基于功能性近红外光谱技术观察注意力缺陷多动障碍儿童脑功能连接和激活特征  

Observation of Brain Functional Connectivity and Activation Characteristics in Children with Attention Deficit and Hyperactivity Disorder Based on Functional Near-Infrared Spectroscopy

作　　者：王静 刘芸 黄浩宇 吴金庭 邹卓 陈颖娟 魏贤召 苏杭 WANG Jing;LIU Yun;HUANG Haoyu;WU Jinting;ZOU Zhuo;CHEN Yingjuan;WEI Xianzhao;SU Hang(Children's Hospital Affiliated to Kunming Medical University(Kunming Children's Hospital),Kunming,Yun nan 650034,China)

机构地区：[1]昆明医科大学附属儿童医院(昆明市儿童医院),云南昆明650034

出　　处：《康复学报》2025年第1期36-43,共8页Rehabilitation Medicine

基　　金：云南省科技厅科技计划项目昆医联合专项(202401AY070001-022);云南省徐开寿专家工作站(202405AF140103);云南省教育厅科学研究基金(2024J0303);昆明市卫生科技人才培养项目医学科技学科后备人才培养计划[2022-SW(后备)005];昆明市卫生科研课题(2023-16-01-001)。

摘　　要：目的 采用功能性近红外光谱技术(fNIRS)探究注意力缺陷多动障碍(ADHD)儿童在静息状态下大脑前额叶脑功能连接的特征及Go/No-go任务态下脑功能激活水平。方法 选取2022年1月—2023年8月于昆明市儿童医院就诊的21例ADHD儿童作为研究对象,即ADHD组;同时选取年龄、智商、性别与之相匹配的20例正常儿童为典型发育组(TD组)。比较2组斯诺佩评估量表(SNAP-Ⅳ)(父母版)评分,并使用fNIRS采集儿童大脑前额叶10 min静息态数据。根据采集到的氧合血红蛋白(HbO2)、脱氧血红蛋白(HbR)和总血红蛋白(HbT)浓度,计算2组静息态下的脑功能连接强度。同时选择Go/No-go任务来评估儿童的反应抑制功能,应用fNIRS检测2组儿童在Go/No-go任务中前额叶血氧浓度水平的变化,计算出2组任务态下的脑功能激活水平。结果 与TD组相比,ADHD组的注意缺陷评分、多动冲动评分和对立违抗评分更高(P<0.05)。应用fNIRS发现,与TD组比较,ADHD组所有通道脑区间功能连接强度以及左背外侧前额叶皮层、右背外侧前额叶皮层、左内侧前额叶皮层、右内侧前额叶皮层的fNIRS静息态大脑功能连接强度较低(P<0.05)。2组Go/No-go任务期间行为表现得分,与TD组比较,ADHD组在No-go block的准确性更低(P<0.05)。2组Go block的准确率和反应时间以及No-go block的反应时间比较,差异均无统计学意义(P>0.05)。在Go/No-go任务态过程中,与TD组比较,ADHD组的左背外侧前额叶皮层、右背外侧前额叶皮层、左内侧前额叶皮层、右内侧前额叶皮层的平均HbO2浓度较低(P<0.05)。2组SNAP-Ⅳ评分与Go/No-go任务态前额叶平均HbO2浓度呈负相关(P<0.05)。结论 fNIRS能够有效检测出ADHD儿童在静息与任务态下大脑前额叶功能的异常特征,主要异常出现在左、右背外侧前额叶皮质和左、右内侧前额叶皮层,这些发现为深入理解ADHD的神经病理机制提供了影像学依据,有望为后续精�Objective To explore the characteristics of functional connectivity in the prefrontal cortex of children with attention deficit hyperactivity disorder(ADHD)at rest and the level of brain functional activation during the Go/No-go task using functional near and infrared spectroscopy(fNIRS).Methods Twenty-one children with ADHD who visited Kunming Children's Hospital from January 2022 to August 2023 were selected as the study subjects,namely the ADHD group.Meanwhile,20 typically developing children matched in age,intelligence quotient(IQ),and gender were selected as the typically developing group(TD group).The scores of the SNAP-ⅣScale(Parent Version)were compared between the two groups,and fNIRS was used to collect 10-minute resting-state data of the prefrontal cortex of the children.Based on the concentrations of oxyhemoglobin(HbO2),deoxyhemoglobin(HbR)and total hemoglobin(HbT)collected,the functional connectivity strength at rest was calculated for both groups.Meanwhile,the Go/No-go task was selected to evaluate children's response inhibition function,and fNIRS was applied to detect the changes blood oxygen concentration levels in prefrontal cortex of the two groups of children during the Go/No-go task,and the brain functional activation levels of the two groups during the task were calculated.Results Compared with the TD group,the attention deficit score,hyperactivity-impulsivity score,and oppositional defiant score of the ADHD group were higher,and the differences were statistically significant(P<0.05).The fNIRS findings revealed that compared with the TD group,the functional connectivity strength among all channels and the resting-state brain functional connectivity strength of the left dorsolateral prefrontal cortex,right dorsolateral prefrontal cortex,left medial prefrontal cortex,and right medial prefrontal cortex in the ADHD group were lower(P<0.05).By comparing the behavioral performance scores during the Go/No-go task,the ADHD group had lower accuracy in the No-go block compared with the TD group(P<0.0

关 键 词：注意力缺陷多动障碍 功能性近红外光谱技术 血氧浓度 功能连接强度 脑功能激活 神经病理机制 

分 类 号：R749.94[医药卫生—神经病学与精神病学]