首发抑郁症患者认知功能与事件相关电位P300研究

目的:研究首发抑郁症患者的认知功能与应用事件相关电位P300的关系,探讨抑郁症合并认知损害的机制。方法:按ICD-10中抑郁发作诊断标准,收集40例首发抑郁患者(研究组),Hamilton抑郁量表(HAMD)评分≥17分;40名正常人(对照组)。应用威斯康星卡片分类测验(WCST)进行认知功能评分,应用Oxford Medelec Synergy肌电/诱发电位仪进行事件相关电位P300检测。分别检测WCST各亚项得分、P3潜伏期和P3波幅,并对两者进行相关性分析。结果:研究组WCST中F2、F3、F4、F5各项评分较对照组显著增高(t=2.536~6.282,P<0.05);研究组P300潜伏期(393.17±22.13)ms较对照组(326.15±21.44)ms显著延长(t=13.757,P<0.05);波幅(4.24±1.36)vμ较对照组(6.36±1.82)vμ明显降低(t=-5.901,P<0.05)。研究组P300潜伏期与持续性错误数、完成第一个分类所需应答数呈正相关关系(r=0.671,0.313;P<0.05),P300波幅与持续性错误数、不能维持完整分类数均呈负相关关系(r=-0.763,-0.655;P<0.05)。结论:抑郁症患者认知功能受损,与事件相关电位P300有关,这从神经电生理方面证实了抑郁症患者存在脑额叶功能损伤。     

正常人的视觉事件相关电位研究

本文利用三种视觉符号编排的刺激序列，记录了９５名正常人的视觉ＥＲＰ，报道了Ｆｚ、Ｐｚ点Ｎ２、Ｐ３波幅和潜伏期的正常值及Ｎ２、Ｐ３的影响因素。结果表明：该刺激序列可引出清晰、稳定的ＥＲＰ波形；Ｐ３波幅与任务和部位有关，靶Ｐ３波幅大于非靶Ｐ３，靶Ｐ３于Ｐｚ点波幅大于Ｆｚ，非靶Ｐ３在Ｆｚ、Ｐｚ点间波幅无明显差异；Ｎ２波幅与任务无关，靶与非靶之间Ｎ２波幅无差异，而与部位有关，Ｆｚ点波幅大于Ｐｚ点；Ｎ２、Ｐ３受年龄的影响．中老年人Ｎ２、Ｐ３潜伏期长于青年人，而波幅中老年人较青年人低。     

空间旋转角度信息冲突诱发的事件相关电位

目的:探讨人脑处理空间旋转角度信息冲突的工作机制。方法:采用美国Neuroscan脑电诱发电位工作站,对19例健康受试者做刺激匹配的事件相关电位研究,要求受试者判断前后呈现的图片中环状轮(环轮)所摆放的空间旋转角度是否相同,并作出按键反应。结果:当一对刺激所摆放的空间旋转角度不同时,可记录到一个明显的负波-N270(F1,18=26.86,P=0.000),右侧较左侧平均波幅明显偏负(F1.18=10.74,P=0.004),波幅以前头部较明显(F2,36=8.91,P=0.001)。结论:空间旋转角度的信息冲突可以诱发N270的产生。     

抑郁症患者的探究性眼动与听觉事件相关电位研究

目的:探讨探究性眼动(EEM)与听觉事件相关电位(ERP)的P300成分对抑郁症患者的诊断价值。方法:对42例抑郁症患者和40例正常健康者分别进行了EEM分析和听觉ERP的P300成分测定,并将结果加以比较。结果:抑郁症组中EEM和听觉ERP的:P300成分的异常率分别为83％(35／42)和81％(34／42),两者异常吻合率为76％(32／42)。抑郁症组EEM分析结果,凝视点数(NEF)和反应探索评分(RSS)值显著低于对照组(P<0．01)。与对照组比较,抑郁症组听觉ERP的N2、P3波潜伏期均延长和P3波幅降低,差异有显著意义(P<0．01)。抑郁症组N2、P3波潜伏期与NEF、RSS呈负相关(r=-0．29～-0．36,P<0．01),P3波幅与NEF、RSS呈正相关(r=0．32～0．33,P<0．01)。结论:EEM和听觉ERP的P3成分测定可作为抑郁症患者的诊断指标应用于临床。     

