| Objective:Alzheimer's disease(AD) is a chronic progressive degenerative disease of central nervous system with cerebral cortex as main diseased region,which is characterized by such psychiatric symptoms as progressive memory deterioration,impairment of cognition,personality change and language handicap.AD incidence is significantly rising year by year,and becomes a serious and growing threat to the physical and mental health of the elderly,and there lack uniform standards for its diagnosis and treatment,therefore,the searching for new anti-dementia drugs and more objective and sensitive indicators to evaluate the AD treatment comes into the focus.Memantine hydrochloride is a new generation drugs for the treatment of AD,has been listed in the application in China,and Aricept is accepted in the international community with its positive efficacy,and is the most commonly used clinical drug in AD treatment.In recent years,pharmaco electroencephalography(PEEG),the rapidly developed new area of EEG,is a quantitative analytical method,which by combining the quantitative EEG technology with pharmacological effects of CNS drugs studies the correlation between the two. Therefore,we use the pharmaco EEG power spectrum technology to directly reflect forecast and monitor in the short term the efficacy of memantine hydrochloride and changes in brain function caused by it,and initially establish its PEEG model to look forward with our humble effects to gain a timely adjustment of drug type and dosage and a optimized drug treatment prescription in clinical work,so as to provide an objective basis to further elucidation of the pathogenesis and drug action mechanisms of AD.Methods:Forty mild to moderate degree Alzheimer's disease patients were randomly divided into memantine group and Aricept group,and recorded and analyzed the quantitative changes in the EEG power spectrum and MMSE before,after 4 weeks and 8 weeks the treatment of memantine hydrochloride,and compared and analyzed the results with Aricept group and control group.Results:1.The MMSE scores of Alzheimer's disease patients compared with the control group were significantly reduced,the differences was significant(P＜0.001); theθfrequency band power values of bilateral brow,temple,cacumen and occipital region were obviously increased,it seemed that changes in bilateral brow and parietal region were significant,the difference was significant(P＜0.01);theα1 frequency band power values of bilateral brow and parietal region increased and theα2 frequency band power values of right parietal region and temporal region and bilateral occipital region decreased,β2 frequency band power values of left temporal region and bilateral occipital region decreased,and the difference was significant(P＜0.05); 2.Four weeks after memantine hydrochloride treatment,the location orientation scores,short memory scores and sum scores of MMSE reached significantly higher than before the treatment,the difference was significant(P＜0.05),except for parietal region and right temporal region,theθfrequency band power values of the other brain mantle district significantly decreased compared with before the treatment,the difference was significant(P＜0.05);theα2 frequency band power values of left occipital region were significantly higher than before treatment,the difference was significant(P＜0.05);3.Eight weeks after memantine hydrochloride treatment,the location orientation scores,transient memory scores,short memory scores and sum scores of MMSE reached significantly higher than before the treatment,,the difference was significant(P＜0.05);θfrequency band power values of bilateral brow, temple,parietal region and occipital region obviously decreased,the difference was significant(P＜0.05);4.Eight weeks after memantine hydrochloride treatment,short memory MMSE scores reached significantly higher than four weeks after treatment, the difference was significant(P＜0.05);theθfrequency band power values of left brow,temple,parietal region and occipital region decreased obviously compared with the values four weeks after the treatment,the difference was significant(P＜0.05);5. There was no significant difference between the short-term efficacies on mild to moderate AD of memantine hydrochloride group and the Aricept group(P＞0.05);6. Removing other factors,there were comparatively large correlations between the time factor and theθfrequency band power value changes of the bilateral brow,temple, parietal region and occipital areas,and theβ1 frequency band power value changes of left occipital region and right parietal region,where four week time had comparatively large correlations with theθfrequency band power value changes of bilateral brow, temple,parietal region and occipital region,as well as with theβ1 frequency band power value changes of right parietal region andβ2 frequency band power value changes of left temporal region,and the eight week time had comparatively large correlations withθfrequency band power value changes of bilateral brow,temple, parietal region and occipital region,as well as with theα2 frequency band power value changes of right parietal region.Conclusion:1.The early efficacy of memantine hydrochloride for mild and moderate AD is definite,which improves the brain functions of brow,parietal region, temple and occipital region differently,the rivalry of memantine hydrochloride to NMDA receptors in the above brain blocks the release of excessive glutamine, corrects or restores the glutamine balance,which further supports the theory of toxic effect of excitatory amino acids;2.Pharmaco EEG,which objectively and sensitively reflects the cerebral cortex area function changes of Alzheimer's disease patients with a certain dosage and time of treatment in a quantization form,can be used an important means to guide the diagnosis and treatment of AD patients;and pharmaco EEG is a more objective sensitive and comprehensive indicator than MMSE in the AD diagnosis and indication of the drug-induced central nervous system effect,and the two should be clinically combined. |
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