闭合性颅脑外伤患者视觉P300地形图的初步研究

目的　探讨闭合性颅脑外伤患者视觉P300地形图的变化。方法　使用Medicide- 03E诱发电位仪对103例闭合性颅脑外伤患者(脑外伤组)进行视觉剌激P300地形图检测,并与66例包括正常人、神经症患者及其他非脑外伤疾病而P300地形图正常者进行对照。结果　脑外伤组患者P300波潜伏期较对照组明显延长(P<0 .001),波幅降低(P<0 .01);视觉P300地形图显示两侧不对称性和扩散性。结论　闭合性颅脑外伤患者视觉P300地形图存在偏侧性和扩散性。     

急性河豚中毒患者P300的研究

目的 研究急性河豚中毒患者的P300的改变。方法 应用纽科公司的Medicid-03E脑诱发电位仪测定21例急性河豚中毒患者的视觉（图像）、听觉刺激诱发P300波之潜伏期和波幅，与30例正常对照组作比较，并比较不同病情患者的P300波改变。结果 病例组视觉（图像）、听觉刺激P300波的潜伏期较正常对照组明显延长（P＜0．001），波幅明显降低（P＜0．001）。P300波之潜伏期和波幅与患者病情严重程度相关，随着中毒症状的改善，P300波的潜伏期逐渐缩短，波幅也逐渐增高。结论 P300波的变化可作为判断急性河豚中毒患者脑认知功能障碍程度和恢复情况的一项客观指标。患者P300波的动态观察更有意义。     

脑立体定向手术对慢性难治性精神分裂症患者认知功能的影响及随访研究

目的探讨脑立体定向手术治疗对难治性精神分裂症患者认知功能和临床疗效的长期影响。方法以40例脑立体定向手术治疗的难治型精神分裂症患者为研究对象，并设立非手术组（43例）和正常组（32例）进行对照。采用美国NICOLET SPRIRIT脑诱发电位生理仪检测事件相关电位P300；应用阳性与阴性症状量表（PANSS）、锥体外系副反应量表（RSESE）、社会功能缺陷量表（SDSS）评测临床表现。结果与术前比较，随访时手术组P300表现为靶刺激N2、P3、P4潜伏期和非靶刺激P2潜伏期缩短（P〈0．05），靶刺激N1潜伏期延迟（P〈0．05），靶刺激P2、P3波幅和非靶刺激P2波幅降低（P〈0．05），靶刺激P4波幅升高（P〈0．05）；与非手术组比较，靶刺激N1、N2、P3潜伏期和靶刺激P2、P3、P4波幅及非靶刺激P2波幅差异均有显著性（P〈0．05）。与正常组比较，术前手术组和非手术组P300表现为靶刺激N2、P3、P4潜伏期延迟（P〈0．05），靶刺激N1潜伏期缩短（P〈0．05），靶刺激P3波幅、非靶刺激P2波幅降低和靶刺激P4波幅升高（P〈0．05）；术后手术组P300各潜伏期指标无显著性差异（P〉0．05），各波幅指标仍有显著性差异（P〈0．05），非手术组潜伏期和波幅的主要指标仍有显著性差异（P〈0．05）。与非手术组相比较，随访时手术组难治性精神分裂症的治愈率、依从性显著升高（P〈0．05），锥体束外症状发生率、病残率、复发率显著下降（P〈0．05）。结论脑立体定向手术对Cz脑区事件相关电位P300产生明显影响，并改善了精神分裂症症状和社会生存能力。     

