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Objective To explore the rapid eye movement (REM) sleep characteristics of different episode types of depression and post-stroke depression (PSD) patients and provide support for clinical diagnosis,treatment and prognosis.Methods Patients with single-episode depression (group A,n =22),patients with recurrent depression (≥ 2 episodes,group B,n=26) and patients with PSD (group C,n=19)were included from Henan Provincial Mental Hospital.20 healthy volunteers were assigned to control group.Participants in the 4 groups were performed polysomnographic recordings (PSG) from 9 PM to 6 AM before treatment.The 3 patients groups were performed the second PSG recordings and HAMD score at the end of 6 week SSRIs treatment.The REM indexes of 4 groups were compared and analyzed.Results First PSG detection showed that REM sleep latencies (RL) were shorter in group A and B (A:(65.57±18.29) min,B:(66.32±15.46) min) than that in group C ((79.17±20.18) min) and control group((87.24±16.55)min);REM activity (RA) (A:(99.82±25.71) u,B:(104.70±28.23) u)and REM density (RD) (A:(81.06± 19.35)％,B:(86.61±23.83) ％) were increased more significantly in group A and B than those in control group ((79.61 ± 18.40) u;(68.11 ± 17.54) ％);REM sleep time (RT) were decreased more signifi-cantly in group C ((51.66±22.26) min) than that in group A((71.43±20.70) min),group B((74.81±17.52) min) and control group ((70.46±16.35) min)(P＜0.05).After treatment,REM sleep latency was prolonged in group A ((65.57±18.29) min vs (81.71±21.62) min),and REM activity was decreased in group A((99.82±25.71) u vs (83.58±27.19) u),the difference was statistically significant (P＜0.05).REMdensity was decreased,but the difference was not statistically significant (P＞0.05).There was no significant difference in the indexes of REM in group C;RT was prolonged ((51.66± 22.26) min vs (68.37 ± 20.16)min) in group C,the difference was statistically significant (P＜0.05).Conclusion Most of depression patients with different episode types have REM disinhibition phenomenon.RD increase may be REM characteristic type of depression patient.Sleep disorders of PSD patients are mainly poor sleep process and sleep continuity and have no characteristics of REM sleep disorder of depression ones.
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Objective To explore the rapid eye movement (REM) sleep characteristics of different episode types of depression and post-stroke depression (PSD) patients and provide support for clinical diagnosis,treatment and prognosis.Methods Patients with single-episode depression (group A,n =22),patients with recurrent depression (≥ 2 episodes,group B,n=26) and patients with PSD (group C,n=19)were included from Henan Provincial Mental Hospital.20 healthy volunteers were assigned to control group.Participants in the 4 groups were performed polysomnographic recordings (PSG) from 9 PM to 6 AM before treatment.The 3 patients groups were performed the second PSG recordings and HAMD score at the end of 6 week SSRIs treatment.The REM indexes of 4 groups were compared and analyzed.Results First PSG detection showed that REM sleep latencies (RL) were shorter in group A and B (A:(65.57±18.29) min,B:(66.32±15.46) min) than that in group C ((79.17±20.18) min) and control group((87.24±16.55)min);REM activity (RA) (A:(99.82±25.71) u,B:(104.70±28.23) u)and REM density (RD) (A:(81.06± 19.35)％,B:(86.61±23.83) ％) were increased more significantly in group A and B than those in control group ((79.61 ± 18.40) u;(68.11 ± 17.54) ％);REM sleep time (RT) were decreased more signifi-cantly in group C ((51.66±22.26) min) than that in group A((71.43±20.70) min),group B((74.81±17.52) min) and control group ((70.46±16.35) min)(P＜0.05).After treatment,REM sleep latency was prolonged in group A ((65.57±18.29) min vs (81.71±21.62) min),and REM activity was decreased in group A((99.82±25.71) u vs (83.58±27.19) u),the difference was statistically significant (P＜0.05).REMdensity was decreased,but the difference was not statistically significant (P＞0.05).There was no significant difference in the indexes of REM in group C;RT was prolonged ((51.66± 22.26) min vs (68.37 ± 20.16)min) in group C,the difference was statistically significant (P＜0.05).Conclusion Most of depression patients with different episode types have REM disinhibition phenomenon.RD increase may be REM characteristic type of depression patient.Sleep disorders of PSD patients are mainly poor sleep process and sleep continuity and have no characteristics of REM sleep disorder of depression ones.
