注意缺陷多动障碍儿童全脑灰质非对称性初步研究

Altered anatomical asymmetry in children with attention deficit/hyperactivity disorder： a pilot optimized voxel-based morphometric study

目的 采用优化的基于体素的形态学测量（OVBM）的方法初步探讨注意缺陷多动障碍（ADHD）儿童全脑灰质结构左右非对称性异常.方法 2005年1月至2006年12月在北京大学第六医院门诊、符合美国精神障碍诊断与统计手册第四版（DSM-Ⅳ）中ADHD诊断标准的25例男孩（ADHD组）及27名年龄、性别、利手相匹配的正常对照（对照组）,使用定式临床诊断性会谈量表（CDIS）进行临床诊断及分型,采集结构磁共振成像（MRI）数据,使用OVBM的方法,计算出全脑灰质每个体素的非对称性指数（AI）,对AI进行组间比较.结果 两组被试全脑灰质的非对称模式相似,组间比较发现ADHD患者额上回（MNI坐标：17,49,26）及额中回（MNI坐标：33,-5,63）的非对称性与正常对照的左＞右的模式相反（经过整体错误率进行多重比较校正至P ＜0.05）.结论 ADHD儿童存在前额叶灰质左右非对称性的异常,非对称性异常可能是ADHD的神经病理机制之一.

Objective Mounting evidence suggests that attention deficit/hyperactivity disorder （ADHD） is related with abnormal anatomical asymmetry in some brain regions,such as basal ganglia.However,few cross-sectional studies have examined the abnormalities of anatomical asymmetry in whole brain of ADHD.Thus this cross-sectional study was to explore the anatomical asymmetry in whole brain of ADHD with optimized voxel-based morphometry （OVBM）.Methods Twenty-five boys with ADHD and 27 age and gender-matched controls were recruited.All participants were right-handed.The grey matter concentration of each voxel was calculated with OVBM.A statistical evaluation of grey matter asymmetry was then conducted on normalized grey matter images and their flipped counterparts.Results One-sample t-test revealed that the whole-brain anatomical asymmetry pattern was similar in two groups.Through group comparisons,ADHD showed reversed left-greater-than-right asymmetry in superior and middle frontal gyri versus controls.Conclusion Anatomical asymmetry of prefrontal cortex is abnormal in children with ADHD.And abnormal anatomical asymmetry may play an important role in the pathophysiology of ADHD.