轻度认知功能障碍和阿尔茨海默病的冲突处理及干扰效应研究

发布时间：2018-05-05 03:36

本文选题：认知损伤 + 事件相关电位　；参考：《中国人民解放军军医进修学院》2012年硕士论文

【摘要】：冲突处理及干扰控制能力是日常生活能力中不可分割的一部分，且随年龄增长逐渐下降，特别是阿尔茨海默病(AD)和轻度认知功能障碍（MCI）患者。本研究主要探讨不同认知功能障碍患者的冲突解决能力有无下降，干扰效应出现的层面是否不同，ERPs相关参数改变能否反映额叶功能改变及能否作为早期诊断认知功能下降的指标等问题。本研究采用改良的EriksenFlanker视觉刺激范式，它是被广泛用来研究冲突解决及干扰效应的任务。16个正常受试者、14个MCI患者和7个AD患者参与本项研究。Flanker范式包括四种状态：无干扰状态（或），表示无干扰；中性状态（++++或++++)，表示知觉层面冲突;匹配状态(或)，表示无冲突;冲突状态(或)，表示知觉及反应层面均发生冲突。中性状态与无干扰状态的差异说明知觉层面存在flanker干扰效应，而冲突状态与中性状态的差异说明存在反应层面的flanker干扰效应。要求受试者对中间的箭头方向做出反应，指向左则左手按键，指向右则右手按键，而忽略旁边的箭头或“+”，同时记录32导脑电、正确率和反应时。结果：（1）行为指标：中性状态与无干扰状态相比较、冲突状态与中性状态相比较，三组受试者分别在中性状态和冲突状态下正确率下降、反应时延长，即在行为学上三组在知觉层面和反应层面均存在flanker干扰效应，AD组在知觉层面、反应层面与NC、MCI组比较具有更明显的干扰效应。MCI组干扰效应较AD弱，但同NC无明显统计学差异。（2）ERPs：相较于MCI和NC组，AD组N2和P300潜伏期延长，MCI组较NC组P300潜伏期延长，差异有统计学意义，，而N2潜伏期则无统计学差异。MCI、AD组较NC组P300波幅显著下降，有统计学差异。进一步分析，与NC相比，MCI在知觉层面表现更显著的干扰效应；AD较MCI表现更明显的反应层面干扰效应。结论：1.随着认知功能下降，MCI和AD组冲突处理及干扰控制能力下降，表现为正确率下降和反应时延长。2.在本刺激范式下，MCI和AD患者N2潜伏期延长，波幅降低，提示额叶冲突处理和干扰控制功能受到影响。且负向波N2在评价认知功能障碍患者的冲突处理及干扰效应方面可能较正向波P300更敏感。3.在本刺激范式下，MCI和AD患者P300潜伏期无明显变化，仅波幅降低，提示P300反映前额叶冲突信息加工及干扰控制功能损害可能并不敏感。4.对干扰控制进行分层提示，MCI在知觉层面较NC表现更明显的干扰效应，AD较MCI和NC表现更显著的知觉和反应层面干扰，并可能作为诊断MCI和AD的潜在性指标。
[Abstract]:The ability of conflict management and interference control is an integral part of the ability of daily living, and decreases gradually with age, especially in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). This study was designed to investigate whether the ability of conflict resolution in patients with different cognitive impairment decreased. Whether the level of interference effect is different whether the changes of ERPs related parameters can reflect the change of frontal lobe function and whether it can be used as an index for early diagnosis of cognitive dysfunction. In this study, the modified Eriksen Flanker visual stimulation paradigm was used. It is widely used to study conflict resolution and interference effects. Sixteen normal subjects, 14 patients with MCI and 7 patients with AD participated in this study. A neutral state (or a neutral state, representing a conflict at the perceptual level; a matching state, representing no conflict; or a state of conflict, indicating a conflict at the perceptual and reaction levels). The difference between neutral state and non-interference state indicates that there is flanker interference effect at perceptual level, while the difference between conflict state and neutral state indicates that there is flanker interference effect at reactive level. The subjects were asked to react to the middle arrow, pointing to the left hand button and the right hand button, ignoring the arrow or "", and recording the 32 EEG, accuracy and response time. Results (1) Behavioral index: compared with non-interference state, conflict state and neutral state, the correct rate of the three groups decreased and the reaction time was prolonged in neutral state and conflict state, respectively. That is to say, in behavioral science, there were flanker interference effects at the perceptual level and response level in AD group, and the interference effect was more obvious in response level than that in AD group, and the interference effect in MCI group was weaker than that in AD group. But there was no significant difference with NC. The N _ 2 and P _ 300 latencies of AD group were longer than that of NC group, and the N _ 2 latency of MCI group was longer than that of NC group, while the N _ 2 latency of MCI group was not significantly different from that of NC group. The amplitude of P300 wave in MCII-AD group was significantly lower than that in NC group. There is a statistical difference. Further analysis, compared with NC, MCI showed more significant interference effect at perceptual level. AD showed more obvious response level interference effect than MCI. Conclusion 1. The ability of conflict processing and interference control in MCI and AD groups decreased with cognitive decline, which showed that the correct rate was decreased and the response time was prolonged. 2. The N _ 2 latency was prolonged and the amplitude was decreased in patients with MCI and AD under this stimulus paradigm, indicating that the frontal lobe conflict management and interference control function were affected. Negative wave N2 may be more sensitive than positive wave P300 in evaluating conflict management and interference effect in patients with cognitive impairment. The P300 latency of MCI and AD patients showed no significant change under this stimulus paradigm, but the amplitude decreased, suggesting that P300 may not be sensitive to the damage of prefrontal lobe conflict information processing and interference control function. The interference effect of AD on perceptual level is more obvious than that of NC, and AD is more obvious in perception and response level than in MCI and NC, and may be used as a potential index for diagnosis of MCI and AD.
【学位授予单位】：中国人民解放军军医进修学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1

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