Perivascular Space Burden in Children With Autism Spectrum Disorder Correlates With Neurodevelopmental Severity.

IF 3.5 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Giulia Frigerio, Gloria Rizzato, Denis Peruzzo, Tommaso Ciceri, Elisa Mani, Fabiola Lanteri, Valentina Mariani, Massimo Molteni, Nivedita Agarwal
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引用次数: 0

Abstract

Background: Cerebral perivascular spaces (PVS) are involved in cerebrospinal fluid (CSF) circulation and clearance of metabolic waste in adult humans. A high number of PVS has been reported in autism spectrum disorder (ASD) but its relationship with CSF and disease severity is unclear.

Purpose: To quantify PVS in children with ASD through MRI.

Study type: Retrospective.

Population: Sixty six children with ASD (mean age: 4.7 ± 1.5 years; males/females: 59/7).

Field strength/sequence: 3T, 3D T1-weighted GRE and 3D T2-weighted turbo spin echo sequences.

Assessment: PVS were segmented using a weakly supervised PVS algorithm. PVS count, white matter-perivascular spaces (WM-PVStot) and normalized volume (WM-PVSvoln) were analyzed in the entire white matter. Six regions: frontal, parietal, limbic, occipital, temporal, and deep WM (WM-PVSsr). WM, GM, CSF, and extra-axial CSF (eaCSF) volumes were also calculated. Autism Diagnostic Observation Schedule, Wechsler Intelligence Scale, and Griffiths Mental Developmental scales were used to assess clinical severity and developmental quotient (DQ).

Statistical tests: Kendall correlation analysis (continuous variables) and Friedman (categorical variables) tests were used to compare medians of PVS variables across different WM regions. Post hoc pairwise comparisons with Wilcoxon tests were used to evaluate distributions of PVS in WM regions. Generalized linear models were employed to assess DQ, clinical severity, age, and eaCSF volume in relation to PVS variables. A p-value < 0.05 indicated statistical significance.

Results: Severe DQ (β = 0.0089), mild form of autism (β = -0.0174), and larger eaCSF (β = 0.0082) volume was significantly associated with greater WM-PVStot count. WM-PVSvoln was predominantly affected by normalized eaCSF volume (eaCSFvoln) (β = 0.0242; adjusted for WM volumes). The percentage of WM-PVSsr was higher in the frontal areas (32%) and was lowest in the temporal regions (11%).

Data conclusion: PVS count and volume in ASD are associated with eaCSFvoln. PVS count is related to clinical severity and DQ. PVS count was higher in frontal regions and lower in temporal regions.

Evidence level: 4.

Technical efficacy: Stage 3.

自闭症谱系障碍儿童的血管周围空间负担与神经发育严重程度相关
背景:成人脑血管周围间隙(PVS)参与脑脊液(CSF)循环和代谢废物的清除。在自闭症谱系障碍(ASD)中大量报道了PVS,但其与CSF和疾病严重程度的关系尚不清楚。目的:通过MRI量化ASD患儿的PVS。研究类型:回顾性。人群:自闭症儿童66例(平均年龄4.7±1.5岁;男性/女性:59/7)。场强/序列:3T、3D t1加权GRE和3D t2加权涡轮自旋回波序列。评估:使用弱监督PVS算法对PVS进行分割。分析整个白质的PVS计数、白质-血管周围间隙(WM-PVStot)和归一化体积(WM-PVSvoln)。六个区域:额、顶叶、边缘、枕、颞和深部脑(WM- pvssr)。同时计算WM、GM、CSF和轴外CSF (eaCSF)体积。采用自闭症诊断观察量表、Wechsler智力量表和Griffiths心理发展量表评估临床严重程度和发展商(DQ)。统计检验:使用Kendall相关分析(连续变量)和Friedman(分类变量)检验比较不同WM地区PVS变量的中位数。采用事后两两比较和Wilcoxon检验来评价PVS在WM地区的分布。采用广义线性模型评估DQ、临床严重程度、年龄和eaCSF体积与PVS变量的关系。p值结果:重度DQ (β = 0.0089)、轻度自闭症(β = -0.0174)和较大eaCSF (β = 0.0082)体积与WM-PVStot计数显著相关。WM-PVSvoln主要受归一化eaCSF体积(eacsvoln)的影响(β = 0.0242;根据WM音量进行调整)。WM-PVSsr的比例在额叶区最高(32%),在颞叶区最低(11%)。数据结论:ASD患者PVS计数和体积与eaCSFvoln相关。PVS计数与临床严重程度和DQ相关。PVS计数在额叶区较高,在颞叶区较低。证据等级:4。技术功效:第3阶段。
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来源期刊
CiteScore
9.70
自引率
6.80%
发文量
494
审稿时长
2 months
期刊介绍: The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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