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1.
目的:观察阿尔茨海默病(AD)患者脑电图(EEG)与听觉认知电位P300的变化,并与神经心理学及痴呆程度进行相关性分析,探讨对老年性痴呆进行综合评价的有效方法。方法:对AD患者36例及正常对照者36名采用EEG和P300检查,结合神经心理学测试[简易智能精神状态量表(MMSE)]进行相关性分析。结果:AD组患者的P300潜伏期明显延长,波幅明显降低,与正常对照组比较差异有显著统计学意义(P〈0.01,P〈0.05);EEG异常率AD组为84%,正常对照组为21 %,两组比较差异有显著统计学意义(P〈0.01)。MMSE总分AD组为19.77±5.22,明显低于对照组(27.66±5.13),差异有统计学意义(P〈0.05)。AD组MMSE评分与P300 PL呈负相关(r=-0.57,P〈0.05),与P300 AMP呈正相关(r=0.37,P〉0.05)。结论:利用EEG和P300结合MMSE量表可对老年性痴呆患者作出确切评价,是早期发现AD的有效手段之一。  相似文献   

2.
事件相关电位和脑电图在痴呆早期诊断中的意义   总被引:2,自引:1,他引:1  
目的 研究血管性痴呆(vascular dementia,VD)患者ERP和EEG的变化特征,并与神经心理学及痴呆程度进行相关性分析。方法 测定68例VD患者及37例健康志愿者的事件相关电位(ERP:N100,P300)、脑电图(EEG),同时采用MMSE进行认知功能评定,并进行相关性分析。结果 68例VD组患者的P300潜伏期明显延长,波幅明显降低,与正常对照组比较有明显差异性(P〈0.01,P〈0.05),N100潜伏期。波幅变化不是很大(P〉0.05),脑电图异常率,VD组94%,正常对照组18%,2组比较有明显差异性(P〈0.01)。VD组患者ERP异常程度与EEG异常程度经相关性分析无相关性。VD组MMSE与正常对照组比较有明显差异(P〈0.05),VD组MMSE评分与P300PL呈负相关(r=-0.57,P〈0.05),与P300AMP呈正相关(r=0.37,P〉0.05)。结论 ERP与认知功能存在明显相关性,提示了ERP是反映其认知功能障碍程度的客观指标之一,可作为检测高危人群普查的手段之一,ERP在判断认知功能方面敏感于其他检查手段,客观性强。  相似文献   

3.
目的探讨事件相关电位视觉P300在血管性痴呆(VaD)患者认知功能评估中的价值。方法应用Nicolet脑诱发电位仪对39例VaD患者分别在多奈哌齐治疗前和治疗32周后进行视觉P300检测,并与34例健康老人作对照,使用简易精神状况检查(MMSE)评估患者的认知功能。结果治疗前VaD组MMSE[(16.4±3.9)分]分值显著低于健康对照组[(28.0±1.5)分]。视觉P300表现为P2、N2、P3靶刺激潜伏期延长,靶刺激P2、P3波幅低,非靶刺激P2波幅低。治疗后VaD患者认知功能改善,其视觉P300主要表现为P3潜伏期缩短,P3波幅增高。结论视觉P300有助于反映VaD患者认知功能的变化,P300这一指标的变化值得进一步跟踪随访。  相似文献   

4.
目的 探讨亚临床肝性脑病(SHE)早期诊断的方法。方法 对46例肝硬化无肝性脑病临床表现的患者进行P300、脑干听觉诱发电位(BAEP)、数字连接测验(NCT)、简明智力状况检查量表(MMSE)及脑电图(EEG)检测和随访,并与43例非肝病患者进行比较。结果 肝硬化组P300潜伏期、NCT时间较对照组明显延长(均P〈0.01);BAEP异常率明显增加(P〈0.01);随肝功能损害程度加重,P300潜伏期逐级显著延长、波幅显著降低,NCT时间显著延长,BAEP异常率显著增加(P〈0.05—0.01)。随访发现P300、BAEP或NCT异常的肝硬化患者HE发生率间差异无统计学意义。结论 P300、BAEP及NCT可作为早期诊断SHE的检测方法。  相似文献   

