CN110074757A - The technology of event related potential N330 wave amplitude early diagnosis Patients with Leukoaraiosis cognition dysfunction - Google Patents

The technology of event related potential N330 wave amplitude early diagnosis Patients with Leukoaraiosis cognition dysfunction Download PDF

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CN110074757A
CN110074757A CN201910273606.5A CN201910273606A CN110074757A CN 110074757 A CN110074757 A CN 110074757A CN 201910273606 A CN201910273606 A CN 201910273606A CN 110074757 A CN110074757 A CN 110074757A
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leukoaraiosis
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黄文�
郑健
程畅
左旭政
陈秀英
唐维菊
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Abstract

The present invention relates to a kind of methods of leukoaraiosis Cognitive function damage early detection.Method of the visual space working memory delayed phase N330 wave amplitude that the present invention is induced using event related potential by delay sample matching way (DMS) normal form as the assessment objective reliable quantizating index of Patients with Leukoaraiosis Cognitive function damage.Experimental considerations unit is constituted by " target-delay-detection " 3 stages, collects the event related potential record of subject, correction rejects artefact, analyzes data, proposes N330 wave amplitude, diagnoses Leukoaraiosis cognitive disorder.Rely on neural scale and iconography at heart as defect existing for detection methods for previous, detection method of the present invention is not influenced by subjective consciousness, objectivity is good, can quantify, and sensibility and specificity is higher, can be fully solved insufficient present on the prior art.

Description

Event related potential N330 wave amplitude early diagnoses Patients with Leukoaraiosis cognitive function The technology of obstacle
Technical field
The invention belongs to medicine and bio-signal acquisitions and processing analysis technical field, and in particular to a kind of Leukoaraiosis The method of disease Cognitive function damage early detection.
Background technique
Leukoaraiosis is generally existing in mid-aged population, and in -75 years old 65 years old the elderlys, 92% people exists different The white matter lesions of degree, and increase with the increase at age.Leukoaraiosis can cause neurological deficit, show as recognizing Functional lesion is even dull-witted, is one of middle-aged and the old's vascular cognitive impairment, the main histological type of vascular dementia.
It is different from dementia caused by senile dementia and other reasons, Vascular Cognitive function caused by buiswangen disease Obstacle and dementia belong to curability disease, and key is still early diagnosis, early treatment.But at present to Patients with Leukoaraiosis The early diagnosis of Cognitive function damage has the following deficiencies: that (1) diagnosis basis is based primarily upon the standard formulation of senile dementia, lacks The weary specificity for vascular cognitive impairment.(2) diagnosis relies primarily on neuropsychological test detection and iconography money Material, but the detection objectivity of neuropsychological test is poor, vulnerable to patient's educational level, subjective consciousness and tester's subjective consciousness Influence;And the morphological change that imaging data represents can not often represent the change of function, and the positive is found often Middle and advanced stage in disease loses early intervention chance.
Therefore, it is badly in need of wanting that a kind of objectivity is good, can quantify and sensibility is higher to Patients with Leukoaraiosis cognitive function The method for damaging detection.
Summary of the invention
Aiming at the above shortcomings existing in the prior art, the purpose of the present invention is to provide a kind of cognitions of leukoaraiosis The method of functional lesion early detection, the detection method are not influenced by subjective consciousness, and objectivity is good, can quantify, and sensibility and Specificity is higher.
