| Objectives: To investigate the electrophysiological features of event-related potential P300(ERP-P300) and it's diagnostic value in vascular cognitive impairment with no dementia (VCIND) and vascular dementia(VaD), and study the relationship between acetylcholinesterase (AchE), vascular cognitive impairment and ERP-P300, meanwhile exploring the risk factors and imaging features of VCI in order to provide theoretical foundations for the prevention, early diagnosis and therapy of VCI.Methods: Hospital patients in neurology fitting the diagnosis criteria of cerebral infarction in 2004 and 2005 were chosen and divided into three groups according to the damage degrees of cognition(50 each group): vascular cognitive impairment with no dementia group(VCIND group), vascular dementia group(VaD group) and control group(cerebral infarction with normal cognition). Neuropsychology scales such as MMSE, HAMD, ADL, CDR, Hachinski ischemic index scale and NIHSS were applied to appraise the patients. Electromyogram-evoked potential instrument was used to detect the ERP-P300;Vital 300 semi-automatic analyzer was also used to detect level of serum AchE;TBA-120FR automatic analyzer was applied for general laboratorial data.Results:1. The target latencies> amplitudes and non-target latencies, amplitudes in Fz, Cz sites were compared by paired t-test(P>0. 05), it proved to be with no statistically significance. The latencies of N200 were 281. 9 + 31. 5ms* 251. 2 + 21. 0ms and 250. 3±23. 4 ms in VaD group, VCIND group and control group respectively, the latencies of P300 were 424. 5 + 31. 5ms, 374. 9+10. 8ms and 336. 5±23. 8ms, the amplitude of P300 are 5. 7 + 3. OuV, 5.8+ 2. 3uV*P7. 1+2. 9uV. The intervals between P200 and N200 were 107. 25 + 33. 26ms, 81. 56 + 26. 05ms, 79. 24±22. 54ms, while N200-P300 were 140. 12+ 34.98ms> 123. 65 + 21. 06ms, 86.18 + 23. 08ms. Compared with VCIND and control group,the latencies of N200, P300 and intervals of P200-N200, N200-P300 were obviously prolonged in VaD group;Compared with the control group, the latency of P300 and interval of N200-P300 in VCIND group were also prolonged, the differences had statistical significance (P=0.000). There had no statistical significance of the rest indexes in the three groups.2. There had no significant deviation of the latencies of N200, P300 and MMSE score in different sex(P > 0. 05). Partial correlative analysis indicated that the latency of N200 had negative correlation with MMSE score, the latency of P300 had negative correlation with MMSE score, has positive correlation with age;P300 amplitude has positive correlation with MMSE score, the latency of N200, P300, P300 amplitude and MMSE score had no correlation with score of NIHSS. We concluded theformula used multiple linear regression (patients with cerebral infarct-tion age 55-85): latency of P300(ms)=498. 63- 7. 71 XMMSE score+1. 07 X age.3. The patients with multiple and large(>50mm:1) infarct focus in VaD group were more than VCIND and control group (P<0. 05). Compared with basal ganglia and cupula-occipital lobe group, the MMSE score was reduced and the latency of P300 was prolonged significantly in fronto-temporal lobe group (P<0. 05) , while there were no statistical difference in age and the and amplitude of P300 (P>0. 05) .4. The probability of combined with stroke in three group had remarkable diffrernces (P<0. 05) , Spearman correlative analysis confirmed that there was negative correlation between the score of past history and that of MMSE.There had no statistical significance on history of smoking,drinking,hypertensive disease, diabetes mellitus> heart disease and level of fasting blood glucose, TC, TG, VLDL-C, plasma viscosity in three groups.5. The levels of serum AchE(U/ml) were 74.00±18.8, 55.62+13.84, 47.85± 11. 24 respectively in VaD group, VCIND group and control group. By means of Spearman correlative analysis, we concluded that the activity of AchE has negative correlation with MMSE score, has positive correlation with the latencies of N200, P300, had no correlation with the amplitude of P300.Conclusion: 1. The electrophysiological features of ERP-P300 in VCIND is thatthe latency of P30(K the intervals of N200-P300 is prolonged, the amplitude of P300 is reduced;in VaD the latency of N200 and the intervals of P200-N200is prolonged excluded the character of VCIND.2. ERP-P300 can objectively reflex the degree of cognitive impairment, has clinical value in diagnosis of VCI.3. The level of AchE has correlation with the cognitive impairment and ERP-P300 in VCI patients.
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