视觉事件相关电位

一、概况 事件相关电位(event-related potential,ERP)1965年由Sutton提出。一般认为有广义和狭义之说,广义指ERP的全部成分,包括P1、N1、P2、N2、P3,MMN、N400、CNV,而狭义仅指P1、N1、P2、N2、N3。关于刺激模式,国内外大多采用听觉刺激。目前国内使用的仪器     

不同性别首发精神分裂症患者听觉事件相关电位的研究

目的 研究不同性别首发精神分裂症患者听觉事件相关电位(ERP)是否存在差异,并分别探讨两组事件相关电位与临床阴性、阳性症状的关系.方法 对60例(男32例,女28例)首发神分裂症患者及30例正常人进行事件相关电位检测,并运用阳性和阴性症状量表进行精神症状评定.结果 ①两患者组的N2、P3潜伏期明显长于对照组,P3波幅明...     

事件相关电位视觉P300地形图临床应用的初步研究

目的：研究临床上一些疾病患视觉P300地形图的变化。方法：使用Neuronic公司的Medicid-03E脑诱发电位仪分别对临床上的一些疾病患进行了视觉P300地形图的测定并与对照组作比较。结果：临床上的一些疾病患视觉P300地形图的改变各有其特点，其P300波的电位值在脑内分布也各不相同。与正常对照组比较有显差异。结论：提示临床上一些疾病导致患视觉P300地形图的改变值得进一步研究。     

视觉事件相关电位（P300）地形图及其应用

一、概念视觉事件相关电位（P300）地形图是一种人们对某种刺激（视觉）事件进行信息加工时,有心理或语言等因素参与的诱发电位地形图,是观察人脑信息加工过程的电位活动的重要手段。它又称为视觉认知电位（cognitive potential）地形图,或称为视觉后发性正相成分（late positive component,LPC）地形图,有的称为视觉联系皮层电位地形图。二、基本方法和原理先做出视觉事件相关电位P300曲线图,然后经过FFT转换为地形图。     

强迫症患者事件相关电位P300临床纵向研究

目的：探讨事件相关电位（event-related potentials,ERPs)听觉P300在强迫症（Obsessive-compulsive disovder,OCD)中的应用价值。方法：收集了36例OCD患者,以33例正常人为对照组,进行听觉P300及地形分布图检查,并与临床相关因素进行对比分析。结果：OCD患者潜伏期N2、P3b,波幅P2、P3b与正常对照组相比有显著性差异。P300地形图全部患者失正态分析,84．21％单纯以强迫行为或强迫思维的患者在P300地形图表现为顶叶能量缺乏,而混合性OCD和伴有中度焦虑或忧郁者76．47％表现为顶叶伴左半球能量降低。经治疗疗效显著的P3b改变,波幅增高,潜伏期缩短,P300地形图能量分布趋向正态;治疗无效的P3b及P300地形图改变不明显。结论：事件相关电位P300可作为一项辅助的生物学指标,有助于OCD患者的病理心理研究及临床分型和疗效的判断。     

首发和复发抑郁症患者临床特征比较

目的:描述首发和复发抑郁症患者的人口学特征、临床特征、治疗特征和生理指标,并探讨抑郁复发的临床特征。方法:以简明国际神经精神疾病访谈、精神症状维度评定量表、汉密顿抑郁量表等为工具,共纳入符合精神障碍诊断与统计手册第5版(DSM-5)的抑郁症诊断标准的患者858例,其中首发529例(58.6%),复发329例(36.0%)。采用χ²检验、Kruskal-Wallis秩和检验比较首发和复发抑郁症在人口学特征、临床特征、治疗特征和生理指标上的差异,运用logistic回归探索复发抑郁症的影响因素。结果:复发抑郁症相对首发抑郁症更有可能存在精神障碍共病(OR=2.11,95%CI:1.00～4.44)、无法工作/学习/从事家务劳动的天数更多(OR=1.26,95%CI:1.01～1.56)、既往使用过1个月以上的精神科药物(OR=1.41,95%CI:1.02～1.97)、既往接受过电休克治疗(OR=3.23,95%CI:1.42～7.36)、腰臀比更大(OR=33.88,95%CI:2.88～399.32)。结论:复发性抑郁症与存在精神障碍共病、无法工作/学习/从事家务...     

