学龄前期儿童焦虑的楔前叶与全脑功能连接特征研究

Study of functional connectivity between precuneus and whole brain among preschool children with anxiety

目的:探索学龄前期儿童焦虑的楔前叶与全脑功能连接特征。方法:选取2019年7月—2020年10月安徽省儿童医院儿童保健门诊体检或就诊的63名学龄前期儿童为研究对象,采用自编的调查问卷收集儿童基本信息,采用中文版《Spence学龄前儿童焦虑量表(SPAS)》评估儿童焦虑状况,以SPAS总得分的上、下50百分位分为焦虑得分高分组(32名)和焦虑得分低分组(31名)。采集儿童脑静息态功能磁共振图像,采用t检验比较2组儿童的楔前叶与全脑功能连接的差异。结果:焦虑得分高分组与焦虑得分低分组儿童年龄、性别、身高、体质量、分娩方式及独生子女情况比较,差异均无统计学意义(P>0.05)。焦虑得分高分组儿童左侧楔前叶与右侧颞下回(t=-3.853)、左侧额上回内侧眶(t=-3.915)、右侧眶部额上回(t=-3.517)、右侧苍白球(t=-3.789)、右侧三角部额下回(t=-5.032)、前额叶(t=-3.490)、左侧岛盖部额下回(t=-4.106)、左侧内侧额上回(t=-3.642)的功能连接较焦虑得分低分组减弱,与顶叶(t=3.709)的功能连接较焦虑得分低分组增强,差异有统计学意义(P<0.001)。焦虑得分高分组儿童右侧楔前叶与右侧颞下回(t=-4.286)、梭状回(t=-4.297)、前扣带回(t=-3.664)、左右侧三角部额下回(t=-4.211,t=-5.082)、左侧额中回(t=-3.698)的功能连接较焦虑得分低分组减弱,与顶叶(t=3.769)的功能连接较焦虑得分低分组增强,差异有统计学意义(P<0.001)。结论:焦虑得分高分组儿童的楔前叶与前额叶、颞叶等脑区的功能连接存在异常,研究结果可为进一步探索儿童焦虑发生的神经学机制和诊治提供参考。

Objective:To explore the functional connectivity between precuneus and the whole brain among preschool children with anxiety.Methods:A total of 63 children were recruited from child health clinic in Anhui Children’s Hospital from July 2019 to October 2020.A self-designed questionnaire and Chinese version of the Spence Preschool Anxiety Scale(SPAS)were applied to collect children’s anxiety information.The resting state functional magnetic resonance of children were collected.The t test was used to compare the difference between the precuneus and the whole brain functional connectivity among children in the high and low anxiety groups.Results:In this study,32 children in the high anxiety group and 31 children in the low anxiety group were included,and there was no significant difference in the main characteristics between the two groups(P<0.001).Compared with the low anxiety group,the functional connectivity between the left precuneus and the right inferior temporal gyrus(t=-3.853),the medial orbit of left superior frontal gyrus(t=-3.915),the right orbital superior frontal gyrus(t=-3.517),the right pallidum(t=-3.789),the right triangular inferior frontal gyrus(t=-5.032),the frontal lobe(t=-3.490),the left insular inferior frontal gyrus(t=-4.106)and the left medial superior frontal gyrus(t=-3.642)were weakened among children in the high anxiety group,while the functional connectivity with the parietal lobes(3.709)was enhanced(P<0.001).Compared with the low anxiety group,the functional connectivity between the right precuneus and the right inferior temporal gyrus(t=-4.286),the fusiform gyrus(t=-4.297),the anterior cingulate gyrus(t=-3.664),the left and right triangular inferior frontal gyrus(t=-4.211,t=-5.082)and the left middle frontal gyrus(t=-3.698)were weakened,while the functional connectivity with the parietal lobes(t=3.769)was enhanced(P<0.001).Conclusion:This study suggested that the functional connectivity of the precuneus with the prefrontal lobe and temporal lobe were abnormal among children with high anxiety.It could provide reference for further exploring the neurological mechanism and diagnosis and treatment of child anxiety.