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目的:探讨2~3岁孤独谱系障碍(ASD)与发育迟缓(DD)儿童突显网络的结构差异。方法:对46名符合美国精神障碍诊断和统计手册第4版(修订版)(DSM-Ⅳ-TR)诊断标准的ASD和39例年龄、性别及发育商匹配的DD儿童(对照组)进行磁共振(MRI)扫描,比较两组前扣带回、岛叶灰质体积和皮层厚度的差异,分析前扣带回与岛叶灰质体积的相关性。使用孤独症诊断访谈量表(修订版)(ADI-R)以及沟通及象征行为量表/发展概况表(CSBS-DP)评估两组儿童的临床症状,分析ASD临床症状与脑结构体积变化之间的相关性。结果:与对照组相比,ASD组左侧岛叶灰质体积、左尾部及左喙部扣带区灰质体积增大(均P<0.05)。两组儿童的前扣带回和岛叶皮层厚度差异均无统计学意义(均P>0.05)。分别以年龄和全脑体积为协变量后ASD组左侧岛叶灰质体积[(7.1±0.6)cm3vs.(6.7±0.8)cm3]、左尾部扣带区灰质体积[(1.9±0.4)cm3vs.(1.7±0.4)cm3]及左喙部扣带区灰质体积[(2.7±0.5)cm3vs.(2.3±0.6)cm3]差异仍有统计学意义(均P<0.05)。ADI-R及CSBS-DP评分与体积的相关分析表明,对照组“用物”分项的评分与右侧岛叶灰质体积(r=0.38,P<0.05)呈正相关,其他相关系数无统计学意义。结论:与智能匹配的发育迟缓儿童相比孤独谱系障碍儿童突显网络的重要节点可能存在体积异常。
Objective: To explore the structural differences of prominent networks in children aged 2 ~ 3 years old with autism spectrum disorder (ADD) and developmental delay (DD). Methods: Forty-six children with DDD (control group) matched with diagnostic criteria of DSM-Ⅳ-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, revised edition) Resonance (MRI) scans were performed to compare the differences in anterior cingulate gyrus, island gray matter volume and cortical thickness, and the correlation between anterior cingulate gyrus and island leaf gray matter volume was analyzed. The clinical symptoms of both groups were assessed using the Autism Diagnostic Interview Scale (Revision) (ADI-R) and the Communication and Symbolic Behavior Scale / Developmental Fact Sheet (CSBS-DP) to analyze the clinical symptoms of ASD and the changes in volume of brain structure Relevance between. Results: Compared with the control group, the gray matter volume of left lobe and the gray matter volume of left lobe and left beak in the ASD group were increased (all P <0.05). There was no significant difference in anterior cingulate gyrus and insular cortex between the two groups (all P> 0.05). The left lobe island gray matter volume [(7.1 ± 0.6) cm3 vs. (6.7 ± 0.8) cm3] and the left caudate cingulate gray matter volume [(1.9 ± 0.4) cm3 vs, respectively) were measured using age and whole brain volume as covariates. (1.7 ± 0.4) cm3] and gray volume in the left beak ([(2.7 ± 0.5) cm3 vs (2.3 ± 0.6) cm3], respectively. Correlation analysis between ADI-R and CSBS-DP score and volume showed that there was a positive correlation between the score of control group “matter ” and the volume of right island leaf gray matter (r = 0.38, P <0.05) Statistical significance. CONCLUSIONS: Volume abnormalities may be present in important nodes of the network that are significantly more likely to be impaired in children with impaired pedigree than those with impaired development.