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注意缺陷多动障碍儿童的静息态脑功能磁共振研究
杨润许, 丁凯景, 刘瑞湘, 李雪蓉, 万帅, 康传媛
中国当代儿科杂志 ›› 2013, Vol. 15 ›› Issue (9) : 723-727.
PDF(1575 KB)
PDF(1575 KB)
注意缺陷多动障碍儿童的静息态脑功能磁共振研究
Study on attention-deficit hyperactivity disorder in children based on resting-state functional magnetic resonance imaging
目的 比较注意缺陷多动障碍(ADHD)儿童与正常儿童的静息态脑功能磁共振成像结果的差异,探讨ADHD儿童脑功能失调可能的机制。方法 对符合DSM-IV诊断标准的18名ADHD儿童(ADHD组)及18名正常儿童(对照组)进行静息态功能磁共振扫描,采用局部一致性(ReHo)及低频振幅(ALFF)作为评价指标,比较两组ALFF值及ReHo值的大小。结果 ADHD组的ALFF值在双侧小脑后叶及左侧脑桥较对照组降低,而在右侧中央前回较对照组增高。ADHD组ReHo值在左额内侧回、右额上回及左楔前叶较对照组降低,而在左侧小脑前叶、左侧尾状核、右侧海马旁回、左侧中央前回及右侧额中回较对照组增高。结论 静息状态下,ADHD儿童脑局部(额叶、小脑等)功能活动较正常儿童减弱,支持额叶-小脑环路功能失调假说。
Objective To compare resting-state functional magnetic resonance imaging (fMRI) findings of children with attention-deficit hyperactivity disorder (ADHD) and normal children, and to investigate the possible mechanism of brain dysfunction in children with ADHD. Methods Resting-state fMRI was performed on 18 children who met the DSM-IV diagnostic criteria for ADHD (ADHD group) and 18 normal children (control group) matched for age, sex, IQ, degree of education and handedness. The two groups were compared in terms of amplitude of low frequency fluctuation (ALFF) and regional homogeneity (ReHo). Results Compared with the control group, the ADHD group had decreased ALFF in the bilateral posterior lobes of the cerebellum and the left side of the pons, increased ALFF in the right precentral gyrus, decreased ReHo in the left medial frontal gyrus, right superior frontal gyrus, and left precuneus, and increased ReHo in the left anterior lobe of the cerebellum, left caudate nucleus, right parahippocampal gyrus, left precentral gyrus, and right middle frontal gyrus. Conclusions In resting state, children with ADHD have decreased brain activity in some regions, including the cerebellum and frontal cortex, compared with normal children, which supports the hypothesis of dysfunctional fronto-cerebellar circuits in ADHD.
注意缺陷多动障碍 / 功能磁共振成像 / 低频振幅 / 局部一致性 / 儿童
Attention-deficit hyperactivity disorder / Functional magnetic resonance imaging / Amplitude of low frequency fluctuation / Regional homogeneity / Child
[1] 许茜芳, 王军焕. 儿童注意缺陷多动障碍病因及治疗新进展[J]. 中国医学理论与实践, 2005, 15(5): 718.
[2] 杨志龙,王苏弘,曹健,任艳玲,蔡婧,张毅力,等. 注意缺陷多动障碍儿童静息态功能磁共振比率低频振幅的研究[J]. 中华行为医学与脑科学杂志, 2010, 22(10): 894-896.
[3] 苏渊. 注意缺陷多动障碍儿童多动症状的行为特征[J]. 中国儿童保健杂志, 2005, 13(2): 143-144.
[4] Zang YF, He Y, Zhu CZ, Cao QJ, Sui MQ, Liang M, et al. Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI[J]. Brain Dev, 2007, 29(2): 83-91.
[5] 席芊, 赵小虎, 王培军, 郭起浩, 江虹, 曹歆轶, 等. 轻度认知功能损害患者静息状态脑默认活动网络的功能磁共振研究[J]. 中华老年医学杂志, 2011, 30(7): 529-532.
[6] Fox MD, Greicius M. Clinical applications of resting state functional connectivity[J]. Front Syst Neurosci, 2010, 4:19.