5.
目的观察天智颗粒对认知功能及事件相关电位P300的影响。方法 60例血管性痴呆患者随机分为治疗组和对照组各30例,应用简易智力状态检查量表(MMSE)和日常生活能力量表(ADL)检测2组治疗前后认知功能状态及日常生活能力,并进行治疗前后P300检查,共观察30d。结果治疗前2组MMSE、ADL评分及P300潜伏期和波幅差异均无统计学意义(P〉0.05);治疗后治疗组P300潜伏期缩短、波幅提高,MMSE、ADL评分优于对照组(P〈0.05)。结论天智颗粒能改善VaD患者认知功能、提高患者的日常生活能力。  相似文献   

6.
目的探讨血管性痴呆(VaD)与脑白质疏松症(LA)的相关性.方法对104例LA患者应用分级法将LA分为4级LA1-LA4;应用MMSE和Hachinski量表诊断VaD.结果与LA1组比较,LA3LA4组VaD发生率有明显上升(P<0.01),MMSE评分有明显下降(P<0.01).结论LA的损伤程度与VaD发生率呈正相关,LA分级愈高,痴呆的程度愈重.  相似文献   

7.
目的探讨事件相关电位(Event-related potentials,ERP)P300在评估血管性痴呆(vascular dementia,VaD)患者认知功能中的价值.方法应用Nicolet Bravo脑诱发电位仪对30例VaD患者分别在治疗前和治疗后6周进行ERP P300检测,同期间使用简易精神状况检查(MMSE)来评估患者的认知功能.结果治疗前,VaD组有明显的认知功能缺损,其MMSE[(17.52±3.57)分]分值低于NC组[(26.57±1.43)分,(P<0.01)].其P300表现为P2、N2、P3潜伏期长,P2、P3波幅低,非靶P2波幅低(P<0.05~0.01);治疗后,随着VaD患者的认知功能的恢复,其P300主要表现为P3潜伏期缩短,P3波幅的增高(P<0.05).结论动态检测P300有助于反映VaD患者认知功能的变化,尤其是P3潜伏期的变化较为敏感.  相似文献   

8.
目的研究神经心理测试及听觉事件相关电位(event related potential,ERP)P300在皮质下缺血性脑血管病(subcortical ischemic vascular disease,SIVD)伴不同程度认知功能障碍的临床应用价值。方法 92例SIVD患者,其中血管性无痴呆型认知损害(vascular cognitive impairment no dementia,VCIND)45例,血管性痴呆(vascular dementia,VaD)47例,同时选取45例未发生脑梗死及认知功能障碍的正常人作为对照组。分别对2组患者住院治疗前及正常对照组进行神经心理测试认知评估量表MMSE、MoCA评分和听觉事件相关电位P300检测。结果入院治疗前,VCIND组、VaD组简易精神状态检查(MMSE)和蒙特利尔认知评估量表(MoCA)评分均较正常组偏低(P0.05),VCIND组较VaD组偏低(P0.05),P300检测:与正常对照组潜伏期(318.689±16.123)ms相比,VCIND组患者潜伏期(360.667±16.082)ms,VaD组患者潜伏期(420.333±21.149)ms,各组间听觉事件相关电位P300潜伏期差异均有统计学意义(P0.05)。结论 SIVD患者存在认知功能损害,以执行功能障碍为主,ERP-P300测试能客观反映VCIND患者早期认知功能障碍,P300潜伏期与MMSE及MoCA有相关性,有利于VCIND早期的诊断。  相似文献   

