复发性脑梗塞事件相关电位研究

目的：探讨事件相关电位对复发性脑梗塞患者认知功能障碍的诊断价值。方法：对28例复发性脑梗塞患者进行事件相关电位检测并与对照组比较。结果：复发性脑梗塞组事件相关电位的N2、P3潜伏期与对照组比较显著延长（P＜0．001），而且18例MMES＞17分的复发性脑梗塞患者中7例事件相关电位的P3潜伏期延长。结论：检测事件相关电位是评定复发性脑梗塞患者认知功能障碍的一种敏感、客观的检查手段。     

卒中急性期非痴呆型血管性认知障碍患者工作记忆的事件相关电位特征研究

目的 探索卒中急性期非痴呆型血管性认知障碍(PS-VCIND)患者的工作记忆特点.方法 卒中急性期PS-VCIND及卒中后无认知障碍(PS-NCI)患者各13例,行数字n-back (n=0,1)工作记忆任务的ERP实验,记录行为学数据及EEG,离线处理数据,比较两组在不同记忆负荷下的行为表现及ERP成分的差异.结果 两组被试1-back较0-back任务反应时均延长(P＜0.001),正确率无变化;不同组别(PS-VCIND和PS-NCI)间正确率与反应时差异均无统计学意义.ERP数据示PS-VCIND组1-back较0-back的P300潜伏期延长(P=0.011)、波幅减小(P=0.001);且在1-back任务中,PS-VCIND较PS-NCI组潜伏期延长(P=0.047)、波幅减小(P=0.035).结论卒中急性期PS-VCIND患者存在工作记忆损害,n-back范式诱发的ERP成分可增加卒中后认知障碍早期诊断的客观性.     

事件相关电位P300对早期血管性痴呆的诊断价值

目的：探讨事件相关电位P300对早期血管性痴呆的诊断价值。方法选择50例血管性痴呆患者（血管性痴呆组）、49例动脉硬化症无痴呆患者（动脉粥样硬化组）和48名健康人（健康人组）分别进行P300检查,比较三组的检查结果。结果血管性痴呆组P300潜伏期较动脉粥样硬化组、健康人组明显延长,波幅降低,差异有统计学意义（ P＜0.01）。结论事件相关电位P300检测在血管性痴呆早期诊断中具有较高的应用价值。     

慢性酒精中毒患者事件相关电位研究

慢性酒精中毒已成为影响人类健康的主要疾病之一。在我国目前其患病率呈上升趋势[1] 。因此 ,我们对 1998～1999年间 32例慢性酒精中毒患者进行了有关事件相关电位(ＥＲＰ)检测的初步研究。目的是早期发现慢性酒精中毒患者的认知功能障碍。一、资料与方法1.对象 :本组 32例患者均为男性 ,年龄 34～ 6 6岁 ,平均47 8岁。饮酒史 10～ 37年 ,平均 2 2 6年。饮酒量为 5 0～ 5 5度白酒 ,每日 2 5 0～ 5 0 0ｍｌ,平均 315ｍｌ。 32例患者中 ,14例有明显的记忆力衰退 ,并有感觉、计算、判断和分析能力下降 ,但无明显痴呆。 2例有幻觉、幻听。文化…     

早期帕金森病患者事件相关电位P300研究

目的研究早期帕金森病（PD）患者听觉事件相关电位P300的异常特征，为早期干预PD患者认知功能损害提供实验依据。方法早期PD患者83例（PD组），健康人58例（对照组）。肌电图诱发电位仪测定两组P300波群各成分（N1、P2、N2、P3）潜伏期和波幅、反应时，MMSE评定两组的认知功能。结果PD组N2、P3潜伏期延长（P〈0．05）；P300波群各成分中P3阳性率最高[PD痴呆组为53．3％，PD非痴呆（PD—D）组为29．4％]。结论早期PD患者P300外源性成分P2和内源性成分N2、P3的潜伏期均延长，提示其认知功能异常，还有警觉、选择、注意的障碍。P3潜伏期是识别早期PD伴发痴呆的敏感指标。     

