脑电近似熵分析对帕金森病患者认知功能障碍的评估作用

摘要

目的:观察帕金森病(PD)患者与对照者的脑电近似嫡的差异,并探讨其对PD认知功能障碍的评估作用.方法:对31例PD患者和31例对照组进行简易精神状态检查量表(MMSE)测试、蒙特利尔认知评估量表(MoCA)测试、事件相关电位(ERP)检测P300波潜伏期(P3PL),采集安静闭眼、闭眼心算、安静睁眼三种状态下的脑电信号,利用非线性参数近似熵对脑电数据进行分析.结果:①与对照组相比,PD组MMSE评分和MoCA评分均降低,P3PL延长,差异有统计学意义;②与对照组相比,在安静闭眼、闭眼心算、安静睁眼三种状态下,PD组的近似熵在大部分脑区降低,差异有统计学意义这些脑区在安静闭眼状态时是FP1、FP2、F4、O2、F8、T3、T4、T5、T6,在闭眼心算状态时是FP1、F3、F4、C3、P3、O1、T3、T5、T6,在安静睁眼状态时除C4外的15个脑区;③与对照组相比,PD患者近似嫡变化值于F3、C3、P3、O1降低,差异有统计学意义;④所有受试者安静闭眼、闭眼心算、安静睁眼三种状态下大部分脑区近似熵值与MMSE评分、MoCA评分呈正相关,与P3PL呈负相关.结论:脑电近似熵可以作为一项客观评定PD患者认知功能障碍的电生理指标.%Objective:To examine the differences of cognitive impairment measured by EEG approximate entropy (ApEn) between patients with Parkinson's disease (PD) and healthy controls so as to identify the validity and sensitivity of EEG ApEn as a tool of cognitive assessment for patients with PD. Methods: A cross-sectional survey was carried out among 31 patients with PD and 31 healthy controls, by Mini-mental state examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), Eevent-related potential (ERP)P300 peak latency (P3PL) and EEG ApEn. The EEG was recorded in the three states : eyes closed, eyes opened and mental arithmetic with eyes closed . The EEG ApEn was calculated and compared with different states. Results: 1. Compared with healthy controls, patients with PD had significantly lower scores in MMSE and MoCA and more prolonged P3PL. 2. There were significant differences in EEG ApEn between healthy controls and paitents with PD in terms of Fp1 , Fp2, F4 ,O2, F8, T3, T4 ,T5 and T6 in the eye-closed state, Fp1,F3 ,F4,C3 ,P3 ,O1 ,T3 ,T5 and T6 in mental arithmetic with eyes closed, and all records for the eye-opened state except C4. 3. There were significant differences in the variation of EEG ApEn between healthy controls and paitents with PD in terms of F3 ,C3 ,P3 and O1. 4. There was a significant correlation among the scores of EEG ApEn, MMSE, MoCA and P3PL. Conclusion: EEG ApEn can be used as a tool of assessent for cognitive impairment in patients with PD.