气功所致精神障碍的临床研究

目的：探讨气功所致精神障碍病人的人格特性、主要发病因素和随访研究。方法：（１）测定３５例气功师和２８例气功所致精神障碍病人的ＭＭＰＩ和ＥＰＱ。（２）用自行设计气功所致精神障碍相关因素调查表分析其主要发病因素。（３）对出院诊断为气功所致精神障碍的５７例病人进行随访调查。结果：（１）气功师的ＭＭＰＩ临床量表Ｈｙ原始分显著高于常模,Ｈｓ、Ｄ、Ｐｔ、Ｍａ原始分显著低于常模。气功所致精神障碍病人ＭＭＰＩ特点     

Passive long-latency event-related potentials in mental retardation.

Long-latency auditory event-related potentials (ERPs) were passively recorded in ten mental retardates and ten age-matched normal controls. Patients were mildly to moderately retarded and had epilepsy controlled with monotherapy, ERPs were recorded from CA-A1+A2, with 1000 and 3000 Hz tones in an "oddball" paradigm. Latency and amplitude of N1, N2, P2, and P3 components were compared in controls and retardates. All ten patients had reproducible AEPs, but these were attenuated in amplitude in four, although amplitudes did not differ significantly from controls. P3 was prolonged in latency in four patients, but patients and controls did not differ significantly. AEP latency and amplitude was not correlated with degree of retardation. These findings suggest that "cognitive" evoked potentials an be recorded passively in persons with impaired cognition, but are not correlated with intellectual ability and may not reflect specific cognitive functions.     

脑诱发电位在上海精神科的应用——附1100例分析

本文分析了1984—1991年1100例精神疾病门诊及住院病人的脑诱发电位。并就读谱标准,异常结果,临床应用评价三方面问题作了探讨。     

军人创伤后应激障碍患者的多种诱发电位变异与临床随访

目的:探讨军人创伤后应激障碍(PTSD)患者诱发电位(BEP)的特征和治疗后的变化,及其与精神症状的关系.方法:应用美国Nicolet Bravo脑诱发电位仪、症状自评量表(SCL-90)和事件影响量表(IES),对86例军人PTSD患者(PTSD组)和56名健康军人(对照组)进行了P300、听觉诱发电位(AEP)、视觉诱发电位(VEP)、SCL-90和IES的测试,并对PTSD组于治疗后3.5个月进行了随访.结果:PTSD组治疗前与对照组比较,P300的P3(t=3.32,P＜0.01)、AEP的N2(t=2.26,P＜0.05)和VEP的P2(t=2.85,P＜0.01)潜伏期均延迟,P300的P3波幅升高(t=4.35,P＜0.01);治疗后与治疗前比较,P300的P3(t=2.80,P＜0.01)和VEP的P2(t=2.34,P＜0.05)潜伏期前移、P300的靶P3波幅降低(t=3.78,P＜0.01);治疗后与对照组比较差异均无显著性(P＞0.05).治疗前BEP各指标与SCL-90、IES及其因子分,以及治疗前后的BEP各指标差值与SCL-90、IES及其因子分的差值,部分有显著性相关(P＜0.05～0.01).结论:PTSD患者诱发电位的变化可能是状态标志,多项BEP指标联合可试用于监测军人精神健康.     

焦虑症患者VEP及AEP临床研究

目的：观察焦虑症患者听觉诱发电位(AEP)及视觉诱发电位(VEP)的特点。方法：对30例符合CCMD-Ⅱ-R诊断标准的焦虑症患者进行VEP和AEP检查，并以30例正常人作对照。结果：VEP在Fz及Cz处的P2、P3波幅明显降低，在Cz处N1潜伏期延长；AEP在Cz及P2处的P2、P3波波幅明显降低，N1潜伏期延长，在Cz处P2潜伏期延长。结论：焦虑症患者的VEP、AEP有波幅降低，潜伏期延长。     

60例气功出偏患者人格特征分析

目的探讨气功出偏患者人格特征。方法采用明尼苏达多项人格测查表对60例接受随访的气功出偏患者及63例正常对照者进行测查。结果①随访组8个临床量表的T分高于正常对照组,差异具有显著性（P〈0．01或〈0．05）;②部分缓解者的疑病症（Hs）,抑郁症（D）,癔病（Hy）,精神分裂症（Sc）等8个量表的T分高于完全缓解者,差异具有显著性（P〈0．01或〈0．05）;③随访组完全缓解者的疑病症（Hs）,癔病（Hy）,妄想（Pa）,精神分裂症（Sc）量表分与正常对照组相比差异非常显著（P均〈0．01）;④以10个临床量表为自变量,以是否发病为因变量,进行Logistic逐步回归分析,结果显示癔病（Hy）、妄想（Pa）、精神分裂症（Sc）进入回归方程（P均〈0．01）;⑤对随访组10个临床量表进行聚类分析。结果表明,精神衰弱（Pt）和精神分裂症（Sc）,抑郁症（D）和癔病（Hy）的相关系数较大,分别为0．77、0．70。结论某些人格特征为气功出偏者的易感素质,建议练习气功前进行筛查。     

