BAEP转颈试验与椎—基底动脉供血不足预后的相关性研究

本文对３９例Ｖ－ＢＡＩ脑干听觉诱发电位（ＢＡＥＰ）异常者（Ａ组）与３０例ＢＡＥＰ转颈试验异常者（Ｂ组）作了西比灵治疗的前瞻性随访分析。结果表明：ＢＡＥＰ转颈试验可使Ｖ－ＢＡＩ的ＢＡＥＰ异常率由转颈前的４４．８３％提高到７９．３１％（Ｐ＜０．０１）；Ａ组Ⅲ、Ⅴ（ＰＬ）及Ⅰ～Ⅲ、Ⅰ～Ⅴ（ＩＰＬ）延长（Ｐ＜０．０１），Ｂ组Ⅲ（ＰＬ）和Ⅰ～Ⅲ（ＩＰＬ）延长为著（Ｐ＜０．０５）；西比灵治疗后Ⅲ、Ⅴ（ＰＬ）、Ⅰ～Ⅲ、Ⅰ～Ⅴ（ＩＰＬ）有明显恢复（Ｐ＜０．０５），且与病情改善程度密切相关。     

脑白质疏松症脑干听觉诱发电位研究

在２４例经颅脑ＣＴ确诊的脑白质疏松症和２０例健康老年人中进行脑干听觉诱发电位（ＢＡＥＰ）研究。结果，病例组ＢＡＥＰ总异常１９例，异常率８３．３％，Ⅲ、Ⅴ波波峰潜伏期及各峰间潜伏期异常率较高；病例组Ⅲ、Ⅴ峰潜伏期及Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ峰间潜伏期均数比对照组大，ｔ－检验；Ｐ＜０．０１。结论：在脑白质疏松症早期临床未提示脑干功能受累时，脑干电生理功能已出现异常ＢＡＥＰ可作为脑白质疏松症脑干功能受累的客观指标在临床上推广应用。     

全麻病人用纳络酮催醒时的BAEP

观察全麻病人用纳络酮催醒时的脑干诱发电位（ＢＡＥＰ）变化。结果表明，全麻诱导期Ｉ、Ⅲ、Ⅴ波的潜伏期都较清醒时延长，在麻醉维持期（催醒前）则进一步延长（Ｐ〈０．０１）。静注纳络酮后各波的ＰＬ均缩短，Ｉ￣Ⅲ，Ⅲ￣Ⅴ，Ⅰ￣Ⅴ波的波间期亦缩短，提示ＢＡＥＰ的变化可作为判断麻醉深浅的客观指标，用ＢＡＥＰ变化来观察纳络酮催醒具有准确和灵敏的特点。     

语言学习困难儿童BAEP的观察与分析

目的：Ｗ工探讨脑干听觉诱发电位（ＢＡＥＰ）在语言学习困难儿童中的变化规律及应用价值。方法：对１１０例患儿根据不同病因分为五组，结合正常对照，进行ＢＡＥＰ描记分析。结果：和ＢＡＥＰ总异常率为８４％，其中５１％为双侧ＢＡＥＰ各波消失；２１％为单侧ＢＡＥＰ各波消失，伴另侧ＢＡＥＰ各波潜伏期延长；１２％为双侧Ⅲ－Ⅴ波潜伏期及Ⅰ－Ⅲ、Ⅲ－Ⅴ峰间期延长，结论：ＢＡＥＰ对于语言学习困难儿童的听力损害及传导路径的     

无定位体征的脑干腔隙性梗塞

部分脑干腔隙性梗塞（腔梗）患者，因无定位体征而常常被误诊为椎基底动脉供血不足（Ｖ－ＢＡＩ）。为了对这些患者作出早期诊断，以利治疗及对预后的估计，对２１例无定位体征的脑干腔梗组（Ａ组）与３０例Ｖ－ＢＡＩ（Ｂ组）患者的临床表现、ＣＴ、ＭＲＩ、经颅多普勒超声（ＴＣＤ）及脑干听觉诱发电位（ＢＡＥＰ）进行比较分析。结果表明：Ａ组以持续症状为主，治疗效果较差，其ＴＣＤ改变不如Ｂ组明显，而ＢＡＥＰ的Ⅲ、Ⅴ波峰潜伏期（ＰＬ）及Ⅲ～Ⅴ波峰间潜伏期（ＩＰＬ）延长比Ｂ组明显。结论：凡症状持续、疗效较差、ＴＣＤ改变不显著而ＢＡＥＰ示听神经中枢段障碍明显者，要高度怀疑脑干腔梗。ＭＲＩ是脑干腔梗可靠而敏感的检查手段。     

