孤独症谱系障碍患儿胼胝体面积与神经行为障碍的相关性研究

Research on the correlation between corpus callosum area and neurobehavioral disorders in children with autism spectrum disorders

目的探讨孤独症谱系障碍(ASD)患儿正中矢状位胼胝体面积与神经行为之间的关系。方法选择2017年1月至2018年12月就诊于安徽省儿童医院的孤独症谱系障碍患儿38例为研究组,同期相匹配的发育正常儿童35例为对照组,应用孤独症行为量表(ABC量表)评价两组儿童神经行为,并进行头颅磁共振成像(MRI)检查,测量正中矢状位测量胼胝体总面积及分区面积,分析两组间的差异,以及胼胝体面积与ASD异常神经行为之间的关系。结果研究组胼胝体各部分面积及总面积均小于对照组[两组面积1区(182.63±30.99)mm^2比(213.82±26.01)mm^2,2区(54.78±10.77)mm^2比(63.75±12.53)mm^2,3区(45.16±6.52)mm^2比(54.04±10.56)mm^2,4区(35.82±8.05)mm^2比(49.93±14.47)mm^2,5区(127.63±26.50)mm^2比(154.32±30.18)mm^2,总面积(445.31±64.91)mm^2比(533.57±60.50)mm^2],差异均有统计学意义(t=-4.189、-2.982、-3.230、-4.363、-3.649、-5.543,均P<0.05),两组差异主要集中在胼胝体膝部和峡部以及总面积。研究组胼胝体总面积与ASD的5项功能障碍评分存在负相关性,其中与交往障碍及语言障碍相关性明显(r=-0.439、-0.544,均P<0.01)。结论孤独症谱系障碍患儿胼胝体的发育存在异常,胼胝体面积越小,临床异常行为症状越重。通过检测ASD儿童的胼胝体面积可以为其诊疗和病情评估提供支持。

Objective To investigate the relationship between median sagittal corpus callosum area and neural behavior in children with autism spectrum disorder(ASD).Methods From January 2017 to December 2018,in Anhui Provincial Children's Hospital,38 children with ASD were selected as the study group,and 35 matched children with normal development were selected as the control group.The autism behavior checklist(ABC)scale was used to evaluate the neurological behavior of children with ASD.All children were examined by cranial MRI.The total and partition area of the corpus callosum were measured at the median sagittal position,and the difference between the two groups was analyzed,as well as the relationship between the area of the corpus callosum and the abnormal neurological behavior of ASD.Results The total and panition area size of corpus callosum in the study group were smaller than those in the control group[area 1:(182.63±30.99)mm^2 vs.(213.82±26.01)mm^2,area 2:(54.78±10.77)mm^2 vs.(63.75±12.53)mm^2,area 3:(45.16±6.52)mm^2 vs.(54.04±10.56)mm^2,area 4:(35.82±8.05)mm^2 vs.(49.93±14.47)mm^2,area 5(127.63±26.50)mm^2 vs.(154.32±30.18)mm^2,total area:(445.31±64.91)mm^2 vs.(533.57±60.50)mm^2],and the differences were statistically significant(t=-4.189,-2.982,-3.230,-4.363,-3.649,-5.543,all P<0.05).The differences between the two groups were mainly concentrated in the area of the knee,the area of the isthmus and the total area of the corpus callosum.The total area of corpus callosum was negatively correlated with 5 neurobehavioral dysfunction scores of ASD.The total area of corpus callosum was significantly correlated with communication disorder and language disorder(r=-0.439,-0.544,all P<0.01).Conclusion There are abnormalities in the development of the corpus callosum in children with ASD.The smaller the area of the corpus callosum,the more severe the clinical abnormal behavioral symptoms is.The measurement of corpus callosum area in children with ASD can provide support for diagnosis and disease assessment.