注意缺陷障碍患儿注视作业时的功能性磁共振成像分析  

Brain functional magnetic resonance imaging study in children with attention deficit disorder hyperactivity during visual attentional task

作　　者：吴丽慧[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：《中华物理医学与康复杂志》2007年第10期692-695,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：浙江省自然科学基金(M303002);浙江省科技厅国际合作面上项目(2004C34008)

摘　　要：目的应用功能性磁共振成像研究正常儿童及注意缺陷障碍(ADHD)患儿在进行注视作业测验时其额、颞叶等皮质区激活状况的差异。方法使用美国GE 1.5T Sigma Horizon LX超导型磁共振仪对19名正常儿童及17例ADHD患儿于注视作业测试时进行fMRI检查。结果(1)正常儿童和ADHD患儿激活脑区范围均较广泛,两组激活脑区在额叶、颞叶、顶叶、枕叶及扣带回部位的分布情况大体相同(P>0.05)。(2)正常儿童与ADHD患儿激活脑区计数如下,左额上回分别为15个和6个,右额上回分别为16个和5个,右额中回分别为16个和8个,左额下回分别为15个和5个,2组对象上述部位脑区激活计数结果差异均有统计学意义(均P<0.05)。(3)fMRI结果显示,ADHD患儿双侧前额叶、右额中回以及左额下回部位功能低下。结论ADHD患儿在选择性注意及执行功能方面存在缺陷,fMRI对检测正常儿童及ADHD患儿大脑皮质激活情况均具有重要意义。Objective To observe the characteristics of brain activity during visual attentional task in healthy children and children with attention deficit disorder with hyperactivity （ADHD） using functional magnetic resonance imaging （fMRI）. Methods The data of 19 healthy children and 17 ADHD children were collected while they were performing the visual attentional task, using brain fMRI （GE 1.5 T Signa Horizon LX）. An offline workstation was used to reconstruct the activation and rest images. Results Significant brain activations in frontal, temporal, parietal gyrus, and cingulated gyrus were observed in the healthy children（ P 〉0.05 ） as well as in the ADHD children. The number of activated locus in the healthy and ADHD children was 15 versus 6 in the left superior frontal gyri, 16 versus 5 in right superior frontal gyri, 16 versus 8 in right middle frontal gyri, and 15 versus 5 in left inferior frontal gyri, respectively. The differences between the healthy and ADHD children with regard to the number of the activated locus in the above brain regions were significant （ P = 0. 017, P = 0. 002, P =0. 006, P =0. 033 ）. When compared to the healthy children, the ADHD children showed significantly decreased activations in bilateral frontal gyri, right middle frontal gyri, and left inferior frontal gyri. Conclusion The ADHD children have deficit in selective attention and functional execution, and the fMRI might be of value on examining brain activation between healthy and ADHD children.

关 键 词：注意缺陷障碍 功能性磁共振成像 注视作业 

分 类 号：R749.94[医药卫生—神经病学与精神病学]