有氧运动改善注意缺陷多动障碍儿童执行功能的脑低频振幅研究

Effect of aerobic exercise on the amplitude of low-frequency fluctuation of executive function in children with attention deficit hyperactivity disorder

目的研究有氧运动改善注意缺陷多动障碍(ADHD)儿童执行功能的脑低频振幅(ALFF)特征,探索有氧运动改善ADHD儿童执行功能的影像学机制。方法2019年3月—2020年12月选取常州儿童医院ADHD专病门诊确诊的ADHD儿童17名,分别进行为期8周的跳绳有氧运动训练,训练前后检查功能磁共振(fMRI)和执行功能,fMRI采用低频振幅指标,执行功能测试采用抑制功能相关的Flanker任务,采用配对t检验比较训练前后ALFF和执行功能反应时,并将ALFF值的变化与执行功能反应时差异做相关性分析。结果ADHD儿童有氧运动训练后ALFF值显著增高的脑区包括内侧额上回、左额上回、左额中回、右侧小脑前叶(校正后P<0.05);Flanker任务反应时较前显著减少(t=-4.75,P=0.001);有氧运动前后内侧额上回(r=-0.53,P=0.02)、左额上回(r=-0.58,P=0.01)、左额中回(r=-0.51,P=0.02)ALFF值变化与执行功能行为学反应时间差异呈负相关。结论有氧运动能改善ADHD儿童执行功能,其脑机制主要与前额叶、小脑自发活动增强有关。

Objective To explore the amplitude of low-frequency fluctuation(ALFF)characteristics of the improvement of executive function in children with attention deficit hyperactivity disorder(ADHD)by aerobic exercise,in order to provide evidence for exploring mechanism of aerobic exercise improving executive function.Methods From March 2019 to December 2020,17 children diagnosed with ADHD in Changzhou Children′s Hospital were enrolled in this study to participated in rope jumping aerobic exercise training for 8 weeks.Functional magnetic resonance imaging(fMRI)and executive function were examined before and after training.The ALFF index was used in fMRI,and the flanker task was used in executive function test.Paired t-test was used to compare ALFF and response time of executive function before and after training,and correlation analysis was conducted between ALFF value changes and the difference of response time of executive function.Results After aerobic exercise training,the brain regions which the ALFF value of ADHD children significantly increased included medial superior frontal gyrus,left superior frontal gyrus,left middle frontal gyrus,and right anterior cerebellar lobe(P<0.05).The response time of the flanker task decreased significantly after training(t=-4.75,P=0.001).The changes of ALFF values of medial superior frontal gyrus(r=-0.53,P=0.02),left superior frontal gyrus(r=-0.58,P=0.01)and left middle frontal gyrus(r=-0.51,P=0.02)before and after aerobic exercise were negatively correlated with the difference of response time of executive function.Conclusion Aerobic exercise can improve the executive function of ADHD children,and the brain mechanism is mainly related to the enhancement of spontaneous activity in the prefrontal lobe and cerebellum.