Kügler C F, Petter J, Taghavy A, Lotterer E, Wensing G, Hahn E G, Fleig W E
1st Department of Internal Medicine, University of Erlangen-Nürnberg, Germany.
Electroencephalogr Clin Neurophysiol. 1994 Jul;91(1):33-41. doi: 10.1016/0013-4694(94)90016-7.
The dynamics of cognitive brain functions of 104 patients with both chronic non-cirrhotic (NC) and cirrhotic liver disease (C: C1, non-encephalopathic; C2, encephalopathic) were investigated by means of visual P300 potentials elicited in both the paradigms of transient (PI) and selective attention (PII). Conventional PVEPs, psychometric tests and quantitative liver function tests were also performed. As compared to both an age-matched control group (N) and the non-cirrhotic patients (NC), the N250 and P300 latencies of the cirrhotics (C) were equally prolonged in both P300 paradigms (P = 0.0001). By contrast, the P300 amplitudes were not different between the patient groups in either P300 paradigm. In the cirrhotics, however, the P300 amplitude differences between PII and PI (+ 3.7 +/- 2.8 muV, mean +/- 1 S.D.) were significantly (P < 0.01) smaller than in the non-cirrhotics (+ 7.5 +/- 5.2 muV) reflecting disturbances in the dynamics of visual attention. Interestingly, these P300 amplitude differences between both paradigms were positively correlated (r = 0.35; P = 0.005) with hepatic metabolic capacity, but not with liver blood flow (r = 0.23; P > 0.05). The diagnostic efficacy of the visual P300 in PI (sensitivity, 48%; specificity, 100%) was lower than that of the visual P300 in PII (79%; 100%) and that of the psychometric tests (63%; 94%), but it remained superior to that of the PVEPs (29%; 97%). It is concluded that in patients with cirrhotic liver disease visual P300 potentials can even reveal the dynamics of minor cognitive brain dysfunction and may also provide interesting pathophysiological information.
通过瞬态（PI）和选择性注意（PII）范式诱发的视觉P300电位，对104例慢性非肝硬化（NC）和肝硬化肝病患者（C：C1，非肝性脑病；C2，肝性脑病）的认知脑功能动态进行了研究。还进行了传统的视觉诱发电位（PVEP）、心理测量测试和定量肝功能测试。与年龄匹配的对照组（N）和非肝硬化患者（NC）相比，肝硬化患者（C）在两种P300范式下的N250和P300潜伏期均同样延长（P = 0.0001）。相比之下，在任一P300范式中，患者组之间的P300波幅并无差异。然而，在肝硬化患者中，PII和PI之间的P300波幅差异（+ 3.7 +/- 2.8 μV，平均值 +/- 1标准差）显著（P < 0.01）小于非肝硬化患者（+ 7.5 +/- 5.2 μV），反映出视觉注意力动态的紊乱。有趣的是，两种范式之间的这些P300波幅差异与肝脏代谢能力呈正相关（r = 0.35；P = 0.005），但与肝血流量无关（r = 0.23；P > 0.05）。PI中视觉P300的诊断效能（敏感性，48%；特异性，100%）低于PII中视觉P300的诊断效能（79%；100%）和心理测量测试的诊断效能（63%；94%），但仍优于PVEP的诊断效能（29%；97%）。得出结论，在肝硬化肝病患者中，视觉P300电位甚至可以揭示轻微认知脑功能障碍的动态变化，并且可能还提供有趣的病理生理信息。
