高功能孤独症患儿胼胝体及额叶体积的磁共振研究

An magnetic resonance imaging study of the corpus callosum and frontal lobe volume in children with high functioning autism.

目的探讨高功能孤独症（high functioning autism，HFA）忠儿的胼胝体以及额叶体积是否异常。方法对17例6～14岁的HFA患儿（智商≥70）以及16名年龄、性别、智商等与患者组相匹配的健康学龄儿帝进行T1加权三维容积磁共振成像。根据改良的Witelson范式将胼胝体划分为五个哑区，采用自编软件计算和比较两组被试胼胝体区及各个亚区的体积，应用个体脑结构地图集（Individual brain atlases using SPM，IBASPM）工具箱计算额叶体积。结果HFA组与正常对照组相比额叶总体积及左侧额叶体积增大[（193．91±23．23）cm^3 vs（177．86±18．2）cm^3，P=0．04；（96．08±11．89）cm^3 vs（87．52±9．14）cm^3，P=0．03]，而右侧额叶、胼胝体总体积及各亚区的体积差异均无统计学意义（P〉0．05）；HFA组胼胝体前三分之一部的体积与额叶总体积、右侧额叶体积早正相关（r=0．51，P=0．04；r=0．50，P=0．04）；未见HFA组中儿童孤独症评定量表评分与胼胝体及额叶的体积存在相关（P〉0．05）。结论HFA患儿的额叶体积增大，未发现胼胝体体积存存异常。

Objective To detect the volume differences in the total area, sub-regions of the corpus callosum and frontal lobe between patients with high functional autism （HFA） and normal children. Methods Structural magnetic resonance images were obtained in 17 HFA patients and 16-age, sex, intelligent quotient, height and weight matched normal controls. The corpus callosum was sub-divided into 5 sub-regions by Modified Witelson scheme. The volumes of the total area and sub-regions of corpus callosum were calculated by self-developed program based on the Matlab version 7.0 software. The volumes of the frontal lobe were calculated by IBASPM toolbox. Furthermore, the relationship between the volumes of the corpus callosum, frontal lobe and severity of symptoms were analyzed. Results Compared with the control group, the volumes of the total frontal lobe and left frontal lobe had a significant increase in HFA patient group [ （ 193.91 ± 23.23 ）cm3 vs （ 177.86 ± 18. 2） cm3 ,P = 0. 04 ; （96. 08 ± 1 1. 89 ） cm3 vs （ 87. 52 ±9. 14） cm3 , P = 0. 031. There were no significant differences in the volumes of the right frontal lobe, total area and sub-regions of the corpus callosum（P 〉 0. 05）. The volume of anterior third of the corpus callosum in the HFA group was significantly positively correlated with the volumes of the total frontal lobe and right frontal lobe （ r = 0. 51, P = 0. 04 ; r = 0. 50, P =0. 04 ）. No significant correlations were found between the scores of （childhood autism rating scale, CARS） and volume of the corpus callosum, frontal lobe in the HFA group（P 〉 0. 05）. Conclusions Our findings demonstrate that the volume of frontal lobe is enlarged in HFA while the volume of the corpus callosum is in normal range.