Visual attention impairment in patients with cerebral small vessel disease: an event-related potential P3 study / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To investigate the value of event-related potential (ERP) P3 in the assessment of visual attention impairment in patients with cerebral small vessel disease (CSVD).Methods:Twenty-five patients with CSVD diagnosed in the Shandong Provincial Hospital Affiliated to Shandong First Medical University from July 2019 to December 2020 were selected as the CSVD group, while 25 healthy subjects who underwent physical examination in the same period were selected as the control group.The neuropsychological evaluation of CSVD group and control group was carried out by Montreal cognitive assessment (MoCA), 7-items generalized anxiety disorder (GAD-7) and patient health questionnaire-9 (PHQ-9). Magnetic resonance imaging brain white matter high signal of CSVD group and control group was carried out by Fazekas score.The amplitude and latency of ERP component P3 were measured by visual tristimulation Oddball experimental paradigm.SPSS 23.0 software was used for statistical analysis.The differences of amplitude and latency between the two groups were compared by repeated measurement analysis of variance.Pearson or Spearman correlation analysis were used to explore the correlation between P3 amplitude, latency and related scale scores.Results:(1)In the amplitude of P3, the interaction effect between group and stimulation was significant( F(2, 96)=3.922, P=0.023). The main effect between groups was significant( F(1, 46)=15.976, P<0.01). The main effect of stimulation was significant( F(2, 96)=86.212, P<0.01). Further simple effect analysis showed that compared with the control group((9.82±5.14)μV, (11.12±4.72)μV) the P3 amplitude induced by target stimulation ((6.59±4.22)μV, F(1, 48)=7.363, P=0.009) and novel stimulation ((7.08±3.91)μV, F(1, 48)=13.907, P=0.001) in CSVD group decreased significantly.(2)In the latency of P3, the main effect between groups was significant( F(1, 48)=4.870, P=0.032). The main effect of stimulation was significant( F(2, 96)=86.212, P<0.01). The interaction effect between group and stimulation was significant( F(2, 96)=4.561, P=0.013). The main effect of stimulation was significant( F(2, 96)=16.299, P<0.01). Further simple effect analysis showed that the P3 latency induced by novel stimulation in CSVD group was longer than that in control group( F(1, 48)=17.124, P<0.01). (3)P3 amplitude induced by target stimulation was positively correlated with MoCA score ( r=0.255, P=0.027). The P3 amplitude ( r=-0.502, P<0.01) and P3 latency ( r=-0.265, P=0.022) induced by novel stimulation were negatively correlated with Fazekas score. Conclusion:The speed and ability of patients with CSVD to process visual spatial information are impaired, especially for rare stimulation.ERP examination may be a rapid, objective and sensitive method for the diagnosis of visual attention impairment in patients with CSVD.