海洛因依赖者对吸毒相关汉字线索的注意偏向

目的:利用情绪Stroop任务测量海洛因依赖者是否存在对吸毒相关汉字线索的注意偏向。方法:男性海洛因依赖者(研究组)与健康志愿者(对照组)各15例,采用NeuroSCAN工作站STIM2编程,记录并比较研究组和对照组对3类汉字(包括海洛因毒品相关类、中性、音乐类、)的反应时(reaction time,RT)及正确率。结果:两组对3类汉字线索的反应正确率之间无差异;与对照组相比,研究组对毒品相关汉字的反应时明显延长(789.23 ms±s102.53 ms vs 701.27 ms±s69.48 ms,P<0.05);而对音乐汉字的反应时显著缩短(630.52 ms±s84.33 vs 739.65ms±s92.28 ms,P<0.01)。重复测量的方差分析发现,存在刺激类别的主效应(F(2,28)=8.94,P<0.01)以及组别和刺激类别的交互效应(F(2,28)=9.58,P<0.01),研究组对海洛因相关汉字的反应时间与吸毒时间呈正相关(r=0.563,P<0.05)。结论:海洛因依赖者对吸毒相关的汉字线索存在着注意偏向。     

听觉事件相关电位P300检测对两种脑梗死早期认知功能损害的临床应用分析

目的探讨听觉事件相关诱发电位(event related potential,ERP)-P300对非痴呆型脑梗死患者血管性认知功能障碍(vascular cognitive impairment,VCI)的应用价值。方法选取60例脑梗死后认知功能损害但未达到痴呆诊断标准的患者,包括皮质梗死患者30例,皮质下梗死患者30例,同时选取30例作为正常对照组患者。对所有患者进行P300检测,观察3组间P300潜伏期及波幅。结果与正常对照组[潜伏期(282.41±23.87)ms和波幅(14.06±1.39)μv]相比,皮质梗死组([潜伏期(339.82±21.27)ms和波幅(10.04±1.18)μv]和皮质下梗死组[潜伏期(362.66±24.34)ms和波幅(10.89±0.76)μv]P300的潜伏期差异均有统计学意义(F=52.94,P<0.05),且波幅差异也均有统计学意义(F=86.83,P<0.05);皮质下梗死组P300潜伏期与皮质梗死组相比差异也有统计学意义,但二者的波幅相比差异无统计学意义。结论脑梗死早期患者存在认知功能的受损,ERP-P300测试有利于脑梗死早期认知功能障碍的诊断,为干预治疗前移评估提供重要意义。     

多媒体感觉统合训练配合言语训练对伴智力低下孤独症谱系障碍儿童智力发育和事件相关电位的影响

目的 探讨多媒体感觉统合训练配合言语训练对伴智力低下孤独症谱系障碍(ASD)儿童智力发育和事件相关电位(ERP)的影响。方法 将三门峡市中心医院接诊的82例伴智力低下ASD病儿采用随机数字表法等分为联合组和常规组,常规组接受常规康复治疗,联合组在常规组基础上给予多媒体感觉统合训练+言语训练,均治疗6个月,比较两组治疗前后孤独症行为评定量表(ABC)、视听整合连续执行测试(ⅣA-CPT)、中国韦氏儿童智力量表(WISC-R)评分及ERP P3潜伏期、波幅的变化。结果 治疗后,两组ABC各维度评分、ERP P3潜伏期均明显降低(P<0.05),ⅣA-CPT评分、WISC-R评分和ERP P3波幅均明显升高(P<0.05);联合组ABC[(45.51±7.58)比(52.83±8.54)分]、ⅣA-CPT、WISC-R评分及ERP P3潜伏期[(426.88±23.71)比(439.72±24.49)ms]、波幅变化幅度[(7.23±1.67)比(6.35±1.40)μV]均大于常规组。结论 多媒体感觉统合训练配合言语训练可有效改善伴智力低下ASD病儿的认知功能、执行功能,促进病儿智力发育和语言发育。     

