MCI)的发生率及特点,为进一步防治MCI提供理论依据。方法采用简易智能状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)对90例2型糖尿病患者(观察组)、及128例健康体检老年人(对照组)进行认知功能评定,对结果进行统计学分析。结果①观察组患者MCI的发病率为36.7%(33/90)明显高于对照组的6.25%(12/192),两组差异有统计学意义(P<0.05);②观察组的MoCA评分及MMSE评分较对照组显著降低(P<0.05);观察组中的MCI患者在MoCA总分较对照组中MCI患者的水平低(P<0.05),而在MMSE评分两者差异无统计学意义(P>0.05)。MoCA分项比较两组间的视空间与执行功能、注意、抽象、延迟回忆,差异有统计学意义(P<0.05),尤其延迟回忆损害最为明显(P<0.01)。结论 2型糖尿病患者中MCI发生率较高,且MCI以延迟回忆损害最为明显。MoCA量表在评价MCI较MMSE量表敏感。     

银杏叶片治疗老年轻度认知功能障碍患者的临床疗效及事件相关电位P300的变化

目的探讨银杏叶片治疗轻度认知功能障碍(MCI)患者的临床疗效及事件相关电位(ERP)P300的变化。方法选取87例MCI患者,随机分为银杏叶片治疗组(治疗组)和对照组,观察治疗前后简易精神状况检查表(MMSE)和临床疗效的变化和事件相关电位(ERP)P300,并与对照组进行比较。结果治疗后治疗组与治疗前及对照组比较,MMSE分值提高(P<0.01,P<0.05),P300电位波幅提高(P<0.01,P<0.05),潜伏期缩短(P<0.01,P<0.05)。结论银杏叶片治疗能够显著改善老年MCI患者认知功能及脑电活动状态。     

轻度认知损害患者的神经心理学特征

目的探讨轻度认知损害(MCI)患者认知功能改变的特征。方法选择37例MCI患者为MCI组,同期选择40例年龄、性别等相匹配的志愿者为对照组,采用成套神经心理学测验评定两组被试者的认知功能。结果MCI组各项神经心理学测验成绩均较对照组差,差异有显著性意义(P<0.05)。结论MCI个体最主要的神经心理学特征为记忆障碍,涉及多种记忆类型的各项记忆加工过程,具有与早期阿尔茨海默病患者相似的特征。     

重复经颅磁刺激对不同类型轻度认知障碍的干预作用

目的探讨重复经颅磁刺激(rTMS)对不同类型轻度认知功能障碍(MCI)的干预作用。方法血管源性MCI(vMCI组)12例,非血管源性MCI(nvMCI组)12例,健康对照组10例,并对vMCI和nvMCI组进行rTMS干预。刺激点位于双侧前颞区,频率为1 Hz,刺激强度为静息运动阈值(RMT)的80%,刺激量为600 pulses/d,连续治疗5 d一个疗程,疗程间间隔3 w,共6个疗程。所有受试在rTMS干预前后均行EEG、P300及临床记忆量表(CMS)测试,分析治疗组与对照组,vMCI组与nvMCI组及rTMS治疗前后EEG、P300及CMS的变化。结果干预后,两治疗组忆商(MQ)值显著增高(P<0.05);vMCI组MQ变化率高于nvMCI组(P<0.05)。各治疗组P300潜伏期较干预前缩短,波幅升高(P<0.05);各治疗组rTMS干预后,慢波频带(δ～θ频带)相对功率比呈降低趋势,快波频带(α～γ频带)相对功率比呈升高趋势;且vMCI组较nvMCI组,上述改变更为明显;健康对照组则表现为慢波频带相对功率比升高,快波频带相对功率比降低(P<0.05,P<0.01,P<0.001)。结论通过rTMS治疗,不同类型MCI患者MQ值、P300及脑电相对功率比均趋于改善,且vMCI组诸项指标的改善明显高于nvMCI组;而健康对照组在无任何干预的情况下存在增龄性的认知功能减退。     

急性白血病P_(170)和CD_(34)抗原共同表达及其临床意义

目的 :探讨急性白血病 (AL ) P1 70 和 CD34 抗原共同表达与患者化疗疗效的关系。方法 :对 81例 AL患者的单个核细胞分别用抗 P1 70 单克隆抗体 UIC2 和抗 CD34 单克隆抗体标记后 ,经流式细胞仪检测后分成 4组 ,观察其与 AL 患者临床疗效的关系。结果 :P1 70 和 CD34 抗原共同高表达组的 AL 患者的临床疗效最差 ;P1 70 和 CD34 比较 ,P1 70 表达增高预后更差。结论 :P1 70 和 CD34 同时高表达临床缓解率更低 ,更有预后意义     

