CAJ | 학술논문

目的探讨抑郁症患者认知功能损害的特点及发病机制.方法使用汉密尔顿抑郁量表(HAMD)、WCST测验、N-BACK任务、P300及fMRI对24例抑郁患者及匹配对照组进行评定,得出相关指标及影像学结果进行统计分析.结果 (1)抑郁组WCST成绩、N-back反应时、P300波幅[(4.12±1.51)μV]、潜伏期[(392.02±23.60) ms]与对照组[P300波幅:(6.42± 1.73) μV;P300潜伏期(309.43±21.39) ms]相比差异有显著性(t=4.922,P＜0.01;f=12.726,P＜0.01).(2)病程和持续性错误数(r=0.596,P＜0.01)、mRT(r=0.518,P＜0.01)呈正相关;P300波幅和完成分类数呈负相关,P300潜伏期和N-back反应时、持续性错误数呈正相关.(3)抑郁组激活相对减弱脑区:双侧额上回、左侧额中回及额下回和顶上小叶.结论抑郁患者表现为以额叶执行功能为主的认知功能损害,病程越长,损害越重.P300潜伏期是反应额叶执行功能的敏感指标.
목적 탐토억욱증환자인지공능손해적특점급발병궤제.방법 사용한밀이돈억욱량표(HAMD)、WCST측험、N-BACK임무、P300급fMRI대24례억욱환자급필배대조조진행평정,득출상관지표급영상학결과진행통계분석.결과 (1)억욱조WCST성적、N-back반응시、P300파폭[(4.12±1.51)μV]、잠복기[(392.02±23.60) ms]여대조조[P300파폭:(6.42± 1.73) μV;P300잠복기(309.43±21.39) ms]상비차이유현저성(t=4.922,P＜0.01;f=12.726,P＜0.01).(2)병정화지속성착오수(r=0.596,P＜0.01)、mRT(r=0.518,P＜0.01)정정상관;P300파폭화완성분류수정부상관,P300잠복기화N-back반응시、지속성착오수정정상관.(3)억욱조격활상대감약뇌구:쌍측액상회、좌측액중회급액하회화정상소협.결론 억욱환자표현위이액협집행공능위주적인지공능손해,병정월장,손해월중.P300잠복기시반응액협집행공능적민감지표.
Objective To investigate the characteristics and relative pathogenesis of cognitive impairment in people with depression.Methods 24 people with depression and 24 healthy controls were evaluated respectively with HAMD scale,the WCST test,N-BACK task P300 and fMRI.Results (1) The WCST scores,N-back reaction (MRT),the P300 incubation period in depression group were significantly different from those in control group(P300 wave amplitude(4.12± 1.51) μV vs (6.42± 1.73) μV ; P300 latency(392.02±23.60) ms vs (309.43± 21.39) ms,t=4.922,P＜0.01 ; t=12.726,P＜0.01).(2) The illness course had positive correlation with Rep(r=0.596,P＜0.01) and mRT(r=0.518,P＜0.01).The P300 latency had positive correcation with Rpe(r=0.929,P＜ 0.01) and mRT(r=0.939,P＜0.01).(3)Compared with control group,the decreased activation area in patients with depression were as follows:bilateral frontal gyrus,left middle frontal gyrus,inferior frontal gyrus and superior parietal lobule.Conclusion The depressive patients exist cognitive impairment mainly in frontal lobe.The longer with the illness,the wose with the impairment.P300 incubation period is a sensitive indicator of the frontal executive function.