Resting-state Functional Magnetic Resonance Imaging To Explore The Pathological Mechanism Of Nocturnal Enuresis In Children

Nocturnal enuresis(NE)is a common developmental disease in school-age children.In addition to the potential side effects of emotional disorder,headache and abdominal pain,NE also have sleep and psychological problems.So far,the pathological mechanism of NE is not clear,and its treatment is limited.This paper will use idex of resting-state functional magnetic resonance imaging : amplitude of low frequency(ALFF),regional homogeneity(Re Ho),and degree centrality(DC)and the functional connectivity(FC)of cingulate gyrus(ACC)and parahippocampal gyrus(PHG)to further explore the relationship between brain dysfunction and sleep,to promote the pathological research and treatment evaluation of NE.A total of 37 cases of NE and age sex matched 37 healthy controls(HC)were recruited.The results showed that the Re Ho of ACC in NE was significantly lower than that in HC;The ALFF value of the cerebellar posterior lobe increased significantly,the DC value of PHG decreased,and the DC value increased in the left occipital wedge.FC with ACC as the seed point found that compared with HC,the brain areas with significantly reduced FC in NE: frontal lobe,PHG,temporal lobe,thalamus and right superior frontal gyrus.The FC analysis with PHG as the seed point found that the brain areas with significantly reduced FC in NE patients: superior temporal gyrus,middle temporal gyrus,inferior callosal gyrus,posterior cerebellar lobe,supraorbital frontal gyrus,precuneus lobe,angular gyrus,parietal lobe,and cingulate gyrus.The discussion found that the decrease of DC value and Re Ho value of ACC in patients with NE may be related to the decrease of ACCability to control consciousness in the process of urination.The decrease of the DC value of PHG may cause the changes in sleep and emotional function in patients with NE,and may also be one of the reasons for the occurrence of NE.The ALFF value in the posterior lobe of the cerebellum in patients with NE is increased,which may be related to the problem of emotional over regulation in patients with NE.The abnormality of temporal lobe function in patients with NE may be related to the disorder of urinary storage;The decrease of FC in the frontal lobe and ACC may reveal the dysfunction of inhibition and micturition control in patients with NE;The decrease of FC in wedge and PHG of NE patients may be related to the insufficient ability of NE patients to switch from sleep to wakefulness(awakening)when facing bladder filling at night;The significant decrease of FC in the cingulate gyrus and PHG may be related to the weak awareness of micturition control ability or micturition safety in patients with NE.In conclusion,the above results suggest that patients with NE may have bladder storage disorder,difficulty in awakening,inhibition dysfunction,etc.these problems also seriously affect the sleep and life of NE.In the process of treatment,we should also pay more attention to the sleep or psychological problems of NE children.This topic provides objective imaging data support for the in-depth study of the pathogenesis of NE,and provides more information for clinical diagnosis and treatment.