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외상후 스트레스장애 환자에 대한 P300의 임상적 적용

Clinical Application P300 of Patients with Post-Traumatic Stress Disorder

이승환|오성희|김형주
대한신경정신의학회 (Korean Neuropsychiatric Association)|2009.12|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제48권 제6호|pp. 460-466

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키워드

외상후 스트레스장애·사건유발전위·P300·인지기능 이상Post-traumatic stress disorder·ERP·P300·Cognitive dysfunction
주제분류정신과학

초록

본 연구에서는 외상후 스트레스 장애환자군과 정상대조군을 대상으로 하여 사건유발 전위 중의 하나인 P300을 시행하였다. 외상후 스트레스장애 환자군에서 정상대조군과 비교하여 P300 전위값이 유의하게 감소되어 있으며 외상후 스트레스 장애 환자의 증상 심각도와 P300 전위값이 상관성이 있음을 확인하였다. 이러한 결과는 외상후 스트레스장애가 정보처리과정의 기능 이상을 동반한 질환임을 뒷받침하며, P300은 외상후 스트레스장애 환자의 증상 심각도를 평가하기 위한 유용한 검사도구일 수 있다.

Abstract

Objectives: Previous studies have suggested that information processing impairment is the main pathophysiology of post-traumatic stress disorder (PTSD). The P300 event-related potential (ERP) has been widely used, in diseases with cognitive dysfunction, such as schizophrenia and Alzheimer’s disease, for detecting abnormality in information processing. This study examined P300 characteristics of PTSD patients. Methods: We recruited 23 patients (mean age 44.35) who met DSM-IV criteria for PTSD and matched 24 normal control (NC) subjects by age and education level. The NC group had no personal history of psychiatric or neurological abnormality. We conducted the Korean version of the structured interview for PTSD (K-SIPS) and Davidson trauma scale (DTS) with the PTSD patients. Then we measured P300 amplitude and latency on 3 electrodes (Cz, CPz, Pz) in both PTSD patients and the NC group. Results: Compared with the NC, the P300 amplitudes of PTSD patients were lower on Cz (PTSD：NC=5.51±2.82 uV：11.80±5.18 uV, p<0.01), CPz (PTSD：NC=5.84±2.71 uV：12.69±4.51 uV, p<0.01) and Pz (PTSD：NC=5.01±2.60 uV：10.99±4.24 uV, p<0.01). We found increasing tendency toward P300 latency in PTSD group compared with NC. However, the BDI and DTS symptom severity scores were negatively correlated with the P300 amplitude of Pz. Conclusion: There was a significant reduction of P300 amplitudes in PTSD patients. Compared to NC group, PTSD patients showed a reduced P300 amplitude significantly correlated with symptom severity. The present findings suggest PTSD patients experience cognitive dysfunction and ERP P300 can be a useful surrogate marker of symptom severity in PTSD patients.

참고문헌 (42)

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