孤独症患儿失匹配负波实验研究

目的 探讨孤独症患儿失匹配负波(MMN)的特点.方法 应用美国Nicolet Bravo脑诱发电位仪对37例孤独症和30例正常儿童进行了MMN检测.结果 与正常儿童组相比,孤独症患儿MMN潜伏期后移,正常儿童组(178.7±21.7)ms,孤独症组(197.1±19.1)ms,t=3.64,P＜0.01;波幅降低,正常儿童组(4.9±1.5)μV,孤独症组(3.3±1.8)μV,t=3.84, P＜0.01.结论 MMN对临床辅助诊断孤独症有一定参考价值.     

强迫症患者的失匹配负波研究

目的 探讨强迫症患者失匹配负波(MMN)的特点.方法 应用美国Nicolet Bravo脑诱发电位仪,对27例强迫症患者和33名正常成人进行了MMN检测.结果 与正常对照组相比,强迫症患者MMN潜伏期延迟(正常组(191±23)ms,强迫症组(208±25)ms,t=2.793,P＜0.01),同时波幅降低(正常组(8.9±1.7)μV,强迫症组(5.4±1.9)μV,t=6.24, P＜0.01).结论 被动事件相关电位MMN可反映强迫症患者自动加工过程.失匹配负波在评价强迫症脑功能失常上可能是有用的指标.     

精神分裂症首发患者的非匹配负波及P300随访研究

目的了解精神分裂症首发患者非匹配负波（MMN）和P300的特征以及治疗缓解后脑电波的变化。方法应用美国Bravo脑电生理仪,比较58例首发分裂症患者和54名健康人的MMN和P300电位,并用阳性和阴性症状量表（PANSS）评定患者精神症状。患者组于治疗5周和14周时随访MMN和P300。结果①精神分裂症首发患者组的MMN潜伏期[（222.4±33.0）ms]比正常对照组[（200.5±30.1）ms]延迟（t=3.66,P〈0.01）,波幅[（4.6±3.3）μV]比对照组[（7.9±3.9）μV]低（t=4.85,P〈0.01）。患者组P300中靶潜伏期P3同时延迟;②MMN潜伏期延长和波幅低,与PANSS阳性症状和思维障碍分呈负相关（r=-0.381,P〈0.05,r=-0.459,P〈0.01）;患者组经治疗14周后,MMN波幅呈增大改变和潜伏期缩短。结论MMN和P300联合应用可能作为精神分裂症首发患者临床检测指标。     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.     

接触性热痛诱发电位对糖尿病小纤维神经病变的评价作用

目的 借助接触性热痛诱发电位(CHEP)为糖尿病神经病变的小纤维神经损害寻求一种新的无创客观定量方法.方法 选取糖尿病患者46例和健康人40名,应用CHEP刺激器,控制温度52℃,分别刺激所有受试者右侧前臂、手背、小腿皮肤,采用Keypoint.net肌电图仪于cz点分别记录N波潜伏期及N-P波波幅;同时行右侧上下肢感觉传导测定.结果 健康对照组各个刺激部位CHEP的引出率为100%,而糖尿病组46例中前臂7例、手背9例、小腿16例未引出肯定CHEP波形.糖尿病组较对照组N波潜伏期延长,N-P波波幅减低.糖尿病组中25例上肢感觉传导正常,其前臂刺激Cz记录的N-P波波幅较对照组减低[分别为(34.0±12.6)、(48.4 ±17.5)μV,Z=-3.151,P<0.01],N波潜伏期差异无统计学意义;手背刺激CHEP潜伏期较对照组延长[分别为(420.4±27.8)、(407.2±24.6)ms,t=2.015,P=0.048],波幅减低[分别为(28.2±10.1)、(43.0±16.6)μV,Z=-3.712,P<0.01].18例下肢感觉传导正常,其小腿刺激CHEP潜伏期延长[分别为(473.5±46.6)、(448.6±35.0)ms,t=2.219,P=0.031],波幅减低[(23.8±7.4)、(41.5±18.5)μV,Z=-3.855,P<0.01].结论 糖尿病患者在早期即有小纤维神经选择性受累,CHEP能够为其提供新的客观定量方法,具有潜在的临床应用价值.     

