GABA and Glutamate in Children with Primary Complex Motor Stereotypies: An 1H-MRS Study at 7T.
GABA and Glutamate in Children with Primary Complex Motor Stereotypies: An 1H-MRS Study at 7T.
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DOI：
10.3174/ajnr.a4547
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Mahone EM
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作者：
Harris AD;Singer HS;Horska A;Kline T;Ryan M;Edden RA;Mahone EM
复杂运动刻板印象（CMS）是有节奏的，重复的，固定的，有目的的，但没有目的的动作，会因分心而停止。它们可能发生在正常健康的儿童身上（初级刻板印象），也可能发生在患有自闭症谱系障碍的儿童身上（二级刻板印象）。这些运动的潜在神经生物学基础尚不清楚，但被认为涉及皮层-纹状体-丘脑-皮层通路。为了进一步明确潜在的神经化学改变，在7点时使用1H MRS测量了四个额纹状体区域的GABA、谷氨酸（Glu）、谷氨酰胺（Gln）、n -乙酰天冬氨酸（NAA）和胆碱（Cho）水平。共有18名原发性CMS患儿和24名典型发展对照，年龄5-10岁，在7T完成MRS。获取来自前扣带皮质（ACC）、前运动皮质（PMC）、背外侧前额叶皮质（DLPFC）和纹状体的单体素STEAM数据，并使用LCModel对肌酸代谢产物进行量化。所有参与者都能很好地耐受7T扫描。与对照组相比，患有CMS的儿童GABA ACC （GABA/Cr, p=0.049; GABA/Glu: p=0.051）和纹状体（GABA/Cr: p= 0.028; GABA/Glu: p=0.0037）水平较低，但DLPFC或PMC水平较低。Glu, Gln， NAA和Cho水平在上述任何地区的各组之间都没有差异。在CMS组中，ACC中GABA/Cr的降低与运动刻板印象的严重程度显著相关（r=-0.59, p= 0.021）。这些结果提示原发性CMS患儿皮质纹状体通路中可能存在gaba能功能障碍。
Complex motor stereotypies (CMS) are rhythmic, repetitive, fixed, purposeful but purposeless movements that stop with distraction. They can occur in otherwise normal healthy children (primary stereotypies), as well in those with autism spectrum disorders (secondary stereotypies). The underlying neurobiological basis for these movements is unknown, but thought to involve cortical-striatal-thalamo-cortical pathways. In order to further clarify potential neurochemical alterations, GABA, glutamate (Glu), glutamine (Gln), N-acetyl aspartate (NAA) and choline (Cho) levels were measured in four frontostriatal regions, using 1H MRS at 7T. A total of 18 children with primary CMS and 24 typically developing controls, ages 5-10 years completed MRS at 7T. Single voxel STEAM acquisitions from the anterior cingulate cortex (ACC), premotor cortex (PMC), dorsolateral prefrontal cortex (DLPFC) and striatum were obtained and metabolites were quantified with respect to creatine using LCModel. The 7T scan was well tolerated by all participants. Compared to controls, children with CMS had lower levels of GABA ACC (GABA/Cr, p=0.049; GABA/Glu: p=0.051) and striatum (GABA/Cr: p= 0.028; GABA/Glu: p=0.0037), but not the DLPFC or PMC. Glu, Gln, NAA, and Cho levels did not differ between groups in any of the aforementioned regions. Within the CMS group, reduced GABA/Cr in the ACC was significantly associated with greater severity of motor stereotypies (r=-0.59, p= 0.021). These results suggest possible GABAergic dysfunction within corticostriatal pathways in children with primary CMS.