双相障碍抑郁发作与单相抑郁症患者听觉事件相关电位P300的对照研究

目的:探讨双相障碍I型抑郁发作与单相抑郁患者听觉事件相关电位P300的差异及与各自临床特征相关性。方法:对60例双相障碍I型抑郁发作患者(双相组)、50例单相抑郁患者(单相组)以及50名正常对照者(对照组)进行P300检测;偏相关分析患者组P300与其临床特征及功能相关性。结果:患者组较对照组N1、P2、N2、P3a和P3b潜伏期显著延长(分别F=9.17,F=8.74,F=15.27,F=7.98,F=10.64;P均0.01);3组间N2-P3b潜伏期差异无统计学意义(F=0.46,P0.05);患者组较对照组N1、P2、N2、P3a、P3b和N2-P3b波幅显著降低(分别F=12.23,F=7.27,F=14.16,F=6.96,F=8.58,F=5.36;P均0.01);患者组较对照组按键反应时间显著延长(F=55.37,P0.01);单相组较双相组N1、N2波幅降低、N2潜伏期延长(P均0.05),双相组较单相组按键反应时间延长(P0.01)。双相组N1波幅与其HAMD评分负相关(P0.01),N2潜伏期与其HAMD评分正相关(P0.01),按键反应时间与其病程和HAMD评分正相关(P均0.05);单相组N2波幅与其HAMD评分负相关(P0.01),按键反应时间与其HAMD评分正相关(P0.05)。结论:双相障碍I型抑郁发作与单相抑郁患者听觉事件相关电位P300均存在异常,但损害有差异;P300异常在二者可能均为状态与素质性并存。

P300 components of auditory event-related potentials in bipolar and unipolar depressive disorder

Objective: To detect the P300 components of auditory event-related potentials in bipolar I and unipolar depressive disorder and the relationship with clinical variables. Method:60 patients with bipo-lar I disorder( BPD) ,50 patients with unipolar depression( UPD) ,and 50 unrelated healthy controls( HC) were included. P300 was measured by brain evoked potentiometer. Partial correlations were computed to explore asso-ciations among the P300 and the clinical data when controlling for gender,age and education level in BPD and UPD. Results:When compared to HC,both Patients groups showed significantly delayed N1,P2,N2,P3a and P3b latency(F=9. 17,F=8. 74,F=15. 27,F=7. 98,F=10. 64,respectively,all P<0. 01). But no significant differences among the three groups in N2-P3b latency(F=0. 46,P>0. 05). When compared to HC,both pa-tients groups showed significantly reduced N1,P2,N2,P3a,P3b and N2-P3b amplitude(F=12. 23,F=7. 27,F=14. 16,F=6. 96,F=8. 58,F=5. 36,respectively,all P<0. 01). When compared to HC,both patients groups showed significantly delayed mean reaction time(MRT)(F=55. 37,P<0. 01). While compared to BPD,UPD showed significantly reduced N1 amplitude and delayed N2 latency(all P<0. 05). Whereas,when compared to UPD,BPD showed significantly delayed MRT(P<0. 01) and reduced N2 amplitude(P<0. 05). N1 amplitude correlated negatively with HAMD score(P<0. 01),N2 latency correlated positively with HAMD score(P<0. 01) and MRT correlated positively with course and HAMD score(all P<0. 05) in BPD. N2 amplitude correlated negatively with HAMD score(P<0. 01) MRT correlated positively with HAMD score(P<0.05) in UPD. Conclusion:Generalized abnormalities of P300 existed in bipolar I and unipolar depression,but the abnormali-ties are different. Abnormalities of P300 may represent the state and trait marker in both bipolar I and unipolar depression.