摘要
目的 分析基于3.0核磁共振成像(Nuclear magnetic resonance imaging,MRI)的注意缺陷多动障碍儿童脑白质网络结构变化与执行功能的关系.方法 将2022年7月2023年7月于本院就诊的80例注意缺陷多动障碍儿童(Attention-deficit/hyperactivity disorder,ADHD)作为研究对象,设为ADHD组;另招募同期健康志愿者60例,设为对照组;比较2组的神经心理学测试量表评分、执行功能特征、脑白质体积、各向异性分数(Fractional anisotropy,FA)和平均扩散率(Mean diffusivity,MD);构建多因素Logistic回归模型分析ADHD儿童执行功能的影响因素并进行验证;分析脑白质体积、FA和MD与患者执行功能的相关性.结果 ADHD组神经心理学测试量表评分、Stroop C、朝向一致目标反应时间等均明显低于对照组(P＜0.05);ADHD组L-海马、R-颞上回、R-楔前叶、R-后扣带回脑白质体积均小于对照组(P＜0.05);R-下纵束、L-扣带回、L-穹隆FA值明显低于对照组;L-额枕下束、R-穹隆MD值明显高于对照组(P＜0.05);脑白质体积、R-下纵束FA、L-扣带回FA、L-穹隆FA、L-额枕下束MD和R-穹隆MD值均为影响患者执行功能的独立危险因素(P＜0.05),建立的Logistic回归分析模型效能良好;脑白质网络结构变化与ADHD儿童执行功能存在一定相关性.结论 ADHD儿童脑白质网络结构变化是影响其执行功能的独立危险因素,与患者执行功能具有显著相关性.
Abstract
Objective To analyze the relationship between structural changes in the brain white matter network and executive functions in children with attention deficit hyperactivity disorder based on 3.0 nuclear magnetic resonance imaging(MRI).Methods Eighty children with attention deficit hyperactivity disorder(ADHD)who visited our hospital from July 2022 to July 2023 were selected as the study subjects and assigned to the ADHD group.Additionally,60 healthy volunteers were recruited during the same period as the control group.Comparison of neuropsychological test scale scores,executive function characteristics,white matter volume,fractional anisotropy(FA),and mean diffusion rate(MD)between the two groups of patients.A multivariate logistic regression model was constructed to analyze and validate the influencing factors of execu-tive function in children with ADHD.The correlations between brain white matter volume and FA and MD and patient executive function were also analyzed.Results Neuropsychological test scale scores,the number breadth forward and word fluency,Stroop C test,directional consensus target RT,dual directional target RT,and executive network efficiency were significantly lower in the ADHD group than in the control group(P＜0.05).The white matter volume in the L-hippocampus,R-superior temporal gyrus,R-anterior cuneiform lobe,and R-posterior cingulate gyrus was lower in the ADHD group than in the control group(P＜0.05).The FA values of the R-lower longitudinal bundle,L-cingulate gyrus,and L-fornix were significantly lower than those of the control group.The MDs of the L-suboccipital bundle and R-fornix were significantly greater than those of the control group(P＜0.05).White matter volume,R-inferior longitudinal bundle FA,L-cingu-late gyrus FA,L-fornix FA,L-suboccipital bundle MD,and R-fornix MD are independent risk factors affect-ing patient executive function(P＜0.05),and the established logistic regression analysis model has good per-formance.Changes in white matter network structure and executive function values are correlated in children with ADHD.Conclusion Structural changes in the brain white matter network of children with ADHD are inde-pendent risk factors affecting executive functions and are significantly correlated with patients'executive functions.
基金项目
河北省医学科学研究课题(2024)(20240752)
NETL
NSTL
万方数据