重复经颅磁刺激对注意缺陷多动障碍患儿的疗效研究  

Efficacy of repetitive transcranial magnetic stimulation in treatment of children with attention deficit hyperactivity disorder

作　　者：陶丹红 孔微 陶明 卢眺眺 韩耀静 邹莹 吴绪旭[2] 石敏 TAO Danhong;KONG Wei;TAO Ming;LU Tiaotiao;HAN Yaojing;ZOU Ying;WU Xuxu;SHI Min(Department of Mental Health,the Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China)

机构地区：[1]浙江中医药大学附属第二医院精神卫生科,杭州310005 [2]浙江医院精神卫生科

出　　处：《浙江医学》2021年第15期1633-1637,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019RC231)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)对注意缺陷多动障碍(ADHD)患儿的临床疗效。方法选取2019年1月至2020年12月在浙江中医药大学附属第二医院就诊的ADHD中注意缺陷与多动/冲动混合型患儿33例,采用rTMS治疗12周,观察并比较治疗前后SNAP-Ⅳ量表(父母版)评分、视听整合持续操作测试(IVA-CPT)及脑涨落图分析(EFG)结果。结果治疗后,ADHD患儿SNAP-IV量表(父母版)总分及注意力缺陷均分、多动-冲动均分较治疗前均明显降低(均P<0.05),对立违抗障碍均分治疗前后比较差异无统计学意义(P>0.05);综合注意力商数、综合控制力商数、听觉/视觉控制力商数、听觉/视觉注意力商数较治疗前均明显升高(均P<0.05);脑电超慢波绝对功率值、脑电超慢波相对功率值和全脑总功率治疗前后比较差异均无统计学意义(均P>0.05)。rTMS治疗过程中均未出现明显的不良反应。结论rTMS治疗能有效改善ADHD患儿注意力、多动等临床症状,且无明显不良反应,可作为安全有效的非药物治疗方法应用于临床。Objective To explore the clinical efficacy of repetitive transcranial magnetic stimulation(rTMS)in treatment of children with attention deficit hyperactivity disorder(ADHD).Methods Thirty-three ADHD children with combined hyperactive-impulsive and inattentive type treated in the Second Affiliated Hospital of Zhejiang Chinese Medical University from January of 2019 to December of 2020 were enrolled in the study.All subject received rTMS for 12 weeks.The results of SNAP-IV,integrated visual and auditory continuous performance test(IVA-CPT)and encephalofluctuography(EFG)were compared before and after rTMS treatment.Results After the treatment,the total score of SNAP-IV scale,attention item and hyperactivity-impulse item in ADHD children were lower than those before treatment(P<0.05),while the oppositional defiant disorder item was not significantly changed after treatment(P>0.05).IVA-CPT test showed that the comprehensive attention quotient,comprehensive control quotient,auditory/visual control quotient and auditory/visual attention quotient were significantly increased after treatment(P<0.05).There were no significant changes in the absolute power value,relative power value and total power on EFG after treatment(P>0.05).No significant adverse reactions occurred during rTMS treatment.Conclusion The rTMS can improve the clinical symptoms of attention and hyperactivity in ADHD children,and have no obvious adverse reactions,indicating that it can be used as a safe and effective non-drug treatment method for children with ADHD.

关 键 词：重复经颅磁刺激 注意缺陷多动障碍 视听整合持续操作测试 脑涨落图分析 注意力 

分 类 号：R749.94[医药卫生—神经病学与精神病学]