1.Application research of resting state functional magnetic resonance imaging in newborn brain damage
Hongxin LI ; Wenjuan TU ; Min GAO ; Kaihua JIANG ; Xuan DONG
Chinese Journal of Applied Clinical Pediatrics 2014;29(5):386-389
Newborn brain damage is the main cause of new-borns' death and disabilities.Current research difficulties lie in analyzing characteristics of cerebral injuries,making objective prognosis and early intervention,as well as analysis of therapeutic effects after recovery.Since subjects are not requested to complete complex tasks while doing resting state functional MRI (rs-fMRI) tests,rs-fMRI is reckoned to be suitable for neonatal brain function research.So far,most rs-fMRI reports regarding cerebral injury are for adults,with only a few have been done on neonates.Foreign research are mainly focused on new borns' brain development.If relevant rs-fMRI research can be done on newborn brain damage,it would be helpful to accurately evaluate structure and function of patients' brain tissue damage.Further research can provide more valuable information in clinics.
2.A semantic processing development study in 7-11 years old children with attention deficit hyperactivity disorder and normal children:an ERP study of N400
Fangqiao ZHAO ; Xuan DONG ; Huijuan SHEN ; Lin CHEN ; Kaihua JIANG ; Yu DONG
Chinese Journal of Behavioral Medicine and Brain Science 2016;25(3):235-239
Objective To explore the developmental characteristics of semantic processing of chil-dren with attention deficit hyperactivity disorder( ADHD) by comparing the event related potential in normal children and ADHD children ( ages 7-11 years old) .Methods 83 ADHD children and 93 normal children ranging from 7 to 11-year were divided into 5 groups to analyze the difference of the amplitude and latency of ERP N400 in three conditions:the related,unrelated and pesudoword after the Chinese character word visual stimulus task.Results (1) The related condition:the amplitude of the 7 years old normal children group was higher than 11 years old((-10.67±4.39)μV,(-4.62±3.55)μV;P=0.005);and the amplitude was highest in 8 years old group in children with ADHD( (-10.77±6.66) ms, F=2.54, P=0.046) .The latency in normal children was shorter at 8 years old((311.7±33.1) ms, P<0.05),but was shorter at 9 years old in ADHD group.( 2) The unrelated condition:the amplitude of normal children aged 10 years was higher than that of other age groups.( 3) The pesudoword condition:the amplitude of 9 years old normal children was higher than other age groups.The amplitude of ADHD in children aged 9 years was higher than that in other age groups( (-16.08±7.14)μV, P<0.05) .Conclusion In the semantic related conditions,the amplitude of the N400 in ADHD children at the age of 8 and the latency at the age of 9 are significantly developed,and in the false words conditions,it is at the age of 11.This suggests that the ability of 7-11 years old ADHD chil-dren's orthographic semantic processing and cognitive development are slower than normal.N400 can better reflect the children's early language cognitive ability,and it is valuable for the early diagnosis of children with ADHD.