To achieve the above object, the invention provides the following technical scheme:
The present invention is a kind of method of leukoaraiosis Cognitive function damage early detection, passes through delay sample match party The visual space working memory delayed phase that formula (Delayed matching-to-sample task, DMS) normal form induces N330 wave amplitude as assessment the objective reliable quantizating index of Patients with Leukoaraiosis Cognitive function damage method, referring to Fig. 1, Fig. 2, comprising the following steps:
(a) stimulation programs of event related potential
(a1) it is presented using E-Prime system editor stimulus modality and control stimulation, visual space Working Memory Task is adopted With DMS normal form: constituting experimental considerations unit by " target-delay-detection " 3 stages.Subject's viewing screen, it is mono- in 3x3 first " beginning " printed words are presented in the grid of first lattice middle, and the presentation time changes at random between 700ms~1400ms;
(a2) target phase: a grey chromosphere is presented on random site in 3x3 cell, time 1000ms is presented, even It is continuous to be presented two grey chromospheres, between each ball between be divided into 60ms, this demands subject remembers the position that grey chromosphere occurs It sets;
(a3) delayed phase: blank 3x3 cell is presented, time 1500ms, this demands subject is in brains The position for constantly repeating the grey chromosphere that reinforcing front is presented, so as to the problem of answering below;
(a4) detection phase: occurs a red ball at random in 3x3 cell, it is desirable that subject judges this red ball Whether the position occurred with the grey chromosphere of any one of the two grey chromospheres in front is consistent, unanimously presses right button, inconsistent by a left side Key, subject are apprised of;After judging, with prestissimo key, experimental setup detection phase up to 5000ms, if by Examination person is during 5000ms according to abandoning handling automatically without making a response;
(b) record of event related potential and analysis
(b1) subject is sitting in quiet screened room, using ERP work station as platform, Galileo system synchronous recording brain electricity Figure carries out off-line type post-processing using German BESA software after completing continuous record EEG;
(b2) after correcting VEOG and HEOG, wave amplitude is greater than ± 120 μ V persons and is considered as artefact automatic rejection, sufficiently exclusion artefact Afterwards, delayed phase eeg data is analyzed, carries out average superposition to correct EEG is reacted.To delayed phase eeg data When being analyzed, analysis time-histories is the delayed phase of 1500 ms after target phase stimulation disappears, and baseline is before stimulation disappears 100ms。
(b3) visual space stimulus material all induces N330, P420, advanced stage negative composition (Late Negative in full brain Component, LNC);LNC is continued for since 700ms to delayed phase terminating and (occurring to detection stimulation).It mentions Event related potential N330 wave amplitude is taken to objectify monitoring index as Leukoaraiosis cognitive disorder.
It is compared with the prior art, the invention has the following beneficial effects:
The present invention takes the lead in visual space working memory delayed phase ERP index (the N330 wave for selecting DMS normal form to induce Width) it is used as leukoaraiosis Cognitive function damage monitoring index, the results showed that and it is white that the Indexs measure can be used as earlier evaluations brain The loose cognitive function of patients of matter damages objective reliable quantizating index;Our early-stage studies have been found that in Ischemic Stroke hindbrain The extraction stability of N330 wave amplitude is good in White matters lesions patient, and repeatability is high, and N330 wave amplitude is that the memory and delay stage can be with One of the three identifiable ingredients drawn, can react cognitive function overall process.Our test normal form can be good at Now stimulate task, experimental subjects Cognitive Processing task-aware avoids the dispute for being similar to and originating to P300, so as to cause finger The discussion for marking clinical meaning is limited.
The detection method that the present invention uses is not influenced by subjective consciousness, can continuous dynamically recording, can quantify, it is higher Sensibility, specificity;Cheap, easy to implement, basic devoid of risk.Clinically Leukoaraiosis cognitive disorder is examined at present Disconnected to rely primarily on imaging diagnosis and graphic diagnosis, the defect of imaging diagnosis is could be really when iconography symptom occurs in patient It examines, cannot achieve early diagnosis, and MRI, CT examination are not suitable for screening;The defect of graphic diagnosis is for Leukoaraiosis Disease sensibility is poor, and cognitive impairment degree is influenced by factors such as patient itself education levels.Event provided by the invention is related Current potential N330 wave amplitude objectifies monitoring index as Leukoaraiosis cognitive disorder, that is, is able to achieve early diagnosis, and sensibility, spy Anisotropic high, cheap, easy to implement, basic devoid of risk is suitable for extensive screening.
Detailed description of the invention
Fig. 1 is the flow chart that DMS normal form event related potential N330 diagnoses Leukoaraiosis cognitive disorder
Fig. 2 is the time sequencing figure of visual space memory tasks, including " target-delay-detection " 3 stages are constituted in fact Verification certificate member.
Fig. 3 is that DMS normal form induces visual space working memory delayed phase N330 wave amplitude topographic map;It can from figure Out, the visual space working memory delayed phase N330 wave amplitude induced by DMS normal form, wave crest is obvious, and wave amplitude topographic map is aobvious Show: the normal group biggish position of wave amplitude is distributed in bilateral top pillow association area, right side temporal lobe, right frontal lobe, embodies right dominance;Gently The degree larger position of Patients with Leukoaraiosis wave amplitude is located at behind right side temples behind temples, left side;The middle larger position of severe person's wave amplitude Centrally located area, side to the right.
