事象関連電位,聴性中間反応,聴性脳幹反応,体性感覚誘発電位による痴呆鑑別と評価

使用事件相关电位、听觉中间反应、听觉脑干反应和体感诱发电位进行痴呆症的鉴别和评估

• 批准号: 05770434
• 负责人: 五十棲 一男
• 金额: $ 0.58万
• 依托单位: Keio University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-05770434/
• 关键词: Alzheimer型痴呆(DAT); 多発梗塞性痴呆(MID); 聴性中間反応(MLR); 聴性脳幹反応(ABR); 体性感覚誘発電位(SEP); 事象関連電位(ERP); Hachinski Ischemic Score; 改訂長谷川式簡易痴呆検査スケール(HDS-R)

痴呆の中核をなすAlzheimer型痴呆(DAT)と多発梗塞性痴呆(MID)の鑑別は必ずしも容易でない.聴性中間反応(MLR)は上行性網様体賦活系および視床の機能を,聴性脳幹反応(ABR)は脳幹の機能を,また体性感覚誘発電位(SEP)はその潜時によって脳幹から大脳感覚皮質までの機能を反映する.我々は既にネコを用いた動物実験において,中大脳動脈閉塞時にSEPの振幅が著明に低下し,再開通後脳機能回復の程度に従ってSEP振幅が再上昇することを確認した.この現象はヒトMIDにおいても見られることが予測され,さらにMLRやABRでも同様の変化が期待される.本研究の目的は,従来潜時のみが注目され振幅はデータに成りえないとされてきたこれらの電位が,DATとMIDの機能的鑑別と病態評価に使用できるかどうかを検討することにある.方法:1)Alzheimer型痴呆の臨床診断はNINCDS-ADRDA,DSM-III-Rの基準により行い,これらの患者をDAT群とする.2)多発梗塞性痴呆の臨床的診断は,改訂長谷川式簡易痴呆検査スケール(HDS-R)22点以下,Mini-Mental State Exam(MMSE)26点以下,Hachinski Ischemic Score 7点以上の基準により行い,これらの患者をMID群とする.3)ERPには聴覚刺激によるオッドボール課題(計数および反応時間課題),MLRには1.1Hz,0.1ms,90dBの低頻度クリック刺激,ABRには10Hz,0.1ms,90dBクリック音刺激,およびSEPには正中神経1Hz,0.2ms,運動閾値の115%の電気刺激(両側別々)を用いる.いずれも装置には現有設備である日本光電Neuropack8を用いる.4)ERPにおいてはP300頂点潜時を計測し,DAT群とMID群で統計学的比較をおこなう.またP300頂点潜時とHDS-R,MMSEの相関を両群で比較する.5)MLRにおいてはPbの出現率と振幅を両群間で比較し,またHDS-R,MMSEとの関係を検討する.6)ABRにおいてはI〜V波間潜時(CTT)の平均値を両群間で比較し,またHDS-R,MMSEとの関係を検討する.7)SEPにおいては左右2回づつのN20振幅(mA)の平均値を用い,この数値を両群間で比較し,またHDS-R,MMSEの相関を両群で比較する.結果:DATにおいてERPはMMSEが比較的高い例で検査可能であり,これらの症例ではP300潜時が延長した.MLRではPbが半数で欠如した.SEPでは潜時・振幅は正常または軽度低下した.一方MIDではERPは大部分の症例で検査可能であり,P300は欠如例と延長例があった.MLRのPbは欠如例と延長例が見られた.SEPでは潜時・振幅は正常または軽度低下したが,軽症MIDではむしろ振幅増高例が見られた.

It is easy to differentiate between Alzheimer's disease (DAT) and multi-infarct dementia (MID). Sexual intermediate reflex (MLR) is responsible for the function of the ascending neural network activation system and the optic bed, and sexual intermediate reflex (ABR) is responsible for the function of the neural network, and the somatosensory evoked potential (SEP) is responsible for the function of the sensory cortex. The amplitude of SEP is clearly lower when it is opened, and the amplitude of SEP is higher when it is opened again. This phenomenon is expected to change from MLR to ABR. The purpose of this study is to investigate the potential of DAT and MID, and to identify the function of DAT and MID. Methods: 1) Clinical diagnosis of Alzheimer's dementia is based on NINCDS-ADRDA, DSM-III-R criteria. 2) Clinical diagnosis of multi-infarct dementia is based on NINCDS-ADRDA, DSM-III-R criteria. Revised Hasegawa Simple Dementia Test (HDS-R) Below 22 points, Mini-Mental State Exam (MMSE) Below 26 points, Hachinski Ischemic Score above 7 points The patient's MID group was identified as the following:(Counting time problem), MLR is 1.1Hz, 0.1ms, 90dB low frequency, ABR is 10Hz, 0.1ms, 90dB low frequency, The SEP is used to stimulate the central nervous system 1 Hz, 0.2 ms, 115% of the exercise threshold and 115% of the electrical stimulation (side by side). 4) ERP system P300 peak latency measurement, DAT group and MID group statistical comparison. P300 peak latency and HDS-R, MMSE correlation group comparison. 5) MLR peak latency and Pb occurrence and amplitude group comparison. HDS-R, MMSE correlation. 6) ABR peak latency and I~V peak latency (CTT) mean value group comparison. HDS-R, MMSE correlation. 7) SEP peak latency and N20 amplitude (mA) mean value group comparison. HDS-R, MMSE and correlation analysis. Results: ERP was higher than MMSE in comparison with DAT, P300 latency was longer than MMSE, MLR was lower than P300 latency, SEP was lower than MMSE. A party MID and ERP most of the cases were examined, P300 and MLR were examined, MLR and Pb were examined, SEP was examined, MLR and Pb were examined, MLR and Pb were examined, SEP was examined, MLR and Pb were examined, MLR and Pb were examined, SEP was examined, MLR and Pb were examined, MLR and Pb were examined, SEP was examined, SEP was examined, MLR and Pb were examined, SEP was examined, MLR and Pb were examined, SEP was examined, SEP was examined, MLR and MLR was examined.

项目成果

Isozumi K, et al.: "Cerebral ischemia-induced amplification phenomenon of somatosensory evoked potentials in cats." Neuroscience Letters. (in press). (1994)

Isozumi K 等人：“脑缺血引起猫体感诱发电位的放大现象。”