2~3岁孤独症谱系障碍患儿脑白质体积的2年随访研究  

Two-year follow-up study of white matter structures in 2-3 years old children with autism spectrum disorder

作　　者：储康康[1] 祝敬溪[3] 肖婷[1] 肖湘[1] 李赟[1] 武巧荣[1] 方慧[1] 肖朝勇[2] 张久平[1] 邹冰[1] 瞿颖莹 柯晓燕[1] Chu Kangkang;Zhu Jingxi;Xiao Ting;Xiao Xiang;Li Yun;Wu Qiaorong;Fang Hui;Xiao Chaoyong;Zhang Jiuping;Zou Bing;Qu Yingying;Ke Xiaoyan(Child Mental Health Research Center,Nanjing Brain Hospital Affiliated to Nanjing Medical University,Najing 210029, China;Department of Radiology,Nanjing Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China;Department of Psychiatry,the Third People's Hospital of Changshou City,Changshou 215500,Jiangsu Province,China)

机构地区：[1]南京医科大学附属脑科医院儿童心理卫生研究中心,210029 [2]南京医科大学附属脑科医院影像科,210029 [3]常熟市第三人民医院精神科,江苏常熟215500

出　　处：《中华实用儿科临床杂志》2018年第24期1845-1850,共6页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81071111);国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(2016YFC1306205);江苏省重点研发(社会发展)专项(BE2016616).

摘　　要：目的纵向对比分析孤独症谱系障碍(ASD)患儿脑白质体积的发育特征。方法对2011年5月至2014年9月在南京医科大学附属脑科医院儿童心理卫生研究中心就诊的37例ASD患儿(ASD组)及27例年龄、性别及发育商匹配的发育迟缓(DD)儿童(对照组)分别在2~3岁及4~5岁时进行结构磁共振成像(sMRI)扫描。使用基于感兴趣区(ROI)方法研究ASD患儿全脑及各脑叶白质体积随时间变化的特征,并进一步分析ASD患儿脑白质体积变化与临床症状严重程度变化之间的相关性。结果与对照组相比,2~3岁时ASD组患儿全脑白质体积[(383521.84±6427.57)mm^3比(364014.06±6856.97)mm^3]、左脑半球白质体积[(191609.35±3206.60)mm^3比(181695.89±3389.54)mm^3]、颞叶白质体积[(41860.49±816.38)mm^3比(39444.18±834.85)mm^3]、右侧颞叶白质体积[(21312.79±414.07)mm^3比(20084.22±412.13)mm^3]均显著增大,差异均有统计学意义(均P<0.05)。分别以年龄和全脑体积为协变量进行分析后,差异性均消失(均P>0.05)。2年后再进行比较,ASD组患儿全脑白质体积[(417651.42±6443.86)mm^3比(394317.27±6404.86)mm^3]、左脑半球白质体积[(208714.16±3214.61)mm^3比(197192.82±3262.02)mm^3]、右脑半球白质体积[(208937.26±3242.09)mm^3比(197124.45±3193.13)mm^3]、额叶白质体积[(107107.46±1681.99)mm^3比(100326.19±1883.24)mm^3]、左侧额叶白质体积[(54569.63±846.85)mm^3比(51177.25±979.09)mm^3]、右侧额叶白质体积[(52537.83±841.99)mm^3比(49148.94±928.31)mm^3]、颞叶白质体积[(45189.75±833.29)mm^3比(42487.73±786.27)mm^3]、左侧颞叶白质体积[(22204.21±411.77)mm^3比(20922.90±418.46)mm^3]、右侧颞叶白质体积[(22985.54±426.93)mm^3比(21564.83±378.78)mm^3]均大于对照组,差异均有统计学意义(均P<0.05)。以年龄为协变量进行协方差分析时,差异性仍存在(均P<0.05);以全脑体积为协变量分析时,上述差异均无统计学意义(均P>0.05)。2年随访期间,2组全脑、左脑半球、右Objective To explore the developmental characteristics of white matter volume in autism spectrum disorder (ASD) children longitudinal. Methods From May 2011 to September 2014, 37 ASD children (ASD group) and 27 developmental delays (DD) children (control group) were treated at the Child Mental Health Research Center, Nanjing Brian Hospital Affiliated of Nanjing Medical University, and the children whose age, gender and developmental quotient matched with the ASD children were scanned by structure magnetic resonance imaging (sMRI) at the age of 2-3 years old and 4-5 years old respectively.Region of interest(ROI) technology was adopted to investigate the change of the cerebrum white and the sub-lobes structure white matter volume with time.Then the correlation between clinical symptoms and brain white matter volume changes was analyzed. Results Among the 2-3 years old, compared with the control group, the white matter volume of the total brain[(383 521.84±6 427.57) mm^3vs. (364 014.06±6 856.97) mm^3], the left cerebral hemisphere [(191 609.35±3 206.60) mm^3vs. (181 695.89±3 389.54) mm^3], temporal lobe [(41 860.49±816.38) mm^3vs. (39 444.18±834.85) mm^3] and the right temporal lobe [(21 312.79±414.07) mm^3vs. (20 084.22±412.13) mm^3] were significantly larger in the ASD group, and the differences were statistically significant (all P<0.05). With the analysis of covariance with age or the total brain volume as the covariate, the differences disappeared(all P>0.05). Among the 4-5 years old, compared with the control group, the white matter volumes of the total brain[(417 651.42±6 443.86) mm^3vs. (394 317.27±6 404.86) mm^3], left cerebral hemisphere [(208 714.16±3 214.61) mm^3vs. (197 192.82±3 262.02) mm^3], right cerebral hemisphere [(208 937.26±3 242.09) mm^3vs. (7 124.45±3 193.13) mm^3], frontal lobe [(107 107.46±1 681.99) mm^3vs. (100 326.19±1 883.24) mm^3], left frontal lobe [(54 569.63±846.85) mm^3vs. (51 177.25±979.09) mm^3], right frontal lobe [(52 537.83±841.99) mm^3vs. (49 148.94±928.31)

关 键 词：孤独症谱系障碍 脑白质 体积 磁共振成像 随访性研究 

分 类 号：R749.94[医药卫生—神经病学与精神病学]