老年认知功能障碍患者的3种事件相关电位研究

目的：探讨老年认知功能障碍患者，包括轻度认知功能障碍（MCI）和阿尔茨海默病（AD）患者的3种事件相关电位P300，失匹配负波（MMN）和关联性负变（CNV）的改变，以了解三者在MCI中的诊断价值。方法2011年2月至2013年3月上海交通大学附属第六人民医院老年病科门诊或住院的患者及健康体检者120位，年龄≥60岁。测量轻度AD患者（AD组，n＝40）、MCI患者（MCI组，n＝40）、认知正常老人（NC组，n＝40）的事件相关电位（ERP，包括P300，MMN，CNVM1，CNVM2）的峰潜伏期（PL）与振幅（Amp）。结果 AD组ERP的PL均长于MCI组（P＜0.05）。MCI组中P300和MMN的PL（380.94±37.55），（188.63±31.63）ms]均长于NC组（342.88±41.72），（137.48±28.69）ms；P＜0.05]，而MCI组中CNVM1及CNVM2的PL与NC组相比，差异无统计学意义（P＞0.05）。AD组与NC组相比，ERP的Amp明显降低（P＜0.05）。MCI组中MMN和CNVM2的Amp与NC组相比降低（P＜0.05），MCI组与AD组相比，ERP的Amp差异无统计学意义（P＞0.05）。结论 P300，MMN和CNV对MCI的诊断有一定的参考价值，其中P300和MMN区分MCI患者与正常人的敏感性略高于CNV。

Three event-related potentials in elderly patients with cognitive impairment

Objective To investigate the event-related potentials （ERP）, P300, mismatch negativity （MMN）, and contingent negative variation （CNV） in the elderly patients with cognitive impairment, including Alzheimer’s disease （AD） and mild cognitive impairment （MCI）, to evaluate the diagnostic value of the 3 ERP in patients with MCI. Methods A total of 80 cognitive impairment in-and out-patients with age over 60 years in our department from February 2011 to March 2013 were enrolled in this study, and they were divided into mild AD group （n=40） and MCI group （n=40）. Another 40 individuals with normal cognition served as normal control. Peak latencies （PL） and amplitudes （Amp） of the ERP, including P300, MMN, CNVM1, and CNVM2 were measured. Results Compared with the NC group, the PL of ERP were significantly delayed in the AD group （P〈0.05）. The PL of P300 （380.94±37.55）ms] and MMN （188.63±31.63）ms] in the MCI group were longer than those of the NC group （342.88±41.72） vs （137.48±28.69）ms;P〈0.05]. However, significant difference was not found in PL of CNVM1 and CNVM2 between MCI group and NC group （P〉0.05）. Compared with the NC group, the Amp of the three ERP in the AD group were significantly shorter （P〈0.05）. The Amp of MMN and CNVM2 in the MCI group were shorter than those in the NC group （P〈0.05）. There was no significant difference in the Amp of the 3 ERP between the AD and MCI groups （P〉0.05）. Conclusion P300, MMN and CNV （CNVM1 and CNVM2） are of value in the diagnosis of MCI. P300 and MMN are superior to CNV in distinguishing MCI from normal cognitive function.