注意缺陷多动障碍患者大脑持续性注意障碍的血流灌注机制

发布时间：2018-04-22 21:05

本文选题：注意力缺陷障碍伴多动 + 磁共振成像　；参考：《中国医学影像学杂志》2017年03期

【摘要】：目的持续性注意障碍是注意缺陷多动障碍(ADHD)患者的常见症状。本研究采用血流灌注成像研究ADHD患者脑局部血流灌注(CBF)异常,揭示患者持续性注意障碍的神经机制。资料与方法收集2013年6月-2015年9月解放军第401医院收治的16例ADHD患儿,20例正常儿童作为对照。采用GE 3.0T MRI仪进行三维动脉自旋标记(3D-ASL)扫描。扫描过程中连续完成4个持续注意反应任务(SART)片段,总计20 min。采用SPM 8软件对两组受试者大脑单个体素的局部CBF值进行逐一对比分析;并分别将局部CBF变化与SART任务反应时间和目标命中率进行相关性分析。结果 SART任务中ADHD患者额叶背外侧与内侧、运动区等大脑前部区域CBF升高趋势被抑制,而扣带回后部、枕顶沟等大脑后部皮层CBF升高趋势被进一步激活(P0.01);双侧背部额中回、中央前后回部位的CBF变化与SART任务反应时间和目标命中率均具有显著相关性(背侧额中回:r=0.745,P0.001;r=0.591,P0.001;r=-0.521,P0.001,中央前后回:r=0.579,P0.001)。结论 ADHD患者执行SART任务中,大脑前部与后部血流分配存在差异,并与行为指标相关,从而反映了其持续性注意障碍的神经机制。
[Abstract]:Objective persistent attention disorder is a common symptom in ADHD patients. The purpose of this study was to investigate the abnormality of cerebral regional blood perfusion (CBF) in patients with ADHD by perfusion imaging, and to reveal the neuromechanism of persistent attention disorder. Materials and methods from June 2013 to September 2015, 20 normal children with ADHD were collected as control group. 3 D-ASL was scanned by GE 3. 0 T MRI. During the scanning, 4 continuous attention response tasks (SARTT) fragments were completed, for a total of 20 mins. SPM 8 software was used to compare and analyze the local CBF value of the single individual element in the brain of the two groups, and the correlation between the local CBF change and the reaction time and the target hit ratio of the SART task was analyzed. Results the increased trend of CBF in the anterolateral and medial frontal lobe and motor area of ADHD patients with SART task was inhibited, while that in posterior cingulate gyrus, occipitoparietal sulcus and occipital-parietal sulcus was further activated (P0.01), and bilateral dorsal middle frontal gyrus was further activated. The changes of CBF in the central gyrus were significantly correlated with the response time and the target hit rate of the SART task. (the middle middle frontal gyrus of the dorsal middle frontal gyrus was 0.745%, P 0.001, P 0.001, P 0.001, P 0.001, P 0. 521, P 0. 001, and the central gyrus was 0. 579%, P 0. 001, P 0. 001), and the central gyrus was 0. 579%, P 0. 001. Conclusion there are differences in blood flow distribution between the anterior and posterior parts of the brain in patients with ADHD who perform SART tasks, and are related to behavioral indicators, thus reflecting the neural mechanism of persistent attention disorder.
【作者单位】：解放军第401医院崂山分院放射科;第三军医大学新桥医院放射科;解放军71901部队航医室;
【分类号】：R749.94;R445.2

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