事件相关电位进展及其在血管性痴呆中的应用

事件相关电位(ERPs)技术可在无创性条件下给出与人脑认知活动有关的脑电位变化。根据ERPs各成分和有关行为测试的结果,可以推断人脑信息加工过程,因而被认为是观察人脑活动的窗口,并为检查大脑功能状况提供了一个有效的工具。血管性痴呆(CVD)是脑功能严重失调的一种表现,ERPs检测可以客观地评价CVD患者大脑认知功能障碍的程度,尤其对疾病进展的描述、疗效观察、预测病情发展和预后,均可提供有效的信息。     

血管性痴呆与帕金森氏病痴呆患者听觉事件相关电位的对比分析

目的探讨听觉事件相关电位(ERP)在帕金森氏病痴呆(PDD)和血管性痴呆(VD)中的差异以及意义。方法对23例VD患者,16例PDD患者及20位正常人检测ERP,进行对照分析。结果3组间ERP异常程度不同,VD组与PDD组P3潜伏期均较对照组显著延长(P<0.05),而VD组P3延长较PDD组更明显(P<0.05)。N2组间异常程度不同,VD组较PDD组N2潜伏期延长,波幅降低(P<0.05)。ERP的外源成份N1异常程度不同,VD组N1潜伏期延长,波幅降低,与正常对照组相比,差异显著(P<0.05),而PDD组N1潜伏期、波幅与正常对照组相比无显著差异。结论VD、PDD患者听觉ERP的外源、内源成份皆有差异。ERP检测对临床痴呆类型的鉴别,有一定的参考价值。     

血管性认知功能障碍神经心理及事件相关电位的研究

目的探讨非痴呆型血管性认知功能障碍(vascular cognitive impairment no dementia,VCIND)患者神经心理学及事件相关电位P300的特点。方法对64例VCIND患者(VCIND组)及42例其他疾病患者(对照组)行事件相关电位P300检查,使用简易智能状态检查量表(MMSE)、画钟测验(CDT)评定入选者认知功能状态,并进行相关分析。结果与对照组比较,VCIND组患者的CDT、MMSE评分明显降低,差异有统计学意义(P0.01),MMSE评分亚项中的时间定向、地点定向、注意/计算力、短程记忆、言语复述、阅读能力、书写能力、图形描画均明显降低,差异有统计学意义(P0.05,P0.01);P300潜伏期明显延长(P0.01),MMSE评分与P300潜伏期呈负相关(r=-0.615,P0.05)。结论事件相关电位P300检测有助于VCIND的早期诊断。     

血管性认知障碍非痴呆患者事件相关电位-P300的特点

目的探讨血管性认知障碍非痴呆（VC IND）患者的听觉事件相关电位（ERP）-P300特点及其临床意义。方法根据MoCA评分将120例VC IND患者分为两组,22-26分为A组,18-21分为B组。另择健康体检者60例作为对照组。分别对其进行听觉ERP-P300检测。结果与对照组相比,A组P300潜伏期、N200-P300波间期延长,P300波幅减低;B组N200、P300潜伏期,P200-N200、N200-P300波间期明显延长,P300波幅减低（P〈0.05或〈0.01）。VC IND患者N200、P300潜伏期与性别无关,与MoCA分数呈负相关（r=-4.140、-0.895,P均〈0.01）,P300潜伏期与年龄呈正相关（r=0.399,P=0.000）。结论 VC IND患者的ERP-P300特点为P300潜伏期、N200-P300波间期延长,P300波幅减低;ERP-P300对VC IND有一定的早期诊断价值。     

Clinical findings in Alzheimer dementia and multi-infarct dementia

From 1969 to 1989, 63 patients with dementia of the Alzheimer-type (DAT), 84 patients with multi-infarct dementia (MID), and 52 mixed type patients were treated. Two-thirds of the patients were women. Among the 66 men, 23% belonged to the DAT-group, and 56% to the MID-group. While the DAT-group, with regard to the age at on-set of dementia, showed a bimodal distribution with peaks at 51-55 years and at 71-75 years, in the MID-patients and in the MB-patients an age-related increase up to the age of 80 years was evident. Compared to the MID-patients, in the DAT-patients pathological EEG findings were less serious, even if a considerable brain atrophy was already evident. Psychic unbalance and states of temporary mental confusion, however, were more frequent in the MID-patients.     