Sensory and motor evoked potentials findings in patients with thoracic outlet syndrome

OBJECTIVE: Diagnostic utility of somatosensory and motor evoked potentials in two patients with neurogenic and vascular thoracic outlet syndrome (TOS) were investigated. MATERIALS AND METHODS: In two female patients with progressive weakness and sensory disturbance of the arms, mixed nerve somatosensory evoked potentials (SSEP), and motor evoked potentials (MEP) were tested before and after dynamic position of the affected arm. RESULTS: The cortical and cervical (C7) ulnar SSEPs demonstrated no change in latency of major peaks at rest and after abduction of the shoulder. A slight diminishment of cortical amplitude was noted in the first patient after the dynamic position of the arm. The MEPs demonstrated significant drop in amplitude after dynamic position of the arm in both cases signifying neurovascular compression during elevation of the affected arm. No change in MEP latency was noted. The MEP amplitude completely returned to normal after repositioning the arm. CONCLUSIONS: Evoked potential studies are helpful in the diagnosis of neurogenic or vascular TOS. Reduced amplitude of MEP occurs after elevation of the arm above the head which improves after normal position of the arm.     

奥卡西平对癫痫患者运动皮质兴奋性的影响

目的：利用经颅磁刺激（transcranial magnetic stimulation, TMS）技术来研究奥卡西平（oxcarbazepine, OXC）对部分性癫痫患者运动皮质兴奋性的影响，并与卡马西平(carbamazepine, CBZ)的作用相比较。方法：对38例头颅MRI正常的部分性癫痫患者和20例正常对照进行磁刺激，并记录双侧大脑的静息期运动皮质阈值(rest motor threshold, rMT)、运动诱发电位波幅（motor evoked potential amplitude，MEP amplitude）、皮质潜伏期(cortical latency, CL)和中枢传导时间（central motor conduction time, CMCT）。癫痫组中18例给予OXC治疗，20例给予CBZ治疗，在治疗后第2周末、第4周末分别给予TMS。结果： 癫痫组38例治疗前可能致痫灶同侧大脑rMT高于对侧大脑，但差异无显著(P>0.05)。奥卡西平组可能致痫灶同侧大脑rMT在第2周末和第4周末均明显高于治疗前(P<0.05)，卡马西平组可能致痫灶同侧大脑rMT仅在第4周末时高于治疗前(P<0.05)。癫痫组治疗前后同侧大脑MEP amplitude、CL和CMCT差别均无显著，两侧大脑半球间比较差别也无显著。结论： 头颅MRI正常的部分性癫痫患者可能致痫灶所在半球和对侧半球的大脑皮质兴奋性可能存在差异，OXC和CBZ均能降低运动皮质兴奋性，可能机制为细胞膜钠离子通道阻滞。 TMS是从电生理角度研究大脑皮质兴奋性的可靠辅助工具。     

Acute tryptophan depletion attenuates auditory event related potentials in bipolar disorder: a preliminary study

BACKGROUND: 5-HT modulates electroencephalographic (EEG) activity, which is abnormal in bipolar disorder and EEG abnormalities persist in euthymic bipolar patients. The EEG may therefore be a sensitive marker of 5-HT function in bipolar disorder. We examined the effects of acute tryptophan depletion (ATD) on EEG activity in bipolar patients. METHODS: Fourteen patients with DSM IV Bipolar 1 disorder participated in a within-subject, double-blind, placebo-controlled, random-order crossover study. Following ATD quantitative power spectrum brain mapping and measurement of auditory evoked potentials were carried out. RESULTS: ATD produced a significant fall in the amplitude of N1P2 and P300 components of the auditory evoked potential, but no significant changes in the power spectrum. There was an 83% reduction in plasma tryptophan after the depleting but not the control drink. LIMITATIONS: The effect of ATD on brain 5-HT levels was not directly measured. The number of patients is relatively small. The control condition may alter these electrophysiological measures. CONCLUSIONS: ATD attenuates auditory evoked potentials in bipolar disorder with the distribution of this effect being towards the front of the brain. These changes are not related to any change in mood. This is a potential trait marker of bipolar disorder, however there needs to be further exploration of this paradigm in controls and other patient groups.     

