目的 探讨首发未服药青少年抑郁症患者脑功能连接的特点.方法 采用3.0T磁共振成像系统对15例抑郁症患儿和16例对照者进行扫描,应用功能连接方法分析抑郁症患儿和对照组在静息状态下的功能磁共振成像数据.结果 抑郁症组显示前扣带回膝下部与左侧顶叶和右侧额内侧回的功能连接较对照组增强(P<0.005).结论 青少年抑郁症存在与情绪调节有关的神经回路的功能连接异常.

This study aims to investigate the relationship between parental self-reported depression, parent personality, the severity of children's autism spectrum disorders (ASD) symptoms and parenting stress. A case-control study including 361 autistic children and 345 typically developing children and their parents, respectively was conducted from 2009 to 2012 in Shanghai. Parents (n= 722) of autistic outpatients in Shanghai Mental Health Center completed: One in-house questionnaire; Autism Behavior Checklist (ABC); Self-Rating Depression Scale (SDS); Parenting Stress Index (PSI); Eysenck Personality Questionnaire (EPQ). The mean SDS scores of fathers (t= 5.837, P= 0.000) and mothers (t= 10.653, P= 0.000) were higher in the case group than in controls. Parents of ASD children showed much more parenting stress and different personality profiles compared to control group parents (t= 20.836, P= 0.000). Relative analysis showed that parental emotional symptoms were significantly related to parental education level (father: r=-0.304, mother: r=-0.252), parenting stress (father: r= 0.337, mother: r=. 462), and parental personality traits like Neuroticism (father: r= 0.387, mother: r= 0.518) and Psychoticism (father: r= 0.228, mother: r= 0.301). In the subsequent stepwise multiple regression analysis, emotional stability (Neuroticism sub-scale of EPQ) was most significantly correlated to paternal depression (adjusted R-2= 0.153) and parenting burden (Parent domain of PSI) was most significantly correlated to maternal depression (adjusted R-2= 0.284). ASD symptom severity was not related to parental depression. Parental personality traits and parenting stress may be the most salient factors impacting parental depressive symptoms. Understanding how parental personality traits impact on parental emotional states may be an important consideration in the treatment of ASD.

Background Adolescent depression results in severe and protracted suffering for affected individuals and their family members, but the underlying mechanism of this disabling condition remains unclear. Objectives Compare resting-state brain functioning between first-episode, drug-naïve adolescents with major depressive disorder and matched controls. Methods Fifteen adolescents with major depressive disorder and 16 controls underwent a resting-state fMRI scan performed using a 3T magnetic resonance scanner. The amplitude of low frequency fluctuation (ALFF) was used to assess resting-state brain function. Results Adolescents with depression had higher mean (sd) scores on the Children Depression Inventory (CDI) than controls (22.13 [9.21] vs. 9.37 [5.65]). Compared with controls, adolescents with depression had higher ALFF in the posterior cingulate gyrus, left inferior temporal gyrus, right superior temporal gyrus, right insula, right parietal lobe, and right fusiform gyrus; they also exhibited lower ALFF in the bilateral cuneus, the left occipital lobe, and the left medial frontal lobe. Conclusions Adolescent depression is associated with significant changes in the functioning of several regions of the brain.

Background: Adolescent depression results in severe and protracted suffering for affected individuals and their family members, but the underlying mechanism of this disabling condiiton remains unclear. <br> Objectives: Compare resting-state brain functioning between first-episode, drug-na?ve adolescents with major depressive disorder and matched controls. <br> Methods: Fifteen adolescents with major depressive disorder and 16 controls underwent a resting-state fMRI scan performed using a 3Tmagneitc resonancescanner. The amplitude of low frequency lfuctuaiton (ALFF) was used to assess resitng-state brain funciton. <br> Results: Adolescents with depression had higher mean (sd) scores on the Children Depression Inventory (CDI) than controls (22.13 [9.21] vs. 9.37 [5.65]). Compared with controls, adolescents with depression had higher ALFF in the posterior cingulate gyrus, letf inferior temporal gyrus, right superior temporal gyrus, right insula, right parietal lobe, and right fusiform gyrus; they also exhibited lower ALFF in the bilateral cuneus, the letf occipital lobe, and the letf medial frontal lobe. <br> Conclusions: Adolescent depression is associated with significant changes in the functioning of several regions of the brain.

