孤独症患儿神经连接异常的影像特征

doi:10.3969/j.issn.1006-9771.2020.04.016

Abstract

Abstract:

Objective To analyze the structure and function of white matter in autistic children by using diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS), to explore the imaging features of abnormal neural connectivity in children with autism.Methods Autism group (n = 14) and control group (n= 8), aged two to nine years, underwent DTI and MRS scan. Bilateral frontal lobe, hippocampus, genu and splenium of corpus callosum and cerebellum white matter were selected as regions of interest. The data of DTI and MRS were processed by Functool 2.6 software of GEAW4.2 workstation. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of DTI, the absolute concentrations of N-acetylaspartate (NAA), choline (Cho), creatinine (Cr) and the ratios of NAA/Cr and Cho/Cr were recorded respectively.Results Compared with the control group, the FA of left hippocampus (F= 5.922, P = 0.033) and the absolute concentration of Cr in left and right hippocampus (F> 4.715,P < 0.05) decreased significantly in the autism group. The FA was lower in left corpus callosum genu than in the right one ( F = -2.335, P = 0.042), and the ADC was higher in left corpus callosum splenium than in the right one (F = 3.520, P < 0.01) in the autism group. The absolute concentration of NAA, Cho and Cr in left frontal lobe (| t| > 2.648, P < 0.05), the absolute concentration of NAA in left corpus callosum splenium ( t= -3.076, P = 0.009) and Cho/Cr in left cerebellum (t= -2.225, P = 0.044) were significantly lower than those in the right cerebral hemisphere in the autism group. The DTI and MRS indexes were not different between left and right hemispheres in the control group (P > 0.05). Conclusion Abnormal metabolite or functional alternations were found in the frontal lobe, hippocampus, cerebellum and the genu and splenium of the corpus callosum in autistic children, suggesting underconnectivity intra- or inter-hemispheric neural, especially in left hemisphere.

Key words: autism, abnormal neural connectivity, diffusion tensor imaging, magnetic resonance spectroscopy

CLC Number:

R749.94

YAO Tao-tao,CHEN Zhuo-ming,ZHANG Shu-chen. Imaging Features of Abnormal Neural Connectivity in Autistic Children[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(4): 472-478.

Figures/Tables 5

部位	代谢物	对照组		孤独症组		F值^a	P值^a	F值^b	P值^b	t值^c	P值^c	t值^d	P值^d
部位	代谢物	左	右	左	右	F值^a	P值^a	F值^b	P值^b	t值^c	P值^c	t值^d	P值^d
额叶	NAA(mmol/kg)	10915.50±2304.02	11260.50±2374.15	7716.00±5290.04	8425.71±5854.92	1.100	0.308	0.866	0.364	-2.021	0.083	-2.807	0.015
	Cho(mmol/kg)	8662.50±1931.34	8784.88±2263.00	5729.43±4493.54	6494.71±4534.03	0.882	0.187	0.847	0.370	-0.533	0.610	-2.804	0.015
	Cr(mmol/kg)	5984.00±1163.30	5929.00±1506.78	4224.00±2595.13	4735.57 ±2818.30	2.123	0.162	0.613	0.444	0.206	0.843	-2.648	0.020
	NAA/Cr	1.758±0.155	1.927±0.249	1.780±0.247	1.780±0.401	0.415	0.523	0.416	0.527	-1.981	0.088	0.005	0.996
	Cho/Cr	1.472±0.368	1.507±0.354	1.305±0.274	1.349 ±0.200	0.619	0.442	0.839	0.372	-0.526	0.615	-0.609	0.553
海马	NAA(mmol/kg)	6705.00±1459.01	7662.00±2789.01	5160.5±2070.00	5555.14±2480.99	2.978	0.102	4.029	0.060	-1.034	0.335	-1.123	0.282
	Cho(mmol/kg)	6674.25±1021.25	6954.75±1387.34	5107.36±2236.16	5254.07±2304.16	3.033	0.099	3.272	0.087	-0.675	0.521	-0.695	0.499
	Cr(mmol/kg)	4955.50±1403.07	4972.00±1525.66	3424.07±1394.31	3474.43±1641.15	6.502	0.020	4.715	0.044	-0.041	0.968	-0.184	0.857
	NAA/Cr	1.397±0.273	1.547±0.317	1.610±0.517	1.640±0.392	1.621	0.219	0.210	0.652	-0.795	0.453	-0.236	0.817
	Cho/Cr	1.423±0.368	1.466±0.359	1.566±0.500	1.597±0.467	0.785	0.387	0.632	0.437	-0.456	0.662	-0.268	0.793
小脑	NAA(mmol/kg)	8600.00±4215.58	9866.00±4509.24	5305.71±6420.88	5803.21±6493.00	0.905	0.356	1.592	0.225	-2.347	0.066	-1.417	0.180
	Cho(mmol/kg)	8138.17±3011.96	8046.50±3551.14	4482.71±5795.56	4785.79±5463.38	1.325	0.267	1.333	0.265	0.153	0.885	-1.120	0.283
	Cr(mmol/kg)	7206.83±2751.87	7434.17±2739.97	4051.93±4554.73	3367.57±3830.18	1.815	0.197	4.251	0.056	-0.361	0.733	2.032	0.063
	NAA/Cr	0.887±0.600	0.967±0.610	1.054±0.636	1.565±1.365	0.380	0.545	1.153	0.297	-1.202	0.268	-1.639	0.125
	Cho/Cr	0.869±0.573	0.793±0.499	0.864±0.531	1.189±0.783	0.020	0.890	1.455	0.243	0.877	0.410	-2.225	0.044
胼胝体膝部	NAA(mmol/kg)	3900.00±4348.98	4232.00±4872.09	3465.43±5067.72	3769.71±5460.74	0.135	0.718	0.150	0.704	-1.023	0.353	-1.411	0.182
	Cho(mmol/kg)	3818.83±4298.59	3976.50±4589.77	3559.29±5370.07	3667.71±5341.55	0.063	0.805	0.079	0.783	-0.776	0.473	-0.764	0.458
	Cr(mmol/kg)	2035.00±2386.77	2319.17±2699.86	2203.93±3184.85	2218.86±3076.47	<0.001	0.994	0.051	0.825	-1.032	0.349	-0.182	0.858
	NAA/Cr	0.766±1.106	0.708±1.009	0.667±0.807	0.694±0.868	0.348	0.563	0.114	0.739	1.353	0.218	-0.581	0.571
	Cho/Cr	0.757±1.110	0.667±0.953	0.655±0.808	0.676±0.836	0.266	0.612	0.045	0.834	1.360	0.216	-0.734	0.476
胼胝体压部	NAA(mmol/kg)	10051.33±5322.88	10752.00±5691.77	7377.57±7158.37	8255.14±7925.93	1.389	0.257	1.791	0.201	-1.934	0.111	-3.076	0.009
	Cho(mmol/kg)	6538.33±3509.77	6992.33±3793.72	5224.21±4929.72	5637.50±5309.14	1.109	0.309	1.224	0.286	-1.332	0.240	-1.539	0.148
	Cr(mmol/kg)	4563.67±2259.11	4686.00±2354.55	3311.00±3246.49	3501.14±3533.40	1.757	0.205	1.868	0.192	-1.021	0.354	-0.934	0.367
	NAA/Cr	1.401±1.172	1.428±1.198	1.294±1.192	1.393±1.274	0.004	0.952	0.005	0.943	-0.374	0.719	-1.079	0.300
	Cho/Cr	1.013±0.910	0.936±0.806	0.936±0.873	0.978±0.928	0.032	0.860	0.076	0.786	0.896	0.400	-0.478	0.641

