Cohen R A, O'Donnell B F, Meadows M E, Moonis M, Stone W F, Drachman D A
Department of Neuropsychology, Miriam Hospital, Brown University Medical School, Providence, Rhode Island 02906, USA.
J Geriatr Psychiatry Neurol. 1995 Oct;8(4):217-25. doi: 10.1177/089198879500800404.
We compared the relative value of neuropsychological and event-related potentials (ERPs) obtained during both passive and active auditory oddball paradigm measures for determining functional outcome in dementia 4 years following initial assessment. Functional outcome was assessed by structured interview of family members of 29 patients with dementia, and patients' functional status was rated in seven areas: mortality, incontinence, institutionalization, ADL dependence, verbal responsiveness, recognition of family members, and capacity for social interaction. A total functional outcome score (ADLTOTAL) was obtained by summing across these individual outcome measures. Many of the neuropsychological measures correlated strongly with overall functional outcome, whereas P3 amplitude and latency on the active ERP condition were the only ERP indices to predict functional outcome. When ERP and neuropsychological measures were considered simultaneously using stepwise multiple regression analyses, the neuropsychological measures were better predictors of most functional outcomes, although P3 latency was the best predictor of mortality. However, neuropsychological performance and ERPs appear to be sensitive to different functional outcomes. Therefore, evaluation of both ERPs and neuropsychological performance may ultimately have prognostic utility in the assessment of patients with dementia.
我们比较了在被动和主动听觉Oddball范式测量过程中获得的神经心理学指标和事件相关电位(ERP)的相对价值,以确定痴呆症患者在初次评估4年后的功能转归。通过对29名痴呆症患者的家庭成员进行结构化访谈来评估功能转归,并在七个方面对患者的功能状态进行评分:死亡率、失禁、住院、日常生活活动依赖、言语反应、对家庭成员的识别以及社交互动能力。通过对这些个体转归指标进行汇总,得出总功能转归评分(ADLTOTAL)。许多神经心理学指标与整体功能转归密切相关,而主动ERP条件下的P3波幅和潜伏期是仅有的能够预测功能转归的ERP指标。当使用逐步多元回归分析同时考虑ERP和神经心理学指标时,神经心理学指标是大多数功能转归的更好预测指标,尽管P3潜伏期是死亡率的最佳预测指标。然而,神经心理学表现和ERP似乎对不同的功能转归敏感。因此,评估ERP和神经心理学表现最终可能在痴呆症患者的评估中具有预后效用。