T2DM患者脑诱发电位失匹配负波的变化观察

目的观察T2DM患者脑诱发电位失匹配负波的变化特点。方法对50例T2DM患者、40例正常人进行失匹配负波(MMN)检查。结果与正常对照组比较,T2DM患者脑诱发电位的MMN潜伏期延长、波幅降低,2组比较差异有统计学意义(P<0.05)。结论T2DM患者存在认知功能损害,MMN是敏感的检测工具。     

急性脑卒中后脑诱发电位失匹配负波的变化观察

目的观察急性脑卒中后患者脑诱发电位失匹配负波的变化特点。方法对70例脑卒中患者和40例正常人进行失匹配负波(MMN)检查。结果与正常对照组比较,脑卒中患者脑诱发电位的MMN潜伏期延长、波幅降低,2组比较差异有统计学意义(P<0.05)。结论脑卒中患者存在认知功能损害,MMN是敏感的检测工具。     

急性脑卒中后脑诱发电位失匹配负波的变化观察

目的观察急性脑卒中后患者脑诱发电位失匹配负波的变化特点。方法对70例脑卒中患者和40例正常人进行失匹配负波（MMN）检查。结果与正常对照组比较，脑卒中患者脑诱发电位的MMN潜伏期延长、波幅降低，2组比较差异有统计学意义（P〈0．05）。结论脑卒中患者存在认知功能损害，MMN是敏感的检测工具。     

帕金森病患者认知功能障碍与失匹配负波相关性研究

目的:探讨失匹配负波(MMN)与额叶认知功能测试对在评价帕金森病患者(Parkinson's disease,PD)的认知功能中的作用及其临床价值。方法:设28例早期非痴呆非抑郁帕金森病患者和31例年龄、教育年限相匹配的正常对照组分别进行额叶认知功能测试和失匹配负波测定。结果:非痴呆非抑郁帕金森病患者与正常对照组比较:额叶认知测试评分较差,MMN的潜伏期延长,差异有显著性意义;波幅下降,但无统计学意义;MMN潜伏期延长与额叶认知功能障碍程度呈正相关。结论:失匹配负波(MMN)能够客观地反映非痴呆非抑郁帕金森病人早期额叶认知功能障碍。     

焦虑症患者多种事件相关电位的对比研究

目的探讨焦虑症患者三种事件相关电位(ERP)的变异特点。方法应用美国NicoletSpirit脑诱发电位仪,采用光和声成对刺激、反应时间以及听觉靶、非靶刺激序列技术,检测41例焦虑症患者及35名正常人的关联性负变(CNV)、P300及失匹性负波(MMN)。结果CNV:M1波幅研究组低于对照组(P<0.01),指令信号后负变化的出现率研究组高于对照组(P<0.01);P300:在靶刺激中,N2潜伏期研究组短于对照组(P<0.05),P3波幅研究组低于对照组(P<0.01),在非靶刺激中,研究组P2波幅低于对照组(P<0.05);MMN:研究组及对照组之间潜伏期和波幅的差异无显著性(P>0.05)。结论ERP变异特点可能对焦虑症的临床诊断有参考意义。     

