注意缺陷多动障碍共病对立违抗性障碍儿童脑灰质体积及脑功能连接的改变  

Changes of gray matter volume and brain functional connectivity in children with attention deficit hyperactivity disorder comorbid with oppositional defiant disorder

作　　者：王欣[1] 肖勇 周仪 符益纲 Wang Xin;Xiao Yong;Zhou Yi;Fu Yigang(MRI Department,Yancheng First Hospital,Affiliated Hospital of Nanjing University Medical School,Yancheng 224000,China)

机构地区：[1]南京大学医学院附属盐城第一医院(盐城市第一人民医院)磁共振室,盐城224000

出　　处：《中华行为医学与脑科学杂志》2022年第9期833-839,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：江苏省盐城市医学科技发展计划项目(YK2018014)。

摘　　要：目的探讨注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)共病对立违抗障碍(oppositional defiant disorder, ODD)儿童的脑灰质体积变化及静息状态下部分脑区功能连接的改变。方法选取ADHD-200样本数据库中22例ADHD伴ODD(ADHD-ODD组)和年龄、性别与之相匹配的不伴ODD的ADHD儿童(ADHD组, n=22)及正常健康儿童(正常对照组, n=22), 进行结构及静息态功能磁共振扫描, 运用基于体素的形态学测量(voxel-based morphometry, VBM)方法对脑灰质体积进行分析, 并选择体积变化脑区为感兴趣区(region of interest, ROI)进行全脑功能连接的分析。脑灰质体积比较采用单因素方差分析及双样本t检验分析方法, 功能连接比较采用双样本t检验分析方法。结果与正常对照组相比, ADHD-ODD组的左侧小脑前叶(MNI:x, y, z=-19.5, -42, -18)及右侧小脑前叶(MNI:x, y, z=19.5, -39, -21)体积减小。左侧小脑前叶与左侧额上回、额中回(MNI:x, y, z=-24, 19, 43)、右侧额上回、额中回(MNI:x, y, z=30, 9, 45)、双侧楔前叶、后扣带回(MNI:x, y, z=-6, -35, 24)功能连接增强。与ADHD组相比, ADHD-ODD组的右侧小脑前叶(MNI:x, y, z=19.5, -37.5, -22.5)体积缩小。右侧小脑前叶与双侧额上回、额中回、额内侧回、前扣带回、后扣带回(MNI:x, y, z=18, -12, 42)、双侧楔叶(MNI:x, y, z=9, -87, 27)、舌回功能连接增强。结论 ADHD共病ODD儿童的小脑体积减小, 与大脑多个脑区存在过度功能连接, 这可能是其认知、情感及行为障碍的神经病理基础之一。Objective To analyze the changes of gray matter volume and resting-state functional connectivity in children with attention deficit hyperactivity disorder(ADHD)comorbid with oppositional defiant disorder(ODD).Methods A total of 22 ADHD comorbid with ODD children(ADHD-ODD group,n=22)were selected from a public-assess resting-state fMRI ADHD cohort,namely,ADHD-200.Meanwhile,22 age-and sex-matched ADHD children without ODD(ADHD group,n=22)and 22 healthy children(control group,n=22)were also included.T1-weighted MRI and resting-state fMRI scans were performed on all of the participants.The voxel-based morphometric(VBM)method was used to compare the volume of gray matter in three groups.The gray matter with aberrant volume was set as the region of interest(ROI)for mapping the functional connectivity of the whole brain.For comparison of gray matter volumes,one-way ANOVA and two-sample t-test analysis were applied,while two-sample t-test analysis was used for comparison of functional connectivity.Results Compared with the control group,ADHD-ODD group showed decreased gray matter volume in the left cerebellum anterior lobe(MNI coordinate:x,y,z=-19.5,-42,-18)and right cerebellum anterior lobe(MNI coordinate:x,y,z=19.5,-39,-21).The left cerebellum anterior lobe showed increased functional connectivity with left superior frontal gyrus,left middle frontal gyrus(MNI coordinate:x,y,z=-24,19,43),right superior frontal gyrus,right middle frontal gyrus(MNI coordinate:x,y,z=30,9,45)and bilateral precuneus,posterior cingulate gyrus(MNI coordinate:x,y,z=-6,-35,24).Compared with the ADHD group,ADHD-ODD group showed decreased gray matter volume in the right cerebellum anterior lobe(MNI coordinate:x,y,z=19.5,-37.5,-22.5).The right cerebellum anterior lobe showed increased functional connectivity with bilateral superior frontal gyrus,bilateral middle frontal gyrus,bilateral medial frontal gyrus,anterior cingulate gyrus and posterior cingulate gyrus(MNI coordinate:x,y,z=18,-12,42),bilateral cuneus,bilateral lingual gyrus(MNI coordinate:x

关 键 词：注意缺陷多动障碍 对立违抗性障碍 静息态功能磁共振 灰质 基于体素的形态学测量 功能连接 

分 类 号：R749.94[医药卫生—神经病学与精神病学]