注意缺陷多动障碍共患对立违抗障碍儿童大脑皮质形态学特点  

Characteristics of brain cortical morphology in children with attention deficit hyperactivity disorder co-occurred with oppositional defiant disorder

作　　者：司飞飞[1] 刘璐[1] 李海梅[1] 董敏 曹庆久[1] 孙黎[1] 钱秋谨[1] 王玉凤[1] SI Feifei;LIU Lu;LI Haimei;DONG Min;CAO Qingjiu;SUN Li;QIAN Qiujin;WANG Yufeng(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking Uni-versity),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Bejjing 100083,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083

出　　处：《中国心理卫生杂志》2024年第2期97-103,共7页Chinese Mental Health Journal

基　　金：国家重点基础研究发展计划(973计划)(2014CB846104);国家科技支撑计划项目(2015BAI13B01);国家自然科学基金资助项目(81873802、81571340、32071072)。

摘　　要：目的:探讨注意缺陷多动障碍(ADHD)共患对立违抗障碍(ODD)儿童的大脑皮质形态学特点。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的ADHD共患ODD儿童16例,不共患ODD的ADHD儿童20例,及性别、年龄匹配的36例正常对照儿童。采用中国修订韦氏儿童智力量表(C-WISC)评估智商。所有被试进行脑磁共振成像扫描及数据采集,采用FreeS urfer软件分析大脑皮质形态学指标。结果:ADHD伴ODD组[(6528.1±857.5)mm^(3)vs.(7591.2±657.3)mm^(3)]、ADHD不伴ODD组[(6867.2±841.3)mm^(3)vs.(7591.2±657.3)mm^(3)]左外侧颞上回脑区皮质体积均小于正常对照组(P<0.05),而ADHD伴ODD与ADHD不伴ODD两组间体积差异无统计学意义(P>0.05);ADHD组左外侧颞上回脑区皮质体积与ODD症状的相关无统计学意义(P>0.05)。3组间皮质厚度、表面积和曲率差异无统计学意义(均P>0.05)。结论:左外侧颞上回皮质体积减小可能是ADHD儿童的重要脑结构异常指征,共患ODD未改变这一特点。Objective:To investigate the characteristics of cortical morphology in children with attention deficit hyperactivity disorder(ADHD)and those with oppositional defiant disorder(ODD)from both categorical and dimensional analyses.Methods:A total of 72 children were enrolled,including 16 children with ADHD and ODD,20 children with ADHD without ODD,and 36 age-gender-matched normal children.The diagnoses were made ac-cording to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV)criteria.The Chi-nese Wechsler Intelligence Scale for Children(C-WISC)was used to access intelligence quotient.All subjects participated in the magnetic resonance imaging(MRI)scan.The features of cortical morphology were determined using FreeSurfer software.Results:Children with ADHD and ODD[(6528.1±857.5)mm^(3) vs.(7591.2±657.3)]and children with ADHD only[(6867.2±41.3)mm^(3) vs.(7591.2±657.3)mm^(3)]had smaller volume in the left later-al superior temporal gyrus(P<0.05)than controls.No difference was found between ADHD with ODD group and ADHD without ODD group.There was no correlation between the cortical volume of left lateral superior temporal gyrus and ODD symptoms.Conclusion:The reduced cortical volume of left lateral superior temporal gyrus may be an important indication of the abnormal brain structure of ADHD in children.And comorbid status of ODD dose not change this structural variation.

关 键 词：儿童注意缺陷多动障碍 对立违抗障碍 大脑皮质形态学 

分 类 号：R749.94[医药卫生—神经病学与精神病学]