Devinsky O, Sato S, Conwit R A, Schapiro M B
EEG Laboratory, National Institute of Neurological Disorders and Stroke, Bethesda, Md. 20892.
Arch Neurol. 1990 Jan;47(1):58-62. doi: 10.1001/archneur.1990.00530010072022.
We studied 19 young adults (19 to 37 years old) and 9 older patients (42 to 66 years old) with Down's syndrome (DS) and a control group of 13 healthy adults (22 to 38 years old) to investigate the relation of electroencephalographic (EEG) alpha background to cognitive function and cerebral metabolism. Four of the older patients with DS had a history of mental deterioration, disorientation, and memory loss and were demented. Patients and control subjects had EEGs, psychometric testing, quantitative computed tomography, and positron emission tomography with fludeoxyglucose F 18. A "blinded" reader classified the EEGs into two groups--those with normal alpha background or those with abnormal background. All the control subjects, the 13 young adult patients with DS, and the 5 older patients with DS had normal EEG backgrounds. In comparison with the age-matched patients with DS with normal alpha background, older patients with DS with decreased alpha background had dementia, fewer visuospatial skills, decreased attention span, larger third ventricles, and a global decrease in cerebral glucose utilization with parietal hypometabolism. In the young patients with DS, the EEG background did not correlate with psychometric or positron emission tomographic findings, but the third ventricles were significantly larger in those with abnormal EEG background. The young patients with DS, with or without normal EEG background, had positron emission tomographic findings similar to those of the control subjects. The mechanism underlying the abnormal EEG background may be the neuropathologic changes of Alzheimer's disease in older patients with DS and may be cerebral immaturity in younger patients with DS.
我们研究了19名年轻成人（19至37岁）和9名老年唐氏综合征（DS）患者（42至66岁），并以13名健康成人（22至38岁）作为对照组，以研究脑电图（EEG）阿尔法背景与认知功能及脑代谢之间的关系。9名老年DS患者中有4名有精神衰退、定向障碍和记忆力减退病史，已患痴呆症。患者和对照受试者均接受了脑电图检查、心理测试、定量计算机断层扫描以及用氟脱氧葡萄糖F 18进行的正电子发射断层扫描。一名“盲法”读者将脑电图分为两组——阿尔法背景正常组和异常组。所有对照受试者、13名年轻成人DS患者以及5名老年DS患者的脑电图背景均正常。与年龄匹配的阿尔法背景正常的DS患者相比，阿尔法背景降低的老年DS患者患有痴呆症，视觉空间技能较少，注意力持续时间缩短，第三脑室较大，且脑葡萄糖利用整体下降，顶叶代谢减退。在年轻DS患者中，脑电图背景与心理测试或正电子发射断层扫描结果无关，但脑电图背景异常者的第三脑室明显更大。有或没有正常脑电图背景的年轻DS患者，其正电子发射断层扫描结果与对照受试者相似。脑电图背景异常的潜在机制可能是老年DS患者存在阿尔茨海默病的神经病理变化，而年轻DS患者可能是脑发育不成熟。