Fig. 4 is three groups of subject visual space working memory event related potential overall average figures: black curve-control group;Red yeast rice Leukoaraiosis group that line-is slight;The blue middle severe leukoaraiosis group of curve-.It can be seen from the figure that always being put down by ERP Equal map analysis, N330 wave crest is significant [F (2,62)=5.87 (P < 0.01)] with illness group difference in normal group, and white matter of brain is dredged Loose disease patient N330 wave amplitude is substantially reduced.
Specific embodiment
The present invention will be further explained by examples below.The present embodiment is based on the technical solution of the present invention Under implemented, give detailed embodiment and content, but scope of the invention is not limited to the following embodiments.
1, subject is screened
Research object: having recruited the old artificial control groups of 12 head magnetic resonance imaging no abnormality seens in this research, and 13 Mild cerebral ischemic White matters lesions person is turned out to be through head magnetic resonance, it is empty to complete vision by severe ischemic White matters lesions person in 11 Between working memory ERP test.
It is included in standard: (1) risk factors of cerebrovascular diseases: 55~75 years old, hypertension, diabetes, hyperlipidemia, smoking etc.; (2) MRI:Binswange type White matters lesions: high RST extends to periventrcular and deep white matter;Extension emits (< 10mm and the ventricles of the brain It is measured in parallel), the extensive amalgamation high RST of irregular halo (edge > 10mm wide, irregular, extend to deep white matter) The lacunar of (> 25mm, irregular shape) diffusivity white matter change (the diffusivity high RST of no focal lesion) deep grey matter Infarct;Or lacunar infarction: extension emits, irregular halo, merges high RST extensively, diffusivity white matter changes, deep grey matter is more Send out lacunar infarction stove (> 5) and at least moderate White matters lesions.CT: extensive periventrcular and deep white matter damage: patch shape Or the symmetrical region of the low decaying of dispersivity, the intermediate density between white matter and cerebrospinal fluid are extended to the edge determined Centrum ovale, and at least one lacunar infarction.It excludes: non-lacunar stalk under bleeding, cortex and (or) Cortex Extremely, watershed infarcts;Normal pressure hydrocephalus;White matters lesions (such as the multiple sclerosis, primary kirschner sarcoma, brain of cause specific Radiation sickness);(3) Clinical symptoms: with/without the symptom or sign damaged under cortex;(4) status of cognitive function: without cognition function It can damage, the non-dementia type of Cognitive function damage, vascular dementia, as long as completing average accuracy >=80% of this test.
Exclusion criteria: (1) other cause of disease white matter lesions: multiple sclerosis, normal pressure hydrocephalus, hypoxic encephalopathy, outer Wound, infection, poisoning, dysbolism, tumour, radiation encephalopathy etc..(2) exclusion may cause other diseases of Cognitive function damage Disease, it is specific as follows: (2.1) brain organic disease: cerebral hemorrhage, brain trauma, epilepsy, encephalitis, Parkinson's disease, brain tumor, A Erci Silent disease in sea etc.;(2.2) physical disease: serious Organ dysfunction, anaemia, severe malnutrition, hypertension amphibolia, serious Diabetes, hypothyroidism, severe infection etc.;(2.3) mental disease: schizophrenia, affective disorders, alcohol Poisoning phrenoblabia, pharmacological dependence or habituation etc..
According to head routine MRI as a result, the standard recommended according to Cardiovascular Health Study: excluding Lateral ventricle degree >=subcortical white impairer;According to Fazekas White matters lesions grade scoring method (table 1), a group trouble will be entered Degree point 2 group of the person according to ischemic White matters lesions, deep white matter damage (DWML) or telocoele aside either under cortex Matter damages (PVL), 1 grade of damage (the dotted damage of white matter) occurs and all charges to mild cerebral ischemic cerebral white matter damage group (slight group);Out Existing 2 grades or 3 grades damages (white matter lesion starts to be fused to big sheet fusion) all charge to middle severe ischemic cerebral white matter damage group (in Severe group).
