低频重复经颅磁刺激对孤独症谱系障碍儿童认知和执行功能的影响  

Effect of low frequency repetitive transcranial magnetic stimulation on cognitive and executive function in children with autism spectrum disorders

作　　者：张冬青 刘莎莎[1] 郭洪科 张红梅[1] 李冬梅[1] ZHANG Dongqing;LIU Shasha;GUO Hongke;ZHANG Hongmei;LI Dongmei(Department of Rehabilitation Medicine(Mianyang Central Hospital),School of Medicine University of Electronic Science and Technology of China,Mianyang Sichuan 621000,China)

机构地区：[1]电子科技大学附属绵阳医院(绵阳市中心医院)康复医学科,四川绵阳621000

出　　处：《空军医学杂志》2022年第2期134-138,共5页Medical Journal of Air Force

基　　金：四川省基层卫生事业发展研究中心2015年一般项目(SWF215-Y-31)。

摘　　要：目的探讨低频重复经颅磁刺激对孤独症谱系障碍儿童认知和执行功能的影响。方法选取2020年1月—2021年7月在绵阳市中心医院就诊的孤独症谱系障碍患儿60例,按行康复治疗的顺序单双号随机分为观察组和对照组,每组30例。对照组接受常规干预训练,包括应用行为训练和感觉综合训练,观察组在常规干预的基础上联合使用低频经颅磁刺激的干预治疗。干预前后采用孤独症行为量表(ABC)评估2组症状水平,采用语言流畅性、视觉持续注意力和短时口语记忆评估患儿的认知功能,采用威斯康辛卡片分类测试评估2组执行功能。采用统计学分析比较2组干预前后量表评分变化。结果观察组患儿干预后ABC总分及各因子得分均较干预前减低(P<0.05),对照组患儿干预前后语言因子和生活自理因子比较差异无统计学意义(P>0.05),感觉因子、社会交往因子、躯体运动因子、ABC总分较干预前显著降低(P<0.05);观察组患儿干预后ABC总分较对照组减低,差异具有统计学意义(P<0.05)。干预后2组语言流畅性、视觉持续注意力和短时口语记忆能力均较干预前明显提高,差异有统计学意义(P<0.05),且观察组干预后提高水平较对照组显著(P<0.05)。威斯康辛卡片分类测试显示,干预后2组完成总应答数、持续性应答数、持续性错误数较干预前显著减低,且干预后观察组显著低于对照组(P<0.05)。结论低频r TMS可改善孤独症谱系障碍患儿的临床症状,且可以提高ASD患儿的认知和执行功能,未来在常规干预治疗的基础上可联合r TMS对ASD患儿进行干预治疗。Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation oncognitive and executive function of children with autism spectrum disorders.Methods A total of 80 children with autismspectrum disorders treated in Mianyang Central Hospital between January 2020 and July 2021 were selected and randomly divided into the observation group and control group according to the order in which the patients received rehabilitation treatment,with 40 cases in each group.The control group received conventional intervention training,including applied behavior t rainingand sensor y comprehensive t raining while the obser vation g roup additionally underwent low-frequency transcranial magneticstimulation.Before and after intervention,the ABC scale was used to determinethe level of clinical symptoms in the two groups.The cognitive function of these patients was assessed in terms of verbal f luency,visual sustainedattention,and short-term verbal memory while Wisconsin card classification test was used to investigate the executivefunction of the two groups.The changes in scale scores in the two groups after intervention were statistically analyzed.Results After intervention,the total score of ABC and the score of each factor in the observation group became lower(P<0.05).The language factors and self-care factors in the control group were not signif icantly different after inter vention(P>0.05),but sensation factors,social interaction factors,body movement factors and the total score of the ABC were significantly decreased(P<0.05).The total score of the ABC in the observation group was lower than in the control group after intervention,and the difference was statistically signif icant(P<0.05).After inter vention,verbal f luency,visual sustained attention and shor t-ter m oral memor y of the two groups were significantly improved(P<0.05),especially in the observation group(P<0.05).Wisconsin card sor ting test showed that after inter vention,the total number of completed responses and the numbers of p

关 键 词：经颅磁刺激 孤独症谱系障碍 认知功能 执行功能 

分 类 号：R493[医药卫生—康复医学]