高功能孤独障碍患儿胼胝体和额叶纤维的对照研究

The corpus callosum and the frontal lobe fiber in autism children with high functioning

目的 对照分析高功能孤独障碍患儿与正常儿童胼胝体及额叶纤维结构的差异.方法 选取18例高功能孤独障碍患儿（病例组）和16名年龄、性别、智商、身高、体质量与之相匹配的正常儿童（对照组）,进行头部弥散张量成像（diffusion tensor imaging,DTI）扫描.使用DTIStudio软件进行图像处理,计算并比较2组胼胝体各亚区及左、右额叶的各向异性分数（fractional anisotropy,FA）、表面扩散分数（apparent diffusion coefficient,ADC）、纤维数目及平均长度的差异.结果 与对照组相比,病例组胼胝体前1/3部的纤维数目显著下降[（839±193）条vs（630±203）条;F=9.419,P=0.004];纤维的平均长度、FA值的差异无统计学意义（P＞0.05）;病例组胼胝体前1/3部纤维的ADC值显著增大[（0.88±8.56）×10-3 mm2/s vs（0.94±6.98）×10-3 mm2/s;F=5.739,P=0.023].左、右大脑额叶长、短纤维的FA值均较对照组显著减小（F=10.109,P=0.003;F=9.186,P=0.005）,长程纤维的ADC值显著增加（F=6.154,P=0.019;F=6.814,P=0.014）.结论 高功能孤独障碍儿童胼胝体前1/3部纤维减少最明显,额叶与其他脑区之间呈现低连通性.

Objective To detect the fiber structure differences in the corpus callosum and frontal lobe between autism children with high functioning （HFA） and the healthy children. Methods Diffusion tensor image were obtained in 18 HFA patients and 16 normal controls matched with age, sex, intelligent quotient, height and weight. The differences of fiber fractional anisotropy （ FA）, fiber apparent diffusion coefficient （ADC）, fiber number, average fiber length of the subregions of corpus callosum and the frontal lobe between the two groups were measured by the software of DTIStudio. Results Compared with the control group, the fiber number in the HFA group had a significant decrease in anterior third [ （839 ± 193）vs （630 ±203） ;F =9. 419, P =0. 004]. There was no significant difference in FA value and average fiber length （P 〉 0. 05）. ADC value of the HFA group had a significant increase in anterior third [ （0. 88 ±8.56） x 10-3 mm2/s vs （0. 94 ±6. 98） × 10-3 mm2/s;F =5. 739, P =0. 023], in HFA group＇s left and right frontal lobes, the FA values were significantly decreased （F = 10. 109, P = 0.003;F = 9. 186,P = 0. 005 ） and the ADC values of long range fibers were significantly increased （ F = 6. 154, P = 0. 019;F = 6. 814, P = 0. 014）. Conclusion The results indicate the fibers in anterior third of corpus callosum significantly decrease in autism children with high functioning, which implies low connectivity between the frontal and other lobes.