Objective To explore the characteristics of executive function in adolescents with major depressive disorder(MDD). Me-thods A total of 36 first-episode drug naive adolescents with MDD and 40 healthy controls were involved.The current and historical psychia-tric conditions were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version.The depression severity was assessed with the children′s depression inventory.The executive function was measured in digit span test,Stroop color word test and cambridge neuropsychological test automated battery(CANTAB)[including spatial working memory(SWM),stockings of cambridge(SOC),intra-dimensional/extra-dimensional shifts(IED)].Performances on executive function were compared between the 2 groups. Results In digit span test and Stroop color word test,there was no significant difference between the 2 groups(Pa0.05).In CANTAB,adolescents with major depression showed more SWM between errors(8 boxes)(20.27±12.51 vs 13.91±9.72),greater SWM strategy score(34.79±3.35 vs 32.14±4.25),more SOC mean moves(5.98±1.25 vs 5.33±0.96) and more IED total trials(60.74±37.45 vs 35.44±27.40) than those of healthy control group,there were significant differences between the 2 groups(Pa0.05). Conclusions Adolescents with MDD showed deficits in spatial working memory,set-shifting and planning.Executive function impairments of verbal working memory and inhibitory control are not obvious.

近年来,儿童青少年抑郁患者越来越多,并可导致严重的后果,有研究表明儿童青少年抑郁症患者存在脑部结构及功能的改变,本文综述了近几年来儿童青少年抑郁症相关脑影像学研究进展。

Objective:To explore the effect of atomoxetine on the bebavioral problems of children with attention-deficit hyperactivity disorder(ADHD) after treatment.Method:65 children who met criteria for ADHD participated the study.We evaluated behavior prolems of ADHD at baseline and after atomoxetine treatment for 4 weeks and 8 weeks.Behavioral problems were assessed with Conners parent symptom questionnaire(PSQ) and strenghths and difficulties questionnaires(SDQ).Results:Most of all subscales improved significantly after 4 weeks and 8 week treatments(P0.05).The factor of impulsive-hyperactivity and hyperactivity index of PSQ and the subscale of Hyperactivity-Inattention of SDQ got significantly improvement at the end of 4th and 8th weeks.The factors of conduct problems and learning problems of PSQ and the total difficulties of SDQ improved significantly at the end of 8th week.Conclusion:Atomoxetine may improve part of related behavioral problems.

Objective:To explore the characteristic of executive function impairment in patients and its correlation with the tic disorders(TD) symptom.Method:Cambridge neuropsycholigical test automated battery(CANTAB) was used to assess the executive function for 31 TD patients,and equivalent controls and the symptom severity of TD was appraised by the yale global tic severity scale(YGTSS),then the results could be analysed statistically.Results:Compared with controls,children with TD showed more MOT mean latency(P 0.01),RTI choice movement time and reaction time(P 0.05),more SWM between errors(4 boxes)(P0.01) and IED stages completed(P 0.05),but less total trials in IED(P0.01).The scores of motor tic severity in YGTSS were negatively correlated with MOT mean latency,RTI simple movement time in children with TD.Conclusion:There are multiple executive function impairments in children with TD.It is probable that a few significant correlations between tic severity and some executive functions do exist.

Objective To assess the characteristics of visual P300 and mismatch negativity(MMN) of patients with attention deficit hyperactivity disorder(ADHD) before and after methylphenidate treatment. Methods 1.Forty-one ADHD patients(ADHD group),35 healthy children(NC group) were selected in this study.Optical P300 and mismatch negativity of them were tested,using an American Instrument.All ADHD patients received methylphenidate treatment(10-16 mg·d-1,take orally,average 12 mg·d-1).Thirty-six ADHD patients were followed up after 6 months treatment,Optical P300 and MMN were examined.According to the international society of EEG stan-dards,ADHD patients stopped to take methylphenidate 3 to 7 days before examing. Results 1.Compared with NC group,ADHD patients showed significantly prolonged N2/P300 latency [ADHD group:(275±21) ms,NC group(259±17) ms,P<0.01]and P3/P300 latency[ADHD group:(340±20) ms,NC group:(327±16) ms,P<0.01],decreased P3/P300 amplitude [ADHD group:(3.0±1.8) μV,NC group:(5.2±1.5) μV,P<0.05].2.Compared with NC group,ADHD patient showed prolonged MMN latency[ADHD group:(199±20) ms,NC group:(180±23) ms,P<0.01] and decreased MMN amplitude[ADHD group:(3.2±1.5) μV,NC group:(5.6±1.7) μV,P<0.01].3.Compared with the baseline,ADHD patients showed shortened N2/P300 latency[before treatment:(275±21) ms,after treatment:(261±19) ms,P<0.01] and P3/P300 latency[before treatment:(340±20) ms,after treatment:(329±19) ms,P<0.05],increased P3 amplitude after medication of methylphenidate[before treatment:(3.0±1.8) μV,after treatment:(4.7±2.0) μV,P<0.01]. Conclusions Abnormal optical P300 and MMN would be found in ADHD patients.And optical P300 variations before and after medication suggested that attention deficit of ADHD patients might be improved through methylphenidate treatment.