脑干及其周围术中诱发电位监护的实验研究

目的：为探索脑干及周围手术操作对听觉脑干诱发电位（ＢＡＥＰ）、体感诱发电位（ＳＥＰ）的影响，了解术中诱发电位实时监测的意义，进行本研究。方法：对２４只后颅窝及脑干周围手术的动物模型，采用ＢＡＥＰ、ＳＥＰ术中监护，观察了手术操作对诱发电位改变的影响。结果：对脑干及周围手术牵拉、分离、电凝均可以引起ＢＡＥＰ、ＳＥＰ的改变。ＢＡＥＰ的Ⅲ、Ⅴ峰潜伏期，Ⅰ－Ⅲ、Ⅲ－Ⅴ、Ⅰ－Ⅴ峰间潜伏期和ＳＥＰ的Ｎ２０改变均是术中监护的关键性参数。结论：对脑干及其周围作术中诱发电位监护，动态分析ＢＡＥＰ、ＳＥＰ主要波峰的变化，有利于手术质量的提高。     

71例脑干病变患者的脑干听觉诱发电位分析

目的 探讨脑干听沉诱发电位对脑干病变的定位诊断价值。方法 对７１例脑干病变患者及１３０名正常对照者ＢＡＥＰ检查。结果 ５３例患者ＢＡＥＰ异常。主要表现为ⅢⅤ波ＰＬ及Ⅰ－Ⅲ，Ⅲ－Ⅴ，Ⅰ－Ⅴ的ＩＰＬ延长，与对照组比较有显著差异。     

脑干听觉诱发电位在后颅凹肿瘤诊断及术中监护的应用

目的：了解脑干听觉诱发电位技术在后颅凹肿瘤诊断及术中监护的意义，方法：对８例后颅２凹肿瘤２进行了术前检查。其中２例进行术中监护，对ＢＡＥＰ各波波形、潜伏期、波间期的变化进行分析。结果Ⅰ、Ⅲ、Ⅴ波潜期延长４例；Ⅰ－Ⅲ、Ⅲ－Ⅴ、Ⅰ－Ⅴ波波间期延长５例；波形分化不良，重复性差６例；由于手术操作引起的颅内压变化、脑干出血、缺血、受压均可引起ＢＡＥＰ的变化。结论：ＢＡＥＰ对后颅凹病变的早期诊断、术中重要结构     

椎－基底动脉TIA的BAEP转颈试验研究

本文对５０例椎－基底动脉－过性脑缺血发作（ＶＢ·ＴＩＡ）患者于发作间歇期进行了脑干听觉诱发电位（ＢＡＥＰ）转颈试验的研究。结果表明：ＢＡＥＰ转颈试验后，ＶＢ·ＴＩＡ患者的ＢＡＥＰ异常率，由转颈前的４８％显著地增高到８０％（Ｐ＜０．００５）。其ＢＡＥＰ异常主要表现为ＰＬⅠ、ＰＬⅤ、ＩＰＬⅢ～Ⅴ的延长。相比之下，对照组转颈前后ＢＡＥＰ变化无显著性（Ｐ＞０．０５）。由此提示血液动力学因素在本病的发病机制中起着极为重要的作用。     

40例听神经瘤病人的脑干听觉诱发电位分析

目的：探讨听神经瘤患者的脑干听觉诱发电位（ＢＡＥＰ）变化规律及应用价值。方法：对听神经瘤患者作常规ＢＡＥＰ检查。结果：４０便听神经瘤肿瘤侧ＢＡＥ异常率１００％，非肿瘤侧ＢＡＥＰ异常率９０％，以Ⅲ－Ⅴ间期延长尤显著，Ⅲ－Ⅴ／Ⅰ－Ⅲ比值中７２％，结论：听力减退患者进行ＢＡＥＰ测试，对听神经瘤的诊断和鉴别诊断具有重要意义。     

Effect of preexisting borderline personality disorder on clinical and EEG sleep correlates of depression

