CAJ | 학술논문

目的通过静息态功能连接磁共振成像(functional magnetic resonance imaging, fMRI)来研究注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)儿童右侧颞顶叶联合部(right temporal parietal junction,rTPJ)与全脑的功能连接特征,从功能网络角度分析ADHD儿童临床症状与神经网络之间的联系.方法采集30名混合型ADHD儿童及33名正常对照(normal control,NC)儿童静息态下血氧依赖水平(blood oxygenation level dependent,BOLD) fMRI数据,选取rTPJ为感兴趣区,进行功能连接分析比较组内、组间差异及连接强度与注意缺陷评分和多动评分间的关系.结果 rTPJ与全脑功能连接显著区在两组儿童分布相似.与NC组比较,ADHD组rTPJ与全脑功能连接增高区域包括:左侧颞上回(MNI坐标:-33,6,-48)、右侧前扣带回(MNI坐标:6,39,-3)、右侧顶下小叶(MNI坐标:42,-33,30)、左额内侧回(MNI坐标:-3,63,-18);减低区域包括:右侧颞中回(MNI坐标:57,-33,-12)、右侧扣带回(MNI坐标:18,-21,36).相关性分析显示,ADHD组中,rTPJ与全脑功能连接强度的平均值与注意缺陷评分及多动评分呈正相关,而在NC组中,则呈负相关.rTPJ与上述6个脑区间功能连接强度与注意缺陷评分及多动评分存在相关性,但相关性无统计学意义.结论 rTPJ与全脑的异常功能连接可能与ADHD儿童注意力不集中这一临床症状有关.
목적 통과정식태공능련접자공진성상(functional magnetic resonance imaging, fMRI)래연구주의결함다동장애(attention deficit hyperactivity disorder, ADHD)인동우측섭정협연합부(right temporal parietal junction,rTPJ)여전뇌적공능련접특정,종공능망락각도분석ADHD인동림상증상여신경망락지간적련계.방법 채집30명혼합형ADHD인동급33명정상대조(normal control,NC)인동정식태하혈양의뢰수평(blood oxygenation level dependent,BOLD) fMRI수거,선취rTPJ위감흥취구,진행공능련접분석비교조내、조간차이급련접강도여주의결함평분화다동평분간적관계.결과 rTPJ여전뇌공능련접현저구재량조인동분포상사.여NC조비교,ADHD조rTPJ여전뇌공능련접증고구역포괄:좌측섭상회(MNI좌표:-33,6,-48)、우측전구대회(MNI좌표:6,39,-3)、우측정하소협(MNI좌표:42,-33,30)、좌액내측회(MNI좌표:-3,63,-18);감저구역포괄:우측섭중회(MNI좌표:57,-33,-12)、우측구대회(MNI좌표:18,-21,36).상관성분석현시,ADHD조중,rTPJ여전뇌공능련접강도적평균치여주의결함평분급다동평분정정상관,이재NC조중,칙정부상관.rTPJ여상술6개뇌구간공능련접강도여주의결함평분급다동평분존재상관성,단상관성무통계학의의.결론 rTPJ여전뇌적이상공능련접가능여ADHD인동주의력불집중저일림상증상유관.
Objective To investigate the pathophysiological distinction of the functional connectivity between right temporal parietal junction(rTPJ) and whole brain in children with attention-deficit/hyperactivity disorder(ADHD) on resting-state functional magnetic resonance imaging(fMRI) and explore the neurological mechanisms of ADHD at the point of functional connectivity.Methods Resting-state functional magnetic resonance imaging scans were obtained in 30 children with ADHD from The Third Affiliated Hospital of Soochow Univcrsity and another 33 with age and gender matched controls from a normal primary school over the same period, and then,blood oxygenation level dependent(BOLD) signal was acquired to calculate the functional connectivity of rTPJ with other brain regions.Significant differences of connectivity intra-class and between groups were analyzed.Also, the correlation between the connectivity strength and the ADHD rating scales were tested.Results The pattern of functional connectivity of the rTPJ for the ADHD group was similar to that of the normal control group.Compared with the normal controls, the left superior temporal gyrus (MNI coordinates-33,6,48) , the right anterior c ingulate coltex(MNI coordinates 6,39,-3) , the right inferior parietal lobule (MNI coordinates 42,-33,30) , the left medial frontal gyrus(MNI coordinates-3,63,-18) in children with ADHD sbowed an increased resting-state functional connectivity with the whole brain ,while the right middle temporal gyrus(MNI coordinates 57,-33,-12) , the right cingulate gyrus(MNI coordinates 18,-21,36) showed a decreased resting-state functional connectivity with the whole brain.The average connection strength between the rTPJ and the whole brain showed positive correlation with the ADHD scores,while in normal controls,it showed negative.The connection strength between the rTPJ and those 6 brain areas with significant statistical difference was relevant to the ADHD scores,but they had no statistical significance.Conclusion The functional connection abnormalities between tbc rTPJ and the whole brain in children with ADHD may be relevant to the clinical symptom of attention-deficit.