抑郁障碍的P300及非匹配负波实验研究

目的 建立非匹配负波(MMN)并探讨抑郁障碍的特点.方法 应用美国Nicolet Bravo脑诱发电位仪,对35例抑郁障碍和32名正常成人进行了P300和MMN检测.结果 与正常对照组相比,抑郁障碍MMN潜伏期延迟(正常组:(190±21)ms,抑郁障碍(267±27)ms,t=12.94,P<0.01),同时波幅降低(正常组(8.3±1.4)μV,抑郁障碍组(5.1±2.0)μV,t=7.52, P<0.01).结论 非匹配负波新技术可反映抑抑郁障碍及其他精神障碍诱发脑电波的自动加工过程,可推广于临床应用.     

失匹配负波在抑郁症患者中的应用

目的探讨失匹配负波(MMN)在抑郁症患者中的应用价值.方法应用美国Nicolet Bravo脑诱发电位仪对53例抑郁症和50例正常成人进行了MMN检测.结果与正常对照组相比,抑郁症患者MMN潜伏期后移(正常对照组180.2±22.7ms,抑郁症组200.6±20.1ms,t=4.8,P＜0.01),波幅降低(正常对照组4.6±2.0μV,抑郁症组3.4±1.9μV,t=3.12,P＜0.01).结论 MMN技术可反映抑郁症患者诱发脑电的自动加工过程.MMN可作为抑郁症患者的临床应用检测指标.     

注意缺陷多动障碍患儿哌甲酯治疗前后的脑诱发电位研究

目的 探讨注意缺陷多动障碍(ADHD)患儿4种脑诱发电位指标及其治疗前后的特点.方法 应用美国Nicolet Spirit脑诱发电位仪,记录37例ADHD患儿(ADHD组)和30名正常儿童(正常对照组)的事件相关电位P300、失配性负波(MMN)、关联性负变(CNV)和脑干听觉反应(ABR),对其中31例ADHD患儿于哌甲酯(10～15 mg口服)治疗4个月后再次检测.结果 (1)与正常对照组比较,ADHD组P300-N2靶潜伏期长,P300-P3靶波幅低;ABR-波Ⅲ绝对潜伏期短,绝对波幅波V低;MMN潜伏期长,波幅高;CNV-M2波幅低,反应时间(RT)长;差异均有统计学意义(P＜0.05～0.01).(2)哌甲酯治疗4个月后,ADHD组随多动症状改善,P300-N2靶潜伏期缩短[治疗前后分别为(278±18)ms和(261±16)ms,P＜0.01],P3靶波幅升高[分别为(2.8±1.8)μV和(4.2±1.9)μV,P＜0.05];MMN潜伏期缩短[分别为(208±24)ms和(193±24)ms,P＜0.05];CNV-M1波幅升高[分别为(10.3±5.0)μV和(14.3±4.1)μV,P＜0.01];RT缩短[分别为(478±158)ms和(349±144)ms,P＜0.01],但ABR治疗前后的差异无统计学意义(P＞0.05).结论 ADHD患儿的P300,MMN,CNV和ABR 4种脑电诱发电位较正常对照组均有改变;治疗后随多动症状的改善,与认知功能有关的P300,MMN和CNV 3项指标亦有相应的改善.     

焦虑症和抑郁症失匹性负波的临床应用

目的 了解焦虑症(AD)和抑郁症(CD)患者失匹配负波(MMN)的特点.方法 应用Nicolet Bravo脑诱发电位仪,对37例AD患者、32例CD患者和36名正常成人(NC组)进行了MMN检测.结果 与正常对照组相比,AD患者MMN潜伏期延迟,同时波幅降低.CD组的MMN潜伏期变化与AD组基本类似,但MMN波幅改变特征较明显.结论 MMN测定反映了焦虑症和抑郁症患者诱发脑电波的自动加工过程,可用于临床辅助诊断.     

