Clinical study on the value of combining neuropsychological tests with auditory event-related potential P300 for cognitive assessment in elderly patients with cerebral small vessel disease

摘要

Objective To investigate the value of combining neuropsychological tests with auditory event-related potential (ERP) P300 for cognitive assessment in elderly patients with cerebral small vessel disease (cSVD). Methods A total of 183 elderly patients with cSVD were enrolled in this study. They were divided into 3 groups according to brain MRI: lacunar infarct (LACI) group (N = 62), white matter hyperintensity (WMH) group (N = 60) and LACI + WMH group (N = 61). A total of 50 brain MRI normal persons were selected as control group. Montreal Cognitive Assessment (MoCA, Chinese version) was used to evaluate the cognitive function, and the amplitude and latency of P300 were measured in each group. Results Compared with control group, the MoCA total score in LACI, WMH and LACI + WMH groups were significantly lower ( P = 0.042, 0.015, 0.000), and the score in LACI + WMH group was significantly lower than that in LACI and WMH groups ( P = 0.001, 0.042). In the eight cognitive domains of MoCA scale, the visual space and executive function ( P = 0.006, 0.041, 0.035), delayed memory ( P = 0.006, 0.012,?0.048), language ( P = 0.001, 0.032, 0.047) and calculation ( P = 0.009, 0.001, 0.003) in LACI + WMH group were significantly lower than those in control, LACI and WMH groups. The delayed memory in LACI group was significantly lower than that in control group ( P = 0.037). The delayed memory ( P = 0.005) and language ( P = 0.047) in WMH group were significantly lower than those in control group. Compared with control group, the amplitudes of P300 ( P = 0.025, 0.033, 0.000) in LACI, WMH and LACI + WMH groups were significantly decreased, and the latencies ( P = 0.018, 0.000, 0.000) were significantly prolonged. The amplitude of P300 in LACI + WMH group was significantly lower than that in LACI and WMH groups ( P = 0.041, 0.018), and the latency was significantly prolonged ( P = 0.000, 0.022). Conclusions Elderly patients of cSVD all suffer from different degrees of cognitive impairment, especially those with both LACI and WMH. The impaired cognitive domains mainly include visual space and executive function, delayed memory, language and calculation. MoCA scale and P300 examination have their advantages in cognitive assessment, and their combination shows more objective result. Early diagnosis of cSVD in elderly patients with MoCA and P300 is beneficial to timely treatment, delay the progression of this disease and ease the family and social burden. DOI: 10.3969/j.issn.1672-6731.2016.11.009