Zhong Shaogen, Zhang Lichi, Wang Mengxing, Shen Jiayao, 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.
School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Front Psychiatry. 2022 Aug 22;13:966362. doi: 10.3389/fpsyt.2022.966362. eCollection 2022.
Previous neuroimaging studies have shown abnormal brain-bladder control network in children with primary nocturnal enuresis (PNE). The hippocampus, which has long been considered to be an important nerve center for memory and emotion, has also been confirmed to be activating during micturition in several human imaging studies. However, few studies have explored hippocampus-related functional networks of PNE in children. In this study, the whole resting-state functional connectivity (RSFC) of hippocampus was investigated in children with PNE.
Functional magnetic resonance imaging data of 30 children with PNE and 29 matched healthy controls (HCs) were analyzed in our study. We used the seed-based RSFC method to evaluate the functional connectivity of hippocampal subregions defined according to the Human Brainnetome Atlas. Correlation analyses were also processed to investigate their relationship with disease duration time, bed-wetting frequency, and bladder volume.
Compared with HCs, children with PNE showed abnormal RSFC of the left rostral hippocampus (rHipp) with right fusiform gyrus, right Rolandic operculum, left inferior parietal lobule, and right precentral gyrus, respectively. Moreover, decreased RSFC of the left caudal hippocampus (cHipp) with right fusiform gyrus and right supplementary motor area was discovered in the PNE group. There were no significant results in the right rHipp and cHipp seeds after multiple comparison corrections. In addition, disease duration time was negatively correlated with RSFC of the left rHipp with right Rolandic operculum ( = -0.386, = 0.035, uncorrected) and the left cHipp with right fusiform gyrus ( = -0.483, = 0.007, uncorrected) in the PNE group, respectively. In the Receiver Operating Characteristic (ROC) analysis, all the above results of RSFC achieved significant performance.
To our knowledge, this is the first attempt to examine the RSFC patterns of hippocampal subregions in children with PNE. These findings indicated that children with PNE have potential dysfunctions in the limbic network, sensorimotor network, default mode network, and frontoparietal network. These networks may become less efficient with disease duration time, inducing impairments in brain-bladder control, cognition, memory, and emotion. Further prospective research with dynamic observation of brain imaging, bladder function, cognition, memory, and emotion is warranted.
既往神经影像学研究显示，原发性夜间遗尿症（PNE）患儿的脑-膀胱控制网络存在异常。海马体长期以来被认为是记忆和情感的重要神经中枢，多项人体成像研究也证实其在排尿过程中会被激活。然而，很少有研究探讨PNE患儿与海马体相关的功能网络。在本研究中，我们调查了PNE患儿海马体的全静息态功能连接（RSFC）情况。
我们分析了30例PNE患儿和29例匹配的健康对照（HCs）的功能磁共振成像数据。我们使用基于种子点的RSFC方法来评估根据人类脑图谱定义的海马体亚区域的功能连接。还进行了相关性分析，以研究它们与病程、尿床频率和膀胱容量的关系。
与HCs相比，PNE患儿左侧喙海马（rHipp）与右侧梭状回、右侧中央 operculum、左侧顶下小叶和右侧中央前回的RSFC异常。此外，在PNE组中发现左侧尾海马（cHipp）与右侧梭状回和右侧辅助运动区的RSFC降低。经过多重比较校正后，右侧rHipp和cHipp种子点未发现显著结果。此外，在PNE组中，病程分别与左侧rHipp与右侧中央 operculum的RSFC（r = -0.386，p = 0.035，未校正）以及左侧cHipp与右侧梭状回的RSFC（r = -0.483，p = 0.007，未校正）呈负相关。在接受者操作特征（ROC）分析中，上述所有RSFC结果均具有显著性能。
据我们所知，这是首次尝试研究PNE患儿海马体亚区域的RSFC模式。这些发现表明，PNE患儿在边缘网络、感觉运动网络、默认模式网络和额顶网络中存在潜在功能障碍。随着病程延长，这些网络的效率可能会降低，导致脑-膀胱控制、认知、记忆和情感方面的损害。有必要进行进一步的前瞻性研究，动态观察脑成像、膀胱功能、认知、记忆和情感。