2/100Hz经皮穴位电刺激治疗青少年网瘾ET结果的初步探讨

目的:使用脑电超慢涨落分析技术(ET),初步探讨2/100Hz经皮穴位电刺激治疗网络成瘾的脑机制。方法:26名被试随机分成对照组和治疗组。对照组12人,接受模拟经皮穴位电刺激;治疗组14人,接受经皮穴位电刺激。比较两组被试12个脑区内γ氨基丁酸(GABA)、谷氨酸(Glu)、乙酰胆碱(Ach)、去甲肾上腺素(NE)的含量。结果:与对照组相比,2/100Hz经皮穴位电刺激治疗1d后,可显著升高治疗组被试F3、C3、F7、T6脑区GABA含量(P<0.05,P<0.01,P<0.001,P<0.05);显著降低F7、T6脑区Glu含量(P<0.01,P<0.05);显著升高T6脑区NE的含量(P<0.05)。治疗5d后,与对照组相比,治疗组被试Glu含量在F7脑区显著降低(P<0.05)。结论:2/100Hz经皮穴位电刺激通过降低脑内Glu含量来发挥对青少年网络成瘾的治疗作用。     

利培酮联合舍曲林对精神分裂症患者临床症状控制及社会功能的影响分析

目的探析利培酮联合舍曲林治疗精神分裂症(SCZ)的临床疗效。方法132例SCZ患者,随机分为对照组和观察组,各66例。对照组单用利培酮进行治疗,观察组在对照组基础上给予舍曲林治疗。比较两组治疗前后可溶性肿瘤坏死因子受体(sTNFRs)水平、神经电生理特征、阳性与阴性症状量表(PANSS)评分、个人和社会功能量表(PSP)评分。结果观察组治疗后sTNFRs水平(1830.97±20.34)ng/L低于对照组的(2436.28±24.86)ng/L,差异具有统计学意义(P<0.05)。两组治疗后神经电生理特征中P300、N250及错误相关负电位(ERN)波幅均较治疗前明显上升,后正电位(LPP)波幅较治疗前明显下降,且观察组治疗后神经电生理特征中P300、N250及ERN波幅明显高于对照组,LPP波幅低于对照组,差异具有统计学意义(P<0.05)。两组治疗后PANSS评分较治疗前均下降,PSP评分较治疗前升高,且观察组治疗后PANSS评分低于对照组,PSP评分高于对照组,差异具有统计学意义(P<0.05)。结论针对SCZ患者,采用利培酮联合舍曲林治疗临床症状控制效果更佳,社会功能恢复更好。     

索他洛尔在房室旁道射频消融术中的应用

目的探讨索他洛尔在房室旁道射频消融(RFCA)术中的应用。方法18例旁道患者在常规电生理检查后顿服索他洛尔160mg,分别于服药后30、60、90、120和150min重复测量各项电生理参数。结果服药前后心房(A)、心室(V)、房室结(AVN)、旁道前传(APa)、旁道逆传(APr)有效不应期(ERP)分别为(211±24)msvs(243±36)ms、(205±11)msvs(242±28)ms、(269±48)msvs(343±97)ms、(263±45)msvs(400±160)ms、(232±37)msvs(298±50)ms(P<0.05)。无1例旁道阻断。窦房结恢复时间(SNRT)、窦性周长(SCL)分别为(1165±209)msvs(1456±371)ms、(724±116)msvs(996±178)ms(P<0.05)。3例房颤服药后不再诱发,2例心内电刺激难以终止的房室折返性心动过速(AVRT)服药后自行终止于房室结前传。18例患者均消融成功,随访7～18个月,无1例复发。结论索他洛尔显著延长心脏ERP,但不影响旁道的RFCA,能够预防或抑制RFCA术中导管和电刺激诱发的房颤,方便了手术操作。     

