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。

THE PRIMARY STUDY OF P_300 MAPPING IN CLOSED MILD BRAIN INJURY

In an attempt to understanding objective basis of psychiatric,psychological and intellctual change of the patients with closed mild brain injury, we made comparative observation of P300 mapping in 24 patients with colsed mild brain injury and 14 normal controls using Dantec Concerto?BEAM equipment. The results suggested that high amplitude area of P300 mapping was relatively confined to elliptical area close to Cz in normal controls and was confined to Cz area extending to bileteral posterior temporal area in subjects. The latency was longer and the differentiation of wave form was poor in subjects, but the amplitude was higher in the subjects than in normal controls. The repetive trial on the normal controls showed that the latency was a bit shorter and the amplitude was slightly higher. The high amplitude area of P300 mapping confined to more central area of Cz in normal controls and moved to posterior scalp area in subjects. The latency was further longer and the amplitude was widespreadly decreased in subjects, only the amplitude of T3 increased by 38 per cent curiously in subjects. The author suggested that the change above may result from weakening of integrating function of cortex and structures below cortex which P300 may be generated in. The results were consistent with views that P300 was generated by summated potentials of cortex and structures below cortexs.