注意缺陷多动障碍患儿治疗前后功能磁共振成像的比较  

Brain fMRI study in children with attention-deficit/hyperactivity disorder before and after treatment

作　　者：吴丽慧[1] 赵钱雷[1] 尹玲玲[1] 李建策[2] 王美豪[2] 吴伟[1] 

机构地区：[1]温州医学院附属育英儿童医院儿童保健科, 温州325003 [2]温州医学院附属一院放射科

出　　处：《中国行为医学科学》2007年第10期892-894,共3页Chinese Journal of Behavioral Medical Science

基　　金：浙江省科技厅资助项目（2004C34008）;浙江省自然科学基金资助项目（M303002）

摘　　要：目的应用功能性磁共振成像（fMR I）探讨注意缺陷多动障碍（ADHD）患儿哌甲酯（m ethyl-phen idate,又名利太灵）治疗前后激发图像的特点。方法对17例ADHD患儿治疗前进行视觉注意作业的fMR I检查,经哌甲酯（平均10mg/d）治疗2月后复查fMR I（13例）。用Conner行为量表评价多动症状的程度。结果（1）17例ADHD患儿哌甲酯治疗后的Conner行为量表减分率为（49±18）%,有效率为69%。（2）视觉注意作业激活受试者的额叶和颞叶皮层。（3）治疗后13例受试者的右侧额上回和右侧中央旁小叶有增加趋势,右侧额上回治疗前激活脑区计数为5,治疗后激活脑区计数为10;右侧中央旁小叶治疗前激活脑区计数为2,治疗后激活脑区计数为6;差异有显著性（分别为P=0.025和P=0.049）。结论ADHD患儿治疗前后脑功能图像有一定变化,提示认知、注意等缺陷症状是可以治疗的。Objective To compare the characteristics of brain activity during visual attentional task in children with attention-deficit/hyperactivity disorder （ADHD） before and after treatment of methylphenidate, using a functional magnetic resonance imaging （fMRI）. Methods The data on 17 ADHD children were gathered when they performed the visual attentional task, using brain fMRI （GE 1.5T Signa Horizon LX） in the study. After 2 months treatment （average dose of methylphenidate was 10mg/d）, the fMRI data were re-collected from 13 ADHD children. Also all patients were assessed with the Conner behavior scale at the same time. Results 1. ADHD children showed （49 ± 18 ） % reduction in their Conner behavior scale total scores after treatment and had efficacy rate of 69%. 2. The patients before treatment showed the activated areas including frontal and temporal gyri during the visual attentional task. 3. After treatment, 13 patients showed improvement on the activated areas such as right superior frontal gyri and right lobulus para central, The activated areas in the right superior frontal gyri and right lobulus para central were respectively 5 and 2, and increased to 10 and 6 respectively after treatment （ P=0. 025, P = 0. 049）. Conclusion The results indicated that the attention and executive function deficits in ADHD children might be improved by treatment, reflecting by brain fMRI variation before and after treatment.

关 键 词：注意缺陷多动障碍 功能性磁共振 哌甲酯 

分 类 号：R686[医药卫生—骨科学]