甲基苯丙胺成瘾者对成瘾相关线索的注意偏向特征:字词情绪Stroop任务的研究

目的:注意偏向是诱发药物渴求以及产生自动化觅药行为的重要因素,与复吸行为有着紧密的联系,探索甲基苯丙胺成瘾者注意偏向与成瘾程度的关系,可为甲基苯丙胺成瘾早期识别提供理论基础。方法:采用字词情绪Stroop任务、DSM-V诊断表、苯丙胺戒断后症状评定量表对57例甲基苯丙胺成瘾者进行测试,分析其对甲基苯丙胺相关词、情绪词的注意偏向特征。结果:甲基苯丙胺相关词颜色命名的反应时间(743.57 ms±108.93 ms)比情绪词(706 ms±93.69 ms)、中性词都慢(707.03 ms±99.17 ms),且达到了显著性水平(P<0.05);情绪词和中性词颜色命名的反应时间无显著性差异(P>0.05);甲基苯丙胺相关词划分的三种类型(吸毒工具、动作、动机)上不具有显著性差异(F=0.530,P>0.05);词汇类别与成瘾程度不存在交互作用(F=0.160,P>0.05)。结论:甲基苯丙胺成瘾者对成瘾相关词存在注意偏向,但是这种注意偏向不受成瘾严重程度的调节。     

2/100Hz经皮穴位电刺激对社区戒毒康复中阿片成瘾者的作用

目的:评价2/100 Hz经皮穴位电刺激对社区戒毒康复的阿片成瘾者的作用。方法:154例阿片成瘾患者被随机分成两组:HANS组(治疗组)78例,给予2/100 Hz经皮穴位电刺激(HANS);Mock-HANS组(对照组)76例,给予模拟经皮穴位电刺激(Mock-HANS),为期12月。比较两组治疗保持率、尿检阳性率、稽延性戒断症状评分和阿片渴求评分。结果:(1)在第9月末,Mock-HANS组和HANS组的治疗保持率分别为0%和48.7%;在第12月末HANS组的治疗保持率仍为43.6%(P<0.001)。(2)Mock-HANS组和HANS组12个月总的尿检阳性率分别为78.3%和51.2%(P<0.001);比较两组各月的尿检阳性率,除第1、3月外,在其他各月HANS组尿检阳性率均低于Mock-HANS组(P<0.05,P<0.001)。(3)Mock-HANS组的稽延性戒断症状评分在治疗前、后分别为14.7±s3.2和13.6±s2.7;HANS组的稽延性戒断症状评分在治疗前、后分别为15.7±s4.3和11.5±s3.1。HANS组的稽延性戒断症状评分较Mock-HANS组显著降低(P<0.001)。(4)Mock-HANS组的阿片渴求评分在治疗前、后分别为39.1±s12.6和37.8±s10.4;HANS组的阿片渴求度评分在治疗前、后分别为38.1±s10.2和28.5±s7.3。HANS组的阿片渴求评分较Mock-HANS组有显著降低(P<0.001)。结论:2/100 Hz经皮穴位电刺激能够缓解患者的稽延性戒断症状和阿片渴求,降低阿片成瘾患者的尿检阳性率,有利于患者在社区中坚持治疗和康复。     

心肌传导的不均一性与慢性充血性心力衰竭病人的预后

目的研究QRS间期和QRS间期离散度对严重慢性心力衰竭病人预后的预测价值。方法90例继发于缺血性心脏病或扩张型心肌病的严重慢性心力衰竭的住院病人分成3组:存活组50例,心脏性死亡非猝死组25例,猝死组15例。所有病人均有标准12导心电图记录,均测量QRS间期、QT间期,计算QRS离散度、QT离散度、辨别左束支传导阻滞。结果心脏性死亡非猝死组QTd、QRSD、QRSd(单位毫秒ms)与存活组比分别为95±48ms:78±31ms、127±34ms:113±32ms、54±17ms:46±16ms,P<0.05。猝死组QRSD、QRSd与存活组相比分别为132±36ms:113±32ms、56±13ms:46±16ms,P<0.05。此外猝死组LBBB的发生率明显高于存活组,χ2=7.44,P<0.01。结论QRSD、QRSd对严重慢性心力衰竭病人的预后有预测价值并有可能预测死亡方式,伴有LBBB的病人猝死的风险明显增加。     