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Objective To explore the relationship between aural pre-attentive processing and non-rapid eye movement(NREM) sleep interictal epileptiform discharge (IED) in children with benign childhood epilepsy with central-temporal spikes (BECTS),in order to provide objective electrophysiological basis for early assessment of cognitive function lesion of BECTS children and intervention.Methods Twenty-nine children diagnosed as BECTS in the Second Affiliated Hospital of Xinxiang Medical University from February 2012 to November 2015 were selected,including 17 males and 12 females,and they were 4-14 years old with average age of (9.17 ±2.42) years,and the course of disease was 0.5-4.0 years.Twenty healthy children who had hospital routine check-up were selected as healthy control group,containing 14 males and 6 females,and they were 5-13 years old with average age of (8.55 ±3.09) years.Mismatch negativity (MMN) test was carried out in both groups,and the MMN amplitudes and latencies were analyzed.The long-term video electroencephalogram (VEEG) monitoring was conducted in the BECTS group to analyze the discharge phases (waking,sleep),locations and the IED indexes.The intergroup MMN indexes and the correlation between MMN and VEEG in the BECTS group were compared.Results The VEEG showed that the sleep structure of BECTS children did not change obviously.All children's epileptiform discharges were located in the Rolandic area,including 11 cases on the left side,8 cases on the right side,and 10 cases on both sides.Epilepsy discharge time:17 patients showed epileptiform discharges in sleep stages only and 12 patients showed epileptiform discharge in both sleep and waking stages.Epileptiform discharges of the 12 patients increased more significantly in sleep stage than thatin waking stage [(40.24 ± 25.15) times/min vs.(1.92 ± 1.38) times/rmin],and the difference was statistically significant (t =5.270,P =0.000).The sample IED index in stage 1 and 2 of NREM was (40.73 ± 10.69) times/min,in which 2 cases had IED indexes ＜ 5 times/min,the IED indexes of 3 cases ＞ 80 times/min who reached electrical status epilepticus during sleep,and others were 17.2-64.6 times/min.Clinical seizures in sleep stages were monitored in only 4 cases,which showed an electro-clinical segregation phenomenon from large quantities of sleep IED.The MMN amplitude was lower in the BECTS group than that in the healthy control group [(6.06 ± 1.89) μV vs.(7.28 ±1.64) μV],and the difference was statistically significant (t =2.346,P =0.025).Latency of BECTS group was longer than that in the healthy control group [(191.37 ±40.13) ms vs.(179.35 ±39.80) ms],but the difference was not statistically significant(t =1.037,P =0.355).Correlation analysis showed that the MMN amplitude was negatively related to discharge phases (r =-0.407,P ＜ 0.05) and the IED indexes (r =-0.644,P ＜ 0.01),and latency was positively related to the IED indexes (r =0.386,P ＜ 0.05),while the other VEEG indexes were not correlated with MMN.Conclusions The BECTS children have aural pre-attentive processing disturbance,especially unconscious automatic processing ability impairment,which weakenattention switch action of automatic processing switching to focused attention processing and fail to filter irrelevant information effectively.Sleep IED is an important factor in impairing the formation and reinforcement of acoustic discrimination and memory trace,interfering the acquisition,processing,storage and matching of new information,which induces children pre-attentive processing disturbance.The MMN may discover the electrophysiological changes of children pre-attentive processing disturbance in early stage.