3.Attention impairment in children with primary nocturnal enuresis:an event-related potentials study
Li DING ; Jie ZHU ; Huijuan SHEN ; Xiaoyan GU ; Kaihua JIANG ; Xuefeng LIN ; Xuan DONG
Chinese Journal of Behavioral Medicine and Brain Science 2017;26(5):435-439
ObjectiveTo explore the neural mechanism of attention impairment in children with primary nocturnal enuresis.MethodsERPs elicited by performing the continuous operation test(CPT) were assessed in 20 children with primary nocturnal enuresis and 20 normal children.The Go/Nogo measurements of enuretic group at central scalp(Cz) were compared with the normal children and analyzed.Results1.Behavior results: there was no significant difference in the reaction time,the correct number and the false number between primary nocturnal enuresis and control group(P>0.05).2.ERP:(1)Go stimulate:the latency of Go-N2 and P3 of the children with primary nocturnal enuresis were longer than the normal control group(Go-N2:(326.80±46.40)ms vs (295.90±38.27)ms,P3:(438.80±62.60)ms vs (402.60±39.74)ms),and the difference had statistic significance(P<0.05).(2)Nogo stimulate:①Amplitude: the amplitude of Nogo-N2 of the children with primary nocturnal enuresis were lower than that of the normal control group((-10.55±3.30)μV vs (-14.12±5.99)μV),and the difference had statistic significance(P<0.05).There was no significant difference in the amplitude of Nogo-P2 and Nogo-P3(P>0.05).②Latency: the latency of Nogo-P2 of the children with primary nocturnal enuresis was longer than that of the normal control group((214.10±27.85)ms vs (198.30±19.16)ms),and the difference had statistic significance(P<0.05).There was no significant difference in the latency of Nogo-N2 and Nogo-P3(P>0.05).ConclusionAttention impairment in children with primary nocturnal enuresis might be caused by the information processing speed and conflict monitoring function obstacle,but it is not because the reactive inhibition dysfunction,thus result in the lack of arousal function and bedwetting.
4.Chinese character semantic and behavioral problems in 7-8 years old children with attention deficit hyperactivity disorder:an ERP study
Lu LU ; Wenjuan TU ; Fangqiao ZHAO ; Huijuan SHEN ; Kaihua JIANG ; Xujiao PU ; Xuan DONG
Chinese Journal of Behavioral Medicine and Brain Science 2016;25(11):997-1001
Objective To explore Chinese character semantic processing feature and the relationship with behavioral problems in early childhood with ADHD.Methods Twenty ADHD children and twenty normal children (7-8 years old) performed a Chinese character semantic judgment task through event related potential (ERP),meanwhile Conners parent rating scale (PSQ) was completed by parents to analyze behavior problems in children.The relationship between behavioral problems and ERPs was analyzed.Results (1) ADHD group showed smaller amplitudes of P200 compared to the normal group (related (6.6±4.8) μV vs (11.6±6.4) μV;unrelated (6.7±3.7) μN vs (10.8±5.0) μV),and longer latency (related(240±30) ms vs (198±17)ms;the unrelated (232±26)ms vs (194±16)ms;psudoword (233±26)ms vs (197±15)ms),all P<0.05).The amplitudes of N400 wave only showed a decreasing trend in ADHD group(P>0.05),while the latency of N400 was significantly longer than that in normal children in three conditions(P<0.05).(2) Four subscale scores of CPSQ(conduct problem,learning problem,hyperactivity-impulsion and hyperactivity index) were significantly higher in ADHD children compared with normal group.(3)The amplitudes of P200 in related condition had negative correlation with the scores of CPSQ subscale (conduct problem,psychoso matic disorder,hyperactivity-impulsion and hyperactivity index) (r=-0.51,-0.47,-0.45,-0.46,all P<0.05.The latency of P200 in related condition had positive correlation with psychosomatic disorder scores (r =0.54,P=0.01).Conclusion Early semantic recognition disorder exists in 7~ 8 years old ADHD children.P200 can be used as an objective index to evaluate early childhood ADHD's language cognition,and P200 is related to behavior problems (such as conduct problem,impulsions).