Patterns of neuropsychological impairment in dementia of the Alzheimer type and multi-infarct dementia

Patterns of performance on 22 neuropsychological tests were examined in 58 patients with presumed dementia of the Alzheimer type (DAT) and 58 patients with presumed multi-infarct dementia (MID). Few differences between patterns of performance in DAT and MID were found when overall level of performance was taken into account. Within the DAT group, there were some age-related differences in performance that in themselves might support other studies suggesting clinical and neuropathological differences between subtypes of DAT that are related in part to the age at which the condition occurs. However, similar age-related patterns were found in the MID group and the DAT and MID groups did not differ significantly in this respect. Considerable inter-individual variability in pattern of performance was apparent within each group. A proportion of patients were re-assessed 10 months after initial assessment: the extent of decline over time was not predictable from patients' characteristics or test performances at initial assessment. 'De-differentiation' in patterns of impairment, over time or with increasing severity of impairment, was not observed.     

HLA system in senile dementia of Alzheimer type and multi-infarct dementia in Japan

To clarify the genetic factors in demented patients in Japan, HLA antigens were examined by the authors. They found a significant association between HLA B16 and senile dementia of Alzheimer type. Also a significant difference was observed in the occurrence of HLA Cw 3 between patients with dementia and controls. In the general population the frequency of B16 is higher in Europe and the USA than it is in Japan. So the authors suppose that the difference in the prevalence of senile dementia of Alzheimer type between Japan and other countries is caused by genetic factors.     

EEG studies in Alzheimer dementia and multi-infarct dementia at various times of the day

From three men and seven women (mean age 70 years) with dementia of the Alzheimer-type (DAT), and from four men and six women (mean age 77 years) with multi-infarct dementia (MID) closed-eye EEGs were registered at 0800, 1200, 1600, and 2000 hours and recorded on tape for computer processing. The data of both groups were compared statistically and also compared with data of former investigations conducted with 10 healthy elderly volunteers and 10 patients who suffered from cerebral arteriosclerosis with serious disorder of sleep-walking rhythm (HA). Most pathological EEG deviations are found in the MID-patients, but there is no significant distinction compared to the DAT-patients, although three of the latter showed normal EEGs. Compared to the HA the EEGs of the MID-patients differed more from those of the healthy volunteers; however, the physiological circadian variations were not leveled as in the HA. Even in consideration of daytime dependent fluctuations of frequency-parameters, a clear-cut discrimination between DAT and MID by means of the EEG seems impossible.     

Amino acid concentrations in cerebrospinal fluid in presenile and senile dementia of Alzheimer type and multi-infarct dementia

Free amino acid levels were measured in cerebrospinal fluid (CSF) from demented patients (D, n = 30) suffering from presenile and senile dementia of Alzheimer type (PDAT, n = 7; SDAT, n = 9), multi-infarct dementia (MID, n = 14) and a reference sample group consisting of young neurotic patients (R, n = 16). Comparing the amino acid levels in the dementia subgroups, significantly higher alanine, methionine, phenylalanine and tyrosine levels were found both in MID and SDAT vs. PDAT. No difference was seen between SDAT and MID. Compared to the reference sample group, higher glycine levels were found in each dementia subgroup; higher alanine, methionine and ornithine levels in MID, and SDAT; and higher phenylalanine levels in MID. In PDAT the level of tyrosine was lower. Coefficients of correlation were calculated between amino acid levels and age, and the findings in the reference sample groups were divergent from those observed in dementia. The differences observed are discussed in terms of amino acid, carbohydrate and neurotransmitter metabolism.     

Dementia of the Alzheimer type and multi-infarct dementia: a clinical description and diagnostic problems

Patients who had Alzheimer's disease-senile dementia of the Alzheimer type (AD/SDAT) or multi-infarct dementia (MID) were compared with a group of controls. Demented patients had approximately the same degree of dementia and the same duration of illness. The MID group had a significantly higher mean age than the AD/SDAT group. Sixty-three per cent of the AD/SDAT patients were free of other diseases, while 65 per cent of the MID patients had cardiovascular disease. Thirty per cent of the MID patients had a history of previous depression, while only 5 per cent of the AD/SDAT patients had had depression. At the time of the investigation, however, AD/SDAT patients showed significantly more signs of depression than the MID patients. Focal neurologic signs were found in 70 per cent of the MID patients and only 6 per cent of the AD/SDAT patients. The electrocardiogram was normal for every AD/SDAT patient, while 75 per cent of the MID patients had abnormal ECGs. Electroencephalography showed generalized slow frequencies in 79 per cent of the AD/SDAT patients and localized slow frequencies and abnormalities in 65 per cent of the MID patients. Computed tomography of the brain showed that MID patients had significantly greater dilation of the ventricular system, while cortical atrophy did not differ significantly among the three groups. Homovanillic acid in the cerebrospinal fluid was significantly lower in the AD/SDAT group as compared with controls.     

