Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2018, Vol. 14 ›› Issue (02): 133 -140. doi: 10.3877/cma.j.issn.1673-5250.2018.02.002

Special Issue:

Original Article

Research of brain small-world network in children with Tourette syndrome

Yi Liao1, Haibo Qu1,(), Xiaotang Cai2, Gang Ning1, Yuexin Jiang1, Li Bao1, Yujin Zhang1, Xuesheng Li1, Huaiqiang Sun3   

  1. 1. Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China
    2. Department of Pediatrical Neurology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    3. Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2017-11-19 Revised:2018-02-28 Published:2018-04-01
  • Corresponding author: Haibo Qu
  • About author:
    Corresponding author: Qu Haibo, Email:
Objective

To investigate the characteristics of brain small-world network in children with Tourette syndrome (TS) and the relationship between TS regional network features and clinical symptoms by resting state functional MRI (rs-fMRI).

Methods

From September 2015 to August 2017, a total of 25 cases of children who were diagnosed as TS in the West China Second University Hospital of Sichuan University were recruited as the study group. And 22 healthy children for physical examination were selected during the same period in the same hospital as the control group. The rs-fMRI data of subjects in two groups were collected and analyzed by GRETNA software to get brain regions with differences between whole brain and regional network properties. The correlation analysis of these clinical data was carried out. Chi-square test was used to compare the constituent ratio of gender of subjects between two groups. Independent-samples t test was used to compare the age of subjects between two groups. Wilcoxon rank sum test was used to compare the years of education of subjects between two groups. Non-parametric permutation test was used to compare the parameters of whole brain and local network of subjects between two groups. Linear correlation analysis was used to analyze the correlation between the area under curve (AUC) in the brain area with decreased node efficiency (e) and the Yale Comprehensive Symptom Scale (YGTSS) score. This study was approved by the Ethics Committee of Human Beings in West China Second University Hospital of Sichuan University and the guardians of every subject signed informed consent of clinical research.

Results

① There were no significant differences between two groups among the constituent ratio of gender, age, education years and other general clinical data (P>0.05). ② The results of the YGTSS scores of the study group were as follows, the motor tic total score was (13.32±2.94) scores, phonic tic total score was (4.84±5.10) scores, YGTSS total score was (42.16±12.59) scores. ③ The whole brain network of subjects in study group and control group both exhibited small-world network properties. Compared with control group, global efficiency (Eglob) in study group was significantly lower (P=0.014 1), characteristic path length (Lp) and standardized characteristic path length (λ) in study group were both significantly longer (P=0.008 2, 0.035 7), and all the differences between two groups were statistically significant, respectively. The e of left posterior cingulate gyrus (PCC) of study group was significantly lower than that of control group (P<0.000 1), and the e of the right putamen of study group was also significantly lower than that of control group (P=0.000 3), and both the differences between two groups were statistically significant, respectively. The above data of e between two groups were corrected by false positive rate (FDR). ④ In study group, there was a negative correlation between the AUC value of left operculum of gyrus frontalis inferior with decreased e and the YGTSS total score (r=-0.444 3, P=0.026 1), and the AUC value of right temporal pole with decreased e was also negatively correlated with the YGTSS total score (r=-0.462 2, P=0.020 0).

Conclusions

This study reveals that global brain network of children with TS has small-world network properties, but its whole brain and nodal neural network properties are different from healthy children with decreased Eglob, increased Lp and λ, which tends to switch to regular network. The nodal abnormal regions of the neuronal network in children with TS locate in the cerebral cortex-striatum-thalamic-cerebral cortex (CSTC) loop, revealing the characteristics of brain network. It provides whole brain network biomarker to assess the disease status and treatment of children with TS.

表1 2组受试儿一般临床资料比较
图1 抽动秽语综合征患儿全脑节点效率减低的脑区位置示意图
表2 2组受试儿全脑及局部网络属性参数的曲线下面积比较(±s)
图2 研究组25例抽动秽语综合征患儿的全脑节点效率减低脑区节点效率的AUC值与YGTSS总评分相关性分析(图2A:左侧岛盖部额下回e减低区e的AUC值与YGTSS总评分呈负相关关系,r=-0.444 3,P=0.026 1;图2B:右侧颞极e减低区e的AUC值与YGTSS总评分呈负相关关系,r=-0.462 2,P=0.020 0)
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