脑电图评估相位滞后指数与老年帕金森病患者认知功能障碍的关系^*

Electroencephalography assessment of the relationship between phase lag index and cognitive impairment in elderly patients with Parkinson's disease

摘要

目的 分析脑电图评估相位滞后指数 (PLI) 与老年帕金森病患者认知功能障碍的关系。方法 选取 2021 年 12 月—2023 年 12 月南京医科大学附属宿迁第一人民医院收治的 116 例老年帕金森病患者作为研究对象, 采用蒙特利尔认知评估量表 (MoCA)、简易精神状态量表 (MMSE) 评估认知功能, 分为认知功能障碍组 (53 例) 和认知正常组 (63 例), 均进行脑电图评估, 计算 PLI。采用 Pearson 相关系数分析 PLI 与认知功能障碍的关系, 采用多因素 logistic 回归模型分析老年帕金森病患者发生认知功能障碍的因素, 采用 ROC 曲线分析 PLI 预测老年帕金森病患者发生认知功能障碍的价值。结果 认知功能障碍组病程长于认知正常组, MoCA 评分、MMSE 评分均低于认知正常组, 差异均有统计学意义 (P<0.05); 认知功能障碍组 α 频段 PLI 及 α 频段下所有电极 PLI 均低于认知正常组 (P<0.05); α 频段 PLI 分别与 MoCA 评分、MMSE 评分呈正相关 (r = 0.498、0.512, P<0.05); 多因素 logistic 回归分析显示, 病程 (OR = 1.078, 95%CI: 1.026 ~ 4.451)、MoCA 评分 (OR = 0.638, 95% CI: 0.550 ~ 0.741)、MMSE 评分 (OR = 0.750, 95%CI: 0.668~0.843)、α 频段 PLI (OR = 0.078, 95%CI: 0.021 ~ 0.281) 均为老年帕金森病患者发生认知功能障碍的影响因素 (P<0.05); ROC 曲线显示, α 频段 PLI 预测认知功能障碍的 AUC 为 0.697 (95%CI: 0.594~0.799), 灵敏度为 62.3%, 特异度为 7.74%, 约登指数为 0.397, 最佳阈值为 0.275。结论 PLI 在老年帕金森病患者中与认知功能障碍密切相关, 特别是 α 频段 PLI 与认知功能分数呈正相关。

Abstract

Objective To analyze the relationship between electroencephalography phase lag index (PLI) and cognitive impairment in elderly patients with Parkinson's disease. Methods A total of 116 elderly patients with Parkinson's disease admitted to Suqian First People's Hospital Affiliated to Nanjing Medical University from December 2021 to December 2023 were selected and divided into a cognitive impairment group (n= 53) and a normal cognitive group (n= 63) according to the assessment of cognitive function by Montreal cognitive assessment (MoCA) and mini-mental state examiniation scores (MMSE). Electroencephalography assessment was performed for both groups, PLI was calculated. Pearson correlation analysis was performed to analyze the relationship between PLI and cognitive impairment. Multivariate logistic regression analysis analyzed the factors of cognitive impairment in elderly patients with Parkinson's disease, and ROC curve analysis analyzed the value of PLI in predicting cognitive impairment in elderly patients with Parkinson's disease. Results The disease course of the cognitive impairment group was longer than that of the normal cognitive group, and the MoCA score and MMSE score were both lower than those of the normal cognitive group. The differences were statistically significant (P<0.05). The PLI of the α band and all electrodes in the cognitive impairment group were lower than those in the normal cognitive group (P<0.05). PLI in α band was positively correlated with MoCA score and MMSE score (r = 0.498, 0.512, P<0.05). Multivariate logistic regression analysis showed that duration of disease (OR = 1.078, 95%CI: 1.026-4.451), MoCA score (OR = 0.638, 95%CI: 0.550-0.741), MMSE score (OR= 0.750, 95%CI: 0.668-0.843), α band PLI (OR= 0.078, 95%CI: 0.021-0.281) were the influencing factors of cognitive impairment (P<0.05). ROC curve analysis showed that the AUC of α band PLI in predicting cognitive impairment was 0.697 (95% CI: 0.594-0.799), the sensitivity was 62.3%, the specificity was 7.74%, the Youden index was 0.397, and the best threshold was 0.275. Conclusion PLI is closely related to cognitive dysfunction in elderly patients with Parkinson's disease, especially α-band PLI is positively correlated with cognitive function score.

关键词

帕金森病 / 相位滞后指数 / 脑电图 / 认知功能障碍

Key words

Parkinson's disease / Phase lag index / Electroencephalogram / Cognitive impairment

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基金资助

^*国家自然科学基金面上资助项目(3217100541)