伴与不伴抑郁情绪孤独症谱系障碍静息态脑功能磁共振成像差异研究

Differences of brain function between autism spectrum disorder children with and without depression during rest

目的探讨伴与不伴抑郁情绪孤独症谱系障碍(autistic spectrum disorder,ASD)患儿静息态脑功能磁共振成像特征的差异及与其临床特征的相关性,从脑功能角度了解ASD患儿伴发抑郁情绪的病理机制。方法前瞻性地收集20例伴抑郁的ASD患儿、25例不伴抑郁的ASD患儿及25名正常发育(typical development,TD)儿童的一般人口学资料,并使用儿童孤独症评定量表和儿童抑郁量表对ASD症状和抑郁症状进行评估,采集所有被试的大脑T1像结构磁共振数据和静息态功能磁共振数据,计算自动解剖标记(automated antomical labeling,AAL)模板中90个脑区的局部一致性值(regional homogeneity,ReHo)。比较三组脑区ReHo值并分析差异脑区的ReHo值与临床特征相关性。结果基于ReHo值的比较分析显示:与TD组相比,伴抑郁ASD组额叶差异区域主要分布于默认网络、听觉网络、感觉运动区域、注意网络(P<0.001,经AlphaSim校正),颞叶差异脑区主要分布于听觉网络(P<0.001,经AlphaSim校正),顶叶差异区域主要分布于默认网络、感觉运动区域(P<0.001,经AlphaSim校正);与TD组相比,不伴抑郁ASD组额叶差异区域主要分布于听觉网络(P<0.001,经AlphaSim校正),顶叶差异区域主要分布于默认网络、注意网络(P<0.001,经AlphaSim校正);与不伴抑郁ASD组相比,伴抑郁ASD组差异脑区主要分布于感觉运动区域、注意网络(P<0.001,经AlphaSim校正)。伴抑郁ASD组右侧额中回(眶部)ReHo值与儿童孤独症评定量表总分(r=0.631,P=0.003)和儿童抑郁量表总分(r=0.656,P=0.002)呈正相关。结论伴抑郁情绪ASD的发生与大脑广泛区域功能下降相关,尤其是感觉运动区域及注意网络功能下降。

Objective To explore the differences of resting brain function and their correlations with clinical characteristics in autism spectrum disorder(ASD)children with and without depression to understand the pathological mechanism of depression in children with ASD from the perspective of brain function.Methods Twenty ASD patients with depression,25 ASD patients without depression and 25 typical development(TD)children were recruited.The demographic data were collected and the symptoms of ASD and depression were evaluated by childhood autism rating scale and children’s depression inventory.T1 structural magnetic resonance imaging data and resting functional magnetic resonance data of all subjects were collected.Based on MATLAB platform,the values of regional homogeneity(ReHo)of 90 brain regions in AAL template were calculated by using DPASF software.The differences of ReHo values among three groups and the relationships between ReHo values in altered brain regions and clinical characteristics were analyzed.Results Compared with TD group,ASD group with depression had abnormal areas in the frontal lobe including default network,auditory network,sensorimotor network and attention network,the temporal lobe including auditory network,and the parietal lobe including default network and sensorimotor cortex(P<0.001,AlphaSim correction).Compared with TD group,ASD group without depression had abnormal areas in the frontal lobe including auditory network,and the parietal lobe including default network and attention network(P<0.001,AlphaSim correction).Compared with ASD group without depression,ASD group with depression had abnormal brain areas in the sensorimotor network and attention network(P<0.001,AlphaSim correction).The ReHo values of right middle frontal gyrus(orbital part)in ASD group with depression were significantly positively correlated with the total scores of CARS scale(r=0.631,P=0.003)and CDI scale(r=0.656,P=0.002).Conclusion The occurrence of ASD accompanied by depression might be related to the decline of function in a wide range of brain regions,especially in the brain regions within the sensorimotor and attention network.