轻中度阿尔茨海默病与遗忘型轻度认知功能障碍患者的平衡功能

目的 探讨遗忘型轻度认知功能障碍(amnestic mild cognitive impairment,aMCI)和轻中度阿尔茨海默(Alzheimer's disease,AD)患者的平衡功能变化,以及人体姿势平衡仪在鉴别aMCI、轻中度AD以及健康人群中的应用价值.方法 应用人体姿势平衡仪对20例aMCI和20例轻中度AD患者的平衡功能进行测试,并选取20名年龄性别相匹配的健康体检者作为对照.结果 轻中度AD患者的所有平衡仪检测指标均与健康对照有显著差异,其中AD组支撑面积(15 398±926)mm2,睁眼状态时X轴平均位移(Mean X,10.2±4.1)mm、Y轴平均位移(Mean Y,-29.8±10.2)mm、X轴最大值(Max X,30.5±9.5)mm、Y轴最大值(Max Y,42.7±11.4)mm、姿势图长度(LSKG,528.4±105.4)mm、姿势图面积(SSKG,252.5±89.7)mm2,闭眼状态时Mean X(13.1±4.5)mm、Mean Y(-58.2±16.9)mm、Max X(37.7±10.5)mm、Max Y(78.5±18.7)mm、LSKG(816.6±171.3)mm、SSKG(649.0±129.7)mm2,与健康对照组各指标[支撑面积(31 654±2132)mm2,睁眼状态时分别为(5.8±1.4)mm、(-14.9±4.4)mm、(18.3±4.1)mm、(23.3±6.8)mm、(390.3±68.4)mm、(178.8±40.9)mm2;闭眼状态时(7.9±1.5)mm、(-25.6±5.4)mm、(24.7±7.3)mm、(39.9±9.9)mm、(533.5±97.4)mm、(290.5±73.3)mm2]比较差异均有统计学意义(支撑面积t=8.57,睁眼状态时F值分别为17.41、38.10、60.46、102.10、29.31、27.85,闭眼状态时F值分别为37.20、541.79、34.51、185.56、122.83、384.27,均P＜0.05);支撑面积和Mean Y在aMCI组[(23 921±1637)mm2,(-39.8±8.6)mm]和健康对照组[(31 654±2132)mm2,(-25.6±5.4)mm]之间差异有统计学意义(t=6.50,P=0.038;t=-15.34,P=0.012).结论 轻中度AD及aMCI患者均存在平衡功能障碍,人体姿势平衡仪检测对临床上运动表现和平衡能力均在正常范围的aMCI、轻中度AD以及健康人群具有鉴别意义.

Abstract：

Objective To investigate alterations of balance function in patients with mild-moderate Alzheimer's disease (AD) and with amnestic mild cognitive impairment (aMCI),and the possibility of using posturography to differentiate aMCI,mild-moderate AD and normal subjects. Methods The balance function of 20 patients with mild-moderate AD and 20 patients with aMCI were evaluated by posturography,and 20 healthy subjects of the same age range were recruited as controls.Results All posturography measures were significantly altered in mild-moderate AD patients compared with normal controls,with limits of stability( ( 15 398 ± 926 ) mm2 vs ( 31 654 ± 2132 ) mm2 ),open-eyed Mean X ( ( 10. 2 ± 4. 1 ) mm vs (5.8 ± 1. 4)mm) ,Mean Y(( -29.8 ± 10.2)mm vs ( -14.9 ±4.4) mm),Max X((30.5 ±9.5)mm vs (18.3 ±4. 1)mm ),Max Y((42.7 ± 11.4)mm vs (23.3 ±6.8)mm),LSKG((528.4 ± 105.4)mm vs (390. 3 ± 68.4 ) mm ),SSKG ( ( 252. 5 ± 89. 7 ) mm2 vs ( 178.8 ± 40. 9 ) mm2 ),close-eyed Mean X ((13. 1 ±4. 5) mm vs (7.9 ± 1.5)mm) ,Mean Y (( -58.2 ± 16. 9) mm vs ( -25.6 ±5.4) mm) ,Max X ((37.7±10.5)mm vs (24.7 ±7.3) mm ),Max Y ((78.5±18.7)mm vs (39.9 ±9.9) mm),LSKG ((816.6±171.3) mm vs (533.5 ±97.4) mm),SSKG((649.0 ± 129.7) mm2 vs (290.5 ±73.3) mm2),respectively ( t = 8.57; open-eyed F = 17.41,38. 10,60. 46,102. 10,29. 31,27. 85; close-eyed F = 37.20,541.79,34. 51,185.56,122. 83,384. 27 ;all P ＜0. 05) ;limits of stability ( (23 921 ± 1637 )mm2 vs (31 654 ±2132 ) mm2 ) and mean Y ( Antero-posterior sway,( - 39. 8 ± 8. 6 ) mm vs ( - 25.6±5.4 ) mm) were the only parameters which discriminated between aMCI and normal controls,respectively ( t = 6. 50,P = 0. 038; t =- 15.34,P = 0. 012). Conclusions Impairment in balance is a feature not only of mild-moderate AD,but also of aMCI,and posturography may be used as a possible test in differentiating between normal subjects,patients with aMCI and patients with mild-moderate AD whose motor performance and balance features are otherwise clinically normal,limits of stability and mean Y are the most sensitive parameters.     

