Study On The Clinical Application Of Event-related Potentials In Alzheimer's Disease And Vascular Cognitive Impairment

Objective:The purpose of the present study was to analysis the neuropsychological test scores and event-related potential characteristics of patients with MCI,AD and VaD,and explore the relationship between them.It aims to provide quantitative data support for the early diagnosis of MCI and analysis the differences of damaged cognitive processing of AD and VaD.Method:Retrospectively analyzed that outpatients with definite cognitive impairment had attended the memory disorder department of the first hospital of Jilin University during the May 2015 to February 2017.According to the patients' clinical history,neuropsychological test scores and neurological imagings,divided the patients into MCI group of 34 cases,AD group of 42 cases and VaD group of 35 cases.Then separated mild-to-moderate AD group of 32 cases from the AD group.And choose 22 healthy elderly whose age,gender,education level were matched as control group.Collect the general clinical information,the scores of neuropsychological test(Mini-Mental State Examination,Montreal Cognitive Assessment,Activities of Daily Living,clinical dementia rating(CDR)),the average reaction time,latency and amplitude of P300,and latency and amplitude of Mismatch Negativity.Using SPSS20.0 statistical software for data analysis.Result:1?MMSE,MOCA were statistically significant difference among AD,VaD,MCI and NC group(AD< VaD< MCI< NC group)(P < 0.05),but there were no significant difference between mild-to-moderate AD and VaD group(P > 0.05).2?VaD group scored higher than AD group in the directional force,delayed recall,the difference was statistically significant(P < 0.05).3?AD,VaD and MCI have a longer average reaction time of P300 compared with NC group,and the differences between groups are statistically significant(P < 0.05).Compared with MCI group,AD and VaD group extended average reaction time of P300,differences exist statistical significance(P < 0.05),but the difference between AD and VaD group has no statistically significant(P > 0.05).4?P300 amplitude of AD,VaD,MCI compared with NC group were reduced at PZ site,the differences were statistically significant(P < 0.05).5?At PZ and CZ site,MMN latency of AD,VaD,MCI compared with NC group were extended.And MMN latency of AD and VaD were longer than MCI group,difference has statistically significant(AD/VaD>MCI>NC)(P < 0.05);however,these difference has no statistically significant at FZ site(P > 0.05);meanwhile,these difference has no statistically significant among MMN amplitude of AD,VaD,MCI and NC group at PZ,CZ and FZ sites(P > 0.05).6?At PZ,CZ and FZ sites,the latency and amplitude of P300 and MMN of mild-to-moderate AD and VaD group comparison,except MMN amplitude difference was statistically significant at FZ(P < 0.05),there was no statistical significance(P > 0.05).7?At PZ,CZ and FZ sites,latency and amplitude of P300 and MMSE scores of AD,VaD and MCI group was no significant correlation.At CZ site,P300 latency and MOCA scores of MCI group was negatively correlation,while P300 amplitude and MOCA scores was significantly positive correlation.8?P300 latency and memory score of VaD group was significantly negative correlation,the lower scores of patients' memory,the longer time of P300 latency at CZ and FZ sites;P300 latency and language was negative correlation,the lower scores of patients' language,the longer time of P300 latency at CZ site;P300 latency and executive ability was negative correlation,the lower scores of execute ability,the longer time of P300 latency.9?At CZ site,P300 amplitude of VaD group and MOCA scores was significantly positive correlation,and attention and calculation was positive correlation,the higher score of patients' attention and calculation,the higher of the P300 amplitude.10?P300 amplitude and directional ability of AD group was positive correlation at PZ,mean the higher scores of directional ability,the higher of P300 amplitude;P300 amplitude and attention and calculation was positive correlation at FZ,mean the higher scores of attention and calculation,the higher of P300 amplitude.Conclusion:1 ? Neuropsychological test results show that,the cognitive impairment degree of AD patients was more serious than VaD patients in outpatient clinic,the reason may be related to illness incidence,development and observations of patients' families.AD patients was heavier damage than VaD patients in the orientation and delayed memory function domain.2?The average reaction time of P300 is associated with the reaction of cognitive process,it is a sensitive indicator of judge the degree of cognitive impairment.So it can be used as an effective and reliable tool for MCI identification.With the degree of cognitive impairment in patients increased,the average reaction time of patients were longer,but it had not statistically difference between AD and VaD group.3?MCI patients have changes in the ERPs,and the abnormal degree between health person and dementia patients.For early diagnosis of mild cognitive impairment patients,Mo CA was more sensitive than MMSE,P300 was also more sensitive than MMN,and latency was more reliable than amplitude of MMN.4?With the cognitive impairment degree of AD and VaD was heavier,amplitude of P300 was reduced,latency was extended.When AD and VaD patients had the same cognitive impairment degree in clinical manifestations,they also had the similar degree and trend in perception and reaction of impaired cognitive processing stages.5?The combination application of neuropsychological tests and event related potentials can be found early cognitive function impairment,and provide objective data support for judge the degree and development trend of cognitive impairment progress.