| 张杉杉,孙佩,杨芮,唐浩,王晓明.脑小血管病相关认知障碍患者ERP-P300与静息态fNIRS特征及其与脑白质病变的相关性[J].四川精神卫生杂志,2026,(3):212-219.Zhang Shanshan,Sun Pei,Yang Rui,Tang Hao,Wang Xiaoming,ERP-P300 and resting-state fNIRS characteristics of patients with cerebral small vessel disease-related cognition impairment and their correlations with white matter lesions[J].SICHUAN MENTAL HEALTH,2026,(3):212-219 |
| 脑小血管病相关认知障碍患者ERP-P300与静息态fNIRS特征及其与脑白质病变的相关性 |
| ERP-P300 and resting-state fNIRS characteristics of patients with cerebral small vessel disease-related cognition impairment and their correlations with white matter lesions |
| 投稿时间：2026-04-21 |
| DOI：10.11886/scjsws20260421001 |
| 中文关键词: 脑小血管病 认知障碍 功能近红外光谱成像 事件相关电位 |
| 英文关键词:Cerebral small vessel disease Cognitive impairment Functional near-infrared spectroscopy Event-related potential |
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| 中文摘要: |
| 背景 脑小血管病（CSVD）在中老年人群中的发病率较高，致残率、死亡率较高，给家庭及社会造成沉重负担。在CSVD的诸多临床表现中，认知障碍最为常见，也是与精神医学实践关联最为密切的神经精神综合征。既往针对CSVD相关认知障碍（CSVD-CI）的研究多集中于影像学领域，关于无创电生理及脑血流的研究相对较少。目的 分析CSVD-CI患者事件相关电位（ERP）及功能近红外光谱成像（fNIRS）的特征，并考查其与脑白质病变严重程度的相关性，以期为CSVD-CI的客观评估与早期识别提供参考。方法 选取2024年12月—2025年12月川北医学院附属医院收治的40例符合《中国脑小血管病诊治指南2020》诊断标准且伴有认知障碍的CSVD患者为病例组，同期招募与病例组性别、年龄、受教育程度相匹配的40名健康志愿者为对照组。两组均接受简易精神状态评价量表（MMSE）评定、ERP-P300检测以及fNIRS检测。比较两组ERP-P300指标、fNIRS全脑及认知相关感兴趣区域（ROI）的功能连接强度。对患者脑白质病变严重程度进行分级：Fazekas Ⅰ级组（轻度白质病变）与Fazekas Ⅱ~Ⅲ级组（中重度白质病变）。采用Spearman秩相关检验脑白质病变Fazekas分级与ERP-P300潜伏期、fNIRS功能连接强度的相关性。结果 CSVD-CI组MMSE评分低于对照组（Z=-6.250，P<0.01），ERP-P300潜伏期长于对照组（t=12.291，P<0.01）。Fazekas分级Ⅰ级亚组MMSE评分高于Ⅱ~Ⅲ级亚组（Z=-2.420，P<0.05），P300潜伏期低于Ⅱ~Ⅲ级亚组（Z=-4.210，P<0.01），差异均有统计学意义。CSVD-CI组静息态全脑功能连接强度低于对照组，差异有统计学意义（t=10.243，P<0.05）。与对照组相比，CSVD-CI组左侧前运动皮质（PMC）、右侧PMC、左侧额极皮层（FPC）、右侧FPC、左侧背外侧前额叶皮层（DLPFC）、右侧DLPFC、左侧眶额皮层（OFC）和右侧OFC区域内的功能连接强度比较，差异均有统计学意义（PFDR校正均<0.01）。CSVD-CI组和对照组在多个前额叶相关脑区之间的功能连接强度比较，差异均有统计学意义（PFDR校正均<0.01）。CSVD-CI患者脑白质病变严重程度与P300潜伏期呈正相关（rs=0.891，P<0.05），与fNIRS功能连接强度呈负相关（rs=-0.359，P<0.05）。结论 CSVD-CI患者存在P300潜伏期延长、静息态全脑及前额叶多个脑区的功能连接强度降低，且上述指标与脑白质病变严重程度相关。 |
| 英文摘要: |
| Background The prevalence， disability rate and mortality rate of cerebral small vessel disease （CSVD） are relatively high among the elderly population， imposing a heavy burden on families and society. Among the various clinical manifestations of CSVD， cognitive impairment is the most common， and it is also the most closely related neuro-psychiatric syndrome to clinical practice in psychiatry. Previous studies on CSVD-related cognitive impairment （CSVD-CI） have mostly focused on the field of imaging， while studies on non-invasive electrophysiological and cerebral hemodynamic assessments are relatively scarce.Objective To analyze the characteristics of event-related potential （ERP） and functional near-infrared spectroscopy （fNIRS） in patients with CSVD-CI， and to explore their correlations with the severity of white matter lesions， in order to provide references for the objective assessment and early identification of CSVD-CI.Methods A total of 40 patients with CSVD who met the diagnostic criteria of the Chinese Guideline for Diagnosis and Treatment of Cerebral Small Vessel Disease （2020） and had cognitive impairment， as well as were admitted to the Affiliated Hospital of North Sichuan Medical College from December 2024 to December 2025， were enrolled as the case group. Meanwhile， 40 healthy volunteers matched for gender， age and education level were recruited as the control group. Both groups underwent assessment using the Mini-Mental State Examination （MMSE）， ERP-P300 detection， and fNIRS examination. The ERP-P300 indicators， functional connectivity strength of the whole brain and cognitive-related regions of interest （ROI） in fNIRS of the two groups were compared. The severity of the patients' white matter lesions was classified as follows： the Fazekas grade I group （mild white matter lesions） and the Fazekas grades II to III group （moderate to severe white matter lesions）. Spearman correlation analysis was employed to investigate the correlation between the Fazekas grading of brain white matter lesions and the latency of ERP-P300， as well as the strength of functional connectivity measured by fNIRS.Results The MMSE score of the CSVD-CI group was lower than that of the control group （Z=-6.250， P<0.01）， and ERP-P300 lantency was significantly longer than that of the control group （t=12.291， P<0.01）. The MMSE score of the sub-group with Fazekas grade I was higher than that of the sub-groups with grades II to III （Z=-2.420， P<0.05）， and showed a shorter P300 latency than that of the sub-groups with grades II to III （Z=-4.210， P<0.01）. All the differences were statistically significant. The resting-state whole-brain functional connectivity strength in the CSVD-CI group was lower than that in the control group， and the difference was statistically significant （t=10.243， P<0.05）. Compared with the control group， the differences in the functional connectivity strength within the left premotor cortex （PMC）， right PMC， left frontopolar cortex （FPC）， right FPC， left dorsolateral prefrontal cortex （DLPFC）， right DLPFC， left orbitofrontal cortex （OFC）， and right OFC regions in the CSVD-CI group were all statistically significant （PFDR correction<0.01）. The differences in the functional connectivity strength between multiple prefrontal-related brain regions between the CSVD-CI group and the control group were all statistically significant （PFDR correction<0.01）. The severity of white matter lesions in CSVD-CI patients was positively correlated with the P300 latency （rs=0.891， P<0.05）， and negatively correlated with the fNIRS functional connectivity strength （rs=-0.359， P<0.05）.Conclusion Patients with CSVD-CI exhibit prolonged P300 latency， as well as decreased functional connectivity strength in multiple brain regions including the whole brain and the prefrontal lobe during the resting state. Moreover， these indicators are correlated with the severity of white matter lesions. |
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