低频经颅磁刺激联合早期康复训练在伴智力低下孤独症谱系障碍患儿中的应用  

Low Frequency Transcranial Magnetic Stimulation Combined with Early Rehabilitation Training in Children with Mental Retardation and Autism Spectrum Disorders

作　　者：王贝贝[1] 张少华[1] 高芳 赵梦姿 WANG Beibei;ZHANG Shaohua;GAO Fang;ZHAO Mengzi(Pediatric Department,Nanyang First People’s Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院儿科,河南南阳473000

出　　处：《河南医学研究》2024年第14期2592-2595,共4页Henan Medical Research

摘　　要：目的探究低频经颅磁刺激(TMS)联合早期康复训练治疗伴智力低下孤独症谱系障碍(ASD)患儿的效果。方法选取南阳市第一人民医院2018年2月至2022年9月收治的104例伴智力低下ASD患儿,按随机数字表法分成两组,每组52例。以接受早期康复训练的52例伴智力低下ASD患儿列为B组,以接受低频TMS联合早期康复训练的52例伴智力低下ASD患儿列为A组。对比两组治疗前后孤独症行为评定量表(ABC)评分、中国韦氏儿童智力量表(C-WISC)评分、儿童感觉统合评定量表(CSIRS)评分、事件相关电位(ERP)P3潜伏期、波幅、神经递质[γ-氨基丁酸(GABA)、谷氨酸(GLU)、5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)]水平。结果治疗6个月后A组感觉、交往、躯体运动、语言、生活自理评分较B组低(P<0.05);治疗6个月后A组言语智商、操作智商及总智商评分较B组高(P<0.05);治疗6个月后A组学习能力、触觉防御、本体感觉、前庭失衡评分较B组高(P<0.05);治疗6个月后A组ERP P3潜伏期较B组低,波幅较B组高(P<0.05);治疗6个月后A组血清GLU、5-HT、BDNF水平较B组低,血清GABA水平较B组高(P<0.05)。结论低频TMS联合早期康复训练治疗伴智力低下ASD患儿可进一步改善行为能力,提升智力水平,改善感觉统合能力,维持中枢神经系统内环境平衡。Objective To investigate the effect of low-frequency transcranial magnetic stimulation(TMS)combined with early rehabilitation training for children with mental retardation and autism spectrum disorder(ASD).Methods A total of 104 children with mental retardation ASD were selected from Nanyang First People’s Hospital from February 2018 to September 2022 and divided into two groups of 52 cases each according to the random number table method.The 52 children with mental retardation ASD who received early rehabilitation training were classified as group B,and the 52 children with mental retardation ASD who received low-frequency TMS combined with early rehabilitation training were classified as group A.The autism behavior checklist(ABC),the China Wechsler intelligence scale of children(C-WISC)and the children’s sensory integration rating scale(CSIR)scores,event-related potential(ERP)P3 latency,wave amplitude,neurotransmitters[γ-aminobutyric acid(GABA),glutamate(GLU),5-hydroxytryptamine(5-HT),brain derived neurotrophic factor(BDNF)]levels were compared between the two groups before and after treatment.Results After 6 months of treatment,the scores of sensation,communication,body movement,language and self-care in group A were lower than those in group B(P<0.05).After 6 months of treatment,verbal intelligence quotient,performance intelligence quotient and fall intelligence quotient scores in group A were higher than those in group B(P<0.05).After 6 months of treatment,the scores of learning ability,tactile defense,proprioception and vestibular imbalance in group A were higher than those in group B(P<0.05).After 6 months of treatment,ERP P3 latency in group A was lower than that in group B,and its amplitude was higher than that in group B(P<0.05).After 6 months of treatment,the levels of serum GLU,5-HT and BDNF in group A were lower than those in group B,while the level of serum GABA was higher than that in group B(P<0.05).Conclusion Low-frequency TMS combined with early rehabilitation training can further improve t

关 键 词：智力低下 孤独症谱系障碍 神经递质 

分 类 号：R749.94[医药卫生—神经病学与精神病学]