9.
目的探讨事件相关电位中(ERP) P300指标对急性缺血性脑卒中(AICA)患者认知功能的预测价值.方法检查32例AICA患者急性期ERP,并依据6~8个月后复合认知指数标准,分为痴呆和非痴呆组对比P300,并与健康人比较.结果痴呆和非痴呆组P300改变呈同一方向即波幅下降,潜伏期延长.进一步分析所见痴呆组P300潜伏期较非痴呆组延长,波幅下降(P<0.05~0.01).结论 P300改变可优于量表,结合临床后可作为AICA患者急性期认知功能评定的预测手段.  相似文献   

10.
目的比较蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)、简易智能精神状态检查量表(minimental state examination,MMSE)、事件相关电位P300(event related potential P300,ERP-P300)在早期评估急性脑梗死后认知功能障碍的价值。方法以200例急性脑梗死住院患者为研究对象,采用MoCA、MMSE及ERP-P300进行认知功能检测,对比阳性率;再以最敏感量表(MoCA)及临床痴呆评估量表(clinical dementia rating,CDR)为依据分为无认知障碍组(no cognitive impairment,NCI)、无痴呆型认知障碍组(vascular cognitive impairment no dementia,VCIND)和血管性痴呆(vascular dementia,VaD),比较3组MoCA、MMSE及ERP-P300的检测结果。结果MoCA及ERP-P300潜伏期的检出率高于MMSE及ERP-P300波幅的检出率(P0.05)。MoCA、MMSE、ERP-P300潜伏期及ERP-P300波幅在3组间差异有统计学意义(P0.05)。结论在急性脑梗死患者认知功能障碍的早期筛查中,MoCA和ERP-P300潜伏期优于MMSE和ERPP300波幅。  相似文献   

11.
Abstract After Alzheimer’s disease (AD), vascular dementia (VaD) is the most common cause of dementia among the elderly. Abnormalities in neurotransmitter pathways are common pathogenic mechanisms shared by AD and VaD. For one month we studied the effects of donepezil, an acetylcholinesterase inhibitor (5 mg daily), on the cognitive system using P300 auditory event-related potentials (P300) and neuropsychological tests in 10 patients affected by probable VaD according to the NINDS-AIREN criteria. Our data showed a significant improvement of neuropsychological items and P300 latency after one month of donepezil treatment. In conclusion both P300 and neuropsychological tests are indicated in patients with VaD to confirm the efficacy of donepezil treatment during follow-up.  相似文献   

12.
目的:对血管性帕金森综合征(VP)患者和帕金森病(PD)患者的智能和事件相关电位(ERP)进行对比研究,以期探讨两者智能障碍及其电生理变化的特点。方法:用简易智能状态量表对51例VP及50例PD进行评分,并检测其ERP各波的潜伏期及波幅,并与32例正常者作对照。结果:1.VP组痴呆的发生串明显高于PD组;重症痴呆发生率高,提示症状重。2.VP组的N_2、P 300潜伏期较PD组、正常对照组均明显延长,P_(300)波幅较两者均明显降低。3.VP组痴呆者较非痴呆者N_2、P_(300)潜伏期明显延长,P_(300)波幅明显降低,4.VP组痴呆者较PD组痴呆者N_2、P_(300)潜伏期明显延长,P_(300)波幅明显降低。结论:VP与PD比较,智能障碍发生率高,程度重,电生理改变更明显。  相似文献   

