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[自闭症谱系障碍学龄前及学龄儿童的脑结构异常]

[Abnormal brain structure in preschool and school-aged children with autism spectrum disorder].

作者信息

Zhang An-Yi, Jin Xing-Ming, Ma Jun

机构信息

Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2019 Aug;21(8):749-753. doi: 10.7499/j.issn.1008-8830.2019.08.003.

Abstract

OBJECTIVE

To investigate the prevalence and type of abnormal brain structure in preschool and school-aged children with autism spectrum disorder (ASD).

METHODS

A total of 74 252 preschool and school-aged children aged 3-12 years in Shanghai were enrolled as subjects. A questionnaire survey was performed to collect basic information, and their parents and teachers completed the Social Communication Questionnaire (SCQ) based on the children's conditions. ASD was diagnosed by specialist physicians according to the DSM-5 criteria. Brain magnetic resonance imaging (MRI) was performed according to their parents' desires.

RESULTS

The overall prevalence rate of ASD was 2.59‰ (192/74 252) in the preschool and school-aged children. Brain MRI data were collected from 73 children with ASD and 185 healthy children. Among the 73 children with ASD, 40 (55%) had abnormal brain structure, and the most common types were unilateral or bilateral ventriculomegaly in 32 children (80%) and unilateral or bilateral deep frontotemporal sulci in 12 children (30%). Children with ASD showed lower white matter signal in bilateral ventricular and unilateral or bilateral deep frontotemporal sulci, compared to their normal peers (P<0.05).

CONCLUSIONS

There is a high prevalence rate of abnormal brain structure in preschool and school-aged children with ASD, with major types of unilateral or bilateral ventriculomegaly and unilateral or bilateral deep frontotemporal sulci. It is speculated that abnormal brain structure might be associated with the pathogenesis of ASD, and further studies are needed to clarify the association between abnormal brain structure and symptoms in children with ASD.

摘要

目的

探讨自闭症谱系障碍(ASD)学龄前和学龄儿童脑结构异常的患病率及类型。

方法

共纳入上海市74252名3至12岁的学龄前和学龄儿童作为研究对象。进行问卷调查以收集基本信息,其父母和教师根据儿童情况完成社会交往问卷(SCQ)。由专科医生根据DSM-5标准诊断ASD。根据家长意愿进行脑磁共振成像(MRI)检查。

结果

学龄前和学龄儿童中ASD的总体患病率为2.59‰(192/74252)。收集了73例ASD儿童和185例健康儿童的脑MRI数据。在73例ASD儿童中,40例(55%)存在脑结构异常,最常见的类型为32例(80%)单侧或双侧脑室扩大和12例(30%)单侧或双侧额颞叶深部脑沟。与正常同龄人相比,ASD儿童双侧脑室及单侧或双侧额颞叶深部脑沟的白质信号较低(P<0.05)。

结论

ASD学龄前和学龄儿童脑结构异常的患病率较高,主要类型为单侧或双侧脑室扩大和单侧或双侧额颞叶深部脑沟。推测脑结构异常可能与ASD的发病机制有关,需要进一步研究以阐明ASD儿童脑结构异常与症状之间的关联。

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