急性CO中毒后迟发性脑病的相关因素及P300的研究

目的 探讨急性一氧化碳（CO）中毒后迟发性脑病（DEACMP）的相关因素及P300对其病情判定和预后的意义。方法 对44例DEACMP患者与42例未发生迟发性脑病的急性CO中毒（ACMP）患者在C0接触时间，昏迷时间等13个方面进行比较，并行P300检测，且与DEACMP组发生CO中毒初期清醒后所测P300（DEACMP0组）及44名正常人的P300（NC组）进行比较。结果 DEACMP在CO接触时间，昏迷时间，高压氧治疗时间，年龄，合并症等方面与ACMP组比较有极显著差异（P＜0．01），在扩血管药治疗，心脑血管病及呼吸系统疾病史，吸烟，职业方面亦有显著差异（P＜0．05）。DEACMP组较DEACMP0组P300潜伏期明显延长，波幅明显下降（P＜0．01），DEACMP0组较NC组亦有类似改变。结论 长时间接触CO，长时间昏迷，高压氧治疗时间较短，扩血管药治疗时间短，年龄较大，有合并症，患心脑血管病及呼吸系统疾病，吸烟，脑力劳动与发生DEACMP相关。急性CO中毒患者的P300潜伏期越长，波幅越低，其认知功能越差，发生DEACMP的可能性越大。P300对DEACMP的发生，预后可做出较准确评价。     

雌激素对精神分裂症女性患者事件相关电位P300的影响

目的 探讨雌激素对女性精神分裂症事件相关电位P300的影响。方法 将67例女性精神分裂症患者随机分为研究组（32例）和对照组（35例）。研究组在利培酮（3．5—4．5mg／d）治疗的同时口服雌激素（妊马雌酮，0．625mg／d），疗程3个月。治疗前后对两组分别进行P300检查及阳性和阴性症状量表（PANSS）评定。结果 （1）P300：治疗前两组各项指标的差异无统计学意义（P〉0．05）。与治疗前比较，治疗后，在Cz点，研究组靶刺激P2，P3，P4波潜伏期缩短，P3，P4波波幅升高；非靶刺激P2波波幅升高（均P〈0．05—0．01）。在Pz点，研究组靶刺激中潜伏期的5项指标（N1，P2，N2，P3，P4）均缩短，波幅的3项指标（P2，P3，P4）均升高；非靶刺激P2波潜伏期缩短，其波幅升高（均P〈0．05—0．01）。而对照组各项指标治疗前后变化均无统计学意义（P〉0．05）。与对照组比较，治疗后，在Cz点，研究组靶刺激P2，N2，P3，P4波潜伏期短，P3，P4波波幅高；非靶刺激P2波潜伏期短，其波幅高（均P〈0．05—0．01）。在Pz点，研究组靶刺激中潜伏期的5项指标均短，3项指标的波幅均高；非靶刺激P：波潜伏期短，其波幅高（均P〈0．05—0．01）。（2）PANSS：治疗前，两组各因子评分的差异无统计学意义（P〉0．05）。治疗后，研究组的阴性症状、反应缺乏和抑郁因子分低于治疗前（均P〈0．01），亦低于对照组。对照组各因子治疗前后的变化无统计学意义（P〉0．05）。结论 雌激素治疗可使女性精神分裂症患者P姗主要波幅升高，部分潜伏期缩短，精神症状部分改善。     

维、汉民族首次抑郁发作患者血清同型半胱氨酸水平及其与 P300的关系

目的：研究维、汉民族首次抑郁发作患者血清 Hcy水平及其与 P300的关系。方法选取119例首次抑郁发作患者（病例组）及117名健康志愿者（健康对照组），采用酶联免疫法测定两组的血清Hcy水平，采用Brain Master脑诱发电位系统进行P300的检测。结果与对照组相比，病例组患者血清Hcy水平升高，P3潜伏期延长、波幅降低，差异均有统计学意义（P＜0．01）。病例组中维吾尔族和汉族患者之间血清 Hcy水平和P3潜伏期及波幅的差异均无统计学意义（P ＞0．05）。病例组血清H cy水平与P3潜伏期呈正相关，与靶P3波幅呈负相关（ P ＜0．05）。结论首次抑郁发作患者存在认知功能障碍，H cy代谢失衡与抑郁发作患者的认知功能损害相关，与民族因素可能无关。     

