睡眠紊乱与自闭症儿童社交障碍：剂量效应及认知神经机制研究

Sleep disturbance is very common in children with autism spectrum disorder (ASD), and closely associated with their core symptom, social deficit. However, the dose effect of sleep disturbance on social deficit of ASD and the neural mechanism remain unclear. In children with a confirmed diagnosis of ASD identified in our previous epidemiological study, we try to explore the dose effect of sleep disturbance on social deficit, and determine the threshold dose for grouping ASD by sleep disturbance via a case-control study; and then examine the influence of sleep disturbance on face processing and neural response during naturalistic social behavior of ASD children using synchronized eye-tracking and functional near-infrared spectroscopy (fNIRS) to uncover the neural mechanism for that sleep disturbance influences social deficit. In the 2-year following up study, the above issue is further tested with emphasis on progressive trajectory from a developmental perspective. The study has important implications for the dose effect of sleep disturbance on social deficit of children with ASD and the congnitive-neural mechanism, and also provide reference for the assessment and treatment of thier sleep disturbance and social deficit.

睡眠紊乱在自闭症（ASD）儿童中十分常见，与其核心症状——社交障碍密切相关。然而，睡眠紊乱与ASD儿童社交障碍的剂量效应及其认知神经机制尚不清楚。以前期流行病学研究确诊的ASD儿童为对象，我们拟采用病例对照调查研究，探索睡眠紊乱对社交障碍的剂量影响；进而采用同步眼动追踪技术和功能性近红外光谱成像（fNIRS）考察睡眠紊乱对ASD儿童在自然社交行为中面孔加工模式及神经功能反应的影响，揭示睡眠紊乱影响社交障碍的认知神经机制。此外，我们拟通过随访研究验证前述问题，并重点从发展角度探索其进行性变化。本研究对阐明睡眠紊乱对ASD儿童社交障碍影响的剂量效应及认知神经机制具有重要意义，为ASD儿童睡眠紊乱和社交障碍的评估干预提供了参考。

睡眠紊乱在自闭症谱系障碍（ASD）儿童中十分常见，与其核心症状——社交障碍密切相关。然而，睡眠紊乱与ASD儿童社交障碍的剂量效应及其认知神经机制尚不清楚。本项目流行病学研究发现，睡眠时间越短，睡眠质量越差的ASD儿童社交障碍越严重，且睡眠紊乱对ASD儿童社交障碍有显著的预测作用，揭示了睡眠紊乱对ASD儿童社交障碍的剂量依赖影响。实验研究采用同步眼动追踪和功能性近红外光谱成像（fNIRS）技术，结合情绪面孔识别和亲子观影的实验范式，进一步探索了睡眠紊乱影响社交障碍的认知神经机制，发现ASD儿童存在面孔加工模式异常（多注视口鼻部特征区，而对眼部特征区的注视较少），以及内侧前额叶和右侧颞顶联合区脑活动异常（儿童-母亲脑间活动一致性较低），而这可部分中介睡眠紊乱对ASD儿童社交障碍的影响。同时，队列研究和睡眠干预研究有望描绘相关的进行性变化。本研究对阐明睡眠紊乱对ASD儿童社交障碍影响的剂量效应及认知神经机制具有重要意义，为ASD儿童睡眠紊乱和社交障碍的评估干预提供了参考。