Chức năng điều hành, triệu chứng ADHD và kết nối chức năng trạng thái nghỉ ở trẻ em bị đột quỵ perinatal

Suraya Meghji1,2, Alicia J. Hilderley1,2,3,4, Kara Murias2,3,4,5, Brian L. Brooks2,3,4,5,6,7, John Andersen8, Darcy Fehlings9, Nomazulu Dlamini9,10, Adam Kirton1,2,3,4,5,11, Helen L. Carlson1,2,3,4
1Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, Canada
2Alberta Children’s Hospital Research Institute, Calgary, Canada
3Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
4Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
5Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
6Neurosciences program, Alberta Children’s Hospital, Calgary, Canada
7Department of Psychology, University of Calgary, Calgary, Canada
8Department of Pediatrics, University of Alberta, Edmonton, Canada
9Department of Pediatrics, University of Toronto, Toronto, Canada
10Children’s Stroke Program, Division of Neurology, Hospital for Sick Children, Toronto, Canada
11Department of Radiology, University of Calgary, Calgary, Canada

Tóm tắt

Đột quỵ perinatal mô tả một nhóm tổn thương não mạch máu khu trú xảy ra sớm trong quá trình phát triển, thường dẫn đến khuyết tật suốt đời. Hai loại đột quỵ perinatal phổ biến là đột quỵ thiếu máu cục bộ động mạch (AIS) và nhồi máu tĩnh mạch quanh não thất (PVI). Mặc dù đột quỵ perinatal thường được coi là một rối loạn vận động, nhưng các bệnh lý đồng mắc khác cũng thường xuất hiện, bao gồm rối loạn thiếu chú ý - tăng động (ADHD) và thiếu hụt trong chức năng điều hành. Tỷ lệ triệu chứng ADHD cao hơn ở trẻ em có đột quỵ perinatal và cũng có thể xảy ra các thiếu hụt trong chức năng điều hành nhưng các cơ chế nền tảng thì chưa được biết đến. Chúng tôi đã đo lường kết nối chức năng trạng thái nghỉ ở trẻ em bị đột quỵ perinatal bằng cách sử dụng các vùng mạng lưới chú ý lưng, mạng lưới chẩm - đỉnh và mạng lưới chế độ mặc định đã được thiết lập trước đó. Các mối liên hệ với đánh giá của phụ huynh về chức năng điều hành và triệu chứng ADHD đã được xem xét. Tổng cộng có 120 người tham gia từ 6-19 tuổi [AIS N = 31; PVI N = 30; Nhóm chứng N = 59] được tuyển chọn. So với các bạn phát triển bình thường, cả hai nhóm AIS và PVI đều cho thấy giá trị kết nối chức năng trong và giữa các bán cầu thấp hơn trong các mạng lưới được nghiên cứu. Sự khác biệt giữa các nhóm về khả năng kết nối giữa các mạng lưới cũng được chứng minh, cho thấy các tương quan ngược yếu hơn giữa mạng lưới tích cực nhiệm vụ (trước chẩm - đỉnh và chú ý lưng) và mạng lưới tiêu cực nhiệm vụ (mạng lưới chế độ mặc định) ở các nhóm đột quỵ so với các nhóm chứng. Cả giá trị kết nối chức năng trong mạng lưới và giữa các mạng lưới đều có mối liên hệ mạnh mẽ với báo cáo của phụ huynh về chức năng điều hành và triệu chứng ADHD. Những kết quả này gợi ý rằng sự khác biệt trong kết nối chức năng tồn tại cả trong và giữa các mạng lưới sau đột quỵ perinatal, mức độ mà nó liên quan đến triệu chứng ADHD và chức năng điều hành.

Từ khóa

#đột quỵ perinatal #chức năng điều hành #triệu chứng ADHD #kết nối chức năng #trẻ em

Tài liệu tham khảo

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