重新审视 P300 认知研究在痴呆症诊断中的应用：路易体痴呆（DLB）和阿尔茨海默病（AD）的早期痴呆症。

Revisiting P300 cognitive studies for dementia diagnosis: Early dementia with Lewy bodies (DLB) and Alzheimer disease (AD).

机构信息

Department of Neuroscience and Imaging, Aging Research Center, Institute of Neurology, Ce.S.I., Gabriele d'Annunzio University Foundation, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini, 66013 Chieti, Italy.

出版信息

Neurophysiol Clin. 2010 Nov-Dec;40(5-6):255-65. doi: 10.1016/j.neucli.2010.08.001.

DOI:10.1016/j.neucli.2010.08.001

PMID:21093797

Abstract

AIMS OF THE STUDY

Earlier P300 studies were conducted when the prevalence of dementia with Lewy Bodies (DLB) was unknown. Our study aims to examine whether P300 abnormalities are present in DLB and to evidence possible differences between DLB and Alzheimer's disease (AD). A second aim of this study is to look for correlations between P300 recordings and EEG, as abnormal EEG variability has been described in DLB.

PATIENTS AND METHODS

Auditory P300 responses were recorded by a classic oddball paradigm in 50 controls, in 36 DLB patients, and in 40 AD patients with MMSE>20.

RESULTS

Reliable auditory P300 responses were obtained in 26 DLB (72%), 33 AD (82.5%), and 46 controls (92%). P300 was more delayed and had lower amplitude in DLB compared to AD groups. P300 topography was also different as the anterior-to-posterior scalp amplitude gradient was reversed in DLB. P300 latency correlated with neuropsychological test scores and with EEG variables. Gradient inversion and delayed P300 responses in frontal derivations evidenced differences between DLB and AD patients with a sensitivity of 70% and a specificity of 97%.

CONCLUSIONS

P300 recordings are abnormal in DLB and can be useful to distinguish DLB from AD.

摘要

研究目的

早期的 P300 研究是在路易体痴呆（DLB）的患病率未知的情况下进行的。我们的研究旨在检查 P300 异常是否存在于 DLB 中，并证明 DLB 和阿尔茨海默病（AD）之间可能存在差异。本研究的第二个目的是寻找 P300 记录与 EEG 之间的相关性，因为已经描述了 DLB 中 EEG 变异性异常。

患者和方法

通过经典的Oddball 范式记录了 50 名对照者、36 名 DLB 患者和 40 名 MMSE>20 的 AD 患者的听觉 P300 反应。

结果

在 26 名 DLB（72%）、33 名 AD（82.5%）和 46 名对照者（92%）中获得了可靠的听觉 P300 反应。与 AD 组相比，DLB 的 P300 潜伏期更长，幅度更低。P300 地形图也不同，因为 DLB 中的额区到枕区头皮振幅梯度反转。P300 潜伏期与神经心理学测试评分和 EEG 变量相关。在额叶导联中，梯度反转和 P300 潜伏期延迟表明 DLB 和 AD 患者之间存在差异，其敏感性为 70%，特异性为 97%。