Value of BOLD-fMRI in assessing the changes of brain function and therapeutic efficacy in children with autism spectrum disorder after umbilical cord blood mononuclear cell infusion
ZHANG Cong
LI Zhijuan
GAO Duo
ZHOU Lixia
TIAN Xiaoyu
Abstract：Objective To explore the changes in brain function detected by blood oxygen level-dependent functional magnetic resonance imaging(BOLD-fMRI)in children with autism spectrum disorder(ASD)before and after umbilical cord blood mononuclear cell(UCB-MNC)infusion,and to analyze the application value of BOLD-fMRI in evaluating the therapeutic effect by combining with clinical scores.Methods A total of 20 ASD children admitted from August 2021 to July 2022 were enrolled.The Childhood Autism Rating Scale(CARS)was used to assess the children before UCB-MNC infusion and at 6-9 months after infusion.The BOLD-fMRI data were analyzed for regional homogeneity(ReHo)and amplitude of low-frequency fluctuations(ALFF)to compare the changes in brain function before and after treatment.Pearson correlation analysis was performed to explore the correlation between post-treatment CARS scores and ReHo/ALFF values in brain regions with functional changes in ASD children.Results After treatment,the ReHo values in the left postcentral gyrus(L.PoCG),left lingual gyrus(L.LING),left middle frontal gyrus(L.MFG),and right cuneus(R.CUN)of ASD children were significantly higher than those before treatment;the ALFF values in the L.PoCG and left middle occipital gyrus(L.MOG),and right inferior occipital gyrus were also significantly higher than those before treatment(P<0.01).Seventeen children showed symptom relief according to the CARS scale,with a relief rate of 85%;1 child had no change in CARS score after treatment,and 2 children had a slight increase in CARS score after treatment.Compared with those before treatment,the differences in ReHo(post-treatment minus pre-treatment)in L.PoCG,L.LING,right middle frontal gyrus(R.MFG),and R.CUN of ASD children after UCB-MNC treatment were negatively correlated with the differences in CARS scores(post-treatment minus pre-treatment)(r=-0.6340,P=0.0027;r=-0.6678,P=0.0013;r=-0.5768,P=0.0078;r=-0.7565,P=0.0001).The differences in ALFF(post-treatment minus pre-treatment)in the L.PoCG and L.MOG were also negatively correlated with the differences in CARS scores(post-treatment minus pre-treatment)(r=-0.8574,P<0.0001;r=-0.5449,P=0.0130).In 3 children with no reduction in CARS scores,the ReHo value in the cingulate gyrus and the ALFF value in the angular gyrus increased after treatment(P<0.05).Conclusion ASD children showed relieved symptoms after UCB-MNC treatment.The BOLD-fMRI sequence can detect brain regions with changes in ReHo and ALFF at an early stage,which indicates that it has important value in evaluating the therapeutic effect of UCB-MNC infusion in ASD.
Keywords：autism spectrum disorderumbilical cord blood mononuclear cellblood oxygen level-dependent functional magnetic resonance imagingmagnetic resonance imagingregional homogeneityamplitude of low-frequency fluctuationschildhood autism rating scale
Publication Date：2025-11-13
Online Publishing Date：2025-11-26(First online date of this platform, not the publication date of the document)
Pages：9( 97-105 )