孤独症谱系障碍男童视觉相关脑区与全脑功能连通性特征

王晓敏; 翟巾赫; 任喜运; 夏薇; 张碧珊; 李雨彤; 李小雪; 王佳

doi:10.16835/j.cnki.1000-9817.2021.02.023

孤独症谱系障碍男童视觉相关脑区与全脑功能连通性特征

doi: 10.16835/j.cnki.1000-9817.2021.02.023

王晓敏^{1, 2},
翟巾赫²,
任喜运²,
夏薇²,
张碧珊³,
李雨彤²,
李小雪²,
王佳^{1, 2, ,}

1.
黑龙江省医学科学院，哈尔滨 150081
2.
哈尔滨医科大学公共卫生学院儿少卫生与妇幼保健教研室
3.
哈尔滨医科大学附属第二医院影像科

基金项目:

黑龙江省自然科学基金项目 QC2018106

详细信息

作者简介:
王晓敏(1993-)，女，山西人，硕士，初级医师，主要研究方向为儿童发育障碍及行为问题

通讯作者:
王佳，E-mail：wangjiahyd@163.com

中图分类号: R 748 R 445
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- 被引次数: 0
出版历程
- 收稿日期: 2020-09-26
- 修回日期: 2020-10-20
- 网络出版日期: 2021-04-06
- 刊出日期: 2021-02-25

Connectivity between visual brain regions and whole brain among children diagnosed with autism spectrum disorder

1.
Heilongjiang Academy of Medical Sciences, Harbin (150081), China

摘要

摘要: 目的探讨孤独症谱系障碍(ASD)儿童静息态下视觉脑区与全脑功能连接特征，并与症状进行关联性分析，以揭示ASD儿童视觉异常行为背后的脑功能连接特征。方法收集黑龙江省孤独症定点康复机构招募的2018—2019年间进行康复训练的ASD男童(34例)和在哈尔滨市多家幼儿园公开招募的健康对照男童(29例)的功能磁共振(fMRI)数据，基于静息态功能连接(rs-fc MRI)分析方法，将初级视觉脑区(BA17)和高级视觉脑区(BA18/19)为种子点，计算该区域与全脑的功能连接水平，并比较两组差异。采用多种发育量表评估ASD儿童的行为，应用Pearson相关分析探索功能连接强度与孤独症行为之间的关联。结果 ASD组BA17与右侧梭状回(FFG)间正连接减弱，且与孤独症诊断访谈量表修订版(Autism Diagnostic Interview-Revised, ADI-R)社会互动以及儿童孤独症评定量表(Childhood Autism Rating Scale, CARS)总分呈负相关(r值分别为-0.41，-0.48，P均 < 0.05)；BA17与左侧梭状回(FFA)间正连接减弱，且与社交反应量表(Social Responsiveness Scale, SRS)社交动机呈负相关(r=-0.43，P < 0.05)；BA17与左侧后扣带回间的正连接减弱。ASD儿童BA18/19与左侧距状裂周围皮质(CAL)间正连接减弱，且与孤独症特质量表-儿童版(Autism Spectrum Quotient-Children's Version, AQ-Child)注意力转换、CARS总分呈正相关(r值分别为0.43，0.40，P值均 < 0.05)；BA18/19与右侧楔前叶(PCUN)间正连接减弱。结论静息态下ASD儿童初级、高级视觉脑区与全脑的功能连通性异于健康儿童，且异常水平与孤独症行为间存在相关关系。
- 孤独性障碍 /
- 精神卫生 /
- 脑 /
- 磁共振成像 /
- 儿童 /
- 男(雄)性
Abstract: Objective To explore the functional connectivity between the visual brain regions and whole brain in children with autism spectrum disorder (ASD) at resting state, and to further analyze the correlation with their clinical manifestations. Methods The functional magnetic resonance imaging (fMRI) data of 34 boys with ASD enrolled from ASD designated rehabilitation institutions and 29 healthy boys enrolled from several kindergartens in Heilongjiang were collected. Based on the resting-state functional connectivity magnetic resonance imaging (rs-fc MRI) analysis, the BA17 of the primary visual brain region and the BA18/19 of the higher visual brain region were taken as the regions of interest (ROI) to calculate the functional connectivity level between the visual brain regions and whole brain, and the differences between the two groups were compared. Multiple developmental scales were used to evaluate the behavior of ASD children, and Pearson correlation analysis was used to explore the relationship between functional connection strength and autistic behavior. Results The ASD group had decreased positive connectivity between BA17 and the right fusiform gyrus (FFG), and was negatively correlated with social interaction of ADI-R and the total scores of CARS (r=-0.41, -0.48, P < 0.05); ASD group had decreased positive connectivity between BA17 and the left FFG, there was a negative correlation with social motivation of SRS (r=-0.43, P < 0.05); ASD group had decreased positive connectivity between BA17 and the left posterior cingulate gyrus (PCG). Children with ASD had decreased positive connectivity between BA18/19 and left calcarine fissure and surrounding cortex (CAL), which was positively correlated with attention conversion of AQ, total scores of CARS (r=0.43, 0.40, P < 0.05), and the children with ASD had deceased positive connectivity between BA18/19 and right precuneus (PCUN). Conclusion In resting state, the functional connectivity of primary and higher visual brain regions and whole brain of ASD children is different from that in healthy children, and there is a significant correlation between abnormal level and autistic behaviors.
- Autistic disorder /
- Mental health /
- Brain /
- Magnetic resonance imaging /
- Child /
- Male

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表 1 ASD组与对照组男童视觉脑区与全脑功能连通性比较差异脑区信息

Table 1. Differential brain information of visual brain and whole brain functional connectivity comparison between ASD and control boys

种子点	差异脑区	体素个数	MNI			t值
种子点	差异脑区	体素个数	x	y	z	t值
初级视觉脑区	ASD组 < 对照组^*
	右侧梭状回	29	15	-51	-15	-4.18
	左侧梭状回	37	-18	-54	-15	-4.03
	左侧扣带回	72	-12	-60	9	-4.39
高级视觉脑区	ASD组 < 对照组^*
	左侧距状裂周围皮质	72	-9	-63	6	-4.12
	右侧楔前叶	38	18	-63	21	-4.24
注：*表示ASD组相比于对照组脑区连通性减弱；x、y、z为团块峰值点坐标值(基于MNI坐标系统)；t值为各团块峰值点对应的t值。

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表 2 ASD男童视觉脑区功能连接值与行为测评结果的相关性系数(r值，n=34)

Table 2. Correlation analysis between functional connection of visual brain and behavior evaluation results of ASD boys(r, n=34)

量表	维度	右侧梭状回	左侧梭状回	左侧距状裂周围皮质
孤独症诊断访谈量	社会互动	-0.41^*	-0.15	0.23
表修订版	交流	-0.36	-0.16	0.13
	重复行为	-0.32	-0.30	0.10
儿童孤独症评定量表	总分	-0.48^**	-0.12	0.40^*
社交反应量表	社交知觉	0.17	0.06	-0.11
	社交认知	-0.34	-0.25	0.27
	社交沟通	-0.36	-0.29	0.29
	社交动机	-0.34	-0.43^*	0.15
	孤独症行为	-0.20	-0.36	0.34
	总分	-0.32	-0.36	0.28
孤独症特质量表-	社交能力	-0.28	-0.03	0.31
儿童版	注意转移	-0.24	0.01	0.43^*
	注意细节	-0.10	-0.05	-0.09
	交流	-0.32	-0.17	0.25
	想象	-0.23	0.09	0.34
	总分	-0.32	-0.01	0.34
注：P < 0.05，*P < 0.01。

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