ADHD、自闭症谱系障碍、强迫症儿童与匹配对照组的弥散张量成像研究：不同和非不同的脑白质破坏与多维脑-行为关系。

A Diffusion Tensor Imaging Study in Children With ADHD, Autism Spectrum Disorder, OCD, and Matched Controls: Distinct and Non-Distinct White Matter Disruption and Dimensional Brain-Behavior Relationships.

机构信息

From the Centre for Brain and Mental Health and the Department of Diagnostic Imaging, the Hospital for Sick Children, University of Toronto; the Department of Psychology, University of Toronto; the Department of Psychiatry, the Department of Medical Biophysics, the Department of Pediatrics, and the Department of Medical Imaging, Faculty of Medicine, University of Toronto; the Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, University of Toronto; the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and the Kimel Family Translational Imaging-Genetics Lab, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), University of Toronto; the Division of Child and Adolescent Psychiatry, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.; the Pediatric OCD Consultation Service, Anxiety Treatment and Research Centre, St. Joseph's HealthCare, McMaster University, Hamilton, Ont., Canada; and the Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, the Department of Psychiatry, and the Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada.

出版信息

Am J Psychiatry. 2016 Dec 1;173(12):1213-1222. doi: 10.1176/appi.ajp.2016.15111435. Epub 2016 Jul 1.

DOI:10.1176/appi.ajp.2016.15111435

PMID:27363509

Abstract

OBJECTIVE

Neurodevelopmental disorders (NDDs) (attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and obsessive-compulsive disorder [OCD]) share genetic vulnerability and symptom domains. The authors present direct comparison of structural brain circuitry in children and adolescents with NDDs and control subjects and examine brain circuit-behavior relationships across NDDs using dimensional measures related to each disorder.

METHOD

Diffusion imaging and behavioral measures were acquired in 200 children and adolescents (ADHD: N=31; OCD: N=36; ASD: N=71; controls: N=62; mean age range: 10.3-12.6 years). Following Tract-Based Spatial Statistics, multigroup comparison of white matter indices was conducted, followed by pairwise comparisons. Relationships of fractional anisotropy with dimensional measures of inattention, social deficits, obsessive-compulsive symptoms, and general adaptive functioning were conducted across the NDD sample.

RESULTS

Lower fractional anisotropy within the splenium of the corpus callosum was found in each NDD group, compared with the control group. Lower fractional anisotropy in additional white matter tracts was found in the ASD and ADHD groups, compared with the control group, but not in the OCD group. Fractional anisotropy was lower in the ASD and ADHD groups compared with the OCD group but was not different in ADHD participants compared with ASD participants. A positive relation between fractional anisotropy (across much of the brain) and general adaptive functioning across NDDs was shown.

CONCLUSIONS

This study identified disruption in interhemispheric circuitry (i.e., fractional anisotropy alterations in the corpus callosum) as a shared feature of ASD, ADHD, and OCD. However, fractional anisotropy alterations may be more widespread and severe in ASD and ADHD than in OCD. Higher fractional anisotropy throughout the brain appears to be related to better adaptive function across NDDs.

摘要

目的

神经发育障碍（NDD）（注意缺陷多动障碍[ADHD]、自闭症谱系障碍[ASD]和强迫症[OCD]）具有遗传易感性和症状领域。作者介绍了儿童和青少年 NDD 患者与对照受试者之间的结构性大脑回路的直接比较，并使用与每种疾病相关的维度测量来检查 NDD 之间的大脑回路-行为关系。

方法

在 200 名儿童和青少年（ADHD：N=31；OCD：N=36；ASD：N=71；对照组：N=62；平均年龄范围：10.3-12.6 岁）中获得扩散成像和行为测量。在进行基于束流的空间统计学后，对各向异性指数进行了多组比较，然后进行了两两比较。在 NDD 样本中，对注意力不集中、社交缺陷、强迫症症状和一般适应功能的维度测量进行了各向异性分数与各向异性分数的关系。

结果

与对照组相比，每个 NDD 组的胼胝体压部的各向异性分数较低。与对照组相比，ASD 和 ADHD 组的其他白质束的各向异性分数较低，但 OCD 组的各向异性分数没有差异。与 OCD 组相比，ASD 和 ADHD 组的各向异性分数较低，但 ADHD 组与 ASD 组的各向异性分数没有差异。在 NDD 中，各向异性分数（大脑的大部分区域）与一般适应功能呈正相关。