抑郁症负性偏向的脑电生理机制研究

目的分析并探讨抑郁症负性偏向的脑电生理机制。方法抑郁症患者20例为实验组,同期于本院进行体检的正常患者20例为正常组,通过视觉Oddball刺激方式对两组患者进行事件相关电位测定并比较测定结果。结果正常组的P300电位的波幅为(17.62±3.92)μV,潜伏期时长为(268.31±24.29)ms;实验组患者的P300波幅和对应潜伏期分别为(9.84±4.61)μV和(320.66±25.34)ms;实验组患者的电位波幅及正性词准确率与正常组比较差异有统计学意义(P<0.05);负性词的正确率比较差异无统计学意义(P>0.05)。结论认知加工后期对正性刺激的加工缺陷,导致负性刺激的感知水平相对上升,是抑郁症负性偏向的主要生理机制,临床上可通过加强正性刺激对抑郁症患者进行治疗。     

Evidence for a deficit in the salience attribution to errors in smokers

The persisting use of substances despite of adverse consequences is one of the hallmarks of addictive behaviors such as cigarette smoking. In the present study we used event-related potentials (ERPs) to investigate one aspect of adverse consequences: responses to errors in smokers versus non-smokers. The aim of this study was to determine whether cigarette smokers display error-processing deficits as measured using error-related negativity (ERN) and error positivity (Pe). ERPs during an Eriksen flanker task were recorded from smokers and a non-smoking control group. Smokers showed the same ERN response as controls after making an error. However, the later Pe response was reduced as compared to the control group. On the behavioral level, we observed a trend towards increased error rates of smokers on incongruent trials. The present findings reveal that cigarette smoking is associated with reduced error processing. More specifically, while initial error processing seem intact, brain systems reflecting the motivational significance of a performance error seem compromised. It is argued that these cognitive deficits may cause or contribute to the persistence of smoking behavior and addictive behaviors in general.     

Drug-induced stimulation and suppression of action monitoring in healthy volunteers

RATIONALE: Action monitoring has been studied extensively by means of measuring the error-related negativity (ERN). The ERN is an event-related potential (ERP) elicited immediately after an erroneous response and is thought to originate in the anterior cingulate cortex (ACC). Although the ACC has a central role in the brain, only a few studies have been performed to investigate directly the effects of drugs on action monitoring. A recent theory argues that the mesencephalic dopamine system carries an error signal to the ACC, where it generates the ERN. METHODS: ERPs and behavioral measurements were obtained from 12 healthy volunteers performing an Eriksen Flankers task. On each of the 4 test days, the stimulant D-amphetamine, the sedative lorazepam, the antidepressant mirtazapine, or a placebo was orally administered in a double-blind, four-way crossover design. RESULTS: The indirect dopamine agonist amphetamine led to a strong enlargement of ERN amplitudes without affecting reaction times. Lorazepam and mirtazapine both showed slowing of responses, but only lorazepam led to reduced ERN amplitudes. CONCLUSIONS: Administration of amphetamine leads to stimulated action monitoring, reflected in increased ERN amplitudes. This result provides evidence for dopaminergic involvement in action monitoring and is in line with differences in ERN amplitude found in neuropsychiatric disorders also suggesting dopaminergic involvement. The different effects for lorazepam and mirtazapine are probably caused by the neurobiological characteristics of these two types of sedation. Action monitoring is suppressed after administration of lorazepam, because the GABAergic pathways directly inhibit ACC functioning, whereas the histaminergic pathways of mirtazapine do not innervate the ACC directly.     

Alcohol-Induced Changes in Conflict Monitoring and Error Detection as Predictors of Alcohol Use in Late Adolescence

Adolescence is a vulnerable period for the development of substance use and related problems. Understanding how exposure to drugs influences the adolescent brain could reveal mechanisms underlying risk for addiction later in life. In the current study, 87 adolescents (16–20-year olds; the local legal drinking age was16, allowing the inclusion of younger subjects than usually possible) underwent EEG measurements during a Go/No-Go task with and without alcohol cues; after placebo and a low dose of alcohol (0.45 g/kg). Conflict monitoring and error detection processes were investigated with the N2 and the error-related negativity (ERN) ERP components. Participants were followed-up after 6 months to assess changes in alcohol use. The NoGo-N2 was larger for alcohol cues and acute alcohol decreased the amplitude of the NoGo-N2 for alcohol cues. ERN amplitude was blunted for alcohol cues. Acute alcohol decreased the amplitude of the ERN, specifically for control cues. Furthermore, the differences in ERN for alcohol cues between the placebo and alcohol conditions predicted alcohol use 6 months later: subjects who showed stronger blunting of the ERN after acute alcohol were more likely to return to more moderate drinking patterns. These results suggest that cues signalling reward opportunities might activate a go-response mode and larger N2 (detection of increased conflict) for these cues might be necessary for inhibition. The ERN results suggest a deficiency in the monitoring system for alcohol cues. Finally, a lack of alcohol-induced deterioration of error monitoring for cues with high salience might be a vulnerability factor for alcohol abuse in adolescents.     

