6～18岁孤独症个体不同年龄组心理推理能力相关脑区功能连接的差异

Functional connectivity difference of theory of mind related brain regions in different age groups of individuals with autism aged 6-18 years old

目的:分析社会认知中心理推理能力(ToM)相关重要脑区与其他脑区功能连接的随年龄发育模式,探讨孤独症核心症状社会交往障碍的脑机制。方法:43例6～18岁符合美国精神障碍诊断与统计手册第4版孤独症诊断标准的患者及年龄、性别组间匹配的39例正常对照,选取背内侧前额叶(d MPFC)、左侧颞顶联合(l TPJ)、右侧颞顶联合(r TPJ)和右侧颞上沟(r STS) 4个ToM相关的重要脑区,计算其与全脑体素之间的功能连接,通过单变量方差分析探索感兴趣区域的功能连接在被试中的组别及年龄交互作用;并将被试根据年龄分为儿童期(6. 0～11. 9岁)和青春期(12. 0～18. 0岁),探讨不同年龄段的组间差异。结果:r TPJ与右侧缘上回及左侧顶下小叶的功能连接、r STS与双侧额上/中回的功能连接均呈现出组别与年龄的交互作用(校正后P <0. 05);其中,在儿童期,孤独症患者r TPJ与右侧缘上回及左侧顶下小叶的功能连接大于正常对照组(P <0. 05);而青春期,r TPJ和r STS存在显著交互效应的功能连接均小于正常对照组(均P <0. 05)。结论:6～18岁孤独症个体在r TPJ及r STS两个关键脑区的功能连接中表现出多效性的非典型发育模式,该发育模式可能与孤独症患者异常的ToM有关。

Objective:To explore the brain mechanism of social communication deficits of autism,we analyzed the developmental pattern of functional connectivity between important brain regions associated with theory ofmind( ToM) and other brain areas.Methods:Forty-three participants meeting the diagnostic criteria of autistic disorder in the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition( DSM-IV) and 39 age-and sexmatched typically developmental individuals were included.Four ToM-related brain regions( dorsal medial prefrontal cortex( dMPFC),left temporoparietal junction( lTPJ),right temporoparietal junction( rTPJ) and right superior temporal sulcus( rSTS)) were selected to calculate their functional connectivity with whole brain voxels.The diagnostic group-by-age effect of functional connectivity in participants was explored using univariate analysis of variance.According to age,we divided subjects into two cohorts to investigate the differences between groups and cohorts.The two cohorts included childhood( 6.0-11.9 years) and adolescence( 12.0-18.0 years).Results:Functional connectivity of rTPJ with right supramarginal gyrus and left inferior parietal lobule and rSTS with bilateral superior/middle frontal gyrus exhibited diagnostic group-by-age effect( corrected,P<0.05).In childhood,the connectivity of rTPJ with right supramarginal gyrus and left inferior parietal lobule in autism group were higher than typically developed individuals( P<0.05),while all connectivity of rTPJ and rSTS which showed interaction effect in autism were lower than typically developed in adolescence( all P<0.05).Conclusion:Functional connectivity of rTPJ and rSTS exhibits atypical developmental multifinality pattern in autism aged 6-18 years old which may be related to the abnormal ToM in individuals with autism.