学龄期孤独症谱系障碍儿童脑结构与脑内局部活动的关系

The relationship between brain structure and local brain activity in school-age children with autism spectrum disorder

目的探究学龄期孤独症谱系障碍(ASD)儿童脑结构与脑内局部活动的关系。方法选择2019年11月至2021年11月滨州市第二人民医院儿内科收治的ASD患儿作为ASD组,同期招募82例健康儿童作为对照组。比较两组儿童的一般资料、临床症状特征评分、执行功能特征评分、脑结构异常检查结果、脑白质纤维束各向异性分数(FA)和平均弥散系数(MD)值、执行控制网络核心脑区的低频振幅(ALFF)和局部一致性(ReHo)值;Pearson检验分析ASD患儿脑白质纤维束FA、MD分别与执行控制网络核心脑区ALFF和ReHo值及各项评分的相关性。结果ASD组ABC总分、BRIEF总分、双侧侧脑室白质信号降低患儿比例、右侧皮质脊髓束MD、左侧皮质脊髓束MD、左侧前放射冠MD明显高于对照组,WISC-IV总分、胼胝体体部、穹窿、右侧大脑脚、左侧内囊后肢、右侧内囊豆状核后部、左侧前放射冠、左侧上额枕束的FA值、RDLPFC、RPPC脑区的ALFF值、RDLPFC脑区的ReHo值明显低于对照组(P<0.05);ASD组患儿胼胝体体部、穹窿、右侧大脑脚、左侧内囊后肢、右侧内囊豆状核后部、左侧前放射冠、左侧上额枕束的FA值、右侧皮质脊髓束、左侧皮质脊髓束、左侧前放射冠的MD值分别与RDLPFC、RPPC脑区的ALFF值、RDLPFC脑区的ReHo值、ABC总分、WISC-IV总分、BRIEF总分具有明显相关性(P<0.05)。结论学龄期ASD患儿脑白质局部脑结构损伤与执行控制网络核心脑区功能改变有关。

Objective To explore the relationship between brain structure and local brain activity in children with school-age autism spectrum disorder(ASD).Methods Children with ASD admitted to the Department of Pediatrics of Binzhou Second People’s Hospital from November 2019 to November 2021 were selected as the ASD group,and 82 healthy children were recruited as the control group in the same period.The general data,clinical symptom score,executive function score,brain structural abnormality examination results,white matter fiber bundle anisotropy score(FA)and average diffusion coefficient(MD),low frequency amplitude(ALFF)and local consistency(ReHo)of the core brain area of executive control network were compared between the two groups.Pearson test was used to analyze the correlation between FA,MD of white matter fiber bundle and ALFF,ReHo values and scores of core brain area of executive control network in children with ASD.Results The total score of ABC,total score of BRIEF,proportion of children with decreased white matter signal in bilateral ventricles,MD of right corticospinal tract,MD of left corticospinal tract and MD of left anterior radiation crown in ASD group were significantly higher than those in control group.The total score of WISC-IV,corpus callosum,fornix,right cerebral peduncle,left posterior limb of internal capsule,posterior part of right internal capsule,left anterior radiation crown,FA value of left superior frontooccipital tract,ALFF value of RDLPFC and RPPC brain region,ReHo value of RDLPFC brain region were significantly lower than those of the control group(P<0.05).In ASD group,the MD values of corpus callosum body,fornix,right cerebral peduncle,left posterior limb of internal capsule,posterior part of right lentiform nucleus,left anterior radiation crown,left superior frontal occipital tract,right corticospinal tract,left corticospinal tract and left anterior radiation crown were significantly correlated with RDLPFC,RPPC brain area ALFF,RDLPFC brain region ReHo value,ABC total score,WISC-IV total score and BRIEF total score(P<0.05).Conclusion The damage of local brain structure of white matter in school-age children with ASD is related to the functional changes of the core brain area of executive control network.