Department of Psychiatry, Subdivision of Child & Adolescent Psychiatry, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, #26 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-701, Republic of Korea.
Department of Psychiatry, Seonam University, College of Medicine, Myongji Hospital, #55 Hwasu-ro 14Beon-gil, Deokyang-gu, Gyeonggi-do, 10475, Goyang, Republic of Korea.
Brain Imaging Behav. 2018 Apr;12(2):477-487. doi: 10.1007/s11682-017-9716-9.
Several studies have evaluated gray matter abnormalities and white matter integrity in adults with hair pulling disorder (HPD). However, no prior studies have defined the relationship between neuroimaging parameters and clinical measurements in children and adolescents with HPD. The purposes of this study were to determine the correlation between magnetic resonance imaging (MRI) indices and clinical measurements in children and adolescents with HPD, and to compare HPD patients with age- and sex- matched healthy controls (HC). Pediatric HPD patients (n = 9) and HC subjects (n = 10), aged 9-17 years, were recruited. Three-dimensional T1-weighted structural MRI (3D T1W) and diffusion-tensor imaging (DTI) scans were obtained for each subject. Gray matter and white matter volumes were calculated from 3D T1W. Fractional anisotropy (FA) and average diffusion coefficients (D) were mapped from DTI. Voxel-based and region-of-interest correlations between MRI indices and clinical measurements were analyzed. In addition, two-sample t-tests were used to compare voxel-based tissue volumes, FA, and D maps between the two groups. Alterations in both brain tissue volume and white matter integrity were associated with symptom severity, especially in the precuneus, anterior cingulate, temporal cortex, and frontal cortex regions. FA values in HPD patients were significantly higher than those observed in HC subjects, particularly in the cerebellum and cuneus regions. Alterations of brain tissue volumes and microstructural changes are associated with severity of clinical symptoms in children and adolescents with HPD. Fractional anisotropy is the most sensitive method to distinguish pediatric HPD patients from healthy children. The results of this study can facilitate use of MRI indices to follow the transition from pediatric HPD to adult HPD.
几项研究已经评估了患有拔毛障碍（HPD）的成年人的灰质异常和白质完整性。然而，以前没有研究定义 HPD 儿童和青少年的神经影像学参数与临床测量之间的关系。本研究的目的是确定 HPD 儿童和青少年的磁共振成像（MRI）指标与临床测量之间的相关性，并比较 HPD 患者与年龄和性别匹配的健康对照（HC）。招募了 9 名儿科 HPD 患者（n=9）和 10 名 HC 受试者（n=10），年龄为 9-17 岁。对每位受试者进行三维 T1 加权结构 MRI（3D T1W）和弥散张量成像（DTI）扫描。从 3D T1W 计算灰质和白质体积。从 DTI 映射分数各向异性（FA）和平均扩散系数（D）。分析了 MRI 指标与临床测量之间的基于体素和感兴趣区相关性。此外，使用两样本 t 检验比较了两组之间的基于体素组织体积、FA 和 D 图。脑组织体积和白质完整性的改变与症状严重程度相关，尤其是在顶叶扣带回、前扣带回、颞叶和额叶区域。HPD 患者的 FA 值明显高于 HC 受试者，尤其是在小脑和楔前叶区域。脑组织体积和微观结构变化的改变与 HPD 儿童和青少年临床症状的严重程度相关。分数各向异性是区分 HPD 儿童和健康儿童的最敏感方法。本研究的结果可以促进使用 MRI 指标来跟踪从儿科 HPD 到成年 HPD 的转变。
