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目的探讨联合应用视觉Oddball、数字计算和图片再认范式引出的事件相关电位(ERP)特征性成分推断重型颅脑外伤(sTBI)患者智商的可行性。方法采用3种ERP范式检测122名交通事故所致sTBI患者,同时测查韦氏成人智力量表(WAIS),建立回归模型。结果 3种刺激范式在sTBI患者中均能记录到稳定的ERP波形,无明显性别差异,其中图片再认P500潜伏期最长,数字计算P3c次之,视觉VP300最短(P<0.01),3者的波幅与WAIS总智商无明显相关(P>0.05),P500潜伏期均值与总智商的相关性(r=-0.67,P<0.01)高于P3c(r≈-0.57,P﹤0.05)和VP300(r≈-0.43,P<0.05);采用VP300、P3c、P500潜伏期建立的模型分别只能解释伤后WAIS智商方差变异的18%、33%、45%,3个指标联合可达56%;推断模型均不存在明显共线性。结论视觉VP300、数字计算P3c和图片再认P500的潜伏期均可用于推断脑损伤后的智能状态,增加刺激材料复杂性或联合多个ERP指标推断脑外伤后WAIS智商结果更为可靠。
Objective To explore the feasibility of estimating the IQ of patients with severe traumatic brain injury (sTBI) by combining visual Oddball, digital computation and image recognition paradigm with characteristic components of event-related potentials (ERP). Methods Three kinds of ERP paradigms were used to detect 122 patients with sTBI caused by traffic accidents and the WAIS score was measured to establish a regression model. Results The three stimulation patterns recorded stable ERP waveform in sTBI patients. There was no significant gender difference in the three kinds of stimulation paradigms. Among them, P500 had the longest latent period, P3c followed by the number, the shortest visual VP300 (P <0.01) There was no significant correlation between amplitude and WAIS total IQ (P> 0.05). The correlation between P500 latency and total IQ (r = -0.67, P <0.01) ≈-0.43, P <0.05). The models established by latency of VP300, P3c and P500 could only explain 18%, 33% and 45% of variance of WAIS after injury, respectively. There is no obvious collinearity. Conclusions The visual latency of VP300, P3c and P500 can be used to infer the intelligence status after brain injury. To increase the complexity of stimulation materials or to combine multiple ERP indexes to infer the results of WAIS IQ after brain trauma is more reliable.