儿童和少年期高功能孤独症谱系障碍患者扣带束纤维示踪研究  

The tractography study of cingulated bundles in children and adolescents with high-functioning autism spectrum disorders

作　　者：李赟[1] 钱璐[1] 肖运华 常琛[1] 武巧荣[1] 肖朝勇[2] 肖湘[1] 肖婷[1] 储康康[1] 方慧[1] 柯晓燕[1] 

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

出　　处：《中华精神科杂志》2016年第5期317-321,共5页Chinese Journal of Psychiatry

基　　金：国家重点基础研究发展规划（973计划）（2012CB517900）;国家社科基金重大项目子课题（14ZDB161）;国家自然科学基金（91132750）;江苏省科技厅自然科学基金项目（BK2012519）

摘　　要：目的 探讨儿童和少年期高功能孤独症谱系障碍（autism spectrum disorder,ASD）扣带束的完整性及其与儿童和少年期高功能ASD临床症状的相关性.方法 对6～16岁高功能ASD儿童和少年（高功能ASD组,34例）与年龄、性别及智商匹配的发育正常儿童少年（对照组,39名）分别进行弥散张量成像扫描.在交互式纤维示踪技术基础上比较分析2组被试者双侧扣带束的各向异性分数（fractional anisotropy,FA）值及平均弥散率（mean diffusivity,MD）值,并采用Pearson积差相关分析方法比较其与儿童孤独症评定量表评分、孤独症诊断访谈量表修订版评分、年龄、智商之间的相关性.结果 （1）高功能ASD组右侧白质扣带束的FA值较对照组增高（0.36±0.03与0.34±0.03,t=2.74,P＜0.01）.（2）高功能ASD组双侧扣带束FA值与年龄正相关（左侧r=0.42,P=0.02;右侧r=0.38,P=0.03）,左侧扣带束MD值与年龄负相关（r=-0.44,P=0.01）;对照组左侧扣带束的FA值与年龄正相关（r=0.35,P=0.03）.双侧扣带束的FA值和MD值与儿童孤独症评定量表评分、孤独症诊断访谈量表修订版评分、智商均未见相关性.结论 儿童和少年期高功能ASD患者存在右侧白质扣带束完整性的异常,且其扣带束完整性与年龄关系密切.Objective To compare the integrity of cingulate bundles with high-functioning autism spectrum disorder （ASD） and typically developed （TD） children and adolescents,and further to investigate the relationship between eigenvalues of cingulate bundles and clinical symptoms of high-functioning ASD.Methods Thirty-four high-functioning ASD and thirty-nine TD children and adolescents,with age,gender and intelligent quotient （IQ） matched,underwent diffusion tensor imaging （DTI）.Fractional anisotropy （FA）and mean diffusivity （MD） values in the bilateral cingulate bundles were compared using interactive tractography,respectively.Pearson correlation was used to investigate the association of cingulate bundle eigenvalues with scores of Autism Rating Scale （CARS） and Autism Interview Scale-Revised （ADI-R）,as well as age and IQ in high-functioning ASD children.Results Compared with TD children and adolescents,FA value of the white matter cingnulate bundle in the right side was significantly higher in high-functioning ASD group （0.36±0.03 vs.0.34±0.03,t=2.74,P＜0.01）.Moreover,FA values of bilateral cingulate bundles were positively associated with age （left side：r=0.42,P=0.02,right side：r=0.38,P=0.03）,while MD values of left cingulate bundle was negatively correlated with age （r=-0.44,P=0.01） in high-functioning ASD group.There was a significant positive correlation between the left cingulate bundle FA and age in TD group（r=0.35,P=0.03）.There was no significant correlation between FA and MD values of bilateral cingulate bundle eigenvalues and scores of CARS,ADI-R and IQ.Conclusion The integrity of cingulate bundles may be abnormal in high-functioning ASD patients,which be related to age.

关 键 词：孤独性障碍 磁共振成像 弥散 纤维示踪 扣带束 

分 类 号：R749.94[医药卫生—神经病学与精神病学]