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Objective To explore the reactive inhibition and electrophysiological changes under the GO/NOGO paradigm in patients with alcohol dependence (AD) in order to provide a theoretical basis for neuromechanism study of AD executive dysfunctions.Methods The GO/NOGO paradigm event related potentials (ERP) were tested in 51 AD patients and 29 healthy controls, this paradigm behavior and ERP-N1, N2 and P3 latency and amplitude were analyzed.ERPs and execution functions were followed at different time points of withdrawal(4, 9,13 weeks).Results The number of correct responses (29.18±3.03)lowered and error responses (5.16±3.77) heightened in AD patients, and differences had statistical significance compared with those in control group(32.35±2.58,3.19± 1.84, P＜0.05), and there was no group difference in response time.There was no statistical significance in group difference in N1 component under the GO/NOGO tasks and in P3 latency under GO.N2 ((3.48±2.21) μV, (4.49±3.00) pV) and P3 amplitude ((3.47±2.31) μV, (3.92±4.09) μV) decreased and N2 latency ((256.30±31.62) ms, (256.09±33.77)ms) prolonged in AD group under both GO/NOGO tasks and so did P3 latency ((355.33±25.96) ms) under the NOGO, and the differences had statistical significance.Group main effects in N2 and P3 component (P=0.000) and task main effects in N2 amplitude and P3 latency (P＜0.05) were significant,group and task interaction was significant only in P3 latency (P＜0.01).ERPs of AD patients had no notable changes at different time points of withdrawal, executive dysfunctions were the worst within the 1st week of withdrawal and gradually recovered to pre-withdrawal levels.Conclusion AD patients have lower reactive inhibition manifested mainly by weakened capacity to inhibit and adjust conflict monitor and pre-executive motor program, ERP and executive functions cannot be well improved during short-term withdrawal, and the GO/NOGO-ERP can completely reflect electrophysiological changes of reactive inhibition process of AD patients.
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Objective To explore schizophrenic′s executive function and characteristics of event-related potential-P300 (ERP-P300) in a Go/Nogo paradigm in order to provide electrophysiological basis for schizophrenic′s executive function. Methods The Wisconsin card Sorting Tests (WCST) were conducted and ERP-P300s in a Go/Nogo paradigm (Go/NogoERP-P300) were determined in 58 schizophrenics and 30 healthy persons. Results The WCST score was poorer in research group than that in control group. ERP amplitudes lowered and latencies prolonged in Go-P3 and Nogo N2 and P3, and all differences had statistical significances (P < 0.05). But there were no differences in N1 of both tasks and Go-N2; Go-P3, Nogo-N2 and -P3 amplitude and latency were related to the WCST well (P < 0.05). Conclusion Schizophrenics have such lowered executive functions as attention and cognition conversion and reactive inhibition and could normally process task prophase merely , and Go/NogoERP-P300 may be one of electrophysiological methods reflecting schizophrenic′s executive function.
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Objective To explore the characteristic of sleep disorders in the initial stage of withdrawal and their relationships with alcohol craving levels in alcohol dependence (AD) patients,and provide support for diagnosis and prevention of re-drinking.Methods Thirty-two AD inpatients were assigned to AD group and 20 male healthy volunteers to control group.Alcohol craving was assessed with the Pennsylvania Alcohol Craving Scale (PACS) within the 2nd week after alcohol withdrawal for AD patients,and then the whole-night polysomnogram (PSG) tracings were conducted on the day of the night.Results The five item scores of the PACS were from 3.48 to 4.26 in AD patients.The sleep latency was(42.48±22.42) min,total sleep time was(289.61± 103.22)min,sleep efficiency was(71.45± 19.86) ％,S1 sleep was (23.47± 11.07) ％,arousal frequencies was (8.01 ± 2.77),S3+4 sleep was(6.26±5.35)％ in AD group.Compared with control group((19.65±8.57) min,(407.33±21.29) min,(81.52 ± 6.46) ％,(8.79± 1.83) ％,(2.17 ± 1.04),(15.87 ± 5.24) ％ respectively),the differences had statistical significances(t=2.206-9.082,P＜ 0.05-0.001).Alcohol craving levels were positively related to sleep latency,arousal frequencies and S1 sleep (r=0.424-0.898,P＜0.05-0.01) and negatively to total sleep time,sleep efficiency and S3+4 sleep (r=-0.416--0.662,P＜0.05-0.01) in AD group.Conclusion AD patients have sleep continuity and structure disturbances in the initial stage of alcohol withdrawal,sleep continuity and structure disturbances are related to alcohol craving.Improvements of sleep disorders should be paid during clinical alcohol dependence treatment.
