發(fā)布時(shí)間：2018-03-14 12:45

  本文選題：阿爾茨海默病　切入點(diǎn)：認(rèn)知功能障礙　出處：《天津醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討MCI患者和正常老年人在閉目安靜狀態(tài)、任務(wù)負(fù)載狀態(tài)下腦電信號(hào)變化特征,以期為MCI臨床診斷提供客觀指標(biāo)。方法選擇2015年3月-2016年3月在天津醫(yī)科大學(xué)總醫(yī)院神經(jīng)內(nèi)科就診的MCI患者20例作為MCI組,另選擇與之性別、年齡及受教育年限等相匹配的健康志愿者20例作為對(duì)照組。分別進(jìn)行蒙特利爾認(rèn)知評(píng)估量表(MoCA)、記憶障礙自評(píng)量表(AD8)、醫(yī)院焦慮抑郁量表(HADS)、簡(jiǎn)易智能狀態(tài)檢查(MMSE)和臨床記憶量表(CMS)評(píng)分,應(yīng)用數(shù)字化腦電圖記錄系統(tǒng)分別采集MCI組及HC組在安靜狀態(tài)、任務(wù)負(fù)載狀態(tài)下腦電信號(hào),在MATLAB7.04平臺(tái)上計(jì)算腦電復(fù)雜度(Lemple-Zie Complexity,LZC)及時(shí)頻分析,采用SPSS19.0對(duì)結(jié)果進(jìn)行比較分析。結(jié)果1、MCI組MMSE、MOCA評(píng)分均低于HC組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2、HC組的記憶商及其各項(xiàng)分測(cè)驗(yàn)分值除圖像自由回憶外均高于MCI組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3、組間比較:安靜狀態(tài)下,HC組在左額、左顳區(qū)及FP1、F7導(dǎo)聯(lián)LZC值大于MCI組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);認(rèn)知狀態(tài)下,HC組LZC值在右額區(qū)、右半球及FP2導(dǎo)聯(lián)高于MCI組,而在左額區(qū)、左顳區(qū)、左半球及FP1導(dǎo)聯(lián)低于MCI組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)組內(nèi)比較:在安靜狀態(tài)下,左右半球比較,HC組LZC值在左額、左頂、左半球LZC值大于右側(cè),差異有統(tǒng)計(jì)學(xué)意義(P0.05);而MCI組為右額葉LZC值大于對(duì)側(cè),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。不同認(rèn)知狀態(tài)下比較,HC組在任務(wù)狀態(tài)下左額區(qū)、左頂區(qū)、左側(cè)半球及FP1、P3處的LZC值均低于安靜狀態(tài)(P0.05);MCI組右額區(qū)及FP2導(dǎo)聯(lián)腦電LZC值低于安靜狀態(tài),差異有統(tǒng)計(jì)學(xué)意(P0.05)。4、兩組在認(rèn)知狀態(tài)下腦電時(shí)頻圖比較圖片連續(xù)呈現(xiàn)階段(0-3秒):在HC組導(dǎo)聯(lián),未見(jiàn)明顯功率分布;MCI組FP1、F7導(dǎo)聯(lián)可見(jiàn)10Hz左右甚至可達(dá)β頻帶的功率分布,功率值較HC組偏高,FP2、F8、O1、O2導(dǎo)聯(lián)亦未見(jiàn)明顯功率分布。在連續(xù)圖片呈現(xiàn)后至探測(cè)圖片出現(xiàn)階段(4-8秒):組間比較:trial進(jìn)行4-8秒,開(kāi)始時(shí)HC組FP1、F7導(dǎo)聯(lián)功率明顯低于相應(yīng)的MCI組,但功率的頻率分布范圍達(dá)40-80Hz(γ頻帶),較MCI組(4-30Hz,θ-β頻帶)廣泛,約2s后HC組出現(xiàn)明顯的高功率值,頻率主要集中在10Hz左右(α頻帶)。組內(nèi)比較:HC組在Fp1、FP2、F7、F8、O1、O2均可見(jiàn)trial 3S后功率值增高;而MCI組僅在FP2、F8、O1、O2導(dǎo)聯(lián)增高,在FP1、F7導(dǎo)聯(lián)未見(jiàn)明顯改變,仍保持高功率,功率頻帶分布范圍從θ到β頻段(4-30Hz)。結(jié)論1、神經(jīng)心理量表是診斷及評(píng)估MCI的不可缺少的工具。適當(dāng)?shù)恼J(rèn)知功能檢測(cè)量表可針對(duì)性評(píng)估MCI患者的不同認(rèn)知側(cè)面。2、在非線性角度,安靜狀態(tài)下,MCI組腦電LZC值左側(cè)優(yōu)勢(shì)消失,出現(xiàn)左頂葉、左額葉及右側(cè)腦區(qū)代償;LZC值可用做MCI早期功能改變的客觀研究工具。3、在線性角度,MCI腦電存在高頻成分缺失,并且左前額及左前顳區(qū)在認(rèn)知負(fù)載狀態(tài)欠缺活躍度增強(qiáng),可能存在功能障礙。
[Abstract]:Objective to investigate the characteristics of EEG changes in the patients with MCI and the normal elderly under the condition of closed eyes and task load. Methods from March 2015 to March 2016, 20 MCI patients in the Department of Neurology, General Hospital of Tianjin Medical University were selected as MCI group, and their sex was chosen. Twenty healthy volunteers matched in age and years of education were treated with the Montreal Cognitive Assessment scale (MOCAA), the Self-Rating memory Disorder scale (AD8), the Hospital anxiety and Depression scale (HADSE), the simple Mental State examination (MMSE), and the Clinical Cognitive Assessment scale (MMSE). Bed memory scale (BMS) score, The EEG signals of MCI group and HC group were collected by digital EEG recording system under the condition of quiet state and task load respectively. The EEG complexity was calculated on MATLAB7.04 platform and the frequency of EEG was analyzed by Lemple-Zie Complexity (LZC) in time. Results 1 the scores of MMSE MOCA in MMSE MCI group were lower than those in HC group. There was significant difference in memory quotient (MQ) and its subtest scores in MMSE group compared with HC group (P 0.05). The scores of MMSE MOCA in MMSE MCI group were higher than those in MCI group except image free recall. The difference was statistically significant (P 0.05). 