遗忘型轻度认知损害患者的前瞻性记忆障碍

目的 探讨遗忘型轻度认知损害(amnesia mild cognitive impairment,aMCI)患者前瞻性记忆(prospective memory,PM)改变的特征,初步了解基于事件的PM(event-based prospective memory,EBPM)和基于时间的PM(time-based prospective memory,TBPM)在aMCI患者中的损害情况.方法 建立PM的神经心理学测验方法,对30例aMCI患者以及年龄、受教育程度相匹配的30名健康老年人进行测试.结果 与健康对照组[EBPM:(2.33±0.66)分、TBPM:(4.90±1.03)分]相比,aMCI组的EBPM成绩[(0.90±1.09)分]和TBPM成绩[(4.23 ±1.14)分]差异均有统计学意义(t=-6.143,P<0.01;t=-2.383,P<0.05).结论 aMCI患者的记忆障碍不仅表现为回顾性记忆(retrospective memory,RM)损害,PM损害可能更为突出,且EBPM的损害程度大于TBPM和RM,提示EBPM的测查可能有利于aMCI的早期识别.     

老年遗忘型轻度认知损害患者语言工作记忆损害特点

目的 探讨老年遗忘型轻度认知损害(aMCI)患者语言工作记忆损害的特点及机制.方法 采用语言工作记忆检查软件对30例老年aMCI患者进行视觉语言工作记忆及词语流畅性和数字广度测试等神经心理学检查,并选择30名健康老人作对照.结果 aMCI患者的视觉语义工作记忆测试成绩正确率低于对照组,差异具有统计学意义(79.83%±3.22%与87.00%±1.93%,t=-1.03,P=0.002);视觉语音工作记忆测试成绩也低于对照组,但差异无统计学意义(78.92%±8.60%与86.80%±2.14%,t=-2.34,P=0.060);逆序数字广度测试(1.53±0.86与3.63±0.56,t=-1.23,P=0.027)和词语流畅性测试分值均低于对照组(22.96±2.31与31.53±3.72,t=-1.08,P=0.004),差异具有统计学意义.结论 老年aMCI患者的视觉语义性语言工作记忆受损,语音性语言工作记忆相对保留;逆序数字广度和词语流畅性测试成绩亦显著降低.     

