孤独谱系障碍2～3岁患儿杏仁核体积的研究

Amygdala volume in 2-to 3-year-old children with autism spectrum disorder

目的 分析2～3岁孤独谱系障碍（autism spectrum disorder,ASD）儿童与发育障碍儿童杏仁核体积的差异,并对ASD儿童杏仁核体积与社会情绪功能之间的相关性进行研究.方法 对46例ASD儿童（ASD组）和39例年龄、性别、发育商与之匹配的发育障碍儿童（对照组）进行磁共振扫描,手工勾画杏仁核,比较两组杏仁核体积的差异,利用婴幼儿沟通及象征性行为发展量表（Communication and Symbolic Behavior Scales Developmental Profile,CSBS-DP）评估患儿的社会交流能力,分析杏仁核体积与临床症状的相关性.结果 与对照组相比,2～3岁ASD儿童双侧杏仁核体积明显增大[左侧：（0.83 ±0.15） cm^3与（0.72±0.13） cm^3,t=3.55,P=0.001;右侧：（0.86±0.15）cm^3与（0.77±0.12） cm^3,t =2.83,P=0.006];在控制年龄和发育商后,ASD组儿童左侧杏仁核体积与社交领域中的手势项目（r=-0.331,P=0.042）及象征性行为领域中的游戏技巧项目均呈负相关（r=-0.333,P=0.041）.结论 2～3岁的ASD儿童存在杏仁核体积增大,可能与患儿的社会情绪功能受损有关.

Objective To evaluate amygdala volumes in 2-to 3-year old children with autism spectrum disorder （ASD） in comparison with developmental disorder （DD）,and to investigate the correlation between the differential changes of amygdala volume and socio-emotional function impairment.Methods Amygdala was manually traced in 46 ASD children and 39 age,sex and development quotient matched DD children using MRI for volume comparison.The correlation between differential changes of amygdala volume and socio-emotional function was assessed by the Communication and Symbolic Behavior Scales Developmental Profile （CSBS-DP） Infant-Toddler Checklist.Results Compared with DD,the volumes of bilateral amygdala were significantly larger in ASD （left：（0.83 ± 0.15） cm^3 vs.（0.72 ± 0.13）cm^3,t =3.55,P=0.001; right：（0.86±0.15） cm^3 vs.（0.77 ±0.12） cm^3,t =2.83,P=0.006）.Mter age and development quotient were controlled,left amygdala size in children with ASD was significantly associated with gestures area （r =-0.331,P =0.042） and object use area （r =-0.333,P =0.041） in CSBS-DP Infant-Toddler Checklist.Conclusion The abnormal pattern of amygdala size present in 2-to 3-year-old children with ASD may be associated with their socio-emotional function impairment.