医学精品课件孤独症颅脑MRI研究进展2017.8.13

1、孤独症颅脑MRI研究进展胡冰 副主任医师中山大学附属第三医院放射科广东省医学会第十六次放射医学学术会议国家自然科学基金青年项目，项目编号：31100738李咏梅、胡冰、李建英、孟安启、易莉、梁亚勇、陈碧媛、李冬蕴Brain MRI research progress in autismBing Hu MDAssociate Chief Physician, Department of Radiology, the Third Affiliated Hospital of SUN Yat-sen University前言获得1989年奥斯卡最佳影片最佳导演最佳原创剧本最佳男主角雨人巴里莱文森19

2、88年执导的一部剧情电影。目录孤独症简介相关学科研究MRI研究进展早期MRI研究00sMRI研究10sMRI研究今年MRI研究参考文献目录孤独症简介相关学科研究MRI研究进展早期MRI研究00sMRI研究10sMRI研究今年MRI研究参考文献1. 孤独症简介孤独症是一种神经系统失调导致的发育障碍早期不能进行正常的语言表达和社交活动常做出一些刻板、重复性和限制性的动作Autism 一词源于希腊语autor，原意为自我孤独症患者的突出特征 - 自我兴趣孤独症和自闭症是 Autism 的两种译名男性多于女性孤独症的首次发现1943年，在约翰霍普金斯医院工作的医生Leo Kanner发表了第一篇关于孤

3、独症的论文5 岁男孩Donald是第一个被诊断为孤独症的孩子“每当自己一个人的时候，总会感觉自己很幸福，且不愿意其他人打搅他独处”Leo Kanner1Kanner L. Autistic disturbances of affective contact. Acta Paedopsychiatr, 1968, 35(4): 100-136.诊断标准的演变1973年WHO1980年DSM-III1987年DSM-III-R1989年ICD-101994年DSM-IV2000年DSM-IV-TR2013年DSM-VThe Diagnostic and Statistical Manual of

4、Mental Disorders精神疾病诊断与统计手册International Classification of Diseases国际疾病分类DSM-V（2013）统称为孤独症谱系障碍（autistic spectrum disorders, ASD）诊断标准：A. 在各种情景下持续存在的社会交流和社会交往缺陷，包括在现在或过去有以下表现:（1）社会-情感互动缺陷（2）用于社会交往的非言语交流行为缺陷（3）建立或维持与其发育水平相符的人际关系缺陷DSM-VB. 狭隘、重复的行为方式、兴趣或活动内容，包括在现在或过去有以下表现的至少两项:（1）语言、运动或物体运用刻板或重复 （2）过分坚持某

5、些常规以及言语或非言语行为的仪式，或对改变的过分抵抗 （3）高度狭隘、固定的兴趣，其在强度和关注度上是异常的（4）对感觉刺激反应过度或反应低下，对环境中的感觉刺激表现出异常的兴趣DSM-VC. 症状必须在儿童早期出现D. 所有症状共同限制和损害了日常功能E. 这些症状不能用智力发育障碍或全面发育迟缓解释1Coplan J. Atypicality, intelligence, and age: a conceptual model of autistic spectrum disorder. Dev Med Child Neurol, 2003, 45(10): 712-716.2Coplan

6、 J, Jawad AF. Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 2005, 116(1): 117-122.1Coplan J. Atypicality, intelligence, and age: a conceptual model of autistic spectrum disorder. Dev Med Child Neurol, 2003, 45(10): 712-716.2Coplan J, Jawad AF. Modeling clinical

7、outcome of children with autistic spectrum disorders. Pediatrics, 2005, 116(1): 117-122.孤独症的诊断没有特异性实验室诊断手段CT、MRI、SPECT、PET、脑电图、染色体、诱发电位等检查有助鉴别诊断根据典型临床表现自闭症诊断不难诊断可根据DSM-V为标准CHAT、CARS、ABC是国内常用筛查量表ADI-R、ADOS是诊断“金标准”，新的筛查量表如SRS考虑了谱系障碍的问题目录孤独症简介相关学科研究MRI研究进展早期MRI研究00sMRI研究10sMRI研究今年MRI研究参考文献1Wakefield AJ

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