本文選題：孤獨(dú)譜系障礙 + 杏仁核　； 參考：《南京大學(xué)》2012年碩士論文

【摘要】：[目的] 對比分析2-3歲孤獨(dú)譜系障礙(autism spectrum disorder, ASD)兒童與發(fā)育遲緩(developmental delay, DD)兒童情緒面孔加工相關(guān)腦結(jié)構(gòu)網(wǎng)絡(luò)的差異,并對ASD兒童異常腦區(qū)與社會情緒功能之間的相關(guān)性進(jìn)行研究。 [方法] 對29名ASD兒童和27名年齡、性別、發(fā)育商(development quotient, DQ)與之匹配的DD兒童進(jìn)行磁共振成像(magnetic resonance imaging, MRI)掃描,手工勾畫杏仁核,并利用FreeSurfer軟件提取梭狀回、顳上溝、顳上回、枕下回、眶額葉皮層、前扣帶回皮層、額下回島蓋部這些感興趣區(qū)(regions of interest, ROIs)的皮層厚度和體積,以及顱內(nèi)體積(intracranial volumn, ICV),比較兩組ROIs體積、皮層厚度的差異。利用溝通及象征行為量表／發(fā)展概況(Communication and Symbolic Behavior Scales-Developmental Profile, CSBS-DP)嬰幼兒核查表以及孤獨(dú)癥診斷訪談修訂版(Autism Diagnoses Interview-Revised, ADI-R)評估患兒的社會交流能力,進(jìn)一步分析臨床癥狀與腦結(jié)構(gòu)異常之間的相關(guān)性。 [結(jié)果] (1)與對照組相比,在校正ICV后,2-3歲ASD兒童雙側(cè)杏仁核、雙側(cè)梭狀回、雙側(cè)顳上回、雙側(cè)前扣帶回和左側(cè)額下回島蓋部體積明顯增大(p0.05),其中以左側(cè)杏仁核、右側(cè)顳上回以及左側(cè)前扣帶回最為顯著(p0.01)；(2)與對照組相比,即使在校正ICV后,2-3歲ASD兒童雙側(cè)梭狀回、顳上回、枕下回、眶額葉皮層、前扣帶回、額下回島蓋部在皮層厚度上均無統(tǒng)計學(xué)差異；(3)在控制年齡、性別和DQ后,DD兒童左側(cè)杏仁核體積與CSBS-DP嬰幼兒核查表中的“情緒與眼神接觸”子項(xiàng)目存在負(fù)相關(guān)的趨勢(r=-0.40,p=0.087),右側(cè)杏仁核與ADI-R的社會交往(r=-0.48,p=0.040)、言語及非言語交流維度(r=-0.58,p=0.009)呈顯著的負(fù)相關(guān),而在ASD中均為不顯著的負(fù)相關(guān)；ASD兒童右側(cè)梭狀回灰質(zhì)體積與象征性行為維度呈負(fù)相關(guān)(r=-0.48,p=0.023),右側(cè)顳上回灰質(zhì)體積與“情緒及目光接觸”子項(xiàng)目存在負(fù)相關(guān)的趨勢(r=-0.38,p=0.077),右側(cè)前扣帶回灰質(zhì)體積與“情緒與眼神接觸”子項(xiàng)目呈顯著的負(fù)相關(guān)(r=-0.51,p=0.016),而這些相關(guān)性在DD中均未出現(xiàn)。 [結(jié)論] 2-3歲的ASD兒童存在情緒面孔加工相關(guān)腦結(jié)構(gòu)網(wǎng)絡(luò)的受損,以左側(cè)杏仁核、右側(cè)顳上回和左側(cè)前扣帶回灰質(zhì)體積增大最為顯著,而且腦結(jié)構(gòu)的異常與患兒的社會情緒功能受損有關(guān)。
[Abstract]:[purpose] The differences of emotional face processing related brain structure networks between children with solitary pedigree disorder (spectrum disorder, ASD) aged 2-3 years old and those with stunted developmental delayay (DDD) children were compared and analyzed. The correlation between abnormal brain regions and social emotional function in children with ASD was studied. [methods] Magnetic resonance imaging (resonance imaging, MRI) was performed in 29 children with ASD and 27 children with age, sex and development quotient (DQQ). The amygdaloid nucleus was drawn by hand, and the fusiform gyrus, superior temporal sulcus, superior temporal gyrus and suboccipital gyrus were extracted by FreeSurfer software. The cortical thickness and volume of the regions of interest, such as orbital frontal cortex, anterior cingulate cortex, inferior frontal gyrus insular tegmental region, and intracranial volume of intracranial volumn, were compared between the two groups in terms of ROIs volume and cortical thickness. The communication and Symbolic Behavior Scales-Developmental profile (CSBS-DPP) and the revised Autism Diagnoses Interview-Revisited (ADI-R) were used to evaluate the children's social communication ability. To further analyze the correlation between clinical symptoms and abnormal brain structure. [results] 1) compared with the control group, the volume of bilateral amygdaloid nucleus, bilateral fusiform gyrus, bilateral superior temporal gyrus, bilateral anterior cingulate gyrus and left inferior frontal gyrus in ASD children aged 2-3 years after ICV were significantly larger than that in the control group, especially in the left amygdaloid nucleus. The right superior temporal gyrus and left anterior cingulate gyrus were most significant compared with the control group, even after ICV correction, bilateral fusiform gyrus, superior temporal gyrus, inferior occipital gyrus, orbital frontal cortex, anterior cingulate gyrus were found in 2-3 years old ASD children. There was no significant difference in cortical thickness between the subfrontal gyrus and the tegmental part of the subfrontal gyrus (P < 0.05). There was a negative correlation between gender and the volume of left amygdala in children with DQ and the subitems of "emotion and eye contact" in CSBS-DP infant checklist. The social interaction between right amygdala and ADI-R was 0. 48p0. 040, and the dimension of verbal and nonverbal communication was r-0. 58p0. 009). There was a significant negative correlation. In ASD, there was no significant negative correlation between the gray matter volume of right fusiform gyrus and symbolic behavior dimension. The gray matter volume of right superior temporal gyrus was negatively correlated with the subitems of "emotion and eye contact", and the right superior temporal gyrus was negatively correlated with the subitems of "emotion and eye contact". The volume of gray matter in lateral cingulate gyrus was negatively correlated with the subitem of "emotion and eye contact", but none of these correlations were found in DD. [conclusion] In ASD children aged 2-3 years, there was damage to the neural network associated with emotional face processing, especially in the left amygdala, the right superior temporal gyrus and the left anterior cingulate gyrus. And the abnormal brain structure is related to the impaired social emotional function of the children.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.94

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