13.
Fluctuating cognition is evidenced in different forms of dementia and is accompanied by electroencephalographic (EEG) abnormalities. The authors hypothesize that cholinesterase inhibitors are effective mostly in patients with fluctuating cognition. Twenty-three patients affected by mild dementia with similar scores on Mini-Mental State Examination (MMSE), Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog), and Unified Parkinson's Disease Rating Scale evaluation were classified in a group with fluctuating cognition (n = 11) and a group of nonfluctuators (n = 12). All patients were assigned randomly to the branches of a double-blind crossover study of donepezil (DPZ), a 5 to 10-mg dose, versus vitamin E, a 2000 IU dose, for 30 days. MMSE, ADAS-cog, University of California at Los Angeles Neuropsychiatric Inventory (NPI), quantitative EEG, P3 event-related potentials, choice reaction time variability (CRTV) were assessed at baseline and at the end of treatments. At the end of the crossover study all patients received DPZ for 6 months. The dominant EEG frequency variability, low EEG frequencies amplitude, the P3 latency and jitter, CRTV, and NPI was significantly different in the fluctuating cognition group than the nonfluctuating group at baseline (P < 0.001). Short-term DPZ administration induced a significant increase in MMSE scores, reduction of ADAS-cog and of NPI scores (P < 0.003-0.001), increase of EEG alpha activity and reductions of P3 latency and jitter, dominant frequency variability and CRTV (P < 0.009-0.001) in the fluctuating cognition group, and significant increases of MMSE scores (P = 0.03) and a decrease of P3 jitter and dominant frequency variability (P < 0.034-0.041) in the nonfluctuating group. Short-term DPZ effects differed significantly between fluctuating cognition and nonfluctuating patients (0.001). Significant effects of the 6-month observation were observed only in fluctuating cognition patients. Logistic analysis showed that P3 latency predicts the effect of DPZ (P = 0.04, P < 0.01) in the crossover study, and CRTV predicts the effect at the 6-month follow-up.  相似文献   

14.
BACKGROUND:In previous studies, cognitive function in elderly type 2 diabetic patients was evaluated by psychometric tests. These studies have confirmed that P300 event-related potential is an objective way of assessing cognitive function. OBJECTIVE: To analyze the objectivity of P300 for assessment of cognitive function in elderly type 2 diabetic patients. DESIGN, TIME AND SETTING: This case-control experiment was performed at the Department of Endocrinology of the Fourth Affiliated Hospital, Guangxi Medical University from January 2004 to December 2006. PARTICIPANTS: Seventy-two patients (38 males and 34 females) with type 2 diabetes mellitus were enrolled in this study. The patients were divided according to those with diabetes alone (diabetes alone group) (n=38) and those with diabetes and cerebral ischemia (diabetes and cerebral ischemia group) (n=34). A further 31 healthy individuals (16 males and 15 females), who received health examinations over the same period, were included as normal controls (normal control group). METHODS: All subjects were assessed by Mini-Mental State Examination (MMSE). Abnormalities in cognitive functions were identified by analyzing the auditory P300 event-related potentials. MAIN OUTCOME MEASURES: Auditory event-related potentials and MMSE scores. Multiple linear regression analysis was conducted using the "enter method" with the 72 elderly patients with type 2 diabetes mellitus. P3 latency, P3 amplitude and N2 latency served as dependent variables. Age, sex, education, course of the disease, glycosylated hemoglobin, and ischemic brain damage were used as independent variables. RESULTS: No significant difference in scores of MMSE was detected between the diabetes alone and normal control groups (P 〉 0.05). MMSE score was significantly lower in the diabetes and cerebral ischemia group (P 〈 0.01) than in the normal control group. N2 and P3 latencies of auditory event-related potential were significantly longer, and P3 a  相似文献   

15.
The aim of this study is to measure serum levels of neurotropic factor (NF) in patients with dementia. Brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and neurotrophin-3 (NT-3) were determined in Alzheimer's dementia patients without medication (AD; n: 22), Alzheimer's dementia patients receiving cholinesterase inhibitor (CEI) treatment (AD?+?CEI; n: 32) and vascular dementia patients receiving CEI treatment (VaD?+?CEI; n: 27) and the age-matched control group (n: 20). NGF levels were detected to be significantly higher in the control group than in AD group (P?相似文献   