遗忘型轻度认知功能损害患者大脑皮质结构磁共振成像的改变

目的 运用MRI及FMRIB software library(FSL)和Freesurfer软件包分析技术,研究遗忘型轻度认知功能损害(amnestic mild cognitive impairment,aMCI)患者全脑皮质结构改变情况.方法 对20例aMCI患者和20名年龄、性别、文化程度相匹配的健康志愿者,应用SEMENTS trio3.0 T MRI仪,采用高分辨扫描技术获取大脑精细结构立体像,然后应用FSL软件和Freesurfer软件包进行数据分析和后处理,计算出全脑不同部位皮质密度和厚度,比较aMCI组与健康对照组皮质结构特征的区别.结果 与健康对照组相比,aMCI组的左侧额叶、顶叶、颞叶皮质密度显著降低,右侧丘脑、颞叶及左侧岛叶皮质密度轻度降低;aMCI组左侧前扣带回[(2.19±0.24)mm]、顶下小叶[(2.27±0.15)mm],双侧海马旁回[(2.03±0.15)、(2.04±0.17)mm]、额上回[(2.42±0.34)、(2.40±0.28)mm]、额中回[(2.31±0.31)、(2.33±0.29)mm]、颞极[(3.41±0.68)、(3.30±0.56)mm]、颞横回[(2.04±0.12)、(2.01±0.11)mm]、中央前回[(2.20±0.11)、(2.31±0.19)mm]、中央后回[(1.88±0.11)、(1.82±0.09)mm]、缘上回[(2.53±0.33)、(2.55±0.23)mm]的皮质厚度显著降低(t=2.13～3.75,P＜0.05),其余部位无明显改变(t=0.09～1.88,P＞0.05).结论 aMCI患者大脑多个部位存在皮质结构改变,皮质厚度的变薄早于密度的降低.     

遗忘型轻度认知损害患者海马三维磁共振影像特点

目的 运用基于海马表面的形态分析技术,探讨遗忘型轻度认知损害(aMCI)患者的海马三维MRI特点.方法 对15例aMCI患者和16名年龄及教育程度相匹配的对照,行头颅三维MRI扫描,数据采集后采用InsightSNAP 1.4.1软件在可视三维窗口下选取冠状位逐层勾勒海马轮廓,计算机自动计算海马体积后,进行两组间海马体积的统计学分析;将海马磁共振影像经过三维网格重建,其曲面网格参数化为400×200的点,将各点到中轴线的径向距离进行两组间比较,获得左右海马径向距离t值图;再经多重比较校正后,获得aMCI组与健康对照组问的三维海马形态差异图.结果 左侧海马标化平均体积aMCI组(3247.5±600.2)mm3、健康对照组(3467.9±451.3)mm3,两者差异无统计学意义(t=1.161,P=0.255).右侧海马标化平均体积aMCI组(3416.8±699.1)mm3、健康对照组(3469.1±358.9)mm3,两者差异亦无统计学意义(U=0.178,P=0.859).运用基于海马表面的形态分析技术得到两组间三维海马形态差异图,结果显示aMCI组与健康对照组相比双侧海马的外侧及下表面(组织学上的CA1区和下托)明显萎缩.结论 aMCI患者海马体积未见显著性减小,但通过基于海马表面的形态分析,发现aMCI患者的海马部分区域形态有一定程度的萎缩,以双侧海马外侧及下表面的区域性萎缩为主.这一结果可能反映了aMCI的早期影像学标志.     

阿尔茨海默病的前瞻性记忆损害

目的 探讨阿尔茨海默病（Alzheimer's disease,AD）患者前瞻性记忆(prospective memory,PM)改变的特征,初步了解基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆( TBPM)在早期AD患者中的损害情况。方法 建立前瞻性记忆的神经心理学测验方法,测试20例AD患者（AD组）以及年龄、教育程度相匹配的20例遗忘型轻度认知损害（amnesia mild cognitive impairment,aMCI）患者（aMCI组）及30名健康人（NC组）。结果 与NC组及aMCI组前瞻性记忆(2.23 +0.77、4.83+1.09,1.00+1.03、3.10±1.52)及情景记忆成绩(0.70±0.12、0.66 +0.16,0.45±0.07、0.54±0.10)相比,AD组的成绩(0.20±0.41、2.05±1.43,0.33±0.12、0.32±0.10)差异均有统计学意义,而EBPM的成绩差异更明显（t=-2.792,P＜0.01;t=-10.761,P＜0.01）。结论 早期AD患者的记忆障碍不仅表现为情景记忆的损害,前瞻性记忆损害可能更为突出,且AD的前瞻性记忆损害与aMCI患者呈现了一致性,提示前瞻性记忆的早期测查可能会有利于AD的早期诊断。     