不同意识状态下中风患者脑干诱发电位特点

为探讨中风患者在不同意识状态下BAEP特点，分别对27例有意识障碍及25例无意识改变的非脑干部位性中风患者进行BAEP的测定。结果：意识障碍组的Ⅲ、Ⅴ波潜伏期及Ⅴ－Ⅲ、Ⅲ－I波间期延长，同正常对照组及无意识障碍中风组间均有非常显著的差异（P＜0．001），2例Ⅲ、Ⅴ波均消失的昏迷患者死亡。无意识改变的中风患者组Ⅲ、Ⅴ波潜伏期及Ⅴ－Ⅲ、Ⅲ—Ｉ波间期同正常对照组间无显著差异（P＞0．05）。表明非脑干部位性中风患者出现意识障碍，脑干功能继发性受损，同时显示BAEP能对有意识障碍的中风患者的预后做出有价值的判断。     

闭合性颅脑外伤患者病程与P_(300)之间关系的研究

目的　研究闭合性颅脑外伤患者病程与 P30 0 之间的关系 ,并探讨此类患者作 P30 0 测定的最佳时间。方法　应用 Medicid- 0 3E脑诱发电位仪测定 5 18例闭合性颅脑外伤患者的视觉 (图像 )刺激诱发的 P30 0 波之潜伏期和波幅。对其中异常的 385例与 2 14例正常对照组作比较 ,并比较不同伤情、伤后不同时间患者的P30 0 波。结果　病人组 P30 0 波潜伏期较正常对照组明显延长 (P<0 .0 0 1) ,波幅亦明显降低 (P<0 .0 1) ,其 P30 0 改变在伤后 2 5～ 48小时内明显 ,尤以伤后有昏迷者更为突出。随着时间的延长 ,P30 0 波异常程度有所改善。结论　 P30 0 波的变化可作为判断闭合性颅脑外伤患者脑认知功能变化的一项客观指标 ,其中伤后 2 5～ 48小时内测定具有更高的价值 ,根据 P30 0 波的变化能判断患者的伤情和预后。     

P300对颅脑外伤所致精神障碍的认知功能评价

目的探讨颅脑外伤所致精神障碍认知功能障碍的特点及P300对其评价的临床价值。方法对56例颅脑外伤所致精神障碍患者和52例颅脑外伤不伴精神障碍患者以及53例健康者分别进行了P300电位测定和智商测定,并将3组结果加以比较。结果颅脑外伤所致精神障碍患者组与无精神障碍组P300电位成分中N2、P3波潜伏期延长和P3波幅降低,言语智商、操作智商、总智商得分均降低,较健康对照组差异有显著性意义(P<0.01),而颅脑外伤所致精神障碍患者组与无精神障碍组相比,P300电位成分中N2、P3波潜伏期延长和P3波幅降低,言语智商、操作智商、总智商得分均降低,差异有显著性意义(P<0.01),相关分析显示P300潜伏期与言语智商、操作智商、总智商得分呈显著负相关(r=-0.29～-0.33,P<0.01),波幅则呈显著正相关(r=0.31～0.36,P<0.01)。结论P300电位可作为评价颅脑外伤所致精神障碍患者认知状况的重要指标应用于临床。     

精神分裂症患者治疗后多项诱发电位的变化

目的 了解精神分裂症患者P300、听觉诱发电位（AEP）和脑干听觉反应（ABR）的特征以及治疗前后诱发电位的变化。方法 应用美国Nicolet Spirit脑诱发电位仪．记录34例精神分裂症患者和31名正常成人的P300、AEP和ABR．于治疗6个月时进行P300、AEP和ABR随访。结果 1．与NC组比较,精神分裂症组三项诱发电位主成份（P300-P3靶潜伏期、AEP-P2潜伏期和ABR-波V波幅）延迟,波幅降低（P〈0．05～0．01）。2．随访提示：P300中的P3靶潜伏期和波幅,AEP中的P2潜伏期和波幅以及ABR中的波Ⅲ潜伏期和波V波幅改变可能是属于该疾病的状态标志。结论 本组精神分裂症患者的诱发电位变化为状态标志,多项诱发电位指标联合应用可作为精神分裂症治疗监测的有用指标。     