抑郁障碍的事件相关脑电位研究新进展

本文综述了抑郁障碍患者的事件相关电位各成分包括P300、关联性负变（CNV）、失匹配负波（MMN）和听觉门控诱发电位P50的特点以及最新的一些进展。     

帕金森病和皮质下缺血性血管性痴呆患者的失匹配性负波的比较

目的研究比较皮质下缺血性血管性痴呆（SIVD）患者和帕金森病患者认知功能障碍时在失匹配负波（MMN）的特征。方法17例非痴呆非抑郁帕金病患者,26例SIVD患者和21例年龄、教育年限相匹配的正常对照组分别进行失匹配负波（MMN）成分的潜伏期、波幅检测。结果SIVD组与对照组相比,MMN潜伏期延长,波幅明显降低,差异均有统计学意义（P〈0．01）;帕金森病组与对照组相比,MMN潜伏期延长（P〈0．01）;波幅虽呈下降趋势,但无统计学意义。SIVD组与帕金森病组相比,潜伏期延长,波幅明显降低,有显著意义（P〈0．01）。结论失匹配负波（MMN）能够客观地反映非痴呆非抑郁帕金森病人早期额叶认知功能障碍,更能反映SIVD患者在大脑信息处理的早期阶段对所输入信息的感觉记忆及自动选择所存在的障碍,其电生理特征对认知障碍的鉴别有一定价值。     

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.     

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.     

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.     

社区老年2型糖尿病患者共病抑郁的现况调查及相关危险因素分析

目的 了解社区老年2型糖尿病人群伴发抑郁的现状及相关危险因素.方法 选取2015年1月~2016年12月在上海市梅陇社区卫生服务中心就诊的550例老年2型糖尿病(T2DM)患者进行病人健康问卷抑郁量表(PHQ-9)评定及相关问卷调查,根据PHQ-9评分情况将患者分为共病抑郁组和非抑郁组,对两组患者人口学资料进行比较,采用多因素Logistic回归分析探讨糖尿病共病抑郁的相关危险因素.结果 所调查老年2型糖尿病人群抑郁的发生率为45.27%;糖尿病病程、合并躯体疾病数、空腹血糖、HbA1C为社区老年T2DM患者共病抑郁的独立危险因素(P<0.05).结论 老年T2DM患者中抑郁的发病率高,在对社区老年T2DM患者进行指导、治疗时,除了需要积极控制血糖、HbA1C外,还需要积极关注其可能存在的抑郁症状,做到前期预防、早期发现并及时治疗.     

焦虑、抑郁情绪对2型糖尿病疗效的影响

目的：探讨焦虑、抑郁情绪对2型糖尿病患者疗效的影响。方法：136例糖尿病患者治疗前根据抑郁自评量表（SDS）或焦虑自评量表（SAS）评分后分为焦虑、抑郁组64例（SDS或SAS≥50分）和对照组72例（SDS或SAS〈50分）;两组均给予胰岛素治疗1个月。于治疗前后进行空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbA1c）、超敏C-反应蛋白（hsC-RP）及SDS、SAS评分比较。结果：虽经胰岛素系统治疗,但伴有焦虑、抑郁情绪的糖尿病患者的FBG、2hBG及hsC-RP水平仍明显高于对照组（P〈0.05或P〈0.01）;胰岛素用量更多,血糖控制更难达标。结论：焦虑、抑郁情绪严重影响糖尿病的治疗与转归。     

2型糖尿病合并急性脑梗死hs-CRP、Lp(a)检测的临床价值

目的探讨2型糖尿病(DM)合并急性脑梗死(ACI)患者检测高敏C反应蛋白(hs-CRP)、脂蛋白a[Lp(a)]的临床价值。方法收集42例2型糖尿病合并急性脑梗死病例(DM+ACI组),40例单纯T2DM(DM组)及同期40例健康体检者(正常对照组),测定3组人群的hs-CRP、Lp(a)及其他生化指标,并对结果进行统计学分析。结果 DM+ACI组及DM组的血清hs-CRP、Lp(a)水平均显著高于正常对照组(P<0.05)。DM+ACI组血清Lp(a)显著高于DM组(P<0.05),2组hs-CRP水平比较差异无统计学意义(P>0.10)。结论 hs-CRP、Lp(a)检测对2型糖尿病并发急性脑梗死的风险度具有一定的预测价值。     

Assessment of structural brain changes in patients with type 2 diabetes mellitus using the MRI-based brain atrophy and lesion index

