Neural signature of developmental coordination disorder in the structural connectome independent of comorbid autism
Neural signature of developmental coordination disorder in the structural connectome independent of comorbid autism
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DOI：
10.1111/desc.12424
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发表时间：
2016-07-01
影响因子：
3.7
通讯作者：
van Waelvelde, Hilde
中科院分区：
文献类型：
--
作者：
Caeyenberghs, Karen;Taymans, Tom;van Waelvelde, Hilde
患有自闭症谱系障碍 (ASD) 的儿童通常表现出运动笨拙（发育协调障碍，DCD），即他们难以完成需要运动协调的日常任务，例如穿衣、自我护理以及参加体育和休闲活动。先前对这些神经发育障碍的研究已经证明特定大脑区域的功能异常和白质微结构完整性的改变。这些发现表明大脑网络的整体组织在 DCD 和 ASD 中受到影响，并从网络角度支持“连接不良综合征”的假设。没有研究比较 ASD 和 DCD 之间的结构协方差网络，以寻找独立于共病自闭症的 DCD 特征。在这里，我们的目的是解决 DCD 中的异常连接是否与自闭症或共病 DCD 自闭症中出现的重叠的问题。利用图论分析，我们研究了 53 名儿童大脑结构网络的全局和区域拓扑特性的差异：8 名患有 DCD 的 ASD 儿童（DCD+ASD），15 名没有 DCD 的 ASD 儿童（ASD），11 名仅患有 DCD，以及 19 名典型发育（TD）儿童。我们根据来自 Freesurfer 的皮质厚度构建了单独的结构相关网络。孩子们接受了运动 ABC 和 Beery 视觉运动整合测试的评估。行为结果表明，DCD 组和 DCD+ASD 组在各种运动测量方面的平均得分低于 TD 和 ASD 组。此外，尽管所有群体的大脑网络都表现出小世界特性，但与 DCD 和 TD 相比，自闭症儿童的网络拓扑结构发生了显着改变。自闭症谱系障碍 (ASD) 儿童表现出更长的归一化路径长度和更高的聚类系数值。此外，旁边缘区域在奇异疾病中表现出节点聚类系数的变化。这些变化是疾病特异性的，包括 ASD 儿童右侧扣带回峡部和右侧额下回眶部聚类系数的变化，以及与 DCD 相关的外侧眶额皮质的增加。同时符合 DCD 和 ASD 标准的儿童表现出的拓扑变化比仅患有 DCD 的儿童更广泛，即患有 DCD + ASD 的儿童在（旁）边缘区域、主要区域和关联区域中表现出聚类系数的变化。 DCD+ASD 组相对于 ASD 组，左侧关联皮层的聚类系数发生变化。最后，DCD+ASD 组在右额下回眶部具有 ASD 特异性异常，推测这反映了非典型的情绪认知处理。我们的结果提供证据表明 DCD 和 ASD 是神经发育障碍，连接异常的重叠程度较低。 DCD+ASD 的同时发生还与独特的拓扑模式相关，突出了共病神经发育障碍的独特神经特征。
Children with autism spectrum disorders (ASD) often exhibit motor clumsiness (Developmental Coordination Disorder, DCD), i.e. they struggle with everyday tasks that require motor coordination like dressing, self-care, and participating in sport and leisure activities. Previous studies in these neurodevelopmental disorders have demonstrated functional abnormalities and alterations of white matter microstructural integrity in specific brain regions. These findings suggest that the global organization of brain networks is affected in DCD and ASD and support the hypothesis of a dys-connectivity syndrome' from a network perspective. No studies have compared the structural covariance networks between ASD and DCD in order to look for the signature of DCD independent of comorbid autism. Here, we aimed to address the question of whether abnormal connectivity in DCD overlaps that seen in autism or comorbid DCD-autism. Using graph theoretical analysis, we investigated differences in global and regional topological properties of structural brain networks in 53 children: 8 ASD children with DCD (DCD+ASD), 15 ASD children without DCD (ASD), 11 with DCD only, and 19 typically developing (TD) children. We constructed separate structural correlation networks based on cortical thickness derived from Freesurfer. The children were assessed on the Movement-ABC and the Beery Test of Visual Motor Integration. Behavioral results demonstrated that the DCD group and DCD+ASD group scored on average poorer than the TD and ASD groups on various motor measures. Furthermore, although the brain networks of all groups exhibited small-world properties, the topological architecture of the networks was significantly altered in children with ASD compared with DCD and TD. ASD children showed increased normalized path length and higher values of clustering coefficient. Also, paralimbic regions exhibited nodal clustering coefficient alterations in singular disorders. These changes were disorder-specific, and included alterations in clustering coefficient in the isthmus of the right cingulate gyrus and the pars orbitalis of the right inferior frontal gyrus in ASD children, and DCD-related increases in the lateral orbitofrontal cortex. Children meeting criteria for both DCD and ASD exhibited topological changes that were more widespread from those seen in children with only DCD, i.e. children with DCD+ASD showed alterations of clustering coefficient in (para)limbic regions, primary areas, and association areas. The DCD+ASD group showed changes in clustering coefficient in the left association cortex relative to the ASD group. Finally, the DCD+ASD group shared ASD-specific abnormalities in the pars orbitalis of right inferior frontal gyrus, which was hypothesized to reflect atypical emotional-cognitive processing. Our results provide evidence that DCD and ASD are neurodevelopmental disorders with a low degree of overlap in abnormalities in connectivity. The co-occurrence of DCD+ASD was also associated with a distinct topological pattern, highlighting the unique neural signature of comorbid neurodevelopmental disorders.