[7] Chao-Gan Y, Yu-Feng Z. DPARSF: A MATLAB Toolbox for "Pipeline" Data Analysis of Resting-State fMRI[J]. Front Syst Neurosci, 2010, 4:13.
[8] Bledsoe JC, Semrud-Clikeman M, Pliszka SR. Neuroanatomical and neuropsychological correlates of the cerebellum in children with attention-deficit/hyperactivity disorder——combined type[J]. J Am Acad Child Adolesc Psychiatry, 2011, 50(6): 593-601.
[9] Cubillo A, Halari R, Ecker C, Giampietro V, Taylor E, Rubia K. Reduced activation and inter-regional functional connectivity of fronto-striatal networks in adults with childhood attention-deficit hyperactivity disorder (ADHD) and persisting symptoms during tasks of motor inhibition and cognitive switching[J]. J Psychiatr Res, 2010, 44(10): 629-639.
[10] Lemiere J, Danckaerts M, Van Hecke W, Mehta MA, Peeters R, Sunaert S, et al. Brain activation to cues predicting inescapable delay in adolescent attention deficit/hyperactivity disorder: an fMRI pilot study[J]. Brain Res, 2012, 1450:57-66.
[11] Cao Q, Zang Y, Zhu C, Cao X, Sun L, Zhou X, et al. Alerting deficits in children with attention deficit/hyperactivity disorder: event-related fMRI evidence[J]. Brain Res, 2008, 1219:159-168.
[12] Posner J, Maia TV, Fair D, Peterson BS, Sonuga-Barke EJ, Nagel BJ. The attenuation of dysfunctional emotional processing with stimulant medication: an fMRI study of adolescents with ADHD[J]. Psychiatry Res, 2011, 193(3): 151-160.
[13] Siddiqui SV, Chatterjee U, Kumar D, Siddiqui A, Goyal N. Neuropsychology of prefrontal cortex[J]. Indian J Psychiatry, 2008, 50(3): 202-208.
[14] Shimamura AP. Memory and the prefrontal cortex[J]. Ann N Y Acad Sci, 1995, 769:151-159.
[15] Bush G, Frazier JA, Rauch SL, Seidman LJ, Whalen PJ, Jenike MA, et al. Anterior cingulate cortex dysfunction in attention-deficit/hyperactivity disorder revealed by fMRI and the Counting Stroop[J]. Biol Psychiatry, 1999, 45(12): 1542-1552.
[16] Tian L, Jiang T, Wang Y, Zang Y, He Y, Liang M, et al. Altered resting-state functional connectivity patterns of anterior cingulate cortex in adolescents with attention deficit hyperactivity disorder[J]. Neurosci Lett, 2006, 400(1-2): 39-43.
[17] Smith AB, Taylor E, Brammer M, Halari R, Rubia K. Reduced activation in right lateral prefrontal cortex and anterior cingulate gyrus in medication-naive adolescents with attention deficit hyperactivity disorder during time discrimination[J]. J Child Psychol Psychiatry, 2008, 49(9): 977-985.
[18] Berquin PC, Giedd JN, Jacobsen LK, Hamburger SD, Krain AL, Rapoport JL, et al. Cerebellum in attention-deficit hyperactivity disorder: a morphometric MRI study[J]. Neurology, 1998, 50(4): 1087-1093.
[19] 王璐, 范国光, 于兵, 麻宏伟, 潘学霞, 郭启勇. 注意缺陷多动障碍儿童小脑功能缺陷的功能磁共振成像[J]. 中国医学影像技术, 2009, (9): 1560-1563.
[20] Yang H, Wu QZ, Guo LT, Li QQ, Long XY, Huang XQ, et al. Abnormal spontaneous brain activity in medication-naive ADHD children: a resting state fMRI study[J]. Neurosci Lett, 2011, 502(2): 89-93.
[21] 曹庆久, 臧玉峰, 王玉凤. 不同亚型注意缺陷多动障碍儿童静息态的脑功能磁共振研究[J]. 北京大学学报·医学版, 2007, 39(3): 261-265.
国家自然科学基金(编号:30900488);国家科技支撑计划课题(编号:2009BAI77B05);云南省高层次卫生技术人才培养专项经费(编号:D-201238)。