DWI predicts future progression to Alzheimer disease in amnestic mild cognitive impairment

The authors assessed whether measures of hippocampal water diffusivity at baseline can predict future progression to Alzheimer disease (AD) in amnestic mild cognitive impairment (aMCI). Higher baseline hippocampal diffusivity was associated with a greater risk of progression to AD in aMCI (p = 0.002). Magnetic resonance diffusion-weighted imaging may help identify patients with aMCI who will progress to AD as well as or better than structural MRI measures of hippocampal atrophy.     

Conversion of amnestic Mild Cognitive Impairment to dementia of Alzheimer type is independent to memory deterioration

BACKGROUND: Mild Cognitive Impairment defines a transitional stage between normal ageing and dementia, and reflects the clinical situation where a person has memory complaints and objective evidence of cognitive impairment but no evidence of dementia. To plan the care of patients with MCI, it is important to predict as accurately as possible potential risk factors modulating the conversion to AD. AIM: To investigate the risk factors associated of conversion to dementia of Alzheimer type (AD) for subjects with amnestic Mild Cognitive Impairment (aMCI). METHODS AND MATERIALS: One hundred nineteen subjects consecutively recruited who met the operational criteria for aMCI (with or without deficits in other cognitive domains). They underwent multidimensional assessment and a neuropsychological battery at baseline and at follow-up, after 1 year. Diagnosis for dementia was based on a deficit in two or more cognitive domains severe enough to affect the participant functional abilities. Subjects converted to AD over time were classified as Demented; subjects that remained unchanged, or became cognitively normal during follow-up, were defined as Stable. RESULTS: Demented MCI (N = 40; 33.6%) were older (mean age 73.5 +/- 8.5 vs. 69.2 +/- 7.0; p = 0.006) when compared to Stable (N = 79; 66.4) and their global cognitive performances, at baseline, were more compromised when assessed by ADAS-Cog (mean score 10.7 +/- 3.9 vs 6.7 +/- 3.4; p = .000) and by MMSE (mean score 26.1 +/- 1.9 vs. 27.3 +/- 1.8; p = 0.002). Demented were similarly compromised in basic activities of daily living (BADL mean 0.2 +/- 0.4 vs 0.1 +/- 0.3 functions lost; p = NS) but more compromised on instrumental daily functions (IADL mean 0.7 +/- 0.8 vs. 0.1 +/- 0.5 functions lost; p = 0.001). The presence of white matter lesions (WML) on CT or MRI was more pronounced in Demented group (p = 0.02). After 1 year; Demented worsened on phonemic verbal fluency (PFL) (p = 0.009), Raven's coloured matrices (p = 0.003), Trail Making test A and B (p = 0.008 and p = 0.007 respectively) and in Instrumental Activities of Daily Living (IADL) (p =0 .000) respect to Stable. Logistic regression analysis revealed that ADAS-Cog basal score, Trail Making B, IADL but not memory deterioration were significantly associated to the conversion to AD. CONCLUSIONS: In subjects with aMCI poor global cognitive performance at baseline, the worsening on executive functions and on functional status but not the worsening on memory functions are independently associated with the conversion to dementia of Alzheimer type at 1 year, follow-up.     

瞬目反射对原发性和继发性三叉神经痛的鉴别诊断价值

目的研究瞬目反射(BR)对原发性和继发性三叉神经痛的鉴别诊断价值。方法采用神经电生理检查方法,对23例原发性三叉神经痛及7例继发性三叉神经痛患者进行BR检测,记录潜伏期及波幅的变化,并与正常对照组比较。结果原发性三叉神经痛组与正常对照组间BR各波潜伏期及波幅差异无统计学意义(P>0.05);继发性三叉神经痛组BR各波潜伏期较原发性三叉神经痛组和正常对照组显著延长(均P<0.01)。结论BR对鉴别原发性和继发性三叉神经痛具有临床应用价值。