采用视听整合测试评估经颅磁刺激治疗注意缺陷多动障碍的效果  

A study of rTMS treatment for ADHD patients evaluated by integrated visual and auditory continuous performance test

作　　者：薛青[1,2] 戚小红 高乐虹[1,2] 毛薇[1] 魏荣 李莉萍[1,2] 林华[1,2] 王玉平[1,2,3,4] XUE Qing QIXiaohong GAO Lehong MAOWei WEIRong LILiping LINHua WANG Yuping(Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China Beijing Key Laboratory of Neuromodulation, Beijing 100053, China Department of Pediatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China Beijing Institute for Brain Disorders, Beijing 100069, China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]脑功能疾病调控治疗北京市重点实验室,北京100053 [3]首都医科大学宣武医院儿科,北京100053 [4]北京脑重大疾病研究院,北京100069

出　　处：《中国医药导报》2017年第29期69-71,79,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81501119);国家高技术研究发展863计划(2015AA020514);宣武医院英才计划

摘　　要：目的探索低频阈强度重复经颅磁刺激(r TMS)治疗注意缺陷多动障碍(ADHD)的效果。方法纳入2013年1月~2016年1月于首都医科大学宣武医院神经内科和儿科门诊就诊的ADHD儿童和青少年患者共20例,根据随机数字表分为真刺激组和假刺激组,每组各10例。真刺激组给予0.5 Hz 100%静息运动阈值的刺激;假刺激组给予0.5 Hz 10%静息运动阈值的刺激,刺激靶点均是右顶区,1个疗程为10 d。所有患者分别在治疗前、1个疗程治疗结束时进行视听整合持续性操作测试(IVA-CPT),并比较测试结果。结果与治疗前比较,真刺激组的听觉反应时间、听觉正确反应数、视觉反应时间、视觉正确反应数均在治疗结束时有显著改善(P<0.05);假刺激组的治疗前后比较,听觉反应时间、听觉正确反应数、视觉反应时间、视觉正确反应数均无显著改善(P>0.05)。两组间治疗前参数比较差异无统计学意义(P>0.05),但治疗后两组间比较,真刺激组的听觉反应时间缩短(P<0.05),视觉反应时间缩短(P<0.05),视觉正确反应数增加(P<0.05),两组间听觉正确反应数差异无统计学意义(P>0.05)。结论低频阈强度r TMS刺激右侧顶区皮层能改善ADHD儿童和青少年的症状。Objective To explore the effect of rTMS for attention deficit hyperactivity disorder （ADHD）. Methods 20 children and adolescents with ADHD treated in Neurology and Pediatrics Outpatient Clinics of Xuanwu Hospital, Cap- ital Medical University from January 2013 to January 2016 were enrolled in the study. These patients were then divided into two groups randomly, each group had 10 cases. The active treatment group received active stimulation and the sham treatment group were given sham stimulation. The parameters of active condition was 0.5 Hz, 100% of the motor threshold, while the sham condition was 0.5 Hz, 10% of the motor threshold; the target was right parietal region; one course was 10 days. At the end of one-course treatment, integrated visual and auditory continuous performance test （I-VA-CPT） was applied to assess the severity of ADHD, and the results were compared. Results In the active treatment group, compared with before treatment, auditory response time, correct auditory response, visual response time and correct visual response showed significant improvement after treatment （P 〈 0.05）, however, no significant improvement of any parameter was revealed in the sham treatment group （P 〉 0.05）. Between the two groups, significant differences were showed after treatment in auditory response time （P 〈 0.05）, visual response time （P 〈 0.05） and correct visual response （P 〈 0.05）, except correct auditory response （P 〉 0.05）, but before treatment, these parameters had no significant differences between the two groups （P 〉 0.05）. Conclusion Right parietal region low-frequency rTMS for ADHD children and adolescents can improve their clinical symptoms.

关 键 词：重复经颅磁刺激 注意缺陷多动障碍 视听整合持续性操作测试 

分 类 号：R749.94[医药卫生—神经病学与精神病学]