【摘要】 目的探讨图片再认事件相关电位(ERP)对重型颅脑损伤(sTBI)后记忆障碍法医学鉴定的应用价值。方法采用韦氏记忆量表(WMS-RC)和Neuroscan ERP仪,对74例健康志愿者(对照组)及需评定精神伤残等级的29例重型颅脑损伤后记忆障碍者(sTBI组)进行记忆能力和图片再认ERP检测。结果sTBI组WMS-RC各分测验量表分及记忆商数(MQ)均值均明显低于对照组(P<0.01);完成ERP任务的反应时、正确率明显延长和降低(P<0.01)。对照组在靶与非靶刺激呈现后170ms和500ms左右均可记录到潜伏期无显著性差异的二个正向波(P170和P500),但靶刺激诱发的P500波幅明显高于非靶刺激(P<0.01);sTBI组可记录到相似的ERP波形,但各成分的波幅、潜伏期均明显降低和延长(P<0.01)。sTBI组P500潜伏期与WMS-RC的记图、再认、再生分测验量表分和MQ值均呈高度负相关(r=-0.73～-0.83,P<0.01),而与伤残等级呈明显正相关(r=0.65,P<0.01)。结论图片再认诱发的P500潜伏期与WMS-RC反映的短时记忆功能及鉴定的精神伤残等级明显相关,可为sTBI后记忆障碍的伤残鉴定提供一项较客观的神经电生理依据。更多还原

【Abstract】 Objective To investigate the application value of event-related potentials(ERP) with picture recognition in expertise of memory disorder induced by severe traumatic brain injury (sTBI). Methods ERP were recorded in 29 patients with memory disorder induced by sTBI and 74 healthy controls, while they were asked to compare target and non-target pictures and judge whether it was target stimulus. Memory function was examined by the Chinese Wechsler memory scale revised (WMS-RC). Results The mean scale scores of all sub-tests and memory quotient (MQ) of sTBI patients were significantly lower than those of controls (P<0.01). The mean reaction time and the correct rate of picture recognition of patients was significantly longer and lower than that of controls (P<0.01). In controls, P170 and P500 were two positivegoing waves in the 170-ms and 500ms poststimulus range for target and non-target stimuli, which had no difference on the latency, but P500 amplitude of target stimulus was significant higher than that of non-target stimulus (P<0.01). Compared to controls, the mean amplitude and latency of P170 and P500 of sTBI patients was significantly lower and prolonged (P<0.01). In sTBI group, the latency of P500 was significant negatively correlated with MQ and the scale scores of "picture recognition", "re-recognition", and "visual reproduction" in WMS-RC (r=-0.73~-0.83, P<0.01), and positively correlated with mental disability grade of sTBI (r=0.65, P<0.01). Conclusion The components of memory ERP (P500) are significantly correlated with shortterm memory of WMSRC and mental disability grade of sTBI; it may be an assistant index for assessing the severity of memory impairment induced by sTBI in forensic expertise.更多还原