CAJ | 학술논문

目的探讨酒依赖(alcohol dependence,AD)患者的反应抑制功能及其GO/NOGO范式的电生理改变,为酒依赖执行功能障碍的神经机制研究提供理论依据.方法对51例AD患者和29例健康对照组进行GO/NOGO范式事件相关电位(event-related potential,ERP)测试,分析此范式下行为学变化及ERP-N1、N2、P3波潜伏期、波幅.AD患者在戒断不同时点(4,9,13周)进行ERP记录和执行功能测试.结果行为学上,AD患者正确反应数[(29.18±3.03)个]下降,错误数[(5.16±3.77)个]增多,与对照组[(32.35±2.58)个,(3.19±1.84)个]比较差异有统计学意义(P＜0.05),反应时间两组差异无统计学意义(P＞0.05);两组ERP在GO/NOGO二任务下的N1成分及GO任务的P3潜伏期差异无统计学意义,GO/NOGO任务下,AD组N2[(3.48±2.21)μV,(4.49±3.00) μV]、P3[(3.47±2.31) μV,(3.92±4.09) μV]波幅降低,N2潜伏期[(256.30±31.62)ms,(256.09±33.77) ms]延长,P3潜伏期[(355.33±25.96) ms]在NOGO任务延长,与对照组比较差异有统计学意义(P＜0.05);组别主效应在N2、P3成分均显著(P=0.000),任务主效应在N2波幅、P3潜伏期显著(P＜0.05),组别×任务交互作用只在P3潜伏期显著(P＜0.01).AD患者戒断不同时点ERP无明显改变,执行功能在戒断1周时最差,后渐恢复至戒断前水平.结论 AD患者存在反应抑制功能下降,主要表现为对冲突监控和执行前运动程序进行抑制、调整的能力减弱,短期戒断期间ERP及执行功能改善不佳,GO/NOGO任务ERP能完整反映AD患者反应抑制过程的神经电生理变化.
목적 탐토주의뢰(alcohol dependence,AD)환자적반응억제공능급기GO/NOGO범식적전생리개변,위주의뢰집행공능장애적신경궤제연구제공이론의거.방법 대51례AD환자화29례건강대조조진행GO/NOGO범식사건상관전위(event-related potential,ERP)측시,분석차범식하행위학변화급ERP-N1、N2、P3파잠복기、파폭.AD환자재계단불동시점(4,9,13주)진행ERP기록화집행공능측시.결과 행위학상,AD환자정학반응수[(29.18±3.03)개]하강,착오수[(5.16±3.77)개]증다,여대조조[(32.35±2.58)개,(3.19±1.84)개]비교차이유통계학의의(P＜0.05),반응시간량조차이무통계학의의(P＞0.05);량조ERP재GO/NOGO이임무하적N1성분급GO임무적P3잠복기차이무통계학의의,GO/NOGO임무하,AD조N2[(3.48±2.21)μV,(4.49±3.00) μV]、P3[(3.47±2.31) μV,(3.92±4.09) μV]파폭강저,N2잠복기[(256.30±31.62)ms,(256.09±33.77) ms]연장,P3잠복기[(355.33±25.96) ms]재NOGO임무연장,여대조조비교차이유통계학의의(P＜0.05);조별주효응재N2、P3성분균현저(P=0.000),임무주효응재N2파폭、P3잠복기현저(P＜0.05),조별×임무교호작용지재P3잠복기현저(P＜0.01).AD환자계단불동시점ERP무명현개변,집행공능재계단1주시최차,후점회복지계단전수평.결론 AD환자존재반응억제공능하강,주요표현위대충돌감공화집행전운동정서진행억제、조정적능력감약,단기계단기간ERP급집행공능개선불가,GO/NOGO임무ERP능완정반영AD환자반응억제과정적신경전생리변화.
Objective To explore the reactive inhibition and electrophysiological changes under the GO/NOGO paradigm in patients with alcohol dependence (AD) in order to provide a theoretical basis for neuromechanism study of AD executive dysfunctions.Methods The GO/NOGO paradigm event related potentials (ERP) were tested in 51 AD patients and 29 healthy controls, this paradigm behavior and ERP-N1, N2 and P3 latency and amplitude were analyzed.ERPs and execution functions were followed at different time points of withdrawal(4, 9,13 weeks).Results The number of correct responses (29.18±3.03)lowered and error responses (5.16±3.77) heightened in AD patients, and differences had statistical significance compared with those in control group(32.35±2.58,3.19± 1.84, P＜0.05), and there was no group difference in response time.There was no statistical significance in group difference in N1 component under the GO/NOGO tasks and in P3 latency under GO.N2 ((3.48±2.21) μV, (4.49±3.00) pV) and P3 amplitude ((3.47±2.31) μV, (3.92±4.09) μV) decreased and N2 latency ((256.30±31.62) ms, (256.09±33.77)ms) prolonged in AD group under both GO/NOGO tasks and so did P3 latency ((355.33±25.96) ms) under the NOGO, and the differences had statistical significance.Group main effects in N2 and P3 component (P=0.000) and task main effects in N2 amplitude and P3 latency (P＜0.05) were significant,group and task interaction was significant only in P3 latency (P＜0.01).ERPs of AD patients had no notable changes at different time points of withdrawal, executive dysfunctions were the worst within the 1st week of withdrawal and gradually recovered to pre-withdrawal levels.Conclusion AD patients have lower reactive inhibition manifested mainly by weakened capacity to inhibit and adjust conflict monitor and pre-executive motor program, ERP and executive functions cannot be well improved during short-term withdrawal, and the GO/NOGO-ERP can completely reflect electrophysiological changes of reactive inhibition process of AD patients.