Patients with type 2 diabetes mellitus(T2 DM) often have cognitive impairment and structural brain abnormalities.The magnetic resonance imaging(MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function,and can therefore also be used to reflect whole-brain structural changes related to T2 DM.A total of 136 participants(64 men and 72 women,aged 55–86 years) were recruited for our study between January 2014 and December 2016.All participants underwent MRI and Mini-Mental State Examination assessment(including 42 healthy control,38 T2 DM without cognitive impairment,26 with cognitive impairment but without T2 DM,and 30 T2 DM with cognitive impairment participants).The total and sub-category brain atrophy and lesion index scores in patients with T2 DM with cognitive impairment were higher than those in healthy controls.Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2 DM patients with cognitive impairment and patients with T2 DM and cognitive impairment.After adjusting for age,the brain atrophy and lesion index retained its capacity to identify patients with T2 DM with cognitive impairment.These findings suggest that the brain atrophy and lesion index,based on T1-weighted and T2-weighted imaging,is of clinical value for identifying patients with T2 DM and cognitive impairment.Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2 DM that is complicated by cognitive impairment.This study was approved by the Medical Ethics Committee of University of South China(approval No.USC20131109003) on November 9,2013,and was retrospectively registered with the Chinese Clinical Trial Registry(registration No.Chi CTR1900024150) on June 27,2019.     

Cerebral perfusion alterations in type 2 diabetes mellitus – a systematic review

Type 2 diabetes mellitus (T2DM) is related to abnormal brain structure and function, increasing the risk of cognitive impairment and dementia. We systematically reviewed the published literature focusing on cerebral perfusion in patients with T2DM. Although no significant difference was found in global cerebral blood flow (CBF) between the T2DM group and the healthy control group, the regional cerebral perfusion in T2DM was significantly reduced in multiple locations, including the occipital lobe, domains involved in the default mode network and the cerebellum. The decline in regional CBF was associated with a wide range of cognitive disorders in T2DM, including learning, memory, attention, and executive processing, as well as visual function. In addition, diabetes-related biochemical indicators, such as glycated hemoglobin and insulin resistance, were negatively correlated with regional CBF. In general, these functional perfusion imaging studies indicate that decreased CBF in T2DM may be a potential cause of cognitive impairment.     

发作期抑郁症患者不同情绪面孔刺激下的N170研究

目的探讨高兴、中性、悲伤3种情绪面孔刺激对于发作期抑郁症患者执行持续注意任务时N170的影响;分析发作期抑郁症患者抑郁、焦虑严重程度与N170波幅和潜伏期的相关性。方法选取28例22~69岁抑郁症患者(患者组)和31名20~61岁正常对照者(对照组)。要求被试在高兴、中性、悲伤3种情绪面孔刺激随机呈现后执行注意与选择任务,分别检测被试执行任务时脑电视觉诱发电位,比较患者组和对照组在高兴、中性、悲伤3种情绪面孔诱发的N170波幅和潜伏期,采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)分别评估患者组抑郁、焦虑严重程度。结果与对照组比较,患者组在高兴、中性、悲伤3种情绪面孔刺激下所诱发的头颅局部(T5、T6、O1、O2)N170潜伏期差异有统计学意义(P0.05),而N170波幅差异无统计学意义(P0.05)。患者组中性情绪面孔刺激下T5部位N170波幅与HAMD总分存在正相关(r=0.443,P=0.018)。结论发作期抑郁症患者对于不同情绪面孔的初始认知加工有损害,并且抑郁严重程度在部分脑区与中性情绪面孔刺激所诱发的N170波幅有相关性。     

