额叶及相关环路在孤独症认知灵活性损伤中的作用

Role of frontal lobe and its related circuits involved in cognitive flexibility impairment in autism

孤独症谱系障碍是一种多因素疾病,社交障碍及重复刻板行为是其核心症状,随着诊断手段的提高,其检出率逐年上升。多数孤独症患者认知灵活性受损非常明显,且越来越多的研究表明认知灵活性受损与其核心症状发生发展有关,然而孤独症认知灵活性损伤机制尚不明确。额叶在高级认知中起着重要作用,其完全发育与认知功能有关。近年来有研究显示孤独症患者额叶功能异常与其认知灵活性缺陷密切相关,额叶的异常改变及相关的默认模式网络功能异常、额叶纹状体环路缺陷可能是孤独症患者认知灵活性损伤的重要机制。文章结合近年来对孤独症认知灵活性的临床及基础研究,对额叶及相关环路参与其损伤的相关机制进行综述。

Autism spectrum disorder(ASD)is a multifactorial disease,with social difficulties and repetitive behaviors as its core symptoms.With the improvement of diagnostic methods,the detection rate of ASD is increasing year by year.Cognitive flexibility impairment is very obvious in most autistic patients.More and more studies have shown that cognitive flexibility impairment is related to the occurrence and development of core symptoms.However,the mechanism of cognitive flexibility impairment in autism remains unclear.The frontal lobe plays an important role in advanced cognition,and its complete development is related to cognitive function.Recent studies have shown that frontal lobe dysfunction is closely related to cognitive flexibility deficits in autistic patients,and the abnormal changes in the frontal lobe,the associated default mode network dysfunction and frontal striatal circuit defects may be the important mechanisms of cognitive flexibility impairment.Based on the recent clinical and basic studies on cognitive flexibility in autism,this article reviews the mechanisms of frontal lobe and related circuits involved in the impairment of cognitive flexibility in autism.