From self-induced to perceived errors – A generalized over-monitoring activity in obsessive–compulsive disorder

Well-functioning error monitoring of the inner and outer environments is essential for adaptively altering behavior, while malfunction characterizes conditions such as obsessive–compulsive disorder (OCD). The underlying brain processing is manifested as Error-Related Negativity (ERN) signal elicited following error comission, and Perceived Error Related Theta Activity (PERTA) signal elicited following detection of discrepancy in the environment. Yet, while enhanced ERN was repeatedly demonstrated in OCD patients and was found to be potentiated among their unaffected first degree relatives, no comparable observations were reported with regard to PERTA. We recorded EEG activity while OCD patients, OCD patients’ siblings (Family), and healthy controls (HC) performed computerized tasks. For the examination of ERN we used the Stroop task and for the examination of PERTA we presented correct and incorrect mathematical equations. Increased ERN (0–120 ms post response) was observed in both the OCD and Family groups, but only the OCD patients’ signal significantly differed from that of HC's. Similarly, modified PERTA activity was observed in both the OCD and Family groups in the N1 peak (65–125 ms post perceived error), but only for the OCD group this activity significantly differed from that of HC. Both ERN and PERTA's N1 are fast occurring peaks, which suggests that OCD is associate with a constantly over-activated detection system that monitors the inner and outer environment and reacts promptly following detection of a mistake. Furthermore, the modified but non-significantly different activity of the Family group suggests that the pathological condition evolves in vulnerable individuals with neuronal predisposition.     

Monoaminergic modulation of behavioural and electrophysiological indices of error processing

Rationale

Error processing is a critical executive function that is impaired in a large number of clinical populations. Although the neural underpinnings of this function have been investigated for decades and critical error-related components in the human electroencephalogram (EEG), such as the error-related negativity (ERN) and the error positivity (Pe), have been characterised, our understanding of the relative contributions of key neurotransmitters to the generation of these components remains limited.

Objectives

The current study sought to determine the effects of pharmacological manipulation of the dopamine, noradrenaline and serotonin neurotransmitter systems on key behavioural and event-related potential correlates of error processing.

Methods

A randomised, double-blinded, placebo-controlled, crossover design was employed. Monoamine levels were manipulated using the clinically relevant drugs methylphenidate, atomoxetine and citalopram, in comparison to placebo. Under each of the four drug conditions, participants underwent EEG recording while performing a flanker task.

Results

Only methylphenidate produced significant improvement in performance accuracy, which was without concomitant slowing of reaction time. Methylphenidate also increased the amplitude of an early electrophysiological index of error processing, the ERN. Citalopram increased the amplitude of the correct-response negativity, another component associated with response processing.

Conclusions

The effects of methylphenidate in this study are consistent with theoretical accounts positing catecholamine modulation of error monitoring. Our data suggest that enhancing catecholamine function has the potential to remediate the error-monitoring deficits that are seen in a wide range of psychiatric conditions.     

