儿童抽动秽语综合征脑皮层厚度改变的磁共振研究

Brain cortex thickness alteration in Tourette syndrome in children: a magnetic resonance imaging study

目的本研究旨在应用基于脑表面分析(surface based analysis,SBA)方法分析磁共振脑结构图像,探究儿童抽动秽语综合征患者脑皮层厚度改变及与临床资料的相关性。方法纳入50名儿童抽动秽语综合征患者为病例组,43名健康儿童为对照组,采集MRI三维T_1加权图像,采用Free Surfer软件进行分析,得到两组皮层厚度有差异的脑区,并与临床资料进行相关性分析。结果病例组的左侧中央后回、岛叶、缘上回、额下回三角部、岛盖、颞中回、额中回喙部、顶上小叶、右侧颞中回、右侧额上回、额中回尾部、岛叶、枕外侧回的皮层厚度较对照组减低,其差异有统计学意义。右侧额上回的皮层厚度与威斯康辛卡片测试的持续错误数分数呈负相关(r=-0.517)。左侧额中回喙部的皮层厚度与STROOP测试的错误分数呈负相关(r=-0.46)。左侧岛叶的皮层厚度与耶鲁综合抽动症状量表的总分呈负相关(r=-0.45)。结论本研究揭示了儿童抽动秽语综合征患者存在执行功能受损,尤其是抑制性控制受损;左侧岛叶皮层厚度与儿童抽动秽语综合征患者的症状严重程度相关。

Objective To explore brain cortex thickness differences between children with Tourette syndrome and healthy controls on MRI via a surface based analysis(SBA)and correlation with clinical information.Methods 50 children with Tourette syndrome were included as the case group and 43 healthy children as the control group.Three dimensional T1-weighted MRI(3D-T1WI)images were collected and analyzed by FreeSurfer software to find the cortical thickness differences between case group and control group.Correlation analysis was then conducted between the brain structural image and clinical data.Results Comparing to the control group,Tourette syndrome group demostrated significant decreased thickness in postcentral gyrus,insula,supramarginal gyrus,pars triangularis,pars opercularis,parsoobilalis,middle temporal gyrus,rostral middle frontal gyrus,superiorparietal gyrus of the left hemisphere,and significantly decreased thickness in middletemporal gyrus,superior frontal gyrus,caudal middle frontal gyrus,insula,lateral occipital gyrus of right hemisphere.In correlation analysis,the WCST persistant error scores were negatively correlated with the cortex thickness in right superior frontal gyrus(r=-0.517),the STROOP error scores were negatively correlated with the cortex thickness in left rostral middle frontal gyrus(r=-0.46),and the The Yale Global Tic Severity Scale(YGTSS)total scores were negatively correlated with the cortex thickness in left insula(r=-0.45).Conclusion This study revealed impaired executive function in children with Tourette syndrome,particularly impaired inhibit control.The left insular cortex thickness correlated with the severity of symptoms in children with Tourette syndrome.