Zhong Shaogen, Shen Jiayao, Wang Mengxing, Mao Yi, Du Xiaoxia, Ma Jun
Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Nephrology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Neurosci. 2022 Jul 19;16:913489. doi: 10.3389/fnins.2022.913489. eCollection 2022.
Primary nocturnal enuresis (PNE) is a common developmental condition in school-aged children. The objective is to better understand the pathophysiology of PNE by using insula-centered resting-state functional connectivity (rsFC).
We recruited 66 right-handed participants in our analysis, 33 with PNE and 33 healthy control (HC) children without enuresis matched for gender and age. Functional and structural MRI data were obtained from all the children. Seed-based rsFC was used to examine differences in insular functional connectivity between the PNE and HC groups. Correlation analyses were carried out to explore the relationship between abnormal insula-centered functional connectivity and clinical characteristics in the PNE group.
Compared with HC children, the children with PNE demonstrated decreased left and right insular rsFC with the right medial superior frontal gyrus (SFG). In addition, the bilateral dorsal anterior insula (dAI) seeds also indicated the reduced rsFC with right medial SFG. Furthermore, the right posterior insula (PI) seed showed the weaker rsFC with the right medial SFG, while the left PI seed displayed the weaker rsFC with the right SFG. No statistically significant correlations were detected between aberrant insular rsFC and clinical variables (e.g., micturition desire awakening, bed-wetting frequency, and bladder volume) in results without global signal regression (GSR) in the PNE group. However, before and after setting age as a covariate, significant and positive correlations between bladder volume and the rsFC of the left dAI with right medial SFG and the rsFC of the right PI with right medial SFG were found in results with GSR in the PNE group.
To the best of our knowledge, this study explored the rsFC patterns of the insula in children with PNE for the first time. These results uncovered the abnormal rsFC of the insula with the medial prefrontal cortex without and with GSR in the PNE group, suggesting that dysconnectivity of the salience network (SN)-default mode network (DMN) may involve in the underlying pathophysiology of children with PNE. However, the inconsistent associations between bladder volume and dysconnectivity of the SN-DMN in results without and with GSR need further studies.
原发性夜间遗尿症（PNE）是学龄儿童常见的发育性病症。目的是通过使用以脑岛为中心的静息态功能连接（rsFC）来更好地理解PNE的病理生理学。
我们招募了66名右利手参与者进行分析，其中33名患有PNE，33名健康对照（HC）儿童（无遗尿症），两组在性别和年龄上匹配。获取了所有儿童的功能和结构MRI数据。基于种子点的rsFC用于检查PNE组和HC组之间脑岛功能连接的差异。进行相关性分析以探讨PNE组中以脑岛为中心的异常功能连接与临床特征之间的关系。
与HC儿童相比，PNE儿童显示出左、右脑岛与右侧额上回内侧（SFG）的rsFC降低。此外，双侧背侧前脑岛（dAI）种子点也显示与右侧内侧SFG的rsFC降低。此外，右侧后脑岛（PI）种子点显示与右侧内侧SFG的rsFC较弱，而左侧PI种子点显示与右侧SFG的rsFC较弱。在PNE组中，在未进行全脑信号回归（GSR）的结果中，未检测到异常脑岛rsFC与临床变量（如排尿欲望觉醒、尿床频率和膀胱容量）之间存在统计学显著相关性。然而，在将年龄作为协变量前后，在PNE组中进行GSR的结果中，发现膀胱容量与左侧dAI与右侧内侧SFG的rsFC以及右侧PI与右侧内侧SFG的rsFC之间存在显著正相关。
据我们所知，本研究首次探讨了PNE儿童脑岛的rsFC模式。这些结果揭示了PNE组在未进行和进行GSR时脑岛与内侧前额叶皮质的异常rsFC，表明突显网络（SN）-默认模式网络（DMN）的连接障碍可能参与了PNE儿童的潜在病理生理学过程。然而，在未进行和进行GSR的结果中，膀胱容量与SN-DMN连接障碍之间不一致关联需要进一步研究。
