CAJ | 학술논문

目的:研究哌醋甲酯治疗后注意缺陷多动障碍(ADHD)儿童完成语义工作记忆任务下脑区功能状态的改变,评价fMRI用于研究ADHD治疗机制的可行性.方法:ADHD组儿童6例,男性4例,女性2例,平均年龄12.50±1.87岁,符合DSM-Ⅳ诊断标准.ADHD儿童在治疗前后(检查前3h口服哌醋甲酯,0.2～0.3mg/kg)两种情况下进行行为学评估和功能MRI检查,两次间隔2～4周.刺激任务采用N-BACK模式下的语义工作记忆任务,BLOCK设计方法.fMRI扫描采用GE 3.0T磁共振机,采用配对t检验统计方法.结果:ADHD患儿治疗后脑功能区的激活多于治疗前,1-BACK任务下左侧额中回、双侧额下回、左顶下小叶、双侧基底节等脑区激活与治疗前差异有统计学意义,在2-BACK任务下同时有左颞叶和扣带回激活不同,与认知测试成绩改善具有一定的相关性.结论:哌醋甲酯能增加ADHD患儿的工作记忆功能脑区的激活,fMRI是研究哌醋甲酯治疗ADHD机制的新方法.
목적:연구고작갑지치료후주의결함다동장애(ADHD)인동완성어의공작기억임무하뇌구공능상태적개변,평개fMRI용우연구ADHD치료궤제적가행성.방법:ADHD조인동6례,남성4례,녀성2례,평균년령12.50±1.87세,부합DSM-Ⅳ진단표준.ADHD인동재치료전후(검사전3h구복고작갑지,0.2～0.3mg/kg)량충정황하진행행위학평고화공능MRI검사,량차간격2～4주.자격임무채용N-BACK모식하적어의공작기억임무,BLOCK설계방법.fMRI소묘채용GE 3.0T자공진궤,채용배대t검험통계방법.결과:ADHD환인치료후뇌공능구적격활다우치료전,1-BACK임무하좌측액중회、쌍측액하회、좌정하소협、쌍측기저절등뇌구격활여치료전차이유통계학의의,재2-BACK임무하동시유좌섭협화구대회격활불동,여인지측시성적개선구유일정적상관성.결론:고작갑지능증가ADHD환인적공작기억공능뇌구적격활,fMRI시연구고작갑지치료ADHD궤제적신방법.
Purpose: To compared the difference of brain activation before and after methylphenidate treatment in ADHD children under cognitive task. Methods: Six children(4 boys, 2 girls; mean + SD = 12.50 + 1.87 years) were enrolled in the study according to the ADHD criteria of DSM - Ⅳ. The cognitive and behavior examinations and fMRI scans were taken twice, which were before and after treatment re-spectively. ADHD children took the verbal working memory task designed with N - BACK block model and were scanned with GE 3.0 Telsa magnetic resonance machine. The interval between the two fMRI scans was 2 - 4 weeks and the second examination was hold in 3 hours after methylphenidate treatment. The fMRI data were analyzed by AFNI software. Results: The brains of ADHD children were more acti-vated after treatment than that before treatment, especially in the areas of left middle frontal cortex, bilateral inferior frontal cortexes, left inferior parietal lobules, left superior parietal lobule, bilateral thalamus under the 1 - back task. The left temporary cortex and left anterior cingulated cortex were more activated under the 2 - back task. Conclusion: The increase of brain activation in ADHD children after treatment of methylphenidate can be discovered by fMRI examination, fMRI is a new tool to research the mechanism of methylphenidate therapy.