急性颅脑损伤后血清甲状腺素的改变及其意义

目的探讨急性颅脑损伤后血清甲状腺素水平的改变及其意义。方法应用磁性酶联免疫定量分析法检测１５６例急性颅脑损伤患者伤后２４～７２小时及存活者伤后２周的血清Ｔ３、游离Ｔ３（ＦＴ３）、Ｔ４、游离Ｆ４（ＦＴ４）及促甲状腺激素（ＴＳＨ）水平的改变,并与１００名正常对照者比较。结果伤后患者早期血清Ｔ３、ＦＴ３水平显著降低（Ｐ〈０．００１）,而Ｔ４、ＦＴ４显著升高（Ｐ〈０．０１）;颅脑损伤愈重,昏迷程度愈深,上     

Abnormalities in event-related potential and brainstem auditory evoked response in children with nocturnal enuresis

To evaluate central nervous system functioning involvement in nocturnal enuresis, P300 and N200 event-related brain potentials and brainstem auditory-evoked potentials (BAER) were assessed in a group of 35 enuretic boys aged 7-9 years. The measurements of enuretic group were compared to those of age and sex matched non-enuretics. P300 latency in the enuretic group was significantly longer than in non-enuretic group (420 ms at parietal scalp (Pz), 414 ms at central scalp (Cz) versus 386 ms at Pz, 376 ms at Cz; P < 0.01 and P < 0.01, respectively). Both enuretic and non-enuretic subjects were divided into three subgroups his age. There was no significant difference in terms of both P300 amplitude and N200 latency and N200 amplitude between non-enuretic age subgroups. But, P300 latency over central scalp in 8 years old non-enuretic subgroup was significantly longer than in 9 years old non-enuretic subgroup (P < 0.01). No significant difference was found in latency and amplitude of P300 and N200 latency between enuretic subgroups. However, N200 amplitude at Cz in 8 years old enuretic subgroup was significantly lower than both in 7 years old enuretic subgroup and in 9 years old enuretic subgroup (P < 0.01 and P < 0.01, respectively). There were significant topographical differences in latency and amplitude of P300 and in N200 latency in enuretic age subgroups, only. There was no significant difference in interpeak latencies I-III, I-V and III-V and wave latencies I, III and V of BAERs between enuretic group and non-enuretic subgroup. Longer interpeak and wave latencies of BAERs were found both in 8 years old enuretic subgroup and 8 years old non-enuretic subgroup. CONCLUSION: Longer P300 latency in primer enuretics compare to non-enuretics is an evidence of a maturational delay of central nervous system functioning.     

Event-related potential P300 in cerebral infarction

N1, P2 and P300 potentials were studied in 20 cases of cerebral infarction and 47 healthy controls with standard technique of auditory event-related potentials. Healthy controls of both sexes, different ages, education levels and cognitive capacity did not show apparent differences in the latency of p300 (P greater than 0.05, respectively). The patient group, however, revealed significant (P less than 0.001) prolongation of latency of P300 (mean = 409.6 +/- 50 ms) as compared with 28 well matched healthy subjects (mean = 337.7 +/- 24 ms). Although there was some decline of amplitude of P300 in the patient group, the difference between the control and patient groups was not significant (P greater than 0.05). There was significant difference in the Cognitive Capacity Screening Examination findings between the control and patient groups (P less than 0.01), but it seemed that the evaluation of latency of cognition-related p300 might be more objective and sensitive (P less than 0.001).     

The evaluation of cognitive functions with P300 test for chronic obstructive pulmonary disease patients in attack and stable period

