伴有与不伴有学习障碍的注意缺陷多动障碍患儿功能磁共振成像的对比研究

Brain fMRI study between attention-deficit hyperactivity disorder children with and without learning disability

目的探讨伴有与不伴有学习障碍(LD)注意缺陷多动障碍(ADHD)患儿功能磁共振成像(fMRI)的异同。方法使用超导型磁共振仪,对19名健康儿童,17例ADHD患儿及10例合并LD的ADHD患儿进行视觉注意作业的fMRI检查。结果(1)与正常儿童相比,ADHD组显示双侧前额叶(左额上回:正常儿童组15/4,ADHD组6/11,P<0.05;右额上回:正常儿童者组16/3,ADHD组5/12,P<0.01)、右额中回(正常儿童组16/3,ADHD组8/9,P<0.05)以及左额下回(正常儿童组15/4,ADHD组5/12,P<0.01)功能低下。(2)伴有LD的ADHD组在右侧扣带回(3/7)激活脑区计数低于ADHD组(13/4),差异有显著性(P<0.05)。结论伴有LD的ADHD右侧扣带回受损更明显,其余fMRI模式与ADHD组相似。

Objective To assess the characteristics of brain activity during visual attentional task in attention-deficit hyperactivity disorder （ADHD） children with and without learning disability, using a functional magnetic resonance imaging （fMRI）. Methods The data on 19 healthy children, 17 ADHD children, and 10 ADHD children with learning disability were gathered when they performed the visual attentional task, using brain fMRI （GEI. 5T Signa Horizon LX） in the study. And the data of activation and rest images were reconstructed with an offline workstation and the activation map was obtained. Results 1. Compared with healthy children, ADHD children showed significant reduction in bilateral frontal gyri （ in left superior frontal gyri the rate in healthy children were 15 to 4 and in ADHD children were 6 to 11, P = 0. 017 ; in right superior frontal gyri the rate in healthy children were 16/3 and in ADHD children were 5 to 12. P=0. 002）, right middle frontal gyri（the rate in healthy children were 16/3 and in ADHD children were 8 to 9, P = 0. 033 ）, and left inferior frontal gyri （the rate in healthy children were 15 to 4 and in ADHD children were 5 to 12, P=0. 006）. 2. The ADHD with learning disability showed significantly lower than ADHD patients with right cingulated gyrus （ P = 0.04 ）, and no differences among other brain areas. Conclusion The ADHD with learning disability had poorer deficit in right cingulated gyrus, though they have similar fMRI model with ADHD children.