注意缺陷/多动障碍工作记忆的bold-功能磁共振成像研究

目的应用bold-功能磁共振成像(bold-fMRI)技术来研究注意缺陷/多动障碍(AD/HD)患者的工作记忆。并探讨使用哌醋甲酯1个月治疗前后AD/HD患者的脑部激活的改变情况。方法利用倒数n刺激模式(n-back)对7例AD/HD(注意缺陷为主型)和7名正常人进行blod-fMRI检查,对照研究AD/HD患者在工作记忆时涉及的各脑区的激活情况。结果AD/HD组治疗后的1-back任务较治疗前1-back任务在右额下回和右额中回激活明显,二者有显著性差异(P<0.05);AD/HD组在治疗后的2-back任务较治疗前2-back任务在左额下回和左顶叶后下部激活明显(P<0.05)。正常组的1-back任务与患者组治疗前的1-back任务比较没有显著性差异,正常组的2-back任务与患者组治疗前2-back任务比较在左额下回和左顶叶后下部激活明显(P<0.05)。结论AD/HD障碍患者存在执行功能方面的缺陷,AD/HD患者的语义性工作记忆缺损可能与前额叶和顶叶的功能缺陷有关。

The study of working memory and test of functional MRI in children with attention deficit hyperactivity disorder

Objective To study the working memory of AD/HD as well as to explore the characteristics of functional areas of working memory with blood oxygenation level dependent functional magnetic resonance imaging(bold-fMRI) in AD/HD children before and after methylphenidate treatment. Methods 7 AD/HD patients and 7 health controls were took part in this study. All subjects were imaged by functional MRI (fMRI)with n-back model in order to study the characteristics of functional areas of working memory in AD/HD patients. Results The greater activations in right inferior frontal gyrus and right middle frontal were observed in AD/HD children in conducting 1-back after treatment, in contrast to before treatment. Which had significant differences(P<0.05). The similar differences between pre-and post-treatment in conducting 2-back were observed in the left inferior frontal and left posterior parietal cortex(P<0.05). The controls showed no significant differences during 1-back task ,in comparison to AD/HD group pre-treatment. The controls showed significant activation during 2-back task in left inferior frontal gyrus and left posterior parietal cortex ,in comparison to AD/HD group pre-treatment. Conclusions AD/HD children have deficiency in executive functions, the deficiency of verbal working memory of AD/HD children correlated to the functional deficiency of prefrontal cortex and parietal cortex.