2-3岁广泛性发育障碍儿童脑体积的对照研究

发布时间：2018-03-22 22:29

本文选题：广泛性发育障碍　切入点：脑　出处：《南京医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：【目的】对比分析2~3岁广泛性发育障碍（pervasivedevelopmentaldisorder,PDD）儿童与发育障碍（developmentaldisorder,DD）儿童脑体积的差异，，并对PDD儿童脑体积的异常与临床症状之间的相关性进行研究。【方法】对50例PDD儿童（病例组）和36名年龄、性别、智商与之相匹配的DD儿童（对照组）进行T1加权三维磁共振成像扫描，应用基于体素的形态测量法（voxel-basedmorphometry,VBM）比较两组全脑和脑灰、白质体积的差异，利用《沟通及象征行为量表/发展概况表》（communicationandsymbolicbehaviorscales-developmentalprofile,CSBS-DP）和《孤独症诊断访谈量表》（autismdiagnosticinterview-revised,ADI-R）等临床心理评估工具对病例组的临床症状进行评估,并进一步分析临床症状与其脑灰、白体积异常之间的相关性。【结果】（1）与对照组相比，2~3岁PDD儿童全脑及脑灰、白质体积显著增大（P0.05）；以智商为协变量进行协方差分析时，差异仍然存在；以年龄为协变量进行协方差分析时，PDD儿童的全脑体积较对照组仍存在差异（P0.05），而脑灰、白质体积的差异消失（P0.05）。（2）Pearson相关分析表明：PDD儿童的脑灰、白质及全脑体积与CSBS-DP各分表得分及总分均未显示显著相关（P0.05），脑灰质体积与ADI-R中刻板行为总分显著正相关（P0.05）。（3）应用VBM分析发现，PDD儿童较对照组左侧颞中回及颞上回灰质体积显著增大；右侧中央前回、左侧中央后回灰质体积显著减小；额中回、左侧额上回、左侧颞中回、右侧额中回及右侧颞横回处脑白质体积显著增大（P0.001）。【结论】（1）2~3岁的PDD儿童已出现了脑灰、白质及全脑体积的明显异常，且分布广泛；（2）2~3岁PDD儿童的脑灰质体积增大与其刻板行为症状严重程度正相关。
[Abstract]:[purpose]. The difference of brain volume between 2 and 3 years old children with generalized developmental disorder (PDD) and developmental disorder (DDD) was compared and the correlation between abnormal brain volume and clinical symptoms in children with PDD was studied. [methods]. T1-weighted three-dimensional magnetic resonance imaging was performed in 50 children with PDD (case group) and 36 children with age, sex and intelligence quotient (control group). The whole brain and brain gray of the two groups were compared with voxel-based morphometry-VBM-based morphometry. The difference of white matter volume was evaluated by using communication and symbolic behavior scale / development profile (CSBS-DPN) and autismdiagnostic interview-revised ADI-RRV to evaluate the clinical symptoms of the patients, and to further analyze the clinical symptoms and brain ash. The correlation between abnormal white volume. [results]. (1) compared with the control group, the white matter volume increased significantly in the whole brain and brain ash of PDD children aged 2 to 3 years, and the difference was still present when the intelligence quotient was used as a covariable in the analysis of covariance. The whole brain volume of children with PDD was still different from that of the control group in covariance analysis with age as covariable, while the difference of brain gray volume and white matter volume disappeared (P 0.05). Pearson correlation analysis showed that the brain ash of children with 20% PDD was higher than that of the control group (P < 0.05). There was no significant correlation between the volume of white matter and whole brain and the score and total score of CSBS-DP. There was no significant correlation between the volume of gray matter and the total score of stereotype behavior in ADI-R. (P0.05) VBM analysis showed that the gray of left middle temporal gyrus and superior temporal gyrus was higher in children with PDD than in the control group. The mass volume increased significantly; The volume of gray matter in the right precentral gyrus and left posterior central gyrus decreased significantly, while in the middle frontal gyrus, the left superior frontal gyrus, the left middle temporal gyrus, the right middle frontal gyrus and the right transverse temporal gyrus, the volume of white matter increased significantly (P 0.001). [conclusion]. Brain gray matter, white matter and whole brain volume were significantly abnormal in 3 year old PDD children, and the increase of gray matter volume was positively correlated with the severity of stereotypical behavioral symptoms in 3 year old PDD children.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.94

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