1 Fazekas White matters lesions grade scoring method of table
Control group: it is included in standard: age, gender, schooling, the ventricles of the brain/brain ratio { ventricles of the brain area/(encephalic area-brain Room area) } it is matched with test group, conventional head B-sonography scanning is shown no obvious abnormalities, impassivity mental disease medical history, symptom and body Sign;Behavior Test average accuracy >=80%.
2, related neural psychology inspection
(1) Montreal Cognitive Assessment scale (Montreal Cognitive Assessment, MoCA): by The dedicated of the establishments such as Nasreddine checks and examine the tool for executing function, including seven subscales: visual space executive capability, name, Remember (including delay memory), attention, language, abstract, directive force, amounts to 30 points, if the length of education enjoyed≤12 of subject Year, 1 point is added in test result, corrects the bias of schooling, score is higher, and cognitive function is better, and >=26 points are normal, survey The examination time about 10 minutes.In view of the research purpose of this research, we are primarily upon delay memory scale.
(2) Wechsler Adult Intelligence Scale (Wechsler adult intelligence scale, WAIS): being that the U.S. faces Bed psychologist Wechsler is worked out, and 16 years old or more adult is suitable for, and is current internationally recognized relatively good testing intelligence It tests.Hunan Medical University, China Gong Yao is revised prior to nineteen eighty-two, referred to as revision Wechsler Adult Intelligence Scale (WAIS-Revised in China,WAIS-RC).In view of the research purpose of this research, we are primarily upon digit span test (along back number) sum number The test of word symbolic coding.Along back number test attention and temporary memory, it is desirable that subject is along back number, successfully to carry on the back Highest digit out is number of scoring, and is divided into 12 points along back highest, fall-back highest is divided into 10 points;Digit symbol test is provided to information Processing speed and movable direct measurement: it is required that subject fills corresponding symbol according to number, filling is correct in observation 90 seconds Symbol remembers 1 point, reverses symbol and remembers half point.The sample for starting practice not-time is not also scored.Highest 90 is divided.
(3) space perception, eye hand coordination, thinking flexibility etc. trail making test A (trail making test A): are checked and examined Ability.Be it is a kind of pan, visual movement tracking, divided attention and recognize flexibility test.As a result with all numbers of connection Time and connection error indicate that normal person's deadline is within 1 minute or so, mistake 1.It is generally believed that main reflection is right The function of side cerebral hemisphere is to reflect more original perceptual motor speed, more sensitive to diffusivity and side property cerebral injury, right The screening of frontal lobe dysfunction is also useful.Within the scope of VCI, surveyed with hypertensive patient's line of amalgamation cerebral white matter damage Test hypertensive patient and brain stem lacunar infarction patient that scoring is lower than amixis cerebral white matter damage.
3, to the method for leukoaraiosis Cognitive function damage early detection, comprising the following steps:
(a) stimulation programs of event related potential
(a1) experimental considerations unit is constituted by " target-delay-detection " three phases;First in the lattice of 3x3 cell middle " beginning " printed words are presented in son, and the presentation time changes at random between 700ms~1400ms;
(a2) target phase: a grey chromosphere is presented on random site in 3x3 cell, time 1000ms is presented, even It is continuous to be presented two grey chromospheres, between each ball between be divided into 60ms, this demands subject remembers the position that grey chromosphere occurs It sets;
(a3) delayed phase: blank 3x3 cell is presented, time 1500ms, this demands subject is in brains The position for constantly repeating the grey chromosphere that reinforcing front is presented, so as to the problem of answering below;
(a4) detection phase: occurs a red ball at random in 3x3 cell, it is desirable that subject judges this red ball Whether the position occurred with the grey chromosphere of any one of the two grey chromospheres in front is consistent, unanimously presses right button, inconsistent by a left side Key, subject are apprised of;After judging, with prestissimo key, experimental setup detection phase up to 5000ms, if by Examination person is during 5000ms according to abandoning handling automatically without making a response;
(a) record of event related potential and analysis
(b1) subject is sitting in quiet screened room, using ERP work station as platform, Galileo system synchronous recording brain electricity Figure, according to international 10~20 systems, recording electrode be placed in FP1, FP2, F3, F4, C3, C4, P3, P4, O1, O2, F7, F8, T3, T4, T5, T6, FPZ, Fz, Cz, Pz, Oz, 512Hz, reference electrode are placed in two sides ear-lobe, and grounding electrode is placed in FPZ point and Fz Between point, placement electrode recording level eye electricity on the outside of eyes, right eye disposes electrode to record vertical eye electricity up and down;Wherein, A/D is converted Rate is 16bit, and filtering band logical is 0.1~35Hz, and sample frequency is to use adhesive fixed metal electrode, scalp impedance < 5k;It is complete After continuous record EEG, off-line type post-processing is carried out using German BESA software;
(b2) after correcting VEOG and HEOG, wave amplitude is greater than ± 120 μ V persons and is considered as artefact automatic rejection, sufficiently exclusion artefact Afterwards, delayed phase eeg data is analyzed, carries out average superposition to correct EEG is reacted, analysis time-histories is the target phase The delayed phase of 1500ms after stimulation disappears, baseline are preceding 100 ms of stimulation disappearance.
