注意缺陷多动障碍患儿近红外脑成像的低频振幅研究

目的 采用近红外成像技术(NIRS)分析注意缺陷多动障碍(ADHD)患儿静息态脑功能特点以及与症状严重程度的相关性,进而探索ADHD的病理机制。方法 收集2017年3-6月期间20例ADHD患儿及性别、年龄匹配的20例正常儿童,使用韦氏智力量表、ADHD症状评定问卷评定其智商和症状严重程度,近红外脑成像收集静息态脑功能数据。采用低频振幅(ALFF)及Pearson偏相关分析方法评估静息态脑区活动水平以及与症状严重程度的相关性。结果 1)与对照组相比,ADHD组在右侧背外侧前额叶、右运动前区及辅助运动区、左侧背外侧前额叶及额极、左侧颞上/中回及初级听觉区、左侧额下回、左侧眶额叶皮层的ALFF值增高,差异有统计学意义(t=-2.48,-2.41,-2.66、-2.12、-2.51、-0.039,P<0.05)。2)ADHD组左侧额下回、眶额叶皮层、额极(r=0.562, P=0.036)以及左侧颞上/中回、初级听觉区(r=0.541, P=0.046)的ALFF值与多动冲动分存在显著正相关(P<0.05)。结论 ADHD患儿存在脑功能的异常,即在大脑静息态下脑区自发活动可能增强;ADHD患儿的脑功能异常与多动冲动症状严重程度相关。

Amplitude of low frequency fluctuation study on brain in children with attention deficit hyperactivity disorder-based on near infrared imaging technology

Objective Using near infrared spectroscopy (NIRS)to investigate spontaneous activity′s characteristics of the brain area in the resting-state and the correlation with clinical symptomsin in children with attention deficit hyperactivity disorder(ADHD), and then explore the pathological mechanism of ADHD. Methods A total of 20 ADHD children and 20 normal controls matched by sex and age were collected from March to June 2017.The Chinese Wechsler Intelligence Scale for Children, ADHD symptom rating questionnaire were used to access intelligence quotient and clinical symptoms.NIRS was used to collect brain images.The amplitude of low-frequency fluctuation (ALFF) and Pearson partial correlation analysis were used to explore the differences of brain function and the correlation with clinical symptoms of ADHD. Results 1)Children with ADHD had higher ALFF in right dorsolateral prefrontal cortex, right pre-motor and supplementary motor cortex, left dorsolateral prefrontal cortex and frontopolar area, left superior/ middle temporal gyrus and primary auditory association cortex, left inferior prefrontal gyrus, left orbitofrontal area than control subjects(t=-2.48,-2.41,-2.66,-2.12,-2.51,-0.039,P<0.05).2)In the ADHD group, the associations between the scores of hyperactivity and impulsivity with left inferior prefrontal gyrus, orbitofrontal area, frontopolar area(r=0.562,P=0.036)and left superior/middle temporal gyrus, primary auditory association cortex(r=0.541, P=0.046) were positive(P<0.05). Conclusions Brain functional abnormalities contributed to the emergence of ADHD.Children with ADHD probably have higher spontaneous activity of the brain area in the resting state.The brain functional connectivity was associated with the severity of hyperactivity impulsive symptoms in ADHD.