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目的:探讨6~18岁高功能孤独症患者的灰质体积异常脑区以及异常脑区发育特点。方法:纳入19例6~18岁符合美国精神障碍诊断与统计手册第4版孤独症诊断标准且总智商≥70的高功能孤独症患者,以及年龄、总智商、性别组间匹配的16例正常对照,以磁共振成像检查收集被试的脑影像学资料,采用基于体素的形态学测量方法计算两组被试大脑各区域的灰质体积,在统计学参数图(SPM)软件SPM8中进行双样本t检验得出差异脑区,对结果进行错误率(FDR)多重比较校正(P<0.05)。采用偏相关分析两组被试差异脑区灰质体积与年龄的相关性。结果:高功能孤独症组的右侧额下回眶额部灰质体积小于正常对照组(FDR校正,P<0.05)。正常对照组右侧额下回眶额部灰质体积与年龄呈负相关(r=-0.592,P<0.05),高功能孤独症患者右侧额下回眶额部灰质体积与年龄呈负相关(r=-0.696,P<0.01)。结论:与正常人相比,6~18岁高功能孤独症患者右侧额下回眶额部发育异常,此脑区可能参与孤独症的病理机制。
Objective: To investigate the characteristics of gray matter volume abnormalities and abnormal brain development in 6-18-year-old high-functioning autism patients. Methods: A total of 19 high-functioning autism patients aged 6-18 years who met diagnostic criteria of autism of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders with a total IQ ≥ 70 and 16 matched normal, age-matched, and gender-matched normal subjects In contrast, brain MRI data of subjects were collected by magnetic resonance imaging. Volumes of gray matter in each region of two groups of subjects were calculated using a voxel-based morphological measurement method. In the statistical parametric map (SPM) software SPM8, double Differences in brain regions were obtained from the sample t-test, and the results were corrected for multiple comparisons of error rates (FDR) (P <0.05). Partial correlation analysis was used to analyze the correlation between gray matter volume and age in two groups of subjects. Results: The volume of the right frontal orbital frontal cortex in high-function autism group was smaller than that in the normal control group (FDR-corrected, P <0.05). There was a negative correlation between gray volume of right orbital frontal gyrus and age at the right side of normal control group (r = -0.592, P <0.05). The volume of right orbital frontal gyrus in patients with high functional autism was negatively correlated with age r = -0.696, P <0.01). CONCLUSIONS: Compared with normal controls, the right frontal orbitofrontal gyrus develops abnormally in 6-18-year-old high-functioning autism patients. This brain region may be involved in the pathogenesis of autism.