Two groups of depressed patients were studied: (1) The first group comprised 15 inpatients who were diagnosed as predominantly “borderline personality disorders” based on DSM-III and psychometric test criteria; these patients were also clinically depressed. (2) The second group consisted of 18 inpatients who met Research Diagnostic Criteria (RDC) for major depressive disorder (MDD) but who failed to meet the above criteria for borderline personality disorder. Subsequent to the selection of patients for study, an independent diagnostic evaluation revealed that MDD patients with borderline personality disorder had higher ratings than nonborderline MDD patients on items from the Schedule for Affective Disorders and Schizophrenia such as total anxiety, anger, schizotypal features, miscellaneous psychopathology, and alcohol and drug abuse. A further breakdown of miscellaneous psychopathology items revealed greater subjective anger, self-pity, and demandingness in borderline patients. A comparison of RDC subtypes in the two groups revealed a significant increase in bipolar II diagnoses in the borderline MDD group. Electroencephalographic (EEG) sleep studies carried out in a subsample of MDD borderline (n=8) and primary MDD nonborderline (n=11) patients revealed no significant differences between the two groups. Thus, in contrast to the EEG sleep findings reported for secondary depression with other antecedent psychiatric disorders, the present study indicated that a preexisting diagnosis of borderline personality disorder in MDD patients did not alter the characteristics short latency of rapid eye movement (REM) sleep and the sleep continuity disturbances reported in primary MDD. These data confirm earlier reports by Akiskal (1981), Carroll et al. (1981), and McNamara et al. (1982) concerning the phenomenological and EEG sleep profiles of borderline patients.     

The effect of visitors upon a female latency age group: An explosive example whereupon affect was liberated

The penultimate session of a latency age female group was noteworthy as members received a visit from both their ex-therapist and the sister of a group member. These visitors enabled that member to reveal her intrapsychic conflicts and social strengths in more energetic and manifest fashion than was usual for her.     

大鼠CB／CT微量注射CGRP或SP引起的对伤害性刺激反应的易化作用

探讨降钙素基因相关肽（CGRP）和P物质（SP）在SD大鼠扣带束及周围皮质（CB/CT）对伤害性刺激反应的作用。应用热板和机械压力实验法，以大鼠后抓缩抓反应潜伏期（HWL）为痛阈指标，观察CB/CT微量注射CGRP或SP后HWL的变化。CB/CT内注射0.125,0.25,0.5mol CGRP或SP均显著地降低大鼠对热板的双侧HWL，且呈量效关系；0.125nmolCGRP或0.5nmol SP能显著降低大鼠对机械压力的HWL。CB/CT微量注射CGRP或SP使大鼠对热板和机械压力刺激发生痛敏。     

Effect of core cooling on short and long latency reflex responses

Subjects were immersed in 10°C water until the rectal temperature dropped to 35°C. Reflexes of wrist flexors were tested before and after cooling with tendon taps and torque motor produced perturbations. Comparison of pre- and post-cooling reflex responses showed that the longer latency reflex (LLR) was delayed in onset more than the short latency monosynaptic reflex (SLR) response.This implies that a portion of the LLR pathway is separate and distinct from the SLR pathway.     

Dynamic coupling of excitatory and inhibitory responses in the medial nucleus of the trapezoid body

The neuronal representation of acoustic amplitude modulations is an important prerequisite for understanding the processing of natural sounds. We investigated this representation in the medial nucleus of the trapezoid body (MNTB) of the Mongolian gerbil using sinusoidal amplitude modulations (SAM). Depending on the SAM's carrier frequency (f(C)) MNTB cells either increase or decrease their discharge rates, indicating underlying excitatory and inhibitory/suppressive mechanisms. As natural sounds typically are composed of multiple spectral components we investigated how stimuli containing two spectral components are represented in the MNTB, especially when they have opposing effects on the discharge rate. Three conditions were compared: SAM stimuli (1) with rate-increasing f(C), (2) with rate-increasing f(C) and an additional unmodulated rate-decreasing pure tone, and (3) with rate-decreasing f(C) and an unmodulated, rate-increasing pure tone. We found that responses under all three conditions showed comparable strength of phase-locking. Adding a rate-decreasing tone to a rate-increasing SAM increased phase-locking for modulation frequencies (f(AM)) of < or = 600 Hz. A comparison of two possible coding strategies--phase-locking vs. envelope reproduction--indicates that both strategies are realized to different degrees depending on the f(AM). We measured latencies for following modulations in rate-increasing and rate-decreasing SAMs using a modified reverse correlation approach. Although latencies varied between 2.5 and 5 ms between cells, a decrease in rate consistently followed an increase in rate with a delay of about 0.2 ms in each cell. These results suggest a temporally precise representation of rate-increasing and rate-decreasing stimuli at the level of the MNTB during dynamic stimulation.     

Electrophysiological index of acoustic temporal regularity violation in the middle latency range

Objective

Acoustic violations in temporal regularity have been traditionally indexed by mismatch negativity (MMN). However, recent studies have demonstrated that humans can detect auditory changes in physical sound features, such as frequency, location and intensity, in the first 50 ms after sound onset. Our aim was to examine if temporal regularity violations could be detected in the middle latency range.

