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 gyms, decreased ReHo in the left medial frontal gyms, right superior frontal gyms, and left precuneus, and increased ReHo in the left anterior lobe of the cerebellum, left caudate nucleus, right parahippocampal gyms, left precentral gyrus, and right middle frontal gyms. 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.