5.Application of magnetic resonance diffusion tensor imaging technology in neonates with hypoxic-ischemic encephalopathy in the subacute stage
Hongxin LI ; Qian WANG ; Wenjuan TU ; Min GAO ; Kaihua JIANG ; Yajuan LU ; Xuan DONG
Chinese Journal of Applied Clinical Pediatrics 2015;30(24):1868-1872
Objective To discuss the value of magnetic resonance (MR) diffusion tensor imaging (DTI) technology in the diagnosis of the apparent diffusion coefficient (ADC) and the fraction anisotropy (FA) of neonates with hypoxic-ischemic encephalopathy (HIE) in the subacute stage.Methods Ten cases of normal full-term neonates and 34 term neonates diagnosed with HIE in the subacute stage were investigated with conventional MR and DTI.Of the 34 cases, 15 cases were mild HIE, 12 cases were moderate HIE,7 cases were severe HIE.ADC/FA values in different parts of the brain were analyzed.And the receiver operating characteristic (ROC) curve was used,the sensitivity and specificity of the FA in specific parts were also analyzed.Results (1) On convention MRI : according to the MRl scoring system,score of mild group was(2.6 ±-1.7) points, moderate group was (3.0 ± 1.5) points, severe group was (5.8 ± 1.3) points.There was significant difference between mild group and severe group, moderate and severe group (P < 0.05).(2) The ADC and FA values in each group on DTI : ADC values in all of the regions of interest (ROIs) had no statistic difference between the HIE group and the controls(all P > 0.05).FA values in posterior limb of internal capsule (PLIC) ,splenium had statistic difference between the HIE group and the controls.FA values in mild group were (0.317-0.018,0.339 ±0.025) ,moderate group (0.295 ±0.025,0.324 ±0.026) and severe group (0.252 ±0.039,0.253-0.036) and control group (0.455 ± 0.047,0.372 ± 0.032).(3) ROC analysis of the neonates diagnosed with HIE:the area under the ROC curve of FA values in PLIC, Splenium had statistic difference between mild group and moderate group (P < 0.05).The area under the ROC curve in each group was 0.744 (P =0.032) ,0.658 (P =0.164).ROC curve was used to evaluate the diagnostic accuracy of FA values in PLIC between HIE group and control group,when FA value was lower than 0.337,0.803 was the largest area under the ROC curve, and there was significant difference between them(P < 0.01).Conclusions FA values can reflect the brain white matter WM injury of HIE neonates quantitatively,and its diagnostic veracity is better than ADC value and conventional MR during the subacute phase of HIE.The diagnostic veracity of FA values in PLIC is higher than other parts.When the FA value is lower than 0.337, there is good sensitivity and specificity in diagnosis of HIE, so DTI technology can provide accurate and objective basis for clinical treatment with good sensitivity and specificity about the diagnosis of HIE in early stage.
6.Comparative ERP and behavior study of ADHD and normal children in mental arithmetic practice
Huijuan SHEN ; Xuan DONG ; Yuejia LUO ; Ting WU ; Yang YI ; Kaihua JIANG ; Lin CHEN
Chinese Journal of Behavioral Medicine and Brain Science 2014;23(7):619-621
Objective To compare the differences of event-related potentials (ERP) of left and right cerebral hemispheres and behavioral characteristics in the mental arithmetic practice between ADHD and normal children,and to explore the neural mechanisms of mental arithmetic by ADHD children.Methods ERP and behavioral data of 32 ADHD and 32 normal children in mental arithmetic,to illustrate,simple addition,subtraction and multiplication within 20 were recorded.Results ERP:① The differences of N2 amplitudes in ADHD children 's left and right cerebral hemispheres while doing mental arithmetic,such as,addition,subtraction and multiplication were not statistically significant (addition:(-6.2±7.3) μV,(-6.6± 8.1) pV ; subtraction:(-5.5±6.4) μV,(-5.8± 6.5) μV ; multiplication:(-5.9± 8.2) μV,(-6.0± 8.6) μV ; all P>0.05).However,normal group's N2 amplitude of left hemisphere(F3) were obviously higher than those of the right hemisphere (F4),considered to be statistically significant difference (addition:(-6.8±4.0) μV,(-5.9±4.3) μV ; subtraction:(-7.5±4.8) μV,(-6.3±4.4) μV ;multiplication:(-6.9±3.7)μV,(-5.7±4.4)pV ; all P<0.05).② ADHD group's N2 amplitude of subtraction practice was significantly lower than that of addition and multiplication,while normal control group was the opposite.③There were not statistically difference between N2 incubation of left and right hemisphere while addition,subtraction,and multiplication were done (P>0.05).Behaviorism:① ADHD group's reaction time towards answer making were much longer than those of the normal control group (addition:(983± 183) ms,(833± 164) ms ; subtraction:(1005±160)ms,(859±170)ms;multiphcation:(975±180)ms,(836±175)ms; P<0.05).② Accurate rate:ADHD group were all lower than those of normal group.Conclusion There were functional limitations of no obviously advantage hemisphere and two hemisphere coordination while ADHD children were performing mental arithmetic,also hmitations in conflicting information processing,decision making,and more obviously in subtraction practice.
