2~6岁孤独症谱系障碍儿童神经发育与脑血流量的研究

Neurodevelopment and cerebral blood flow in children aged 2-6 years with autism spectrum disorder

摘要:

目的 研究孤独症谱系障碍（autism spectrum disorder, ASD）儿童的神经发育特点，分析ASD儿童神经发育指标与脑血流量（cerebral blood flow, CBF）的相关性，探索ASD儿童神经发育的潜在机制。方法 回顾性选择初次诊断为ASD的145例2~6岁儿童为研究对象，收集Gesell发育诊断量表、孤独症儿童行为量表（Autism Behavior Checklist, ABC）得分及CBF结果，比较ASD儿童神经发育的性别差异，并分析CBF与神经发育指标的相关性。结果 ASD男童精细运动和个人-社交发育商低于ASD女童（P<0.05）。ASD儿童粗大运动发育商与左侧额叶CBF（r=-0.200，P=0.016）、右侧额叶CBF（r=-0.279，P=0.001）、左侧顶叶CBF（r=-0.208，P=0.012）及右侧顶叶CBF（r=-0.187，P=0.025）呈负相关。ABC总分与左侧杏仁核CBF呈正相关（r=0.295，P<0.001）。结论 早期干预训练要重视性别及发育结构特点，精准干预；CBF有潜力成为ASD病情评估的生物标志物。

Abstract:

Objective To investigate the neurodevelopmental characteristics of children with autism spectrum disorder (ASD), analyze the correlation between neurodevelopmental indicators and cerebral blood flow (CBF), and explore the potential mechanisms of neurodevelopment in ASD children.Methods A retrospective study was conducted on 145 children aged 2-6 years with newly-diagnosed ASD. Scores from the Gesell Developmental Diagnosis Scale and the Autism Behavior Checklist (ABC) and CBF results were collected to compare gender differences in the development of children with ASD and analyze the correlation between CBF and neurodevelopmental indicators.Results Fine motor and personal-social development quotient in boys with ASD were lower than those in girls with ASD (P<0.05). Gross motor development quotient in ASD children was negatively correlated with CBF in the left frontal lobe (r=-0.200, P=0.016), right frontal lobe (r=-0.279, P=0.001), left parietal lobe (r=-0.208, P=0.012), and right parietal lobe (r=-0.187, P=0.025). The total ABC score was positively correlated with CBF in the left amygdala (r=0.295, P<0.001).Conclusions Early intervention training should pay attention to gender and developmental structural characteristics for precise intervention in ASD children. CBF has the potential to become a biological marker for assessing the severity of ASD.