注意缺陷多动障碍儿童MRI皮层下结构体积与认知功能关系研究

Study on the relationship between subcortical structure volume and cognitive function of MRI in children with attention deficit hyperactivity disorder

目的 探讨注意缺陷多动障碍(ADHD)儿童认知功能与MRI大脑皮层下结构体积的相关性。方法 纳入2022年2月至2023年2月来自河北省妇幼保健中心发育行为儿科的受试者124例,包括认知正常儿童(NC)39例和ADHD儿童85例。采用倾向性评分法按1∶3的比例均衡儿童的临床资料;比较两组儿童的一般资料、认知功能和MRI大脑皮层下结构;分析ADHD儿童大脑皮层下结构与认知功能的关系。结果 倾向性评分匹配后NC组(33例)与ADHD组(74例)基线特征均衡;ADHD组儿童的工作记忆指数(WMI)、加工速度指数(PSI)、符号编码测验评分、迷宫测验评分明显低于NC组儿童,注意力缺陷多动障碍评定量表(SNAP-IV)均分、Weiss’s功能性缺陷程度总分、执行功能行为评定量表(BRIEF)总分、连线测验评分明显高于NC组(P<0.05);相较于NC组,ADHD组双侧丘脑、海马、杏仁核、伏隔核及脑干结构体积上均显著缩小(P<0.001);左侧海马体积与记忆功能紧密相关,而左侧丘脑体积与语言、执行和视空间功能有显著联系(P<0.05)。结论 ADHD儿童的记忆功能与左侧海马体积紧密相关,而语言、执行及视空间功能则与左侧丘脑体积存在显著联系。

Objective To explore the correlation between cognitive function and subcortical structure volume of MRI in children with attention deficit hyperactivity disorder(ADHD).Methods A total of 124 subjects from the Department of Developmental Behavioral Pediatrics of Hebei Center for Women and Children's Health from February 2022 to February 2023 were included,including 39 children with normal cognition(NC)and 85 children with ADHD.The tendency score method was used to balance the clinical data of children according to the proportion of 1:3.The general data,cognitive function and sub-cortical structure of MRI were compared between the two groups.To analyze the relationship between subcortical structure and cognitive function in children with ADHD.Results The baseline characteristics of NC group(33 cases)and ADHD group(74 cases)were balanced after propensity score matching.The scores of working memory index(WMI),processing speed index(PSI),symbol coding test and maze test in the ADHD group were significantly lower than those in the NC group,while the average score of attention deficit hyperactivity disorder scale(SNAP-IV),the total score of Weiss's functional defect,the total score of executive functional behavior scale(BRIEF)and the score of attachment test in the NC group were significantly higher than those in the NC group(P<0.05).Compared with NC group,the volume of bilateral thalamus,bilateral hippocam-pus,bilateral amygdala,bilateral nucleus accumbens and brainstem decreased in ADHD group(P<0.001).The results of cor-relation analysis showed that the volume of the left hippocampus was correlated with memory function,and the volume of the left thalamus was correlated with language function,executive function and visual-spatial ability(P<0.05).Conclusion The volume of the left hippocampus is related to the memory function of the children with ADHD,and the volume of the left thalamus is related to the language,executive and visual spatial function of the children with ADHD.