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Objective To explore the effect of relaxation treatment (RT) on the sleep quality of patients with generalized anxiety disorder (GAD).Methods Ninety-two GAD patients were recruited and evenly divided into a study group (n =46) and a control group.The control group was treated with conventional medications,while the study group received RT in addition.The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to test for changes in sleep before and after treatment.Results There were no significant differences between the two groups before treatment in terms of average PSQI scores or PSG results.After treatment,both groups scored significantly better on the PSQI than before the treatment.PSG showed that after treatment there was less awakening,greater sleep efficiency and longer total sleep time.There was shorter sleep latency and rapid eye movement sleep latency,shorter duration of shallow sleep,and longer duration of deep sleep and rapid eye movement sleep in the study group,as well as fewer awakenings,greater sleep efficiency and longer total sleep time.The PSQI and PSG results of the two groups after treatment were significantly different.Conclusions RT can significantly improve sleep disorders in GAD patients.
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Objective To observe the changes of brainstem auditory evoked potential (BAEP) and lower limb short latency somatosensory evoked potential ( SLSEP) in acute carbon monoxide poisoning patients and explore the predictive value of BAEP and SLSEP for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods Sixty-six acute CO poisoning patients was divided into a DEACMP group and a non-DEACMP group according to their symptoms. At the same time, 60 healthy subjects were included in the control group. BAEP and lower limb SLSEP dynamic testing were conducted at different time points. Results The abnormal rates in the first test of BAEP and lower limb SLSEP in the acute CO poisoning patients were 31.8% and 68.2% respectively.The BAEP results in the acute stage and later in the DEACMP group were comparable to those of the non-DEACMP group and the normal control group. Interpeak latency of Ⅰ-Ⅲ was not significantly different, but the remaining indices were significantly longer. Compared to the control group, the lower limb SLSEP readings in the acute DEACMP group and the non-DEACMP group were significantly longer. Compared to the non-DEACMP group and the control group, the SLSEP results of the DEACMP group were significantly extended. The specificity index of the BAEP predicted DEACMP up to 85.7% , significantly more than SLSEP testing. Conclusions Early detection of BAEP can help predict DEACMP. This finding should be promulgated and applied.
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Objective:To explore the relationship between sleep structure changes and state or trait anxiety in patients with insomnia.Methods:Investigations were conducted with the State-trait Anxiety Inventory (STAI) and whole-night ploysomnography (PSG) recorded in 31 patients with insomnia and 20 normal controls.Repeated examinations were conducted in return visits 3～4 months after discharge.Results:Compared to control group,the patients with insomnia had decreased sleep time[(333.71±84.33) min vs.(403.65±19.29) min] and sleep efficiency[(70.41±17.35) % vs.(83.45±4.42) %],and increased sleep latency[(39.48±24.24) min vs.(19.65±8.57) min],REM sleep latency[(106.60±42.89) min vs.(86.80±12.25) min],proportion of S_1 sleep time[(25.36±14.22) % vs.(8.86±1.77) %]and awakening times[(4.45±2.51)vs.(1.75±1.07)].The proportions of S_(3+4) time[(7.38±9.70) % vs.(13.78±4.24) %] and REM sleep time reduced[(14.54±5.61) % vs.(19.18±2.14)%] (Ps<0.05).According to the STAI,scores of both state anxiety[(47.94±8.96) vs.(39.15±4.51)] and trait anxiety[(49.94±8.90) vs.(42.05±7.13)] were significantly higher in insomnia group than in control group (Ps<0.05).State anxiety was positively correlated with sleep latency (r=0.42),REM sleep latency (r=0.25),awakening times (r=0.44) and proportion of S_1 sleep time (r=0.34) (Ps<0.05),and negatively correlated with proportion of REM sleep time (r=-0.41,P<0.01).Trait anxiety was positively correlated with sleep latency (r=0.37,P<0.01) and wakefulness frequency (r=0.29,P<0.05).In return visits,the sleep structure improved,state anxiety score reduced,and trait anxiety had no significant changes.Conclusion:Patients with insomnia have significant sleep structural changes and higher state and trait anxiety.Their sleep structural changes are possilly related to state and trait anxiety.