2～3岁孤独谱系障碍儿童尾状核体积与重复刻板行为关系的研究

发布时间：2018-01-22 17:48

本文关键词： 孤独谱系障碍尾状核体积重复刻板行为半自动勾画法自动分割法　出处：《南京医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：[引言] 孤独谱系障碍(autism spectrum disorder, ASD)是一种起病于儿童早期的神经发育障碍,重复刻板行为(restricted, repetitive behavior, RRB)是其核心症状之一。已有研究发现成年ASD患者的尾状核体积存在异常增大且与RRB的严重程度相关,但幼儿期ASD尾状核体积与RRB之间的关系如何仍需进一步研究。 [目的] 本研究选取2～3岁ASD以及发育迟缓(developmental delay, DD)儿童为研究对象,对比分析两组被试尾状核体积的差异,并进一步探讨体积变化与RRB的特点及严重程度之间的相关性。同时在尾状核体积计算方法学上拟比较半自动勾画与软件自动分割方法的优劣。 [方法] 对66名ASD儿童和36名性别、年龄、智商与之相匹配的DD儿童采用T1-weight加权序列进行头部的三维磁共振成像(magnetic resonance imaging,MRI)扫描,分别使用ITK-SNAP软件半自动勾画法和Freesurfer软件自动分割法,计算两组被试的尾状核体积,并分别比较半自动勾画以及软件自动分割法所得ASD组与DD组的尾状核体积。同时结合修订版孤独症诊断访谈量表(Autism Diagnostic Interview-Revise, ADI-R)中高、低水平RRB分及RRB总分以及重复刻板行为量表-修订版(Repetitivebehaviorscale-revised, RBS-R)各分量表分,进行尾状核体积与RRB特征及严重程度的相关分析。 [结果] (1)两组被试尾状核体积比较：运用半自动勾画法可得,ASD组的尾状核左侧(3504.15±508.68mm3vs3206.60±490.68mm3, P=0.005).右侧(3683.31±483.59mm3vs3313.07±453.24mm3, P=0.001)以及总体积(7187.46±959.00mm3vs6519.67±901.87mm3, P=0.001)较DD组显著增大。在校正了ICV后,ASD组尾状核的左侧(P0.001)、右侧(P=0.001)以及总体积(P0.001)较DD组仍增大,且差异更加显著。Freesurfer软件自动分割计算可见ASD组的尾状核左侧(3423.95±411.67mm3vs3212.97±405.23mm3, P=0.015)、右侧(3543.98±396.30mm3vs3337.50±414.45mm3, P=0.015)以及总体积(6967.939±795.16mm3vs6550.47±792.09mm3, P=0.013)较DD组显著增大；在校正了颅内体积(intracranial volume, ICV)后,ASD组尾状核左侧(P0.001)、右侧(P0.001)以及总体积(P0.001)较DD组仍增大,且差异更加显著。 (2)尾状核体积与RRB严重程度的相关分析：结果显示,在ASD组,半自动勾画法得到的尾状核左侧(r=0.359,P=0.004)、总体积(r=0.317,P=0.013)与ADI-R低水平RRB分呈显著正相关；在校正ICV后,半自动勾画法得到的尾状核左侧(r=0.417,P=0.001)、右侧(r=0.296,P=0.025)总体积(r=0.372,P=0.004)以及软件自动勾画法得到的尾状核左侧(r=0.384,P=0.003)、右侧(r=0.363,P=0.006)及总体积(r=0.385,P=0.003)均与ADI-R低水平RRB分呈显著正相关；而两种方法所得ASD儿童的尾状核左、右侧以及总体积,在ICV校正前后,均未与ADI-R高水平RRB分或RRB总分表现出显著相关。此外,自动分割法所得左侧以及尾状核总体积与RBS-R中限制性行为呈显著性正相关。 (3)两种计算方法的一致性检验：两种方法的组内相关系数(intraclass correlations, ICC)为尾状核左侧(a=0.746)、右侧(α=0.706)、总体积(a=0.797夕,一致性较好。 [结论] 2-3岁的ASD儿童已表现出尾状核体积的异常增大,且与低水平的RRB相关。本文的发现强调了尾状核在ASD的RRB发病机制中的作用。此外,在2-3岁儿童脑结构分析中,半自动勾画法与软件自动分割法均能够敏感的探测尾状核的体积,并且二者结果相近。
[Abstract]:[introduction]
Autism spectrum disorder (autism spectrum, disorder, ASD) is a kind of disease in early childhood neurodevelopmental disorders, repetitive behaviors (restricted, repetitive, behavior, RRB) is one of the core symptoms. It has been found that there was increased and the severity of abnormalities associated with RRB adult patients with ASD caudate nucleus volume, but the relationship between children ASD caudate nucleus volume and RRB to still need further study.
[Objective]
This study selected 2 ~ 3 years old and ASD retardation (developmental delay, DD) of children as the research object, comparative analysis of two groups of subjects were different volume of the caudate nucleus, and to further explore the correlation between the volume with the change of RRB and the severity of the volume of the caudate nucleus. At the same time computing methodology to compare the semi automatic drawing with the software automatic segmentation methods.
[method]
The age of 66 ASD children and 36 gender, three-dimensional magnetic resonance imaging IQ matched DD children using T1-weight weighted sequence head (magnetic resonance imaging, MRI) scanning, respectively using ITK-SNAP software automatic segmentation method for semi automatic drawing method and Freesurfer software, calculated two groups'responses caudate nucleus volume that compares semi automatic drawing software and automatic segmentation method of the ASD group and the DD group of the caudate nucleus volume. At the same time combined with the revised version of the Autism Diagnostic Interview scale (Autism Diagnostic Interview-Revise, ADI-R) in the high and low levels of RRB and RRB and repeat stereotyped behavior scale revised (Repetitivebehaviorscale-revised, RBS-R) respectively subscale scores, correlation analysis of caudate nucleus volume and RRB features and severity.