7.Comparative study on the developmental characteristics of mathematical cognitive between ADHD and nor-mal children
Huijuan SHEN ; Lin CHEN ; Fangqiao ZHAO ; Kaihua JIANG ; Yu DONG ; Ting WU ; Li DING ; Yang YI ; Xu-an DONG
Chinese Journal of Behavioral Medicine and Brain Science 2016;25(8):703-708
Objective To compare the differences of the development of mathematical cognitive characteristics between ADHD children and normal children aged from 7 to 12 years old with event?related potentials ( ERP ) in the mathematical tasks, and to explore the neural mechanisms and characteristics. Methods ERP and behavioral data of 72 ADHD children and 88 normal children in three groups( 7?8 years old,9?10 years old,11?12 years old) were recorded,and analyzed N1,P2 and N2 components'amplitude and latency of Fz by judging the answers to simple calculation within 20. Results ( 1) Vertical comparative a?nalysis( the three age groups were compared):the differences of N1,P2 and N2 amplitudes in normal groups were considered to be statistically significant (right answer:N1(-3.8±2.1)μV,(-4.3±3.4)μV,(-2.2± 2.4)μV;P2(10.6±4.3)μV,(12.6±5.1)μV,(8.5±2.4)μV;N2(-6.5±3.1)μV,(-10.2±4.2)μV,(-6.8± 3.4)μV;error answer:N1(-2.8±2.7)μV,(-4.5±3.0)μV,(-2.9±2.5)μV;P2(9.3±5.9)μV,(12.1±5.0)μV,(8.2±3.6)μV;N2(-7.4±3.7)μV,(-11.4±5.5)μV,(-7.7±3.7)μV;all P<0.05),while was not sig?nificant in ADHD group(all P>0.05). (2)Horizontal comparative analysis(ADHD group and normal group were compared):N1 amplitude of ADHD group aged from 7 to 8 years old was higher than normal group’ s while judging the right answer((-5.3±2.4)μV,(-3.8±2.1)μV, P<0.05).P2 and N2 components’ ampli?tude of ADHD group aged from 9 to 10 years old were lower than of that normal group.(right answer:P2(9.6 ±4.4)μV,(12.6±5.1)μV;N2(-8.0±4.3)μV,(-10.2±4.2)μV;error answer:P2(9.6±4.4)μV,(12.1± 5.0)μV;N2(-7.9±4.6)μV,(-11.4±5.5)μV;all P<0.05).(3)Comparison of different tasks(the judge?ment of right and wrong answer):There was no statistically significant difference between ADHD and normal group in amplitude( P>0.05) . The latent period of the wrong answers was longer than that of the right ones among normal groups aged from 11?12 while the difference of ADHD group had no statistical significance ((312.9±42.3)ms,(292.2±21.2)ms, P<0.05). Conclusion The development trend of mathematical ERP component in ADHD children is different from normal ones,and it is closely related to the maldevelopment of frontal lobe.The characteristics of cognitive deficit differ from ages.ADHD children in low and intermediate level were damaged primarily with inhibition function,while the senior were damaged mainly in collision de?tection function.
