Preliminary Study Of Brain Network In Changes Of The Children With ADHD After Therapy By The MPH Based On R-fMRI

Objective:Resting-state functional MRI(R-fMR1)data combined with graph theory analysis method was used to study effective treatment of Attention Deficit Hyperactivity Disorder(ADHD)in children with methylphenidate treatment.The correlation study of brain function network changes at 6-8 weeks after discontinuation provides the basis for functional neuroimaging in clinical treatment of ADHD-related symptom improvement,withdrawal or not,medication duration,and efficacy evaluation.Methods:1.Clinical data collection.The 25 patients with ADHD were divided into two groups:the effective group consisted of 13 patients with ADHD treated with methylphenidate for more than 8 weeks,and those with effective treatment and DSM-IV ADHD diagnostic criteria as the experimental group;untreated ADHD group For the control group of 12 patients,the two groups matched in age,gender,IQ,and clinical symptoms.2.R-fMRI section.Using the PHILIPS Achieva 3.0T MR scanner,the functional magnetic resonance(R-fMRI)data of the resting group of the active group and the non-medication group were collected to obtain the data of the brain magnetic resonance of ADHD children.The R-fMRI data preprocessing uses the Gretna software package based on the Matlab platform to perform graph theory analysis and processing on the network connection and topology structure,and calculates the attribute parameters of the brain structure network.The preprocessing process includes time point correction,head motion correction,image registration,image normalization,and smoothing operation.The AAL brain template is used to divide the preprocessed image into 90 regions,and the BOLD signal of all voxels in the corresponding region is calculated.Arithmetic mean values were calculated using graph theory analysis for resting-state functional magnetic resonance data of children with active medication,withdrawal,and untreated medications of ADHD.Finally,various graph theory indicators were calculated based on the complex network theory system and the theoretical system of brain science.3.Differences in the characteristics of resting state brain networks and related analysis.Paired t-test was used to compare the difference of brain function network between the effective group and the withdrawal period of 9 cases.The difference of brain function network was compared between 12 untreated contol groups and medication-contained effective groups by two-sample t-test.Differences of Local and Global Network Properties of Brain Network during Drug Withdrawal from Non-dosed Control Group and Medication-effective Group.Explore how to build complex brain networks.Firstly,based on the complex network theory,various graph theory indicators are calculated,statistical analysis is performed,global network attributes are analyzed,and the calculated graph indicators are used to further analyze the local network of each group of data,and the nodes are grouped in terms of efficiency.Inter-individual analysis provides a reliable functional morphological basis for clinical treatment and efficacy.Results:A total of 13 patients with ADHD who took the drug and effective group to complete the scanning of the clinical data and resting magnetic resonance data during the medication,including 12 males(92.3,female 1(7.7%).The oldest 13 years old(2 Person),the youngest 8 years old(3 persons),the average age is 9.77±1.69 years old,the highest IQ is 106(1 person),the lowest is 85(1 person),the average IQ is 94.54 ± 6.06,Nine patients completed the clinical data of discontinuation period and data of resting state brain function;the effective group had sex(sex),age(a difference of<1 year),IQ(a difference of<15),and body weight(a difference of about 5 Kg).A total of 12 children with ADHD who matched the untreated control group were included in the study,and the topological attributes of the functional network based on 90 brain regions were analyzed in each group of patients,and some of the map indicators such as Cp,Lp,and y were calculated based on graph theory analysis.Eglob,Eloc,Dnod,Nbc,Cp,and Eloc measure the degree of network local accumulation,is an indicator of network separation and reflects how a node’s neighbors are connected to each other;Lp and Eglob measure the network The overall line efficiency is an indicator of network integration,referring to the average length between any two nodes;gamma is standardized The clustering coefficient refers to the ratio of the real network clustering coefficient to the random network clustering coefficient;X is the standardized path length and refers to the ratio of the real network path length to the random network path length;a is the small world index;a The average number of connections for the selected node and other nodes;Nbc is the average number of connected neighbor nodes.1.Medication effective group medication period,withdrawal period:① The ARS and PSQ scores increased in patients with ADHD who received the drug-effective group(n=9)(P<0.05),(increased ADHD symptom assessment scale for children with ADHD in the advanced age group(>9 years old).The children in the younger age group(<9 years old)were lower(P<0.05).② The areas with significantly increased efficiency in the medication-dosing period compared with the medication-withdrawal period were inferior frontal gyrus,right anterior cingulate gyrus,lateral cingulate gyrus,right fusiform gyrus,and right caudate nucleus.The reduced area had a left central groove cap,left angled gyrus,and right insula(P<0.05).2.Drug-administered group and medication-free control group① The ADHD medication group and the non-dosed control group;the PSQ total score,ARS total score,attention deficit factor score,and CPT error number T value were all lower(P<0.05);② The areas with significant increase in node efficiency were left insula,left hippocampus,left lateral orbital septum,and left superior orbital gyrus(P<0.05).3.Medication withdrawal group and non-drug control group① The PSQ total score is low,Rey’s complex graphic grade and Stroop’s color words score are high(P<0.05);② The area where the efficiency of the 3 nodes was significantly increased was the inferior frontal gyrus,the right caudate nucleus,and the middle temporal gyrus.Conclusion:1.Clinical symptoms and resting state brain function of patients with ADHD treated with methylphenidate are differently degraded after discontinuation of tissue.The brain regions with the first decline appear to be concentrated in the prefrontal and anterior cingulate gyrus.However,the clinical manifestations,cognitive function and brain function of children with drug withdrawal period were still lower than those of children without ADHD;partial network analysis found that there were significant differences in the brain area after discontinuation of the temporal frontal gyri,temporal lobe,and anterior The cingulate gyrus and paraballoon cingulate,caudate nucleus(striatum);this study only found that the patient’s age is a factor affecting the extent of clinical symptoms after drug withdrawal,clinical symptoms of ADHD children aged>9 years of age The degree is lighter than the age of 9 years old.2.The brain-structured network research method based on graph theory can comprehensively and stereoscopically detect and quantitatively analyze the characteristics of changes in brain topology network topology properties,providing a basis for exploring the central mechanism of ADHD,observing changes in brain network structure,and interpreting corresponding clinical performance.A new direction.