4, statistical procedures
Data processing is carried out using SPSS15.0 statistical software.Quantitative target detection uses the form of average ± standard deviation Expression selects the inspection of Fisher exact probability, one-way analysis of variance, two factor duplicate measurements variance analyses, correlation analysis.Two In factor duplicate measurements variance analysis, 2 factors are respectively as follows: group (3 is horizontal): control group, slight group and middle severe group;Entirely 8 parts of brain (8 levels): left frontal lobe (FP1, F3), middle frontal lobe (FPZ, Fz), right frontal lobe (FP2, F4), central area (C3, Cz, C4), top (P3, Pz, P4), occipital lobe (O1, Oz, O2), left temporo (F7, T3, T5), right temporo (F8, T4, T6).P≤0.05 Think statistically significant.
3, result
Fig. 3 is DMS normal form induction visual space working memory delayed phase N330 wave amplitude topographic map, can from figure Out, the visual space working memory delayed phase N330 wave amplitude induced by DMS normal form, wave crest is obvious, and wave amplitude topographic map is aobvious Show: the normal group biggish position of wave amplitude is distributed in bilateral top pillow association area, right side temporal lobe, right frontal lobe, embodies right dominance;Gently The degree larger position of Patients with Leukoaraiosis wave amplitude is located at behind right side temples behind temples, left side;The middle larger position of severe person's wave amplitude Centrally located area, side to the right.
Fig. 4 is three groups of subject visual space working memory event related potential overall average figures, it can be seen from the figure that passing through ERP overall average map analysis, N330 wave crest is significant [F (2,62)=5.87 (P < 0.01)] in normal group and illness group difference, brain Leukoaraiosis patient's N330 wave amplitude is substantially reduced.
Table 2 gives 8 parts of the full brain of 3 groups of subjects (8 levels): left frontal lobe (FP1, F3), middle frontal lobe (FPZ, Fz), Right frontal lobe (FP2, F4), central area (C3, Cz, C4), top (P3, Pz, P4), occipital lobe (O1, Oz, O2), left temporo (F7, T3, T5), the N330 wave amplitude of right temporo (F8, T4, T6)
Table 2 is the N330 wave amplitude (average plus-minus standard deviation) at 8 positions of the full brain of 3 groups of subjects
Note: compared with the control group: *: P < 0.01 of *: P < 0.05, *
It is possible relative to control group for buiswangen disease patient in view of N330 wave amplitude is found in above-mentioned statistical analysis There are the differentiation of clinical meaning and theoretical value effects, so we continue to do 24 buiswangen disease patient's N330 waves The correlation analysis (table 3) of scale score is assessed in width and cognition, and significant relevant portion is presented in table.
Table 3 is the correlation analysis between N330 wave amplitude and cognitive function assessment
Note: *: P < 0.01 of *: P < 0.05, *
From upper table 2 and table 3 it is found that the visual space working memory delayed phase that the present invention is induced by DMS normal form N330 wave amplitude, can EARLY RECOGNITION patient Cognitive function damage, especially visual space working memory is impaired, at the same time as commenting Estimate the objective reliable quantizating index of Patients with Leukoaraiosis Cognitive function damage.
Finally, it is stated that the above examples are only used to illustrate the technical scheme of the present invention and are not limiting, although referring to compared with Good embodiment describes the invention in detail, those skilled in the art should understand that, it can be to skill of the invention Art scheme is modified or replaced equivalently, and without departing from the objective and range of technical solution of the present invention, should all be covered at this In the scope of the claims of invention.