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组别	n	性别(男/女,n)	年龄(岁)	头围(cm)
对照组	8	6/2	3.7±2.2	50.4±1.4
孤独症组	14	12/2	4.4±1.9	51.1±1.6
χ²/t值		0.393	0.809	1.033
P值		0.602	0.428	0.314

部位	代谢物	对照组		孤独症组		F值^a	P值^a	F值^b	P值^b	t值^a	P值^a	t值^b	P值^b
部位	代谢物	左	右	左	右	F值^a	P值^a	F值^b	P值^b	t值^a	P值^a	t值^b	P值^b
额叶	FA	0.298±0.038	0.347±0.022	0.272±0.108	0.284±0.129	0.464	0.510	0.883	0.368	-1.641	0.199	-0.857	0.411
额叶	ADC	8.715±0.319	8.552±0.167	8.912±0.581	8.985±0.472	0.553	0.473	2.423	0.148	0.689	0.540	-0.372	0.718
海马	FA	0.503±0.032	0.489±0.042	0.396±0.074	0.408±0.076	5.922	0.033	4.022	0.070	0.998	0.392	-0.511	0.621
海马	ADC	9.340±0.423	8.962±0.141	9.034±0.729	9.000±0.539	0.480	0.503	0.090	0.770	1.433	0.247	0.135	0.895
小脑	FA	0.395±0.120	0.406±0.107	0.392±0.158	0.439±0.127	0.002	0.964	0.181	0.679	-0.820	0.472	-1.621	0.136
小脑	ADC	8.797±0.764	8.645±0.774	7.988±0.761	8.071±0.751	3.227	0.100	0.747	0.406	2.845	0.065	-0.768	0.460
胼胝体膝部	FA	0.642±0.143	0.619±0.138	0.478±0.209	0.547±0.223	1.423	0.258	0.213	0.654	1.975	0.143	-2.335	0.042
胼胝体膝部	ADC	8.675±0.364	8.490±0.193	8.554±2.874	8.321±2.808	0.009	0.925	0.013	0.913	0.871	0.448	1.383	0.197
胼胝体压部	FA	0.679±0.171	0.702±0.138	0.656±0.103	0.646±0.105	0.024	0.881	0.732	0.411	-0.542	0.625	0.354	0.730
胼胝体压部	ADC	9.472±0.217	9.133±0.365	9.607±0.256	9.235±0.473	0.881	0.368	0.258	0.621	2.205	0.115	3.520	0.006

Imaging Features of Abnormal Neural Connectivity in Autistic Children

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