心因性阳痿患者的神经电生理表现

目的 :研究心因性阳痿患者的神经电生理学改变。方法 :对 30例心因性阳痿患者 (心因组 )进行球海绵体肌反射 (BCR)、坐骨海绵体肌反射 (ICR)及阴茎背神经体感诱发电位 (SSEP)的潜伏期、波幅检测 ,并与正常人 (对照组 )进行比较。结果 :病人组与对照组BCR、ICR、SSEP的P4 1波潜伏期比较差异无显著意义 (P >0 0 5 ) ,而病人组P4 1波波幅较对照组明显降低 (P <0 0 5 )。结论 :心因性阳痿患者SSEP的P4 1波幅降低 ,这似乎有助于心因性阳痿鉴别诊断     

阿尔茨海默病与脑血管病痴呆患者的诱发电位比较研究

目的：观察阿尔茨海默病痴呆（AD）和脑血管病痴呆（VD）视觉及听觉诱发电位的特点。方法：收集25例AD组、24例VD及22名正常老年人（NC），完成听觉诱发电位（AEP）和视觉诱发电位（VEP）检查，并进行简易智力状态检查（MMSE）评分比较。结果：与NC组相比，AD组AEP的N1、P2，VEP的P1潜伏期延迟，AEP的P2、P2，VEP的P2、P3波幅降低；VD组VEP的P2潜伏期延迟，P2和P3波幅降低。AD组和VD组相比，AD组AEP的N1、P2潜伏期延迟于VD组。AD组VEP的P2波的潜伏期，VD组AEP的P3波幅及VEP的N1潜伏期改变与其MMSE评分有关联。结论：AD组和VD组的诱发电位有类似变化，两组的VEP和AEP变化与MMSE相关。     

闭合性轻度脑外伤事件相关电位地形图的初步研究

为了解脑外伤后病人精神心理和智力改变的客观依据,我们使用DantecConcerto~(TM)仪,对24例闭合性轻度脑外伤患者和14例正常人P_(300)分布地形图的变化进行了对比观察。结果发现正常组P_(300)高波幅区相对集中于Cz附近的椭园形区域内,而脑外伤组则从Cz向两侧颞后播散,潜伏期延长,波形分化不良,波幅反而较正常组高;重复试验时,正常组潜伏期略为缩短,波幅稍增高,分布更集中于Cz为中心的小范围内,而脑外伤组向整个后头部移动,潜伏期进一步延长,波幅普遍明显下降,唯有T_3点反而奇异地升高38％。作者认为以上改变可能是参与P_(300)发生的皮层和皮层下结构中的微细结构受损害而使其整合功能被削弱的结果。这一结果与认为P_(300)发生于大脑皮层及皮层下各结构的综合反应的观点是一致的。     

P300等诱发电位对亚临床肝性脑病早期诊断的意义

目的:观察事件相关电位P_(300)、体感诱发电位、视觉诱发电位和脑干听觉诱发电位在亚临床肝性脑病诊断中的意义。方法:50例亚临床肝性脑病患者进行了心理测验,并做了头颅CT和视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位检查,30例正常人做为对照组。结果:亚临床肝性脑病的心理测验,韦氏法智力低下率为76％,视觉诱发电位异常率为13％,脑干听觉诱发电位异常率为20％,体感诱发电位异常率为40％,事件相关电位异常率为71％,正常对照组四种诱发电位的正常率是100％。头颅CT结果与亚临床肝性脑病无关。结论:视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位在亚临床肝性脑病中是异常的。事件相关电位更为敏感,对亚临床肝性脑病的早期诊断有重要意义。     

Information processing deficits in relatives of manic depressive patients

BACKGROUND: The importance of genetic factors in the aetiology of manic-depressive illness (MDI) has been repeatedly confirmed and indicators of vulnerability to the illness in families with affective disorders are needed. Abnormal event-related potentials (ERP) may be markers of genetic vulnerability to mental illness. Long latency and low amplitude of P300 have consistently been reported in schizophrenic patients and their relatives. A few studies have also shown P300 deficits in MDI patients, but no ERP study has been performed on their relatives. METHODS: ERPs were recorded during an auditory oddball task in 19 relatives belonging to families with two or more bipolar patients and in controls with no familial or personal history of affective disorders. The relatives were selected as having no affective disorders on a lifetime basis, but eight had an anxiety disorder. RESULTS: In all relatives, a lower P300 amplitude and a longer P300 latency was found, with much longer reaction time and post-N200 duration till button-press than controls. A lack of P300 amplitude dominance in the right hemisphere was also found in relatives in comparison with controls. There also appeared to be a frontal predominance of ERP abnormalities in relatives. CONCLUSION: We report the first evidence of deficits in reaction time and in P300 amplitude and latency, and a lack of P300 right-sided dominance, in relatives of manic-depressive patients. This pattern may constitute an endophenotypic marker of manic-depressive disorder.     

