孤独症谱系障碍男童脑岛与感觉及社交脑区功能连接特征

  目的  探究孤独症谱系障碍(autism spectrum disorder, ASD)男童脑岛与感觉、社交相关脑区功能连接特征，为探索ASD男童感觉异常影响核心症状的中枢神经基础提供基础资料。  方法  收集在黑龙江省孤独症定点康复机构进行训练的34例ASD男童与29例幼儿园健康对照(TD组)男童的静息态功能磁共振数据，基于功能连接分析方法，以感觉相关脑区、脑岛、社交相关脑区为种子点，比较两组被试种子点间的功能连接(FC)水平的差异，结果经FDR校正。采用孤独症诊断观察量表(ADOS)、儿童孤独症评定量表(CARS)、孤独症特质量表-儿童版(AQ-Child)评估ASD男童的核心表型。  结果  与TD组相比，ASD组男童触觉、嗅觉和听觉脑区与脑岛之间的FC水平升高；脑岛与双侧杏仁核、内侧前额叶皮质(mPFC)之间的FC水平升高(P值均 < 0.05)。Pearson相关性分析表明，ASD组听觉脑区(BA42)与左侧脑岛FC值与ADOS的沟通(r=-0.44)、相互性社会互动(r=-0.43)、沟通和社会互动总分(r=-0.49)、AQ-Child的细节关注(r=-0.41)得分均呈负相关；右侧脑岛与右侧杏仁核FC值与AQ-Child的注意力转移得分均呈正相关(r=0.38)，右侧脑岛与mPFC间的FC值与ADOS的刻板行为和局限兴趣(r=0.48)、AQ-Child的注意力转移(r=0.49)、AQ-Child总分(r=0.41)、CARS总分(r=0.41)均呈正相关(P值均 < 0.05)。  结论  ASD儿童脑岛与感觉、社交相关脑区功能连接存在异常，且与临床症状相关，可开展深入研究，探索其中枢神经机制。

Functional connectivity among insula,sensory and social brain regions in boys with autism spectrum disorder

  Objective  To identify the functional connectivity characteristics of insula, sensory and social related brain regions in boys with autism spectrum disorder(ASD), to explore the central nervous basis of sensory abnormality affecting core symptoms in boys with ASD.  Methods  Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected from 34 boys with ASD and 29 typical development boys (TD group). Based on functional connectivity analysis, the sensory-related brain regions, insula, and social-related brain regions were taken as regions of interest to calculate the functional connectivity (FC) level between the regions of interest, the differences between the two groups were compared and the results were corrected by FDR. The Autism Diagnostic Observation Schedule (ADOS), Childhood Autism Rating Scale (CARS) and Autism Spectrum Quotient-Children's Version (AQ-Child) were used to assess the core phenotypes of boys with ASD.  Results  Compared with the TD group, the levels of FC between tactile brain regions and insula, olfactory brain regions and insula, auditory brain regions and insula in boys with ASD group were significantly increased. The level of FC between the insula and bilateral amygdala, insula and the medial prefrontal cortex(mPFC) were significantly increased(P < 0.05).Pearson correlation analysis showed that the level of FC between auditory brain region(BA42)and left insula in ASD group was negatively correlated with the scores of communication subscale of ADOS(r=-0.44), social interaction subscale of ADOS(r=-0.43), communication & social interaction subscale of ADOS(r=-0.49), attention to details subscale of AQ-Child(r=-0.41). The level of FC between the right insula and right amygdala was positively correlated with the attention switch subscale of AQ-Child(r=0.38), the level of FC between right insula and mPFC was positively correlated with the scores of repetitive behavior subscale of ADOS(r=0.48), the attention switch subscale of AQ-Child(r=0.49), total scale subscale of AQ-Child(r=0.41), total scale of CARS(r=0.41)(P < 0.05).  Conclusion  The levels of FC between insula and sensory-related, social-related brain regions are abnormal in children with ASD, which have significant correlations with clinical symptoms. In-depth studies can be conducted to explore underlying neutral mechanisms.