Trapezius motor evoked potential in evaluations of corticospinal tract lesions

Background:  We wanted to know whether trapezius motor evoked potentials (MEPs) are helpful in the evaluation of corticospinal (CS) lesions above the fifth cervical segment (C5) and compared trapezius MEP measurements in patients with and without radiological evidence of CS lesions.
Methods:  Trapezius MEPs were routinely recorded in all MEP studies performed in our hospital. Patients who had MEP studies as well as brain and cervical spine imaging were retrospectively assigned to two groups. Group 1 had radiological evidence of CS lesion above the level of C5 whilst group 2 did not.
Results:  Forty-nine patients were included in the study. Twenty-eight patients were assigned to group 1 and 21 patients to group 2. The frequencies of abnormal values in the two groups were compared. Twelve (43%) patients in group 1 and three (14%) in group 2 had prolonged MEP latencies. Thirteen patients in group 1 had indentation or impingement of the cervical cord by intervertebral discs as the only relevant radiological abnormality. Seven (54%) of these patients were found to have prolonged trapezius MEP latencies, providing functional correlates to the radiological abnormalities.
Conclusions:  Our study gives evidence to the usefulness of trapezius MEP study in the evaluation of CS lesions.     

Brain magnetic resonance image changes in a family with congenital and classic myotonic dystrophy

We present the clinical manifestations, brain magnetic resonance images (MRI), and genetic analysis of a family with 2 siblings with congenital myotonic dystrophy type 1 (DM1) and 4 patients with classic DM1. These 2 patients with congenital DM1 had severe mental retardation and a characteristic feature of hyperintensity of white matter at the posterior-superior trigone (HWMPST), in addition to ventricular dilatation in T2-weighted images (T2WI) of brain MRI. In 2 of the 4 classic DM1 patients, brain T2WI MRI showed hyperintensity lesions in the bilateral frontal and/or temporal regions, which were absent in congenital DM1. In conclusion, we suggest that the HWMPST in brain MRI is a characteristic finding in congenital DM1, and that the severe cognitive impairments are not only attributable to the subcortical white matter lesions. In congenital DM1, the cognitive function is a diffuse impairment, which is different from that in classic DM1.     

抑郁症、焦虑症患者事件相关电位对照研究

目的:探讨抑郁症、焦虑症患者脑诱发电位的变异特点及临床应用价值.方法:共有46例抑郁症患者(抑郁症组)、41例焦虑症患者(焦虑症组)及42名健康志愿者(正常组),使用美国Nicolet Bravo脑电生理仪进行事件相关电位P300(P300)和关联性负变化(CNV)的检测.并于治疗2个月时对两患者组进行相同项目的随访.结果:与治疗前比较,抑郁症组P300靶N2、P3潜伏期缩短(P＜0.05),靶P3波幅升高(P＜0.01),CNV潜伏期M1缩短(P＜0.01),波幅M1、M2升高(P均＜0.05).焦虑症组P300靶P3潜伏期缩短(P＜0.05),CNV波幅M1下降(P＜0.05),指令信号后负变化(PINV)的出现率下降(P＜0.05).治疗后与正常组比较,抑郁症组P300非靶P2波幅偏低(P＜0.01),P300的双峰P2波和CNV的PINV出现率均偏高(P＜0.05～0.01);焦虑症组CNV的潜伏期M2缩短(P＜0.01).抑郁症组与焦虑症组治疗后比较在P300非靶P2波幅、双峰P2波出现率,CNV潜伏期M2和PINV出现率等指标之间差异有显著性(P均＜0.01).结论:抑郁症、焦虑症患者脑诱发电位有自己的变异特点,在诊断和鉴别诊断方面有一定的价值.     

Alzheimer's disease and type 2 diabetes: exploring the association to obesity and tyrosine hydroxylase

Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) are two debilitating health disorders afflicting millions worldwide. Recent research has revealed similarities between AD and T2DM. Both these protein conformational disorders are associated with obesity, insulin resistance, inflammation and endoplasmic reticulum stress, en-route initiation and/or stage aggravation. In this mini review we have tried to summarize studies describing obesity, insulin resistance and glucocorticoid imbalance as common patho-mechanisms in T2DM and AD. A reduction in tyrosine hydroxylase (TH) in the brain has been found to occur in Parkinson's disease (PD). AD, T2DM and PD share common risk factors like depression. Thus, whether TH is involved in the 'state of cognitive depression' that is the hallmark of AD and often accompanies PD and T2DM is also explored.