定量脑电图对脑白质损害患者认知功能障碍的诊断价值

目的探讨定量脑电图对脑白质损害(WMLs)患者认知功能障碍的诊断价值。方法纳入WMLs患者152例(WMLs组),再依据Fazekas分级分为3个亚组:Fazekas 1级亚组(45例)、Fazekas 2级亚组(52例)和Fazekas 3级亚组(55例);另选择同期门诊体检及头颅MRI阴性的健康人群为对照组(45例)。所有研究对象均进行定量脑电图分析和MoCA量表认知功能测试,并采集相关数据进行统计学分析。结果 Fazekas 1级亚组MoCA量表各项评分与对照组比较差异无显著性;Fazekas 2级亚组在MoCA量表总分、视空间与执行能力、命名、注意力、复述、延迟记忆、抽象理解等7项评分低于对照组(P0.05);Fazekas 3级亚组MoCA量表总分及各项评分均显著低于对照组和Fazekas2级亚组(P0.05)。Fazekas 2级亚组和Fazekas 3级亚组额区、中央区、颞区、顶区及枕区的功率谱比值显著低于对照组(P0.05),其功率谱比值与MoCA量表评分呈中度正相关关系(r=0.411~0.593,P0.05)。结论定量脑电图与MoCA量表评估WMLs存在相关性,可用于脑白质损害患者认知功能障碍的诊断和评估。

The Diagnostic Value of Quantitative EEG on Cognitive Impairement in Patients with White Matter Lesions

Aim To investigate the value of quantitative analysis of digital EEG (qEEG) for diagnosing cognitive impairment in white matter lesions (WMLs) patients. Methods 152 patients with WMLs (45 patients for Fazekas Grade 1,52 patients for Fazekas Grade 2,55 patients for Fazekas Grade 3) and age-matched 45 normal controls were enrolled in the study. Montreal Cognitive Assessment Scale (MoCA) assessment and qEEG analysis were applied to all the participants. The analysis of data was performed and discussed. Results Test scores for visuospatial and executive functioning, naming, attention, language, abstraction, delayed recall, orientation in patients with Fazekas Grade 2 and 3 were significantly lower than that of normal control groups (P<0.05). qEEG analysis revealed a significant increase in delta and theta frequencies, and decrease in alpha and beta frequency band in cerebral bioelectrical activity in patient withFazekas Grade 2 and 3. In addition, power spectral ratios (alpha + beta] / delta + theta]) in frontal, central, temporal, parietal, and occipital regions were significantly decreased in patients with Fazekas Grade 2 and 3 compared with the normal controls groups. The slowing in EEG was moderately correlated with MoCA scores (r=0.411-0.593; P<0.05). Conclusion qEEG was moderately correlated with MoCA scores and could increase the diagnostic power in detecting cognitive impairment in WMLs patients.