Methods

We used an oddball paradigm with 290 ms as standard stimulus onset asynchrony (SOA) and 200 ms as deviant SOA. We also employed a control paradigm that comprised of seven SOAs including 200 and 290 ms, in order to control for differences due to refractoriness.

Results

In the middle latency range, temporal regularity violations led to enhanced Pa and Nb responses, which behaved differently to the corresponding SOAs in the control condition. In the long latency range, temporal regularity violations led to similar behaviours in both oddball and control paradigms.

Conclusions

These findings suggest that with a fast presentation rate, human brains are capable to detect temporal regularity violations in the middle latency range.

Significance

Together with previous studies that found early change detection responses, the current study emphasises that the human brain can encode simple regularity violation as early as approximately 50 ms post-stimulus onset.     

不同病程阶段发作性睡病患者PSG检查比较

目的分析不同病程阶段发作性睡病患者电生理指标的差异。方法收集2009年1月至2010年1月在北京宣武医院睡眠中心确诊的发作性睡病患者45例。根据患者检查时的病程长短,分成三组。每位患者均进行多导生理记录仪睡眠监测(PSG)及多次小睡潜伏时间试验记录其指标。结果病程≥10年的发作性睡病患者的深睡眠比例显著低于病程<10年的患者;病程≥20年的发作性睡病患者的睡眠中清醒时间显著高于病程<10年的患者;病程≥20年的发作性睡病患者的腿动指数和MLST平均REM睡眠潜伏期显著高于病程<20岁的患者。其他指标没有统计学差异。结论随着病程的延长,发作性睡病患者的基本特征并没有改变,但是会掺杂一些年龄因素造成的睡眠障碍问题。     

Transcarpal motor conduction velocity in carpal tunnel syndrome.

Transcarpal motor conduction to abductor pollicis brevis (APB) was evaluated in 43 patients (70 hands) with suspected carpal tunnel syndrome (CTS). Transcarpal motor conduction was abnormal in 80% of hands compared with 11.5% with prolongated distal motor latency from wrist stimulation. Transcarpal motor conduction was comparable in sensitivity with transcarpal sensory conduction and 2nd lumbrical-interosseous latency difference. Transcarpal motor conduction is a sensitive test for diagnosis of CTS. Sensory fibers were no more susceptible than motor fibers to compression in the carpal tunnel, and fibers to APB were as susceptible as those to the 2nd lumbrical muscle.     

Distal motor latency and residual latency as sensitive markers of anti-MAG polyneuropathy

There is debate whether the terminal latency index (TLI) is a sensitive marker for polyneuropathy with anti-myelinassociated-glycoprotein antibodies (anti-MAGP). We examined 6 patients with an anti-MAGP and 6 patients with a chronic inflammatory demyelinating polyneuropathy (CIDP). The electroneurographic features studied were: distal compound motor action potential (CMAP), distal motor latency (DML), motor conduction velocity (MCV) elbow to wrist (distal MCV), MCV axilla to elbow (proximal MCV), MCV distal/proximal, terminal latency index (TLI), residual latency (RL), F-wave, and modified F ratio.We found significant differences between anti-MAGP and CIDP for DML and for RL.No significant differences were found for TLI and the other measures. The TLI values were not significant probably because our patients had a longer duration of disease,which supports the hypothesis of a distal to proximal progression of conduction slowing over time. We propose that a residual latency >4.0 and a distal motor latency >7.0 are strongly suggestive for an anti- MAGP.     

Multimodality evoked potentials in progression of metachromatic leukodystrophy

A 2-yr-3-mo-old girl with metachromatic leukodystrophy (MLD) was examined using serial multiple electrophysiological procedures. Sensory nerve conduction velocity was delayed earlier and more severely than motor nerve conduction velocity. Visual evoked potentials (VEPs) showed prolonged latency of wave IV. Auditory brainstem responses (ABRs) showed prolonged latency of waves I and V, and the I-V interval. As to the interpeak latency of somatosensory evoked potentials (SEPs), the P9-P14 and the P14-N20 intervals were prolonged on admission. Two months later, both intervals were more prolonged, but the prolongation of the P9-P14 interval was the most prominent. The demyelination in our case may have started in the cerebral white matter, progressed to the peripheral nerves, and at last via the spinal root reached the brainstem. An electrophysiological follow-up study may be valuable in the understanding of the progressive pathological changes and in the evaluation of therapeutic measures.