端粒酶在急性白血病细胞中的表达及其与P-170表达的关系

目的：探讨端粒酶在急性白血病发生发展中的作用，及其与多药耐药P－170表达的关系。方法：采用PCR ELISA方法检测6例正常人和22例急性白血病未治时端粒酶活性及其中10例患者化疗前后端粒酶活性变化，10例患者端粒酶活性与P－170表达的关系。结果：端粒酶活性在白血病细胞株和急性白血病患者骨髓中的高度表达与正常人有明显区别（P＜0.01），化疗后端粒酶活性水平明显下降（P＜0.01），急性白血病端粒酶表达与P－170有一定相关性。结论：端粒酶活性与恶性血液病的发生、发展有关，为恶性血液病的诊断和疗效监测提供了一种较理想的参考指标。     

Correlation between GP-170 expression,prognosis, and chemoresistance of superficial bladder carcinoma

Purpose To study GP-170 in superficial bladder cancer at initial diagnosis and at recurrence and to evaluate if intravesical chemoprophylaxis modifies the expression of GP-170 in tumor recurrences.Materials and methods GP-170 was retrospectively assessed in 160 patients affected by primary superficial transitional cell carcinoma of the bladder and followed for up to 10 years. Eighty-four patients (52.5%) recurred after transurethral resection (TUR). Adjuvant intravesical chemotherapy after TUR was adopted in 52 patients. The correlations between GP-170 and G-grade, T-category, risk of recurrence and of progression, and adoption of adjuvant intravesical chemotherapy were investigated. The correlations between variations in grade and stage at recurrence and modifications in GP-170 expression were also studied.Results No significant correlation between GP-170 expression and G-grade and T-category was found. A significant correlation was detected between GP-170 expression and recurrence (P=0.0383). It showed a biphasic pattern, i.e., tumors that did not express GP-170 had a higher recurrence rate, but high GP-170 levels were also associated with an increasing risk of recurrence. Intravesical chemotherapy did not induce significative variations in GP-170 expression. No correlation was found between progression and GP-170.Conclusion GP-170 seems to be an independent prognostic factor for recurrence in superficial bladder tumors. A negative GP-170 pattern and high levels of GP-170 are associated with an increasing risk of recurrence but have no impact upon progression. In our experience, GP-170 is neither induced nor modified by intravesical chemotherapy, although it might represent a factor of chemoresistance when strongly expressed.This study was supported by a grant of the Associazione Italiana per la Ricerca sul Cancro (AIRC)     

Visual expertise with nonface objects leads to competition with the early perceptual processing of faces in the human occipitotemporal cortex

Human electrophysiological studies have found that the processing of faces and other objects differs reliably at approximately 150 ms after stimulus onset, faces giving rise to a larger occipitotemporal field potential on the scalp, termed the N170. We hypothesize that visual expertise with nonface objects leads to the recruitment of early face-related categorization processes in the occipitotemporal cortex, as reflected by the N170. To test this hypothesis, the N170 in response to laterally presented faces was measured while subjects concurrently viewed centrally presented, novel, nonface objects (asymmetric "Greebles"). The task was simply to report the side of the screen on which each face was presented. Five subjects were tested during three event-related potential sessions interspersed throughout a training protocol during which they became experts with Greebles. After expertise training, the N170 in response to faces was substantially decreased ( approximately 20% decrease in signal relative to that when subjects were novices) when concurrently processing a nonface object in the domain of expertise, but not when processing untrained objects of similar complexity. Thus, faces and nonface objects in a domain of expertise compete for early visual categorization processes in the occipitotemporal cortex.     

Impaired face and body perception in developmental prosopagnosia

Prosopagnosia is a deficit in face recognition in the presence of relatively normal object recognition. Together with older lesion studies, recent brain-imaging results provide evidence for the closely related representations of faces and objects and, more recently, for brain areas sensitive to faces and bodies. This evidence raises the issue of whether developmental prosopagnosics may also have an impairment in encoding bodies. We investigated the first stages of face, body, and object perception in four developmental prosopagnosics by comparing event-related potentials to canonically and upside-down presented stimuli. Normal configural encoding was absent in three of four developmental prosopagnosics for faces at the P1 and for both faces and bodies at the N170 component. Our results demonstrate that prosopagnosics do not have this normal processing routine readily available for faces or bodies. A profound face recognition deficit characteristic of developmental prosopagnosia may not necessarily originate in a category-specific face recognition deficit in the initial stages of development. It may also have its roots in anomalous processing of the configuration, a visual routine that is important for other stimuli besides faces. Faces and bodies trigger configuration-based visual strategies that are crucial in initial stages of stimulus encoding but also serve to bootstrap the acquisition of more feature-based visual skills that progressively build up in the course of development.     

