CAJ | 학술논문

目的探讨静息态下Tourette综合征(TS)患儿症状严重程度与静息态功能磁共振脑低频振幅的相关性.方法本组16例,均来自首都医科大学附属北京安定医院儿科门诊,均为首发TS患儿,男13例,女3例,年龄6～16岁,平均(11.00±2.92)岁,平均受教育年限(5.06±2.86)年；病程14 ～ 104个月,平均(48.44±25.00)个月.入组时耶鲁大体抽动严重程度量表评分:严重程度分:(37.88±5.39)分,综合损伤分:(25.63±12.63)分.对本组患儿进行静息态功能磁共振的扫描.分别在0.01 ～0.1 Hz,0.01 ～0.027 Hz及0.027 ～0.073 Hz频段内计算脑低频振幅(ALFF)值,并将患者ALFF值与其抽动症状严重程度进行相关分析,设P＜0.05且k值≥10为差异有统计学意义.结果以下脑区的抽动症状严重程度评分与ALFF值呈正相关:左额上回眶部(0.01～0.1 Hz:r=0.83,0.027 ～0.073 Hz:r=0.91,P均＜0.05)、右额中回(0.01 ～0.027 Hz:r =0.85,0.027 ～0.073Hz:r=0.57,P均＜0.05)、左额中回眶部(0.01～0.027 Hz:r =0.64,P＜0.05).以下脑区的抽动症状严重程度评分与ALFF值呈负相关:右距状沟及周围皮质(0.01～0.1 Hz:r=-0.65,0.01 ～0.027Hz:r=-0.69,P均＜0.05)、左距状沟及周围皮质(0.027 ～ 0.073 Hz:r=-0.81,P＜0.05).结论首发TS患儿抽动症状严重程度与特定区域的脑功能活动异常有关.
목적 탐토정식태하Tourette종합정(TS)환인증상엄중정도여정식태공능자공진뇌저빈진폭적상관성.방법 본조16례,균래자수도의과대학부속북경안정의원인과문진,균위수발TS환인,남13례,녀3례,년령6～16세,평균(11.00±2.92)세,평균수교육년한(5.06±2.86)년；병정14 ～ 104개월,평균(48.44±25.00)개월.입조시야로대체추동엄중정도량표평분:엄중정도분:(37.88±5.39)분,종합손상분:(25.63±12.63)분.대본조환인진행정식태공능자공진적소묘.분별재0.01 ～0.1 Hz,0.01 ～0.027 Hz급0.027 ～0.073 Hz빈단내계산뇌저빈진폭(ALFF)치,병장환자ALFF치여기추동증상엄중정도진행상관분석,설P＜0.05차k치≥10위차이유통계학의의.결과 이하뇌구적추동증상엄중정도평분여ALFF치정정상관:좌액상회광부(0.01～0.1 Hz:r=0.83,0.027 ～0.073 Hz:r=0.91,P균＜0.05)、우액중회(0.01 ～0.027 Hz:r =0.85,0.027 ～0.073Hz:r=0.57,P균＜0.05)、좌액중회광부(0.01～0.027 Hz:r =0.64,P＜0.05).이하뇌구적추동증상엄중정도평분여ALFF치정부상관:우거상구급주위피질(0.01～0.1 Hz:r=-0.65,0.01 ～0.027Hz:r=-0.69,P균＜0.05)、좌거상구급주위피질(0.027 ～ 0.073 Hz:r=-0.81,P＜0.05).결론 수발TS환인추동증상엄중정도여특정구역적뇌공능활동이상유관.
Objective To examine the relationship between tic symptom severity and amplitude of low frequency fluctuation (ALFF) brain functioning of the first-episode Tourette syndrome through restingstate functional magnetic resonance imaging (fMRI).Method Sixteen subjects were all recruited from the outpatient department of pediatrics,Beijing Anding Hospital,Capital Medical University and were all firstepisode Tourette syndrome patients [male:13,female:3 ; age:6-16 years ; mean age:(11.00 ± 2.92)years] ; mean education time:(5.06 ± 2.86) years; course:14-104 months ; mean (48.44 ± 25.00)months ; scores of YGTSS at baseline:tic severity score:37.88 ± 5.39 ; global damage score:25.63 ±12.63.All the subjects experienced resting-state fMRI scans and ALFF were calculated in three frequency ranges:0.01-0.1 Hz,0.01-0.027 Hz and 0.027-0.073 Hz.First-episode Tourette syndrome patients and 16 gender,age,and education-matched normal controls experienced resting-state fMRI scans.Correlation analysis was performed in between the amplitude of low frequency fluctuation (ALFF) and the severity of tic symptom.P ＜ 0.05 and k value ≥ 10 were considered to be of significance.Result In tic symptom patients,tic severity (total tic scores of YGTSS) was positively correlated with the ALFF values in the orbital part of left superior frontal gyrus (0.01-0.1 Hz:r =0.83,0.027-0.073 Hz:r =0.91,P ＜0.05,respectively),right middle frontal gyrus (0.01-0.027 Hz:r =0.85,0.027-0.073 Hz:r =0.57,P ＜ 0.05,respectively) and orbital part of left middle frontal gyrus (0.01-0.027 Hz:r =0.64,P ＜0.05).Tic severity was negatively correlated with the ALFF values in the right calcarine fissure and surrounding cortex (0.01-0.1 Hz:r =-0.65,0.01-0.027 Hz:r =-0.69,P ＜0.05,respectively) and the left calcarine fissure and surrounding cortex (0.027-0.073 Hz:r =-0.81,P ＜ 0.05).Conclusion Tic symptom severity of the first-episode Tourette syndrome is associated with abnormal brain activity patterns of specific brain areas.