首发精神分裂症和首发抑郁症患者细胞因子的变化及意义

目的 探讨首发精神分裂症和首发抑郁症患者病理过程中细胞因子的变化及意义.方法 使用ELISA法对首发精神分裂症和首发抑郁症患者各30例同时测定治疗前后血浆白细胞介素-2、-6(IL-2、-6)和可溶性白细胞介素-2、-6受体(sIL-2R、-6R)浓度,以30名健康人为对照组.结果 治疗前2个患者组血浆IL-2、-6和sIL-2R、-6R均高于对照组(P<0.05或P<0.01);精神分裂症组血浆sIL-2R高于抑郁症组(P<0.05),而IL-2、-6和SIL-6R低于抑郁症组(P<0.01).治疗后,精神分裂症组m浆IL-2和sIL-6R、抑郁症组血浆IL-2、sIL-6R、sIL-2R和IL-6均下降(P<0.01);精神分裂症组血浆IL-2和sIL-6R仍低于抑郁症组(P<0.05);精神分裂症组血浆sIL-2R和IL-6、抑郁症组血浆sIL-6R仍高于对照组(P<0.05或P<0.01).结论 首发精神分裂症和首发抑郁症患者均处于免疫激活状态,细胞因子表达水平的差异可能是二者表现不同临床症状的免疫学基础.     

重性抑郁症首发未用药患者的枕叶GABA波谱研究

在中枢神经系统中,γ-氨基丁酸(GABA)是主要的抑制性神经递质。由于GABA在普通磁共振波谱(MRS)上为低谱峰信号,且与其他物质的波峰重叠,因此难以准确得出其在脑内感兴趣区的含量。为观察抑制性神经递质GABA在首发未用药重性抑郁症(MDD)患者枕叶的含量改变,本研究采用了J-耦合编辑点分辨波谱(MEGA-PRESS)技术检测18例首发未用药重性MDD(17项HAMD评分>18分)患者和23名健康对照被试枕叶皮层的GABA含量。采用双样本t检验及相关分析进行统计学处理。结果表明,病例组枕叶GABA含量(11.35±3.26)显著低于对照组(27.30±8.87),P<0.001。病例组枕叶GABA含量与汉密尔顿抑郁量表及贝克抑郁自评量表相关性均不显著。首发未用药重性MDD患者的枕叶GABA含量降低,可能导致其视觉功能下降。     

Increased bone remodeling in first-episode major depressive disorder

OBJECTIVE: Bone mineral density is decreased in patients with depressive disorder. This study evaluated biochemical bone remodeling markers in patients having their first depressive episode who had not taken psychotropic medications to evaluate possible pathogenic mechanisms implicated in the loss of bone mineral density in early states of this illness. METHODS: Serum osteocalcin, parathyroid hormone, bone alkaline phosphatase, telopeptide, collagen type I C-terminal propeptide, cross-laps, and 25-hydroxyvitamin D levels were measured in 19 depressive patients and 19 age-matched healthy women. In addition, serum cortisol and interleukin-6 were determined. Patients were assessed with the Schedules for Clinical Assessment in Neuropsychiatry interview and met criteria for a single depressive episode. RESULTS: Depressed patients had increased levels of osteocalcin (p = .003), an osteoblastic marker; telopeptide (p = .01), an osteoclastic marker; and cross-laps (p = .000), another osteoclastic marker. Parathyroid hormone was lower in patients (p = .02), whereas the rest of the markers were comparable between patients and healthy control subjects. Serum cortisol was higher in depressed patients than in control subjects (p = .003), but cortisolemia and interleukin-6 did not show any relationship with bone markers in patients. Clinical severity of the illness and weight loss due to depression in patients did not correlate with bone remodeling markers. CONCLUSIONS: These data suggest that an increase in bone remodeling not due to vitamin D deficiency induces a release of calcium from bone and inhibition of parathyroid hormone secretion.     

