注意缺陷多动障碍患儿静息态下小脑功能连接的特征  

Characteristics of functional connectivity based on cerebellum at resting state on children with attention deficit hyperactivity disorder

作　　者：江凯华[1] 董选[1] 周金金 丁志丽 方祯 郑爱斌 Jiang Kaihua;Dong Xuan;Zhou Jinjin;Ding Zhili;Fang Zhen;Zheng Aibin(Department of Children's Health Research Center,Changzhou Children's Hospital,Nantong University,Changzhou 213003,Jiangsu Province,China;Department of Radiology,Changzhou Children's Hospital,Nantong University,Changzhou 213003,Jiangsu Province,China)

机构地区：[1]南通大学附属常州儿童医院儿童健康研究中心,江苏常州213003 [2]南通大学附属常州儿童医院放射科,江苏常州213003

出　　处：《中华实用儿科临床杂志》2018年第24期1855-1858,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：江苏省科技专项(BL2014037);常州市社会发展科技项目(CE20175036).

摘　　要：目的探讨注意缺陷多动障碍(ADHD)患儿小脑在静息态下功能连接的特点及其与认知功能相关的脑机制。方法研究对象为2015年6月至2017年7月在南通大学附属常州市儿童医院ADHD专科门诊确诊的ADHD患儿30例(ADHD组)及来自常州市一所普通小学的健康儿童33例(健康对照组),对2组儿童进行静息态下功能及结构像磁共振成像(MRI)扫描,以既往低频振幅研究发现存在功能异常的左侧小脑为种子点,比较ADHD与健康对照组儿童小脑功能连接特征的差异性。结果以左侧小脑(-49.5,-58.5,-18.5)为种子点,ADHD组左侧额中回[体积=835mm^3,坐标(-27,-21,51)]、右侧额中回[体积=755mm^3,坐标(45,-3,6)]、右侧颞上回[体积=256mm^3,坐标(45,-24,-6)]和左边缘叶[体积=513mm^3,坐标(-15,-3,-18)]功能连接值均高于健康对照组,差异均有统计学意义(t=4.10、4.38、3.97、3.32,均P<0.05)。结论ADHD患儿小脑与左侧额中回、右侧额中回、右侧颞上回和左边缘叶存在功能连接异常,可能是ADHD患儿注意力下降、多动冲动等核心症状及认知功能障碍的脑机制之一。Objective To explore the characteristics of functional connectivity based on cerebellum at resting state and the brain functions related to cognitive function on attention deficit hyperactivity disorder (ADHD). Methods Thirty ADHD children (ADHD group) were diagnosed at ADHD Specialist Clinic of Changzhou Children′s Hospital, Nantong University from June 2015 to July 2017, and 33 healthy children (healthy control group) were selected from a normal school in Changzhou.Then, they received the functional and structural magnetic resonance imaging(MRI) scans.Finally, the differences of the characteristics of functional connectivity were compared between the 2 groups based on cerebellum which had been found with dysfunction on the previous study of amplitude of low-frequency fluctuation. Results It all showed positive activated brain regions when comparing ADHD group and healthy control group based on left cerebellum (-49.5, -58.5, -18.5) as ADHD children′s functional connectivity scores were higher in left middle frontal gyrus[volume=835 mm^3, coordinate(-27, -21, 51)], right middle frontal gyrus[volume=755 mm^3, coordinate(45, -3, 6)], right superior temporal gyrus[volume=256 mm^3, coordinate(45, -24, -6)], left limbic lobe[volume=513 mm^3, coordinate(-15, -3, -18)], and there were statistically significant differences between the 2 groups (t=4.10, 4.38, 3.97, 3.32, all P<0.05). Conclusions There exist abnormal functional connectivity between cerebellum and left middle frontal gyrus, right middle frontal gyrus, right superior temporal gyrus and left limbic lobe.It may be one of the brain mechanisms of the main clinical manifestations of the decreasing of attention, hyperactivity and impulsiveness and the dysfunction of cognitive function.

关 键 词：注意缺陷多动障碍 小脑 静息态功能磁共振成像 功能连接 认知功能 

分 类 号：R749.94[医药卫生—神经病学与精神病学]