Wang Longlun, Ding Shuang, Qin Weixuan, Zhang Yun, Qin Bin, Huang Kaiping, Zheng Helin, Cai Jinhua
Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
Quant Imaging Med Surg. 2024 Dec 5;14(12):9347-9360. doi: 10.21037/qims-24-950. Epub 2024 Nov 29.
Little is known about the precise impaired patterns of white matter (WM) fiber tracts in preschool-aged children with autism spectrum disorder (ASD). Thus, we used diffusion tensor imaging (DTI)-based automated fiber quantification (AFQ) to explore the changes in WM fiber tracts in preschool-aged children with ASD and its correlation with the severity of clinical manifestations.
A total of 43 pediatric ASD and 42 age- and sex-matched typical developing children were examined with DTI. AFQ was used to quantify 100 nodes of 16 specific WM fiber tracts. The DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were compared between the two groups. Correlation analysis was performed to evaluate whether abnormal DTI metrics correlated with the Childhood Autism Rating Scale.
Compared with typical developing children, at the entire level, the ASD group exhibited a decreased FA [P=0.04 after false discovery rate (FDR) correction] and an increased MD (P=0.048 after FDR correction), and RD (P=0.024 after FDR correction) in the left inferior longitudinal fasciculus (ILF). A decreased FA (P=0.02 after FDR correction) and an increased RD (P=0.024 after FDR correction) were shown in forceps minor. An increased MD (P=0.016 after FDR correction) and RD (P=0.026 after FDR correction) were shown in the left inferior frontal-occipital fasciculus (IFOF). At the point-wise level, significantly decreased FA, and increased MD and RD were observed in the anterior part of forceps minor, left IFOF, and posterior part of left ILF in the ASD group (all P<0.05 after FDR correction). Furthermore, there was a negative correlation between FA of the posterior part of left ILF and the Childhood Autism Rating Scale within the ASD group (r=-0.475, P<0.001).
Preschool-aged children with ASD displayed a site-specific propensity for WM fiber tract impairment, mainly in the left cerebral hemisphere. The decreased integrity for the posterior part of the left ILF may reflect the severity of autistic symptoms.
关于自闭症谱系障碍(ASD)学龄前儿童白质(WM)纤维束的确切受损模式知之甚少。因此,我们使用基于扩散张量成像(DTI)的自动纤维定量(AFQ)来探索ASD学龄前儿童WM纤维束的变化及其与临床表现严重程度的相关性。
对43例儿科ASD患儿和42例年龄及性别匹配的正常发育儿童进行DTI检查。AFQ用于量化16条特定WM纤维束的100个节点。比较两组之间的DTI指标,包括分数各向异性(FA)、平均扩散率(MD)、径向扩散率(RD)和轴向扩散率(AD)。进行相关性分析以评估异常DTI指标是否与儿童自闭症评定量表相关。
与正常发育儿童相比,在整体水平上,ASD组左侧下纵束(ILF)的FA降低(错误发现率校正后P=0.04),MD升高(错误发现率校正后P=0.048),RD升高(错误发现率校正后P=0.024)。小钳夹处FA降低(错误发现率校正后P=0.02),RD升高(错误发现率校正后P=0.024)。左侧额枕下束(IFOF)的MD升高(错误发现率校正后P=0.016),RD升高(错误发现率校正后P=0.026)。在逐点水平上,ASD组小钳夹前部、左侧IFOF和左侧ILF后部的FA显著降低,MD和RD升高(错误发现率校正后均P<0.05)。此外,ASD组内左侧ILF后部的FA与儿童自闭症评定量表之间存在负相关(r=-0.475,P<0.001)。
ASD学龄前儿童表现出WM纤维束损伤的部位特异性倾向,主要在左侧大脑半球。左侧ILF后部完整性的降低可能反映了自闭症症状的严重程度。