16.
Alzheimer's disease (AD) and vascular dementia (VaD) patients exhibit similar patterns of deficits in many cognitive tasks in the early clinical stages. Considering that preclinical cognitive deficits are well documented in AD, the purpose of the present study was to investigate if such deficits are also present in VaD. The cognitive outcome measure was the Mini-Mental State Examination (MMSE). The sample was taken from a population-based study and consisted of 699 persons who were nondemented at baseline, but out of whom 35 persons were diagnosed with VaD and 170 with AD at a 3-year follow-up. Both the incident VaD and AD cases exhibited baseline deficits on the total score of the MMSE and three of the subscales: orientation to time, orientation to place, and delayed memory. Further, both dementia groups exhibited precipitous decline on most MMSE subscales during the 3-year follow-up period. Logistic regression analyses showed that all subscales that revealed deficits at baseline predicted dementia status at follow-up. Delayed memory was the best predictor in both preclinical VaD and preclinical AD. Thus, these results demonstrate preclinical cognitive deficits in VaD in a measure of global cognitive functioning, which closely resemble those observed in AD. This observation suggests that circulatory disturbance is associated with cognitive problems several years before the actual VaD diagnosis.  相似文献   

17.
The uncompetitive N-methyl-D-aspartate (NMDA) antagonist memantine was tested against placebo in two randomized controlled trials. In total, 900 patients suffering from mild-to-moderate "probable" VaD (according to NINDS-AIREN criteria) were included. In these prospective, 2-arm parallel, multicenter trials conducted in the United Kingdom (MMM500) and in France (MMM300), patients suffering from "probable" vascular dementia (according to NINDS-AIREN criteria) were recruited. Active treatment in both trials was memantine at the standard daily dose of 10 mg b.i.d. The cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) was a primary endpoint in both trials, and in both trials a statistically significant difference was seen between treatment groups after 28 weeks. In a pooled analysis of the data, various subgroups were examined. In a first analysis, patients were stratified by their severity of dementia (measured by the MMSE total scores at baseline). In this analysis, memantine was superior to placebo in all subgroups, but the magnitude of effect was clearly more pronounced in the more severely demented patients. A second analysis stratified the patients by the neuroradiological findings at baseline ("small vessel" versus "large vessel" type of VaD). The cognitive benefit by memantine treatment was larger for the small vessel group and, interestingly, also the decline in the placebo group was faster in the small vessel patients. In these trials, memantine at a dose of 10 mg b.i.d. was safe and very well tolerated with a frequency of dropouts due to adverse events that was close to placebo.  相似文献   

18.
同型半胱氨酸与阿尔茨海默病及血管性痴呆   总被引:2,自引:0,他引:2  
目的研究同型半胱氨酸(Homocysteine,Hcy)及叶酸、维生素B_(12)与阿尔茨海默病(Alzheimer Dis- ease,AD)和血管性痴呆(Vascular dementia,VaD)的关系,并通过Hcy揭示AD发病的血管危险因素。方法用美国国立神经病学、语言障碍和卒中-阿尔茨海默病和相关疾病学会(NINCDS-ADRDA)标准的可能标准严格筛选AD患者35例,用ADDTC诊断标准筛选VaD患者30例,并同期选择31例无临床脑血管病史、无认知功能障碍的健康查体中心志愿者为对照组。取肝素抗凝的血浆用循环酶法进行Hcy的测定。取血清由全自动化学发光免疫检测仪进行叶酸和维生素B_(12)的测定。结果AD组和VaD组血浆Hcy水平显著高于对照组,血清叶酸和VitB_(12)水平显著低于对照组。VaD组存在痴呆程度越高血浆Hcy水平越高这一显著正相关关系,而AD组这一正相关关系无统计学意义;且发现VaD组患者MMSE评分越低其血浆Hcy水平越高这一显著负相关关系,而AD组这一关系仍无统计学意义。在所有研究对象中存在血浆Hcy水平与血清叶酸及VitB_(12)水平的显著负相关关系。结论提示高Hcy血症可能是引起AD和VaD的一个重要危险因素,Hcy作为一个新的血管因素加强了AD与血管危险因素之间的联系,并且提示积极治疗高Hcy血症在预防AD和VaD方面可能有积极意义。  相似文献   

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