FOCAL CEREBRAL HYPOPERFUSION IN CHILDREN WITH DYSPHASIA AND OR ATTENTION DEFICIT DISORDER
FOCAL CEREBRAL HYPOPERFUSION IN CHILDREN WITH DYSPHASIA AND OR ATTENTION DEFICIT DISORDER
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DOI：
10.1001/archneur.1984.04050190031010
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发表时间：
1984-01-01
影响因子：
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通讯作者：
BRUHN, P
中科院分区：
文献类型：
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作者：
LOU, HC;HENRIKSEN, L;BRUHN, P
与学习障碍有关的神经机制在很大程度上是未知的。采用Xe-133吸入和放射计算机断层扫描技术对13例言语障碍和/或注意缺陷障碍（ADD）患儿的三维区域脑血流量（rCBF）进行了研究。与9名正常儿童的平均CBF分布相比，所有患者的两半球rCBF分布均异常。低灌注区，由此推断，低代谢活动主要见于心室周围白质和主要动脉区域之间的边界区。在吞咽障碍患者中，两个外围区域的部分灌注不足，物体命名任务无法在相关皮质区域产生增加的流量。不同的吞咽困难综合征患者表现出不同的rCBF模式。11例ADD患者均出现额叶白质灌注不足，其中7例出现尾状核区灌注不足。盐酸哌甲酯增加了中脑和基底节区等中央区灌注，减少了运动和初级感觉皮质区灌注。儿童认知障碍中低灌注结构的位置与早期缺氧缺血性事件在其起源中的作用一致。
The neural mechanisms involved in learning disorders are largely unknown. Three-dimensional regional cerebral blood flow (rCBF) was studied in 13 children with dysphasia and/or attention deficit disorder (ADD), using Xe-133 inhalation and emission computed tomography. The rCBF distribution was abnormal in both hemispheres in all patients, as compared with the mean CBF distribution of 9 normal children. Regions of hypoperfusion and, by inference, low metabolic activity were predominantly seen in the periventricular white matter and in border zones between major arterial territories. In patients with dysphasia, parts of both perisylvian regions were hypoperfused, and object-naming tasks failed to produce an increased flow in relevant cortical regions. Patients with different dysphasic syndromes appeared to have different patterns of rCBF. All 11 patients with ADD had hypoperfusion in the white matter of the frontal lobes, and 7 also in the caudate nuclei region. Methylphenidate hydrochloride increased perfusion in the central region, including the mesencephalon and the basal ganglia, and decreased perfusion of motor and primary sensory cortical areas. The location of hypoperfused structures in cognitive disorders of childhood is consistent with a role for an early hypoxic-ischemic event in their origin.