Claims (3)

1. a kind of method of leukoaraiosis Cognitive function damage early detection, which is characterized in that matched by delay sample The visual space working memory delayed phase that mode (Delayed matching-to-sample task, DMS) normal form induces Method of the N330 wave amplitude as the assessment objective reliable quantizating index of Patients with Leukoaraiosis Cognitive function damage, including it is following Step:
(a) stimulation programs of event related potential
(a1) it is presented using E-Prime system editor stimulus modality and control stimulation, visual space Working Memory Task uses DMS Normal form: experimental considerations unit is constituted by " target-delay-detection " 3 stages.Subject's viewing screen, first 3x3 cell just " beginning " printed words are presented in intermediate grid, and the presentation time changes at random between 700ms~1400ms;
(a2) target phase: a grey chromosphere is presented on random site in 3x3 cell, time 1000ms is presented, is continuously in Existing two grey chromospheres, between each ball between be divided into 60ms, this demands subject remembers the position that grey chromosphere occurs;
(a3) delayed phase: presentation blank 3x3 cell, time 1500ms, this demands subject are continuous in brains The position for repeating the grey chromosphere that reinforcing front is presented, so as to the problem of answering below;
(a4) detection phase: occurs a red ball at random in 3x3 cell, it is desirable that subject judges this red ball with before Whether the position that the grey chromosphere of any one of the grey chromosphere in two, face occurs is consistent, unanimously presses right button, inconsistent to press left button, quilt Examination person is apprised of;After judging, with prestissimo key, experimental setup detection phase up to 5000ms, if subject According to abandoning handling automatically without making a response during 5000ms;
(b) record of event related potential and analysis
(b1) subject is sitting in quiet screened room, and using ERP work station as platform, Galileo system synchronous recording electroencephalogram is complete After continuous record EEG, off-line type post-processing is carried out using German BESA software;
(b2) after correcting VEOG and HEOG, wave amplitude is greater than ± 120 μ V persons and is considered as artefact automatic rejection, after sufficiently excluding artefact, Delayed phase eeg data is analyzed, carries out average superposition to correct EEG is reacted.Delayed phase eeg data is carried out When analysis, analysis time-histories is the delayed phase of 1500ms after target phase stimulation disappears, and baseline is 100ms before stimulation disappears.
(b3) visual space stimulus material all induces N330, P420, advanced stage negative composition (Late Negative in full brain Component, LNC);LNC is continued for since 700ms to delayed phase terminating and (occurring to detection stimulation).It mentions Event related potential N330 wave amplitude is taken to objectify monitoring index as Leukoaraiosis cognitive disorder.
2. the method for leukoaraiosis Cognitive function damage early detection according to claim 1, which is characterized in that step Suddenly the method for (b1) physical record electroencephalogram are as follows: according to international 10~20 systems, recording electrode be placed in FP1, FP2, F3, F4, C3, C4, P3, P4, O1, O2, F7, F8, T3, T4, T5, T6, FPZ, Fz, Cz, Pz, Oz, 512Hz, reference electrode are placed in two and pick up the ears It hangs down, grounding electrode is placed between FPZ point and Fz point, and placement electrode recording level eye electricity, right eye dispose electrode up and down on the outside of eyes Record vertical eye electricity;Wherein, A/D conversion ratio is 16bit, and filtering band logical is 0.1~35Hz, and sample frequency is solid using adhesive Determine metal electrode, scalp impedance < 5k.
3. the method for leukoaraiosis Cognitive function damage early detection according to claim 1, which is characterized in that step Select in (b3) related potential N330 wave amplitude to objectify monitoring index as Leukoaraiosis cognitive disorder suddenly.Our early-stage studies It has been found that the extraction stability of N330 wave amplitude is good in Patients with Leukoaraiosis, repeatability is high, and N330 wave amplitude is memory One of three identifiable ingredients that delayed phase can be drawn, can react cognitive function overall process.
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CN112690806B (en) * 2020-12-28 2022-03-01 苏州大学 Method and system for evaluating cognitive function of brain injury patient after injury
CN117936066A (en) * 2023-09-11 2024-04-26 天津大学 INPH prediction method based on visual Oddball paradigm

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