Department of Paediatrics, Turku University Hospital, Turku, Finland.
Clin Neurophysiol. 2011 Jan;122(1):62-72. doi: 10.1016/j.clinph.2010.05.031. Epub 2010 Jul 6.
The purpose of this study was to analyze event related potentials mismatch negativity (MMN) and P3a in childhood cancer patients at the time of diagnosis (Study 1) and after treatment (Study 2) to evaluate their clinical usefulness in screening potential treatment-related neurotoxicity.
The MMN and P3a to phonetic stimuli were examined in 27 childhood cancer patients with age- and sex-matched controls. Neuropsychological tests were also studied.
The MMN peak amplitude was attenuated in the patient group at Study 1. Between the studies, poorer enhancement of the MMN peak amplitude correlated with deterioration in the Verbal intelligence quotient (IQ) in leukaemia patients. In addition, prolongation of the MMN peak latency correlated significantly with deterioration in the Full Scale and Performance IQ in the patient group. Deterioration in the Arithmetic subtest and Performance IQ correlated negatively with the age at diagnosis.
The MMN changes between the studies associated with deterioration in the neuropsychological tests indicating that the method could be clinically useful. The performance of the younger patients was more likely to deteriorate during the treatment.
Changes in the MMN response during cancer treatment seem to be of clinical importance as indicates of the cognitive outcome of childhood cancer patients.
本研究旨在分析儿童癌症患者在诊断时（研究 1）和治疗后（研究 2）的事件相关电位失匹配负波（MMN）和 P3a，以评估其在筛查潜在治疗相关神经毒性方面的临床应用价值。
对 27 例年龄和性别匹配的儿童癌症患者和对照组进行了语音刺激的 MMN 和 P3a 检测。还研究了神经心理学测试。
在研究 1 中，患者组的 MMN 峰值幅度减弱。在两项研究之间，MMN 峰值幅度的增强较差与白血病患者言语智商（IQ）的恶化相关。此外，MMN 峰潜伏期的延长与患者组全量表和操作智商的恶化显著相关。算术亚测验和操作智商的恶化与诊断时的年龄呈负相关。
研究之间的 MMN 变化与神经心理学测试的恶化相关，表明该方法具有临床应用价值。治疗期间，年龄较小的患者的表现更有可能恶化。
癌症治疗过程中 MMN 反应的变化似乎具有临床重要意义，表明其可作为儿童癌症患者认知结果的指标。
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