食管癌合并抑郁症患者脑电图改变与额叶认知障碍的相关性
Correlation between Electroencephalogram Alterations and Frontal Cognitive Impairment in Esophageal Cancer Patients Complicated with Depression.
作者信息
Cao Yin, Chen Xia, Xie Hui, Zou Ling, Hu Li-Jun, Zhou Xian-Ju
机构信息
Department of Neurology, Laboratory of Neurological Diseases, Changzhou No. 2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu 213003, China.
Electroencephalogram Laboratory, Changzhou No. 2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu 213003, China.
出版信息
Chin Med J (Engl). 2017 Aug 5;130(15):1785-1790. doi: 10.4103/0366-6999.211552.
BACKGROUND
Some esophageal cancer patients complicated with depression exhibit cognitive impairments. Frontal electroencephalogram (EEG) may be used as a reliable biomarker for prefrontal-mediated cognitive functions. This study was to investigate alterations of EEG and frontal cognitive impairment in esophageal cancer patients complicated with depression and to assess their correlation.
METHODS
Sixty-five esophageal cancer patients with depression (study group) and 62 healthy controls (control group) were included in this study. The study group were assigned into psychotic depressed (PD, n = 32) and nonpsychotic depressed (NPD, n = 33) subgroups based on complication with psychotic symptoms (Brief Psychiatric Rating Scale [BPRS] >35). EEG examination, Beck self-rating depression scale, and BPRS were used to assess clinical symptoms. Chi-square test, two independent sample t-test, one-way analysis of variance, and Kruskal-Wallis test were utilized to compare the variables between two groups. EEG abnormalities and scores of frontal cognitive function test were analyzed by partial correlation analysis in the PD and NPD subgroups.
RESULTS
Compared with control group, the study group displayed greater scores either in the Stroop test (19.89 ± 2.05 vs. 24.12 ± 2.19, P = 0.006) or Color Trails Test (CTT; 11.92 ± 1.01 vs. 15.02 ± 1.63, P = 0.008), and reduced score (35.05 ± 2.01 vs. 32.11 ± 2.38, P = 0.007) in the verbal fluency test (VFT). Compared to NPD subgroup, PD subgroup exhibited increased scores in Stroop test (22.89 ± 2.07 vs. 25.38 ± 2.32, P = 0.009) and CTT (13.16 ± 1.71 vs. 15.82 ± 1.13, P = 0.008). Moreover, increased scores in Stroop test and CTT as well as scores in VFT were associated with the severity of depression. The study group had an abnormal frontal EEG, such as α forward, α asymmetry, α moderation, and increased θ activity relative to control group. Similarly, compared with NPD subgroup, PD subgroup displayed α forward, α asymmetry, and α moderation. The correlation test revealed that α forward and α asymmetry were negatively associated with VFT score, but positively correlated with the scores of CTT and the Stroop test in PD subgroup. In addition, α asymmetry in NPD subgroup was positively related to CTT scores.
CONCLUSION
This study indicated that frontal cognitive impairment in esophageal cancer patients complicated with depression is associated with EEG alterations.
背景
一些合并抑郁症的食管癌患者存在认知障碍。额叶脑电图（EEG）可用作前额叶介导的认知功能的可靠生物标志物。本研究旨在调查合并抑郁症的食管癌患者的脑电图改变和额叶认知障碍，并评估它们之间的相关性。
方法
本研究纳入了65例合并抑郁症的食管癌患者（研究组）和62例健康对照者（对照组）。根据是否伴有精神病性症状（简明精神病评定量表[BPRS]>35），将研究组分为精神病性抑郁（PD，n = 32）和非精神病性抑郁（NPD，n = 33）亚组。采用脑电图检查、贝克抑郁自评量表和BPRS评估临床症状。采用卡方检验、两独立样本t检验、单因素方差分析和Kruskal-Wallis检验比较两组间的变量。对PD和NPD亚组的脑电图异常和额叶认知功能测试得分进行偏相关分析。
结果
与对照组相比，研究组在Stroop测验（19.89±2.05对24.12±2.19，P = 0.006）或色线试验（CTT；11.92±1.01对15.02±1.63，P = 0.008）中的得分更高，而在言语流畅性测验（VFT）中的得分更低（35.05±2.01对32.11±2.38，P = 0.007）。与NPD亚组相比，PD亚组在Stroop测验（22.89±2.07对25.38±2.32，P = 0.009）和CTT（13.16±1.71对15.82±1.13，P = 0.008）中的得分更高。此外，Stroop测验和CTT得分以及VFT得分的增加与抑郁严重程度相关。研究组额叶脑电图异常，如α前移、α不对称、α调节，相对于对照组θ活动增加。同样，与NPD亚组相比，PD亚组表现出α前移、α不对称和α调节。相关性检验显示，在PD亚组中，α前移和α不对称与VFT得分呈负相关，但与CTT和Stroop测验得分呈正相关。此外，NPD亚组中的α不对称与CTT得分呈正相关。
结论
本研究表明，合并抑郁症的食管癌患者的额叶认知障碍与脑电图改变有关。
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