The Application Of ASSRs,P50,MMN In Exploration Of Cognitive Dysfunction Involving Inputs And Processing In Insomnia Patients

Objective:Anxiety and depression can lead to abnormal memory,attention,speed of information processing or executive function,which often appear in patients with insomnia.ERP,as an effective EEG technique,has been used in cortical information processing.In ERPs,MMN,ASSRs and P50 may be effective detection methods for anxiety and depression.In our study,MMN,ASSRs and P50 were combined to study the inhibitory and habitualization characteristics of cortex,and to explore the pathophysiological mechanism of anxiety and depression in insomnia patients.Methods:30 primary insomnia patients(PI)and 30 healthy control group(NC)were included in this study,and the inclusion criteria or exclusion criteria were strictly implemented.Sleep and sleep efficiency,arousal index,total sleep time,percentage of each sleep stage and heart rate were recorded with PSG as objective parameters.MMN,ASSR and P50 were recorded according to the international 10-20 system,and the amplitude and latency of different brain regions,such as FZ,CZ,PZ,T7 and T8,were selected for analysis.Objective parameters of PSG and general clinical data,such as the degree of anxiety and depression,course of disease,gender,years of education,etc.,were analyzed in relation to the amplitude and latency of MMN,ASSR and P50 in various brain regions.Unpaired t test and rank sum test were used for statistical correlation analysis.Results:1.There was no significant difference in age,gender and BMI between PI group and NC group.Compared with the NC group,the PI group was significantly more prone to depression.2.There were significant gender differences in the ASSR latency at T7 and PZ in the PI group.No matter it was 20 Hz or 40 Hz,the latency was significantly longer for women at T7 than for men at PZ,and the latency was significantly longer for men than women at PZ.3.There was a gender difference in the P50 amplitude gated inhibition ratio(S2/S1)of PZ in the PI group,and the gated inhibition ratio in females was lower than that in males.4.In the PI group,at T7,20 h ZASSRs latency was negatively correlated with BMI,sleep efficiency,wakefulness index,total sleep time,N1% and heart rate;The40HZASSRs amplitude was positively correlated with arousal index and N1%,and negatively correlated with heart rate.In F3,the 40 HZASSRs latency was negatively correlated with the degree of depression,stage IV sleep latency,and REM%.The40 HZASSRs amplitude was positively correlated with sleep efficiency,total sleep time and N3%.5.In the PI group,the P50S2/S1 latency at T7 was positively correlated with arousal index and N1%,S1 latency was positively correlated with arousal index,and S2/S1 amplitude was positively correlated with REM.The S1 latency at TP7 was positively correlated with sleep latency and rapid eye movement.The S2 amplitude and S2/S1 amplitude at P3 were correlated with arousal index,N1% and heart rate,respectively.The P50S1 latency of TP8 in the right temporal lobe was negatively correlated with BMI,S1 amplitude was correlated with heart rate,and S2/S1 amplitude was correlated with REM.The incubation period of S1 and S2/S1 at P4 correlated with education level.The S1 latencies of FPZ and FP2 in the frontal lobes and S2/S1 latencies of FP2 and F4 were positively correlated with the degree of depression.6.Compared with NC group,the incubation period of MMN in PI group was significantly longer.In addition,MMN latency in the midline of FZ,CZ and PZ was positively correlated with the degree of depression.7.In the PI group,women located in FPZ,CZ and PZ had higher MMN amplitudes than men.8.The MMN amplitude of PI group in FZ was positively correlated with BMI,sleep efficiency and N1%,respectively;The MMN amplitude of CZ was positively correlated with BMI,N1% and N3%.MMN amplitude of PZ was positively correlated with BMI,sleep efficiency and N3%.The MMN latency of T8 and TP8 in the right temporal lobe was positively correlated with N1% and N2%.Conclusion:1.ASSRs,P50 and MMN can be used as electrophysiological indexes to detect cognitive impairment in patients with PI;Different cognitive impairments of patients with PI can be detected in multiple dimensions.2.The integration function of ASSRs response information can be used as an index to evaluate the information input and integration of patients with PI,as well as an index to evaluate the emotional defects of patients with PI.3.The filtering function of P50 response to the external information can be used as the evaluation of PI patients’ anti-interference ability to the external environment,as well as the evaluation index of emotional defects of PI patients.4.The matching and processing function of MMN response information can be used as a stable index for cognitive function evaluation of PI patients.