3. Comparison between groups: the LZC value of left frontal, left temporal area and FP1F7 lead in HC group was higher than that in MCI group, and the LZC value of HC group was higher in right frontal area, right hemispheres and FP2 lead than MCI group in cognitive state. In the left frontal region, the left temporal region, the left hemisphere and the FP1 lead group, the difference was statistically significant (P 0.05). The LZC values in the left and right hemispheres were higher than those in the left frontal, left parietal, and left hemispheres groups in the rest state, and the LZC values in the left frontal, left parietal and left hemispheric hemispheres were higher than those in the right. The difference was statistically significant (P 0.05), while in MCI group the LZC value of right frontal lobe was higher than that of contralateral side, and the difference was statistically significant (P 0.05). The left frontal area and left parietal area were compared in different cognitive states in HC group. The LZC values in the left hemisphere and FP1 / P3 were lower than those in the rest P0.05 / MCI group, and the LZC values of the right frontal area and the FP2 lead were lower than those in the quiet state. The difference was statistically significant (P0.05 路4). In the cognitive state, the EEG time-frequency images of the two groups showed a continuous phase of 0-3 seconds: in the lead of HC group, there was no significant difference between the two groups. There was no obvious power distribution in the FP1F7 lead of MCI group, and the power distribution could even reach 尾 band at about 10 Hz. The power value was higher than that in HC group, and there was no obvious power distribution in lead FP2F8O1O _ 2. The power of lead FP1F7 in HC group was obviously lower than that in MCI group at the beginning, and the power of lead FP1F7 in HC group was obviously lower than that in MCI group at the beginning. But the frequency distribution range of power is 40-80 Hz (緯 band is wider than that of MCI group 4-30 Hz, 胃-尾). After about 2 seconds, HC group has obvious high power value, and the frequency is mainly about 10 Hz (偽 frequency band). The power value of trial 3s is higher in Fp1 / FP2F7F8O1O1O _ 2 group than in Fp1 / FP2F7F8O1O1O _ 2 group. However, in the MCI group, only in the FP2F8F8O1O1O 2 lead increased, but no obvious change was found in the FP1F7 lead, and the high power was maintained in the MCI group. Conclusion 1. The neuropsychological scale is an indispensable tool for the diagnosis and evaluation of MCI. Appropriate cognitive function measurement scales can be used to evaluate the cognitive profile of patients with MCI. In the quiet group, the left dominance of LZC disappeared, and the left parietal lobe, left frontal lobe and right brain region compensatory LZC value could be used as an objective tool to study the early functional changes of MCI. There was a loss of high frequency components in the linear angle. Moreover, the left forehead and left anterior temporal region were not active in cognitive load state, and there might be dysfunction.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R749.1
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本文編號(hào)：1611266