注意缺陷多动障碍儿童磁共振成像的低频振幅特点及性别差异

Sex differences in resting-state fractional amplitude of low frequency fluctuation of functional magnetic resonance imaging in children with attention-deficit/hyperactivity disorder

目的:探讨注意缺陷多动障碍(ADHD)儿童静息态脑功能特点以及可能的性别差异。方法:选取38例ADHD儿童(男31例,女7例)及性别、年龄匹配的正常对照42名(男29例,女13例)。使用ADHD评定量表评定症状严重程度,磁共振成像收集静息态数据。采用部分低频振幅(fALFF)评价静息态脑区活动水平。采用协方差分析比较主效应及交互效应。结果:ADHD儿童右侧内侧额上回、右侧辅助运动区的fALFF值高于对照组;左侧壳核、双侧小脑及双侧楔前叶的fALFF值低于对照组(校正P<0.05)。ADHD男孩左侧小脑的fALFF值低于对照男孩,双侧内侧额上回的fALFF值高于对照男孩(校正P<0.05);ADHD女孩双侧小脑及左侧丘脑的f ALFF值高于对照女孩,左侧岛叶的fALFF值低于对照女孩(校正P<0.05)。ADHD女孩左侧小脑的fALFF值和注意缺陷得分负相关(r=-0.89,校正P<0.05)。结论:ADHD儿童与正常对照在静息态脑功能存在差异,同时存在性别差异。

Objective： To find out the difference between children with attention-deficit/hyperactivity disorder and normal control,and the difference between boys and girls with ADHD in resting-state.Methods： There were 38 children with ADHD in this study including 31 boys and 7 girls,meanwhile,42 normal controls whose age and gender were matched with children with ADHD were involved too, including 29 boys and 13 girls.Total scores of ADHD rating scale（ ADHD-RS） were used to measure the severity of symptom for both ADHD and normal control.Magnetic resonance imaging was used to collect the resting-state functional magnetic resonance imaging data,and the fractional amplitude of lowfrequency fluctuation（ fALFF） was measured for each child.Analysis of covariance（ ANCOVA） was used to find out the difference between the group and the sex.Results： Children with ADHD showed a higher fALFF in the right medial superior frontal gyrus and right supplementary motor area,and a lower f ALFF in the left putamen, bilateral cerebellum and bilateral precuneus than controls（ all corrected P〈0.05）.ADHD boys showed a lower fALFF in the left cerebellum and a higher f ALFF in the bilateral medial superior frontal gyrus than boys without ADHD（ all corrected P〈0.05）.ADHD girls showed a higher f ALFF in the bilateralcerebellum and in the thalamus than girls without ADHD,and a lower fALFF in the insula than girls without ADHD（ all corrected P〈0.05）.There was a negative relationship between the fALFF of the left cerebellum of ADHD girls and the scores of inattention symptoms.Conclusion： The fALFF difference exist between ADHD and normal controls,and between boys and girls with ADHD.