Study On The Clinical Application Value Of N200,P300 And Error-related Potentials In Cerebral Small Vascular Cognitive Impairment

Objectives:To analysis the data characteristics of event-related potentials and their correlation with neuropsychological tests in patients with cerebral small vascular cognitive impairment,and to provide objective basis for discovering in early phase and mastering the disease progress.Methods:A total of 70 CSVCI patients from the cognitive and memory disorder out-patient department of the first hospital of Jilin University during the January 2019 to December 2019 were selected as the experimental group,choose 20 healthy patients whose age,gender and education level were matched as control group.Collected the general clinical information and the scores of neuralpsychology test(MMSE,MoCA,MES,ADL,CDR).According to the scores of CDR,the patients were divided into three groups:NC,VCIND and VaD.The Flanker interference pattern was selected to evoked event-related potentials data,Such as N200,P300,ERN,PE.Using SPSS20.0 statistical software to analysis the data.Results:(1)There were no statistically significant differences in gender,age,education level and left-right handedness among patients in NC,VCIND and VaD groups(P>0.05).(2)There were statistically significant differences in the scores of total MMSE,total MoCA,visual space and executive ability,attention and computational power,memory,language ability,abstract ability,delayed recall,directional force and structural ability among the three groups(NC>VCIND>VaD)(P<0.05).In addition to the writing ability,the differences in the total MMSE score,the total MoCA score and other sub-scores of VaD were statistically significant compared with the NC group and VCIND group(P<0.05).There was no statistically significant difference in the total MMSE score and other scores except the structural ability between the VCIND group and the NC group(P>0.05),and there were statistically significant differences in the total MoCA score,visual space and executive ability between the VCIND group and the NC group(P<0.05).There was no significant difference in ADL score between NC group and VCIND group(P>0.05),and there was significant difference in ADL score between VaD group and NC group and VCIND group(P<0.05).(3)The ART difference between NC,VCIND and VaD groups was statistically significant(NC<VCIND<VaD)(P<0.001).Pairwise comparison between groups showed that ART in NC group was significantly smaller than that in VCIND group and VaD group,and the difference was statistically significant(P<0.05).There were statistically significant differences in the correct rate,missed press rate and error rate of the three groups(P<0.001).Pairwise comparison between groups showed that the accuracy rate of VaD group was lower than that of NC and VCIND group,and the omission rate and error rate were higher than that of NC and VCESND group,with statistically significant differences(P<0.05).(4)There were statistically significant differences in N200 latency between the three groups at each electrode site(NC<VCIND<VaD)(P<0.05).Pairwise comparison between groups showed that the latency of Fz,FCz,Cz,Pz VCIND and VaD group was longer than that of NC group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in N200 amplitude between the three groups recorded at each site(P>0.05).(5)There were statistically significant differences in P300 latency between the three groups at Fz,FCz,Cz and CPz sites(NC<VCIND<VaD)(P<0.05).The latency of Fz,FCz,CPz sites VCIND and VaD group was longer than that of NC group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in P300 amplitude between the three groups recorded at each site(P>0.05).(6)The ERN amplitude of patients in the VaD group at the Cz site was lower than that in the VCIND group,and the difference was statistically significant(P<0.001).(7)The latency of N200 at each site was negatively correlated with the total MMSE score,the total MoCA score,the total visual space and executive ability,the attention and computational force,and the score of directional force;The latency of P300 was negatively correlated with the total MoCA score,visual space and execution ability,naming ability,language ability and delayed recall score at FCz.At the Cz site,it was negatively correlated with MoCA total score,naming ability,language ability and delayed recall score.Conclusions:(1)In the early stage,CSVCI patients showed no impairment of their daily living ability and specific cognitive impairment of relatively retained memory.Moreover,with the aggravation of cognitive impairment,the overall cognitive function of CSVCI patients continued to decline.MoCA total score is more valuable for the identification of VCIND and NC,and MMSE is more valuable for the identification of VCIND and VaD.(2)With the aggravation of cognitive impairment in CSVCI patients,ART is gradually prolonged,accuracy rate is gradually reduced,and the rate of missed presses and errors is gradually increased.ART is more sensitive to early recognition of VCIND,and accuracy rate is more valuable to distinguish the degree of cognitive impairment in CSVCI patients.(3)With the aggravation of cognitive impairment in CSVCI patients,the incubation period of N200 and P300 is continuously extended,which can be used as a sensitive indicator to identify CSVCI in the normal population.ERN amplitude continues to decrease,which can be used as a reference for differential diagnosis of VCIND and VaD.(4)N200 incubation period was negatively correlated with MMSE total score and MoCA total score,while P300 incubation period was negatively correlated with MoCA total score.The incubation periods of N200 and P300 can reflect the degree of cognitive impairment in patients with VCIND and VaD,which can be used as an important electrophysiological reference index for the diagnosis of CSVCI patients.