OBJECTIVES: Hypoxia, in chronic obstructive pulmonary disease (COPD), leads to a decrease in cerebral perfusion and an impairment of some cognitive abilities. We aimed to investigate the relation between arterial blood gas analysis (ABA) and pulmonary function test (PFT) parameters with cognitive function of COPD patients during attack and stable period. PATIENTS AND METHODS: ABA, PFT, P300 tests of 30 patients in stabilized period and 30 patients in attack, and 17 healthy controls were evaluated. RESULTS: When both COPD groups and controls were compared, it was seen that latency of P300 was shorter in the control group (p<0.001), but there was no difference between COPD groups (p>0.05). P300 amplitude measures were lower in both COPD groups than control group, but it was not statistically significant (p>0.05). When we compared the measures of attack group, we saw that arterial oxygen tension (PaO(2)), arterial oxygen saturation (SaO(2)), forced expiratory volume in 1s (FEV(1)), FEV(1)/forced vital capacity (FVC) values increased (p<0.001), and P300 latency shortened (p<0.05) in attack group during stable period. P300 latency correlated significantly with PaO(2) (r=-0.557, p<0.001), SaO(2) (r=-0.424, p<0.001), FEV(1) (r=-0.441, p<0.001), FEV(1)/FVC (r=-0.477, p<0.001) values, and age (r=0.329, p<0.05). P300 amplitude is only correlated with PaO(2) (r=0.236, p<0.05). CONCLUSION: Longer latency of P300 appears to be an expected sequel of COPD. P300 test can be considered as a potential objective marker of cognitive impairment.     

正常青年人对图像、照片和汉字刺激诱发P300波的比较

目的比较正常青年人对图像、照片和汉字3种不同刺激所诱发P300波的潜伏期(PL)和波幅(Amp)的差异.方法分别记录和比较32名正常青年人对图像、照片和汉字3种不同刺激诱发P300PL和Amp.结果汉字诱发P300PL与其他两种刺激诱发P300PL之间差异有极显著性(P<0.01),而3类刺激诱发P300Amp不存在差异.性别之间除照片刺激诱发P300PL无差异外,其他指标均存在差异(均P<0.05).结论不同视觉刺激诱发P300PL之间的差异可能与大脑对其分析、加工、整合所需的时间有关.与受试者的性别也有一定关系.     

卒中后抑郁患者的交感神经皮肤反应与事件相关电位对照研究

目的探讨交感神经皮肤反应(SSR)与事件相关电位(ERP)对卒中后抑郁患者的诊断价值。方法对55例卒中后抑郁患者和52例正常健康者分别进行了SSR和ERP测定,并将结果加以比较。结果卒中后抑郁组中SSR和ERP测定中的P300成分异常率分别为87.3%(48/55)和83.6%(46/55),两者异常吻合率为76.4%(42/55)。卒中后抑郁组SSR测定结果中,SSR潜伏期和波幅值较对照组延长和降低,其差异具有显著性(P<0.01),ERP测定中N2、P3波潜伏期和P3波幅较对照组分别延长和降低,存在显著性差异(P<0.01)。其中N2、P3波潜伏期与SSR测定中潜伏期以及波幅与波幅之间呈正相关(r=0.29~0.36,P<0.01),而两者潜伏期与波幅之间呈负相关(r=-0.32~-0.33,P<0.01)。结论交感神经皮肤反应和事件相关电位测定可作为卒中后抑郁患者的诊断指标应用于临床。     

Changes in event-related potentials during dual task walking in aging and Parkinson's disease

ObjectiveTo investigate EEG changes during an auditory odd-ball task while walking (dual-task) in young adults, older adults, and patients with Parkinson's disease.Methods11 young adults, 10 older adults, and 10 patients with Parkinson’s disease (PD) performed an auditory oddball task during standing and walking on a treadmill, while wearing a wireless EEG cap. The amplitude and latency of P300 were compared between groups and within conditions using linear mix model analysis. Gait was evaluated using wearable sensors and cognition was assessed using the Color Trail Test.ResultsP300 latency became longer during walking in all groups (p = 0.005). During walking, older adults (p = 0.005) and patients with PD (p = 0.001) showed prolonged P300 latency compared to young adults. Significant task by group interaction was found in P300 amplitude (p = 0.008). Patients with PD demonstrated reduced P300 amplitude during walking compared to standing (p = 0.023). Among all subjects, better motor and cognitive performance correlated with shorter P300 latency (r = 0.457, p = 0.014 and r = 0.431, p = 0.040, respectively).ConclusionsThese findings provide direct evidence of the physiological recruitment of attentional networks during walking and their impact by ageing and disease.SignificanceThis study is the first to report on changes in P300 latency and amplitude during dual-task oddball walking in older adults and patients with PD.