Event-related potential in patients with diabetes mellitus]

The event-related potential (ERP) was recorded for 24 patients with diabetes mellitus (age 67.5 +/- 8.5 years, mean +/- SD) and 28 healthy controls (age 61.0 +/- 10.6 years) to elucidate the involvement of the central nervous system (CNS) in diabetes mellitus. ERP was recorded during auditory discriminative tasks. The latencies of N100, P200, N200 and P300 from the Pz region were measured. Patients with diabetes mellitus showed significant prolongation of N200 and P300 latencies compared with the normal subjects, while no significant differences in N100 and P200 latencies were found between the two groups. In six of 24 patients, the P300 latency delayed beyond the 2SD of the appropriate age-related value estimated from the normal regression line. The delay of the P300 latency was not related to either the duration of illness, therapeutic methods, or metabolic control. From the present results, it would appear that higher brain function is impaired even in diabetic patients not manifesting overt CNS signs and symptoms.     

Corpus callosum areas in first-episode patients with bipolar disorder

BACKGROUND: Morphological changes in the corpus callosum (CC) have been described in bipolar disorder, but with inconsistencies among the reports. We investigated the CC areas by magnetic resonance imaging (MRI) in 12 first-episode patients with bipolar disorder and 12 controls. METHOD: Twelve medication-naive patients with bipolar I disorder (six males, six females; aged 28 x 2+/-6 x 5 years) with manic or mixed episodes and 12 age- and gender-matched healthy controls (six males, six females; aged 26 x 8+/-7 x 6 years) were recruited to the study. MRI scans was obtained using a 1.5-T GE Signa Excite high-speed scanner. Anatomical measurements were conducted on a computer workstation with the software Scion Image Beta-3b for Windows. Statistical analysis was performed using an analysis of covariance (ANCOVA), the t test, chi2 and partial correlation analyses. RESULTS: Bipolar patients had significantly smaller areas of total CC, anterior body posterior body and isthmus compared with healthy control subjects by ANCOVA, with age, gender and intracranial volume (ICV) as covariates. There was a negative correlation between total CC, posterior body and isthmus areas and Young Mania Rating Scale (YMRS) scores. CONCLUSION: The findings suggest that CC morphology may be associated with the pathophysiology of bipolar disorder.     

Genetic associations with clinical characteristics in bipolar affective disorder and recurrent unipolar depressive disorder

Genetic factors may be associated with disease subtype as well as susceptibility. We have therefore typed polymorphisms at the serotonin transporter, dopamine receptor, tryptophan hydroxylase, tyrosine hydoxylase, and monoamine oxidase A (MAOA) loci in 139 unipolar and 131 bipolar patients and investigated associations with gender, number of episodes, age of onset, history of psychotic symptoms, history of suicidal behavior, and history of substance abuse. In bipolar subjects, the promoter variable number tandem repeat (VNTR) allele 132 of MAOA was associated with history of suicide attempts, P = 0.029, particularly in females, P = 0.006. The Fnu4HI allele 1 of MAOA was also associated with history of suicide attempts in females, P = 0.0162. The serotonin transporter promoter allele 2 was associated with increasing number of manic episodes, P = 0.02, and history of psychotic symptoms, P = 0.0243. One significant association was found in the unipolar group: dopamine D2 receptor promoter allele 2 with history of psychotic symptoms, P = 0. 0165. We have tested multiple loci for a variety of different clinical variables and performed 228 tests of significance in total. It is possible that these preliminary findings are type 1 errors, because one would expect 11 of the 228 tests to reach a nominal significance level of P < 0.05 by chance alone if all the tests were independent. The associations with the MAOA and serotonin transporter loci are consistent with previous data suggesting associations with susceptibility to bipolar affective disorder. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:36-42, 2000 Copyright 2000 Wiley-Liss, Inc.     

冲突性负波N270对抑郁症患者认知功能损害的评价

目的：揭示抑郁症患者的认知功能损害,探讨在该病患者中冲突性负波N270的变化及意义。方法：顺序出现的颜色相同或不同的刺激对随机呈现。25名抑郁症患者和25名年龄、性别匹配的正常对照并判断每对刺激的颜色是否相同并相应按键反应,同时在头皮记录事件相关电位。结果：在患者组和对照组,颜色不同的刺激对均可诱发出N270。患者组N270的潜伏期延长(P_3、P_4,P＜0．05),且缺失率高于对照组(F_3,5/25；F_4,4/25),各部位N270的峰波幅显著低于对照组。结论：抑郁症患者存在认知功能损害,N270可作为评价该病认知功能障碍的一个指标。