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        자폐 장애에서의 국소 대뇌관류 이상

        김수진(Su-Jin Kim),김붕년(Boong-Nyun Kim),조수철(Soo-Churl Cho),강제욱(Je-Wook Kang),김재원(Jae-Won Kim),신민섭(Min-Sup Shin),정광모(Kwang-Mo Cheong),김효원(Hyo-Won Kim) 대한소아청소년정신의학회 2009 소아청소년정신의학 Vol.20 No.3

        Objectives:Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. Methods:Fifty-five children with untreated autism (47 boys and 8 girls, mean age=50.6±20.28 months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants’ SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. Results:The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. Conclusion:The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested “theory of mind” hypothesis and the disturbances in attention shifting that have been observed in autistic children.

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