沿血管周围间隙弥散张量成像分析法对9~18岁孤独症谱系障碍患者脑类淋巴系统改变的探讨  

The exploration of glymphatic system alteration in patients with autism spectrum disorder aged 9~18 years using DTI-ALPS method

作　　者：徐滢莹 苏醒 吉兆正 陈佳璐 李雪[1] 刘靖[1] XU Ying-ying;SU Xing;Siu-Ching Kat(Peking University Sixth Hospital,Peking University Institute of Mental Health,National Health Commission Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100191,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),北京100191

出　　处：《放射学实践》2024年第9期1117-1121,共5页Radiologic Practice

基　　金：国家重点研发计划(2017YFC1309900);国家自然科学基金(81571339);北京市自然科学基金(7164314)。

摘　　要：目的:基于血管周围间隙弥散张量成像分析法(DTI-ALPS)探讨9~18岁孤独症谱系障碍(ASD)男性患者脑类淋巴系统功能改变,以及沿血管周围间隙(ALPS)指数与临床表现间的关系。方法:纳入北京大学第六医院符合美国精神障碍诊断与统计手册第五版(DSM-5)孤独症谱系障碍诊断标准的9~18岁男性34例,以及年龄相匹配的正常男性对照30例。采集所有受试者弥散张量成像(DTI)数据并计算ALPS指数,比较2组受试者临床资料和双侧ALPS指数(ALPS-L、ALPS-R)的差异。采用相关性分析检验双侧ALPS指数与社交反应量表(SRS)的相关性。结果:与正常对照组相比,ASD组ALPS-L及ALPS-R指数显著减低(t=2.060,P=0.044;t=2.675,P=0.010)。总体ALPS-L与SRS量表各因子分及总分无明显相关关系(P均>0.05),总体ALPS-R与SRS社交认知因子分、社交沟通因子分、社交动机因子分无明显相关关系(P均>0.05),总体ALPS-R与SRS社交知觉因子分、孤独症行为方式因子分及SRS总分均呈负相关关系(r=-0.309,P=0.013;r=-0.359,P=0.004;r=-0.298,P=0.017)。结论:ASD患者存在大脑类淋巴系统功能异常,类淋巴系统功能异常与ASD临床症状相关,可能是ASD患者潜在病理基础之一。Objective:To investigate the changes of glymphatic system function in male patients with autism spectrum disorder(ASD)aged 9~18 years using diffusion tensor image analysis along the perivascular space(DTI-ALPS),and to explore the relationship between the DTI-ALPS index and clinical manifestations.Methods:A total of 34 male participants aged 9~18 years meeting the diagnostic criteria for ASD according to the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 30 age-matched male typically developing controls were enrolled at Peking University Sixth Hospital.All participants underwent diffusion tensor imaging(DTI),and the along perivascular space(ALPS)index was calculated.The differences in clinical data and bilateral ALPS index(ALPS-L,ALPS-R)among the two groups were compared,and the correlations between bilateral ALPS index and social responsiveness scale(SRS)in all participants were analyzed.Results:Compared with the control group,the ASD group showed significantly lower ALPS index in bilateral cerebral hemispheres(ALPS-L:t=2.060,P=0.044;ALPS-R:t=2.675,P=0.010).There was no significant correlation between the overall ALPS-L and SRS scores(P>0.05),and there was no significant correlation between the overall ALPS-R and SRS scores for social cognition,social communication,and social motivation(P>0.05).However,there was a negative correlation between the overall ALPS-R and SRS scores for social awareness,autistic mannerisms,and total score(r=-0.309,P=0.013;r=-0.359,P=0.004;r=-0.298,P=0.017).Conclusion:Patients with ASD have glymphatic system dysfunction,which is related to clinical symptoms of ASD and may be one of the underlying pathological bases of ASD.

关 键 词：孤独症谱系障碍 类淋巴系统 血管周围间隙 弥散张量成像 磁共振成像 

分 类 号：R749.94[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]