Cheung C, Chua S E, Cheung V, Khong P L, Tai K S, Wong T K W, Ho T P, McAlonan G M
Department of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong.
J Child Psychol Psychiatry. 2009 Sep;50(9):1102-12. doi: 10.1111/j.1469-7610.2009.02086.x. Epub 2009 Mar 31.
Individuals with autism have impairments in 3 domains: communication, social interaction and repetitive behaviours. Our previous work suggested early structural and connectivity abnormalities in prefrontal-striato-temporal-cerebellar networks but it is not clear how these are linked to diagnostic indices.
Children with autism (IQ > 70) aged 6 to 14 years old and matched typically developing controls were studied using diffusion tensor imaging. Voxel-based methods were used to compare fractional anisotrophy (FA) measures in each group and to correlate FA measures in the autism group with the diagnostic phenotype described by the Autism Diagnostic Interview - Revised (ADI-R) algorithm for ICD-10.
After controlling for the effects of age and white matter volume, we found that FA in the autism group was significantly lower than controls in bilateral prefrontal and temporal regions, especially in the right ventral temporal lobe adjacent to the fusiform gyrus. FA was greater in autism in the right inferior frontal gyrus and left occipital lobe. We observed a tight correlation between lower FA and higher ADI-R diagnostic algorithm scores across white matter tracts extending from these focal regions of group difference. Communication and social reciprocity impairments correlated with lower FA throughout fronto-striato-temporal pathways. Repetitive behaviours correlated with white matter indices in more posterior brain pathways, including splenium of the corpus callosum and cerebellum.
Our data support the position that diagnostic symptoms of autism are associated with a core disruption of white matter development.
自闭症个体在三个领域存在障碍:沟通、社交互动和重复行为。我们之前的研究表明前额叶 - 纹状体 - 颞叶 - 小脑网络存在早期结构和连接异常,但尚不清楚这些异常如何与诊断指标相关联。
对6至14岁且智商大于70的自闭症儿童以及匹配的发育正常的对照组儿童进行扩散张量成像研究。基于体素的方法用于比较每组的分数各向异性(FA)测量值,并将自闭症组的FA测量值与国际疾病分类第10版(ICD - 10)的自闭症诊断访谈修订版(ADI - R)算法所描述的诊断表型相关联。
在控制年龄和白质体积的影响后,我们发现自闭症组双侧前额叶和颞叶区域的FA显著低于对照组,尤其是在与梭状回相邻的右侧颞叶腹侧。自闭症组右侧额下回和左侧枕叶的FA更高。我们观察到从这些组间差异的焦点区域延伸的白质束中,较低的FA与较高的ADI - R诊断算法分数之间存在紧密相关性。沟通和社交互惠障碍与整个额 - 纹状体 - 颞叶通路中较低的FA相关。重复行为与大脑后部通路中的白质指标相关,包括胼胝体压部和小脑。
我们的数据支持自闭症诊断症状与白质发育的核心破坏相关这一观点。