丹参酮Ⅱ-A磺酸钠对家兔心房动作电位及快速起搏所致心房电重构的影响

目的研究丹参酮ⅡA磺酸钠(TSN)对家兔在体心房单相动作电位(AMAP)及短期快速心房起搏时电重构的影响,探讨其防治房颤的可能机制。方法家兔24只,随机分为对照组与TSN组各12只。将电极经颈内静脉置入右心房记录AMAP,观察基础状态下、给药后0.5 h及以600次.m in-1心房快速起搏后0.5 h、8 h AMAP及其频率适应性的变化。结果与起搏前相比对照组AERP200 m s在起搏后0.5h缩短21.2 m s,起博后8h缩短21.6m s(P<0.05),且心房肌的频率适应性丧失。TSN在基础状态下对AMAPA、AMAPD无明显影响,但使AERP200 m s由(105.9±3.8)m s延长至(114.7±7.2)m s(P<0.05)。起搏后TSN组维持原有的心房肌频率适应性。结论快速心房起搏使心房肌的频率适应性丧失而致电重构,TSN能通过抑制L-型钙通道减轻短期快速心房起搏所致电重构。     

Effects of a single dose of cortisol on the neural correlates of episodic memory and error processing in healthy volunteers

Rationale. Neuropsychological impairments seen in depression may be secondary to hypercortisolaemia. Repeated cortisol administration impairs episodic memory with an alteration in event-related potentials (ERPs) recorded during information retrieval. It is unclear whether such ERP effects are specific to episodic memory, or whether repeated cortisol administration is required. Objective. To investigate the effect of a single dose of hydrocortisone on the neural correlates of episodic memory and error detection. Methods. Twenty healthy subjects were treated with hydrocortisone (100 mg) or placebo orally, in a double-blind, two-way crossover study. ERPs were recorded during an episodic memory and a Stroop task, 1–3 h following the medication. Results. Cortisol increased error rates during the Stroop task but had no effect on episodic memory. The magnitude of ERPs associated with incorrect response in the Stroop task between −250 ms and +500 ms post-response was increased by cortisol, with no effect on correct-response ERPs. There was no effect of cortisol on episodic memory-retrieval-dependent ERPs. Conclusions. Cortisol can impair not only episodic memory but also processes involved in error detection. In contrast to repeated cortisol administration, a single dose of cortisol does not alter the behavioural performance or the electrophysiological correlates of episodic memory. However, it increases error rates in a choice response task with associated quantitative changes in incorrect-response ERPs. This probably reflects an alteration in anterior cingulate cortex activity. Such changes may contribute to the neuropsychological impairment seen in depression. This study also demonstrates the utility of ERPs for investigating the effect of neuroendocrine manipulations on the neural correlates of neuropsychological function. Electronic Publication     

Diminished error processing in smokers during smoking cue exposure

Deficits in error processing may contribute to the continuation of impulsive behaviors such as smoking. Previous studies show deficits in error processing among substance abuse patients. However, these studies were all conducted during affectively neutral conditions. Deficits in error processing in smokers may become more pronounced under affectively challenging conditions, such as during smoking cue exposure. The aim of the present study was to investigate whether smokers showed initial error processing deficits, as measured with the error-related negativity (ERN), and decreased motivational significance attributed to an error, as measured with the error positivity (Pe) when exposed to smoking cues. Additionally, we examined the nature of the ERN and Pe amplitudes in more detail by investigating their associations with trait impulsivity, nicotine dependence levels and cigarette craving. Event-related potentials were measured during a modified Erikson flanker task in both smokers and non-smoking controls. Smokers showed reduced ERN and Pe amplitudes after making an error, accompanied by diminished post-error slowing of reaction times. These results suggest that initial error processing and motivational significance attributed to an error are affected in smokers during smoking cue exposure. Furthermore, individual variation in impulsivity and nicotine dependence was associated with reduced ERN amplitudes.     

网瘾青少年所在家庭的家庭功能状况探析

目的:探讨网瘾青少年所在家庭的家庭功能状况。方法:采用家庭功能评定量表对79例有网瘾孩子的家长及79例无网瘾孩子的正常家庭的家长进行评定;并对该79例有网瘾孩子的家长及网瘾青少年进行访谈。结果:(1)t检验发现网瘾组家庭在情感介入、情感反应、沟通、总体功能上分值高于对照组,以上差异均具有统计学意义(P<0.05)。(2)访谈发现,网瘾青少年所在家庭在解决孩子的网瘾问题上都未能较好地实现其各项基本功能。结论:家庭功能失调是造成和维持青少年网瘾症状的重要因素。