8.Associations between semantic priming and problem behavior in boy with attention deficit hyperactivity disorder
Fangqiao ZHAO ; Yang YI ; Xuan DONG ; Huijuan SHEN ; Kaihua JIANG
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(5):411-415
Objective To investigate the semantic priming of boy with attention deficit hyperactivity disorder( ADHD) and explore whether the semantic priming deficits was associated with behavioral problems by event-related potential(ERP). Methods Thirty boy with and without ADHD aged from 7 to 13 years were asked to finish the semantic Semantic judgment task. The study took advantage of t-test ( independent-samples) to compare the amplitude and latency of the N400 in both groups,as well as behavioral data.Behav-ioral problems were assessed by the Achenbach child behavior checklist( CBCL) ,and Pearson correlation a-nalysis were used to explore the relationship between behavioral problems and semantic priming. Result-s Under the condition of semantic correlation,the hyperactive factor of CBCL in ADHA group was positively correlated with ERP N400 amplitude ( r=0.44,P<0.05) and negatively correlated with reaction accuracy ( r=-0.48,P<0.05).Under the semantic irrelevant condition,the latency of ERP N400 in ADHA group was pos-itively correlated with hyperactivity factor (r=0.53,P<0.05)and aggression factor of CBCL(r=0.62,P<0.05).The N400 amplitude of the ADHD group was significant higher than that in the control group under se-mantic related conditions((-11.36±4.77)μV vs (-7.66±5.24)μV,P=0.006),and the latency of the N400 in ADHD was more delay((369.6±44.09)ms vs (341.27±24.54)ms,P=0.004),and the reaction times (RT) was much longer((936.18±135.03)ms vs (857.78±103.45)ms,P=0.014).The latency of the N400 in ADHD was more delay than that in the control group under semantic irrelevant conditions ( ( 383. 93 ±29.66)ms vs (362.33±29.66)ms,P=0.012),and accuracies of ADHD group was lower than that of control group(0.43±0.39 vs 0.81±0.23,P<0.01).Conclusion The present result indicates that children with ADHD exhibit a deficit in the semantic priming mechanism,and the deficit is positively correlated with hy-peractivity and impulsiveness.
9.Role of magnetic resonance diffusion tensor imaging on prognostic evaluation of term neonates with asphyxia
Hongxin LI ; Qinfen ZHANG ; Kaihua JIANG ; Qian WANG ; Min YU ; Xuan DONG ; Wenjuan TU
Chinese Journal of Applied Clinical Pediatrics 2017;32(18):1406-1411
Objective To discuss the prognostic evaluation of magnetic resonance diffusion tensor imaging (DTI) in term neonates with mild and severe asphyxia.Methods Eleven neonates with mild asphyxia,14 neonates with severe asphyxia and 10 control neonates were studied.All the neonates were examined by conventional magnetic resonance imaging(MRI) and DTI.Fraction anisotropy (FA) values,apparent diffusion coefficient (ADC) values,voxel numbers and fiber numbers were calculated in seven regions of interest(ROI) and compared among the 3 groups.The correlation between FA values and neonatal behavioral neurological assessment (NBNA) scores were analyzed.Results (1) FA values in the left and the right thalamus were 0.54 ± 0.08 and 0.56 ± 0.15 in control group,0.45 ±0.03 and 0.44 ± 0.10 in mild group,and 0.21 ± 0.11 and 0.25 ± 0.13,respectively in severe group.FA values in posterior limbs of internal capsule were 0.49 ± 0.09 and 0.48 ± 0.08 in control group,0.37 ± 0.08 and 0.38 ± 0.03 in mild group,and 0.20 ± 0.04,0.19 ± 0.13 in severe group;FA values in thalamus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =9.12,9.11,8.18,8.55,all P < 0.05).Voxel numbers in the left and the right superior longitudinal fasciculus were 1 094 ± 112 and 1 123 ± 113 in control group,986 ± 111 and 1 009 ± 144 in mild group,450 ± 116 and 671 ± 126 in severe group.Voxel numbers in anterior limbs of internal capsule were 947 ± 104 and 1 237 ± 184 in control group,854 ± 118 and 799 ± 114 in mild group,324 ± 110 and 311 ± 126 in severe group.Voxel