从神经心理学和影像学探讨加味五子衍宗颗粒对轻度认知障碍患者的影响

目的　研究补肾方加味五子衍宗颗粒对轻度认知障碍 (MCI)患者记忆功能及脑 CT的影响。方法　参考目前国际公认的 MCI诊断标准 ,筛选出 44名 MCI患者 ,采用随机双盲、双模拟方法 ,分为加味五子衍宗治疗组和银杏叶对照组 ,服药 3个月 ,观察用药前后记忆功能及脑 CT的变化。 2 0名健康者为正常对照。结果　 MCI组的记忆商 (MQ)较正常对照组明显降低 (P<0 .0 1 ) ,海马指数和颞角宽度较正常对照组明显增高 (P<0 .0 1 ,P<0 .0 5)。治疗后加味五子衍宗治疗组和银杏叶对照组的 MQ均较治疗前明显提高 (P<0 .0 1 ) ,海马指数和颞角宽度较治疗前明显变小 (P<0 .0 5)。结论　加味五子衍宗丸治疗 MCI有较好的临床疗效。     

血清中人再生胰岛衍生蛋白1α对阿尔茨海默病的早期诊断价值

目的通过比较阿尔茨海默病（Alzheimer's disease, AD）患者、轻度认知功能障碍（mild cognitive impairment,MCI）患者以及认知功能正常的健康对照者血清中人再生胰岛衍生蛋白1α（regenerating islet-derived1αprotein, Reg-1α）表达水平的差异,探讨血清Reg-1α作为AD早期诊断标志物的临床意义。 方法选取2015年6月至2017年6月浙江医院收治的60～90岁的93例AD患者（AD组）、82例MCI患者（MCI组）以及110例健康对照者（正常组）,收集所有研究对象的外周血样本,分别采用ELISA法和实时荧光定量RT-PCR法检测血清中Reg-1α蛋白和mRNA的表达水平。 结果3组研究对象Reg-1α蛋白及mRNA表达水平的差异均有统计学意义（F=4.522、2.629,均P<0.05）;AD组及MCI组Reg-1α蛋白及mRNA表达水平均显著高于正常组（q=-5.958、-6.914、-5.223、-7.679;均P<0.01）;AD组Reg-1α蛋白表达水平显著高于MCI组（q=7.681,P<0.01）,但Reg-1αmRNA表达水平与MCI组无明显差异（q=3.028,P>0.05）。 结论血清中Reg-1α的表达水平与AD进展相关,或可作为AD的早期诊断标志物。     

Central auditory processing in elderly with mild cognitive impairment

Aim: The aim of the present study was to assess if central auditory processing affected patients with mild cognitive impairment (MCI) or not and to assess sensitivity and specificity of central auditory processing tests in detection of MCI. Methods: This was a case–control study conducted at the Geriatrics Department and Audiology Unit, Ain Shams University Hospital. Participants were 150 elderly diagnosed as MCI compared with 150 normal subjects, based on a neuropsychological diagnostic test battery, the Cambridge Cognitive Examination (CAMCOG), and who were matched for age, sex and average threshold of hearing. Both cases and control groups were subjected to otological examination, immittancemetry, pure tone audiometry, speech audiometry and central auditory processing assessment by the use of a selective auditory attention test, dichotic digits test, auditory fusion test, pitch pattern sequences test and auditory memory battery of Goldman–Fristoe–Woodcock. Results: The MCI group scored significantly lower than the control group in central auditory processing tests (P < 0.05). Sensitivity of dichotic digit test, pitch pattern sequence test and recognition memory test were 76.6%, 71.7% and 70.4%, respectively, while specificity were 56.2%, 81.2% and 92.2%, respectively. When the previous three tests were used together the sensitivity and specificity were 82.8% and 93.2%, respectively. Conclusion: Central auditory processing was affected in MCI patients. The dichotic digit test, pitch pattern sequence test and recognition memory test can be used in detection of MCI with high sensitivity and specificity. Geriatr Gerontol Int 2011; 11: 304–308 .