摘要
目的探讨不同亚型注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童的脑皮质结构特征差异。方法从美国儿童心理研究所健康大脑网络项目中获得412例样本数据,包括ADHD患儿288例(ADHD组),其中混合型151例(ADHD-C组)、多动冲动型20例(ADHD-H组)、注意缺陷型117例(ADHD-I组)以及对照儿童124名(对照组)。使用FreeSurfer软件对脑结构图像进行分析,获取受试者的脑皮质体积及皮质厚度、表面积数据,对三类脑结构特征组间比较分别进行方差分析以及事后简单效应分析。结果ADHD患者中3个亚组与对照组之间,左侧顶上回(Z=5.94)、颞上回(Z=5.49)皮质体积差异有统计学意义(蒙特卡洛校正,P<0.05)。与对照组比较,ADHD-H组在左侧顶上回皮质体积显著增大(Z=6.79),而ADHD-I组在左侧颞上回(Z=-5.12)及外侧枕叶皮质(Z=-6.40)体积显著减小,ADHD-C组在左侧外侧枕叶皮质(Z=-3.37)体积显著减小。ADHD患者中3个亚组间的比较显示,ADHD-I组(Z=-7.33,MNI坐标:x=-26.8,y=-60.6,z=45.4)及ADHD-C组(Z=-7.14,MNI坐标:x=-26.6,y=-60.2,z=45.4)的左侧顶上回皮质体积均小于ADHD-H组,而ADHD-I组及ADHD-C组之间的皮质体积差异无统计学意义(蒙特卡洛校正,P>0.05);进一步控制性分析显示,样本量、年龄、性别对结果无影响。对体积的来源即皮质厚度和表面积分析显示,ADHD亚型在皮质体积的异常主要受脑皮质表面积主导。结论顶上回脑皮质结构可能是区分ADHD不同亚型的主要脑结构特征,这将有助于进一步探究ADHD的神经发育机制并指导临床更加精准及特异化的治疗。
Objective The study aims to explore the abnormal characteristics in cerebral cortex among children with different subtypes of attention deficit hyperactivity disorder(ADHD).Methods Four hundred and twelve samples were obtained from the Healthy Brain Network project of American Child Mind Institute.There were 288 children with ADHD(all subjects:age,M=10.03,SD=3.11;151 of ADHD-C,20 of ADHD-H,and 117 of ADHD-I)and 124 healthy controls(age,M=9.98,SD=2.98).Using FreeSurfer software,we processed the brain structure images and obtained the cortical volume,cortical thickness and surface area for each subject.Analysis of Variance(ANOVA)and post hoc comparison analyses were conducted.Results ANOVA analysis showed significant differences of the cortical volume located in the left superior parietal gyrus(Z=5.94)and superior temporal gyrus(Z=5.49)among the 3 subtypes of ADHD children and the healthy controls(Monte Carlo,P<0.05).Compared with the healthy controls,ADHD-H group exhibited an increased cortical volume in the left superior parietal gyrus(Z=6.79),while the ADHD-I group had a decreased volume in the left superior temporal gyrus(Z=-5.12)and lateral occipital cortex(Z=-6.40).ADHD-C group also had a decreased volume in the left lateral occipital cortex(Z=-3.37).Among 3 subtypes of ADHD patients,both ADHD-I and ADHD-C groups had a smaller volume in the left superior parietal gyrus than that of the ADHD-H group(ADHD-I:Z=-7.33,MNI coordinate:x=-26.8,y=-60.6,z=45.4;ADHD-C:Z=-7.14,MNI coordinate:x=-26.6,y=-60.2,z=45.4).Additionally,there was no statistical difference in cortical volume between the ADHD-I and ADHD-C group(Monte Carlo,P>0.05).Subsequent supplementary analyses showed that the sample size and age had no significant effect on the above results.Moreover,analysis of cortical thickness and the surface area showed that the abnormality of the cortical volume in different ADHD subtypes was mainly determined by the surface area of the cerebral cortex.Conclusion Cortical measures in the superior parietal gyrus might be t
作者
王康程
姚媛
郭玲玲
车超
靳新娟
柴润玉
陈坤平
冯玉苓
邢婕
曹爱华
Wang Kangcheng;Yao Yuan;Guo Li ng ling;Che Chao;Jin Xinjuan;Chai Runyu;Chen Kunping;Feng Yuling;Xing Jie;Cao Aihua(College of Psychology,Shandong Normal University,Jinan 250358,China;Department of Radiology,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Pediatrics,Shandong Rehabilitation Hospital,Jinan 250109,China;Department of Pediatrics,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Child Rehabilitation and Mental Health,Dezhou Maternal and Child Health Hospital,Dezhou 253000,China)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2021年第5期363-373,共11页
Chinese Journal of Psychiatry
基金
中国博士后科学基金面上项目(2019M662433)
国家自然科学基金青年项目(32000760)
山东大学齐鲁医院青年基金项目(2019QLQN01)
山东省自然科学基金面上项目(ZR2020MH162)
山东大学青年团队创新项目(IFYT18037)。
关键词
注意力缺陷障碍伴多动
磁共振成像
皮质结构
Attention deficit disorder with hyperactivity
Magnetic resonance imaging
Cortical structure