[results]
(1) the volume comparison of the caudate nucleus in the two groups: the caudate nucleus of group ASD was obtained by using the semi automatic drawing method.
The left (3504.15 + 508.68mm3vs3206.60 + 490.68mm3, P=0.005). The right side of (3683.31 + 483.59mm3vs3313.07 + 453.24mm3, P=0.001) and the total volume (7187.46 + 959.00mm3vs6519.67 + 901.87mm3, P=0.001) than in DD group increased significantly. After adjustment for ICV, the group ASD left caudate nucleus (P0.001), right (P=0.001) and the total volume (P0.001) than the DD group still increased, and the difference was more significant in.Freesurfer software for automatic segmentation calculation in the ASD group of the caudate nucleus on the left (3423.95 + 411.67mm3vs3212.97 + 405.23mm3, P=0.015), right (3543.98 + 396.30mm3vs3337.50 + 414.45mm3, P=0.015) and the total volume (6967.939 + 795.16mm3vs6550.47 + 792.09mm3, P=0.013) than in DD group increased significantly after adjustment; intracranial volume (intracranial volume, ICV), ASD group (P0.001), left caudate nucleus (P0.001) on the right side and the total volume (P0.001) than the DD group still increased, and the difference is more significant.
(2) the correlation analysis of caudate nucleus volume and RRB severity: the results showed that in the ASD group, semi automatic drawing method of the left caudate nucleus (r=0.359, P=0.004), the total volume (r=0.317, P=0.013) were positively correlated with low levels of ADI-R RRB; after adjusting for ICV, semi automatic drawing hook the left caudate nucleus (r=0.417, P=0.001), right (r=0.296, P=0.025) the total volume (r=0.372, P=0.004) and software automatic drawing method the left caudate nucleus (r=0.384, P=0.003), right (r=0.363, P=0.006) and total volume (r=0.385, P =0.003) and ADI-R RRB were significantly low positive correlation; and the two method of the ASD children left the right caudate nucleus, and the total volume, in ICV before and after correction, were not with high levels of ADI-R RRB or RRB scores showed a significant correlation. In addition, the automatic segmentation method and the limiting behavior left caudate nucleus with the total volume of RBS-R was significantly positive Relevant.
(3) consistency check of the two calculation methods: the intraclass correlations (ICC) of the two methods is the left side (a=0.746), the right side (=0.706) and the total volume (a=0.797 a=0.797) of the caudate nucleus.
[Conclusion]
2-3 year old ASD children have shown abnormal increase of volume of the caudate nucleus, and with a low level of RRB. This finding emphasizes the role of the caudate nucleus in the pathogenesis of RRB in ASD. In addition, in the analysis of children aged 2-3 in brain structure, automatic segmentation method for semi automatic drawing method and software are sensitive enough the detection of the volume of the caudate nucleus, and the two results are similar.

【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：B848.4

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