功能磁共振比率低频振幅技术在夜间遗尿症儿童脑功能失调的机制研究

Mechanism of brain dysfunction on children with nocturnal enuresis by the technique of fractional amplitude of low frequency fluctuation of functional magnetic resonance imaging

目的采用静息态功能磁共振（rs—fMRI）比率低频振幅技术研究夜间遗尿症（nocturnal enuresis，NE）遗尿表现、注意和记忆障碍脑功能失调的病理机制。方法NE与正常儿童各18名分别进行rs—fMRI扫描，采用比率低频振幅（fALFF）技术分析，组间通过双样本t检验比较fALFF值的差异。结果两组fALFF值比较有明显差异的脑区分别位于小脑（MNI坐标值：-12，-57，-33）、左侧前额叶（-21，42，-9）、右侧颞叶（45，-12，-12）、枕叶（-18，-90，39），均为NE组低于正常组（P〈0．05）。NE儿童小脑fALFF值降低使控制排尿的定时功能失调，左侧前额叶活动减弱使其注意执行控制受到抑制，而右侧颞叶和枕叶的fALFF值较正常组低可能与记忆力相关。结论NE患儿遗尿症状与小脑受损有关，小脑和左侧前额叶功能异常使其注意力下降，而NE记忆力障碍可能与右侧颞叶、枕叶损伤有一定联系。

Objective To research the pathological mechanism of the performance of enuresis and the brain dysfunction of attention and memory deficit of nocturnal enuresis （NE） by fractional amplitude of low frequency fluctuation （fALFF） of resting-state functional magnetic resonance imaging （rs-fMRI）. Methods The approach of fALFF was used to analyze on 18 NE children and normal children, both of whom had been examined by rs-fMRI scans. Then the differences of fALFF were compared by two sample t -test. Results The brain regions which had obvious differences of fALFF between two groups were cerebellum（ MNI： - 12, -57, -33 ） ,left frontal lobe（ -21,42, -9）, right temporal lobe（ 45, - 12, - 12） and occipital lobe（ - 18, -90,39）. And the group of NE was lower than normal children on all the four regions. The decrease of the value of fALFF on cerebellum made the dysfunction of timing of controlling urinary. And the weaken of the activity of left frontal lobe made the inhibition of attentional perform. The decrease of the value of fALFF on right temporal lobe and occipital lobe was probably related to memory. Conclusion The performance of NE is associated with the impairment of cerebellum.The dysfunction of cerebellum and left frontal lobe makes attention decrease and the deficit of memory is probably related to the impairment of right temporal lobe and occipital lobe.