抑郁症患者感觉诱发电位变化与自杀行为的相关研究

目的:探讨抑郁症患者感觉诱发电位(SEP)变化与自杀行为的关系。方法:应用国产脑诱发电位仪,记录了48例抑郁症患者和40名正常对照者的SEP。结果:(1)与正常对照组相比,抑郁症组均出现P2主成分波幅降低(正常对照组(6.1±2.5)μV,自杀史阳性组(2.7±1.9)μV,自杀史阴性组(3.8±2.7)μV,P0.01)。(2)抑郁症患者的SEP改变主要与有无自杀行为史可能相关。结论:自杀行为相关的生物学指标与SEP的关系有待下一步随访。     

Scalp topography of SEP late components in patients with supra-tentorial lesions

Summary Somatosensory evoked potentials (SEP) to simultaneous bilateral median nerve stimulation were recorded in 7 patients with unilateral brain lesions, 8 patients with degenerative dementia, and 5 normal volunteers. Right-left amplitude difference was compared from serial topographic images and the amplitude was compared at homologous electrodes. In patients with unilateral lesions, the amplitude from the frontopolar, frontal, anterior-temporal, and/or occipital electrodes was smaller on the affected side at 240 and 360 msec, regardless of whether the subjects showed sensory deficit or not. No significant laterality was seen in the primary sensorimotor areas. Distribution obtained from the patients with degenerative dementia was quite symmetrical. A significant right-left amplitude difference was seen at the anterior temporal site at 180 and 240 msec in normal controls, although an almost symmetrical distribution was obtained on the topographic images. The late components of SEP are not associated with the primary somatosensory function, but possibly with other cortical pathways.     

Diagnostic utility of somatosensory and motor evoked potentials in a patient with thoracic outlet syndrome

OBJECTIVE: To evaluate the utility of somatosensory and motor evoked potentials in the diagnosis of neurogenic thoracic outlet syndrome (TOS). MATERIALS AND METHODS: In a female patient with progressive weakness and sensory disturbance, ulnar nerve somatosensory evoked potentials (SSEP), and intraoperative motor evoked potential (MEP) were performed. RESULTS: The SSEPs demonstrated no significant change in latency of major peaks at rest and after abduction of the shoulder. Diminishment of amplitude was noted after dynamic position of the arm. The MEPs demonstrated no significant change in latency after dynamic position. Diminishment of amplitude was noted after the dynamic position. The amplitude returned to normal after repositioning the arm. CONCLUSIONS: Electrophysiologic study is helpful in the diagnosis of neurogenic TOS. Reduced amplitude of cortical SSEP and myogenic MEP is expected during dynamic position of the affected arm.     

诱发电位在多发性硬化诊断中的价值

目的：评价诱发电位在多发性硬化(MS)诊断中的价值，并为临床提供MS的诱发电位(EP)资料。方法：本课题采用临床病例分析统计方法，对164例MS患者的3项EP资料进行分析。结果：MS患者的3项EP中，视觉诱发电位(VEP)的异常率最高，其次为体感诱发电位(SEP)，脑干听觉诱发电位(BAEP)最低；这3项EP联合检查可使异常率提高，EP发现病灶的敏感性较临床检查高，其不仅可以发现中枢神经系统的病灶，而且还能够发现外周神经系统的病灶。结论：联合应用3项EP检查有助于MS诊断以及亚临床病灶的发现。     

Cortical evoked potentials and clinical rating scales as measures of depressive illness

Relationships between clinical ratings and cortical evoked potentials were examined before and during antidepressant drug treatment in 32 patients with major depressive disorder (DSM-III). Clinical rating scales included Hamilton Rating Scale for Depression, Beck Depression Inventory, Present State Examination (PSE) and Newcastle Scale. Evoked potentials included contingent negative variation (CNV), post-imperative negative variation (PINV) and auditory evoked potential (AEP) There were close correlations between all rating scales, and factor analysis produced only one component, suggesting that the common variance between them related to severity of depression. CNV magnitude before treatment correlated negatively with severity of depression regardless of diagnostic category. Depressed patients had a prominent PINV which persisted during antidepressant treatment. The amplitude of late components (N1P2) of the AEP was reduced strikingly in patients with a history of suicide attempts.     

帕金森病患者正中神经和胫神经体感诱发电位研究

目的:同时观察帕金森病患者正中神经和胫神经体感诱发电位的异常并推测其发生机制。方法:选择30名帕金森病患者和20名健康对照者,刺激正中神经,记录顶叶体感诱发电位的N20、P25、N30波,额叶的P20、N30波的潜伏期和波幅。刺激胫神经,记录顶叶体感诱发电位的P40、N50、P60波的潜伏期和波幅。结果:帕金森病患者上肢额叶N30和下肢N50波幅明显降低(P<0·05)。结论:帕金森病患者上下肢SEP同时出现异常是黑质纹状体系统多巴胺缺乏的结果,下肢N50波幅比上肢N30与临床症状的严重性更有相关性。