Understanding and treating multi-infarct dementia

MID is a controversial entity responsible for at least 15 to 20 per cent of dementia in the elderly. Clinical manifestations include dementia with abrupt onset, step-wise progression, and focal neurologic signs and symptoms. Infarcts are scattered through the brain involving both subcortical and cortical regions secondary to hypertensive atherosclerotic cerebrovascular disease. Diagnosis is based on the presence of dementia with both cognitive and motor sequelae of stroke as suggested by an elevated "ischemic score." Neuro-imaging studies, while not particularly helpful in differential diagnosis, have identified a population with white matter hypodensity without clinical signs of dementia who may serve as a presymptomatic at-risk group, allowing for studies of the pathogenesis of stroke-related dementia. Management of the cognitive difficulties of MID is similar to that of other forms of dementia. Therapy is directed at patients with modalities that will reduce the likelihood of further vascular insults. This would include treatment of hypertension, cessation of smoking, avoidance of excessive alcohol intake, and use of aspirin for patients with atherothrombotic disease. Medical measures have been shown to be effective in reducing the occurrence of stroke. Further studies are needed to assess the benefits of these measures for MID exclusively.     

Randomized clinical trial of daily aspirin therapy in multi-infarct dementia. A pilot study

Seventy multi-infarct dementia patients were randomized into an aspirin-treated group and an untreated control group for an exploratory investigation to determine any effects of 325 mg aspirin daily on cognitive performance. The control group did not receive placebo but evaluations were carried out in a blinded manner. The index group (N = 37, mean age 67.1 years) received 325 mg of aspirin by mouth once daily while the control group (N = 33, mean age 67.6 years) was followed and treated in a similar manner except that they received no aspirin. Both groups had comparable risk factors for stroke, which were treated similarly, as well as comparable initial cerebral blood flow values, as measured by the 133xenon inhalation method, and initial scores on Cognitive Capacity Screening Examination testing. Patients were evaluated at intervals of one year. Significant improvements were demonstrated for cerebral perfusion values (P less than .0001) and cognitive performance scores (P less than .0001) among aspirin-treated patients compared to untreated controls at each of three annual follow-up evaluations. Both men and women benefited from aspirin therapy and their quality of life and independence appeared to be improved, which was not apparent in the control group. Daily aspirin appears to improve or stabilize declines in cerebral perfusion and cognition among patients with multi-infarct dementia.     

A case-control study of clinically diagnosed Alzheimer type dementia

A case-control study was conducted on 31 patients with clinically diagnosed Alzheimer type dementia, and 32 hospital and 373 community controls. Information was obtained from the next-of-kin for all subjects concerning life histories, health practice, eating habits, life events, family histories and past medical events. After adjusting for the effects of other factors, "intake of sweets" was significantly associated with dementia of the Alzheimer type. Those who had restricted intake of sweets were less common in the case group than in two control groups. Other factors examined in this study did not reach statistical significance.     

Alzheimer plaque density and duration of dementia

Thirty-two post-mortem Alzheimer cases with known duration of dementia were studied. Senile plaques (SP) in the neocortex and entorhinal cortex adjacent to the right hippocampus were stained with an antiserum to A4-beta-protein, which is specific for the amyloid protein and detects all plaque types including the amyloid-sparse diffuse plaques. The total number of SP per mm(2) of neocortex was significantly correlated to the duration of dementia (P<0.01). The total of beta-A4 stained tissue per mm(2) neocortex was also correlated to the duration of dementia (P<0.05). Our results support the assumption that more and more plaques form during the course of Alzheimer's disease and that they either disappear more slowly than they are generated or that they persist once they are formed.