Degree centrality of key brain regions of attention networks in children with primary nocturnal enuresis: A resting-state functional magnetic resonance imaging study

Primary nocturnal enuresis (PNE) is always associated with attention impairment, some of which even could develop to attention deficit hyperactivity disorder. The mechanism of attention impairment is not clear, especially lacking of objective indicators of neuroimaging. The aim of this study is to explore the possible functional imaging mechanism of impaired attention in PNE children. A total of 26 PNE children and 26 age-matched normal controls were recruited. Resting-state functional magnetic resonance imaging (rs-fMRI) was performed on these children. Degree centrality (DC) of key brain regions of DAN (lFEF, rFEF, lIFG, rIFG, lIPS, rIPS), VAN (TPJ, VFC) and DMN (PCC, aMPFC, lAG, rAG) were calculated and compared between PNE and normal children. And the correlations between DC values and attention behavioral results were measured. Compared with normal controls, PNE children exhibited lower DC value in the right frontal eye field (rFEF), left inferior parietal sulcus (lIPS), right inferior parietal sulcus (rIPS), temporal parietal junction (TPJ) and left angular gyrus (lAG). The correct number of continuous performance test (CPT) in the PNE group was significantly lower than the normal controls and there was no significant difference in the reaction time between the two groups. The correlation between DC values and attention behavioral results in PNE showed that the DC values of PCC and lAG were negatively correlated with the correct number. This work indicates that the damage of the key brain regions of DAN, VAN and DMN might be the possible functional imaging mechanism of impaired attention in children with PNE.