numbers in posterior limbs of internal capsule were 2 047 ± 129 and 2 137 ± 238 in control group,1 843 ± 233 and 1 753 ± 247 in mild group,867 ± 118 and 999 ± 167 in severe group.Voxel numbers in superior longitudinal fasciculus,anterior and posterior limbs of internal capsule had statistical differences among the 3 groups (F =10.11,9.45,7.33,8.45,12.65,11.23,all P < 0.05);Fiber numbers in the left and the right cingulate gyrus were 245 ±72 and 405 ±94 in control group,225 ±52 and 365 ± 114 in mild group,145 ±62 and 185 ±84 in severe group.Fiber numbers in inferior front-occipital fasciculus were 56 ± 19 and 212 ± 33 in control group,49 ±22 and 197 ± 33 in mild group,33 ± 12 and 156 ± 39 in severe group.Fiber numbers in posterior limbs of internal capsule were 284 ± 112 and 988 ± 233 in control group,234 ± 67 and 678 ± 234 in mild group,114 ± 67 and 188 ± 84 in severe group.Fiber numbers in cingulate gyrus,inferior front-occipital fasciculus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =3.11,3.45,9.88,9.12,7.45,8.88,all P < 0.05).(2) The correlation between FA value and NBNA scores was analyzed:the correlation coefficient in posterior limbs of internal capsule was 0.666 which was higher than those of the other areas.The area under the ROC curve of FA values in anterior limbs of internal capsule was 0.816 (P =0.005),used NBNA scores ≥ 35 as a good outcome.FA values (≥ 0.375) in the posterior limbs of the internal capsules predicted a good outcome and the corresponding sensitivity and specificity was 73.1% and 77.8%,respectively.Conclusion In some ROIs,FA values,voxel numbers,and fiber numbers can quantitatively reflect the degree of white matter injury in neonates with asphyxia.Furthermore,the FA values in the posterior limbs of the internal capsules are closely correlated with NBNA scores,so it has more important clinical significance,and can accurately and objectively assess the prognosis in neonates with asphyxia.
10.Characteristics of functional connectivity based on cerebellum at resting state on children with attention deficit hyperactivity disorder
Kaihua JIANG ; Xuan DONG ; Jinjin ZHOU ; Zhili DING ; Zhen FANG ; Aibin ZHENG
Chinese Journal of Applied Clinical Pediatrics 2018;33(24):1855-1858
Objective To explore the characteristics of functional connectivity based on cerebellum at resting state and the brain functions related to cognitive function on attention deficit hyperactivity disorder (ADHD).Methods Thirty ADHD children (ADHD group) were diagnosed at ADHD Specialist Clinic of Changzhou Children's Hospital,Nantong University from June 2015 to July 2017,and 33 healthy children (healthy control group) were selected from a normal school in Changzhou.Then,they received the functional and structural magnetic resonance imaging (MRI)scans.Finally,the differences of the characteristics of functional connectivity were compared between the 2 groups based on cerebellum which had been found with dysfunction on the previous study of amplitude of low-frequency fluctuation.Results It all showed positive activated brain regions when comparing ADHD group and healthy control group based on left cerebellum (-49.5,-58.5,-18.5) as ADHD children's functional connectivity scores were higher in left middle frontal gyrus [volume =835 mm3,coordinate (-27,-21,51)],right middle frontal gyrus [volume =755 mm3,coordinate(45,-3,6)],right superior temporal gyrus [volume =256 mm3,coordinate (45,-24,-6)],left limbic lobe[volume =513 mm3,coordinate (-15,-3,-18)],and there were statistically significant differences between the 2 groups (t =4.10,4.38,3.97,3.32,all P < 0.05).Conclusions There exist abnormal functional connectivity between cerebellum and left middle frontal gyrus,right middle frontal gyrus,right superior temporal gyrus and left limbic lobe.It may be one of the brain mechanisms of the main clinical manifestations of the decreasing of attention,hyperactivity and impulsiveness and the dysfunction of cognitive function.