注意缺陷多动障碍儿童静息态功能磁共振度中心度的研究

Brain imaging studies in children with attention-deficit hyperactivity disorder revealed by resting-state fMRI degree centrality analysis

目的 运用静息态功能磁共振（functional magnetic resonance imaging,fMRI）度中心度（degree centrality,DC）的分析技术,从网络节点的角度对注意缺陷多动障碍（attention-deficit hyperactivity disorder,ADHD）儿童与正常儿童进行比较研究,探讨ADHD功能脑区的病理机制.方法 学龄期ADHD患儿与正常儿童各30名分别进行静息态fMRI扫描,使用度中心度的方法进行数据分析.结果 ADHD组DC值较正常组低的脑区,右侧后扣带回、左内侧额上回、右侧顶下小叶、右侧额中回、左侧额上回、右侧额上回（t=-5.21,-3.53,-4.87,-4.21,-3.56,-4.06）,组间差异有统计学意义（P＜0.05）；ADHD组DC值较正常组高的脑区,小脑前叶、右侧枕中回、左侧中扣带回、右侧中扣带回（t=4.27,4.25,4.80,5.33）,两组间差异有统计学意义（P＜0.05）.结论 在默认网络及前额叶区域DC值的降低引起中心结构的破坏,认为与ADHD患儿在记忆认知、执行控制等方面的障碍有关；在DC值增高的脑区,可能与ADHD脑功能失调代偿作用,引起执行控制障碍、注意力下降等症状有关.静息态功能磁共振度中心度技术为多动症儿童认知障碍的研究提供了一种新的方法.

Objective To investigate the pathologic mechanisms of functional brain regions in attentiondeficit hyperactivity disorder （ADHD） patients through making comparisons of normal and ADHD children from the perspective of the network nodes with degree centrality（DC） analysis approach of resting-state functional magnetic resonance imaging（fMRI）.Methods To carry out data analysis through DC approach on 30 school-age children and 30 ADHD children,both of whom had been examined by resting-state fMRI scans.Results It showed that ADHD children＇s scores were lower in the right posterior cingulate gyms,left medial superior frontal gyms,right inferior parietal gyrus,right middle frontal gyrus,left superior frontal gyrus and right superior frontal gyrus（t=-5.21,-3.53,-4.87,-4.21,-3.56,-4.06）.There was statistically significant difference between the two groups （P＜0.05）.However,the ADHD group got higher DC scores in the cerebellar anterior lobe,right middle occipital,left middle cingulte gyrus and right middle cingulte gyrus than those of normal children （t =4.27,4.25,4.80,5.33）.There was statistically significant difference between the two groups（P＜0.05）.Conclusion It is deemed that the decrease of DC in the default mode of network （DMN） and frontal gyrus results in the damage of central brain structure,which further leads to ADHD children＇ s difficulties in cognitive memory and executive control.Together with the influence of ADHD cerebral functional compensation,the increase of DC is believed to be connected with executive control disorders and aprosexia.DC is regarded as a new research method to study cognitive disorders of ADHD children.