重复经颅磁刺激对孤独症谱系障碍儿童核心症状及脑功能连接的影响  

Effects of repetitive transcranial magnetic stimulation on core symptoms and brain functional connectivity in children with autism spectrum disorder

作　　者：王静 刘芸[1] 黄浩宇[1] 吴金庭 张杨萍[1] 王文娟[1] 刘春明[1] WANG Jing;LIU Yun;HUANG Haoyu;WU Jinting;ZHANG Yangping;WANG Wenjuan;LIU Chunming(Department of Rehabilitation,Kunming Children’s Hospital,Kunming 650034,Yunnan Province,China)

机构地区：[1]昆明市儿童医院康复科,中国昆明650034

出　　处：《教育生物学杂志》2024年第6期427-431,436,共6页Journal of Bio-education

基　　金：云南省科技厅科技计划项目(202401AY070001-022);云南省徐开寿专家工作站项目(202405AF140103);云南省教育厅科学研究基金(2024J0303);昆明市卫生科技人才培养项目医学科技学科后备人才培养计划〔2022-SW(后备)005〕;昆明市卫生健康委员会卫生科研课题(2023-16-01-001)。

摘　　要：目的探究重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对孤独症谱系障碍(autism spectrum disorder,ASD)儿童核心症状及脑功能连接的影响。方法将65例ASD患儿随机分为对照组和观察组,分别接受常规康复治疗及常规康复联合rTMS治疗。采用孤独症行为量表(autism behavior checklist,ABC)和儿童孤独症评定量表(childhood autism rating scale,CARS)评估治疗前后的ASD核心症状。利用功能性近红外光谱技术(functional near-infrared spectroscopy,fNIRS)检测前额叶皮质中的血氧浓度变化,对感兴趣区域(region of interest,ROI)的静息态功能连接(resting-state functional connectivity,RSFC)进行分析。结果治疗后,2组儿童的ABC和CARS评分相较于治疗前均有显著下降(P<0.05),其中观察组的下降更为明显(P<0.05)。fNIRS检测发现,治疗后观察组ASD儿童ROI脑区内部及脑区间的RSFC高于对照组,其中左右前额叶皮质内部RSFC,以及左右前额叶之间及左颞叶与左前、中间额叶之间RSFC的组间差异有统计学意义(P<0.05)。结论rTMS可有效改善ASD儿童的核心症状和脑功能连接状况。Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)on coresymptoms and brain functional connectivity in children with autism spectrum disorder(ASD).Methods Sixty-five ASD children were randomly divided into a control group and an observation group.The control group received conventional rehabilitation treatment,while the observation group underwent conventional rehabilitation combined with rTMS treatment.Before and after treatment,the autism behavior checklist(ABC)and childhood autism rating scale(CARS)were used to evaluate the core symptoms of ASD.Functional near-infrared spectroscopy(fNIRS)technology was used to detect changes in blood oxygen concentration in the prefrontal cortex,and resting-state functional connectivity(RSFC)of the region of interest(ROI)was analyzed.Results After treatment,the ABC and CARS scores of both groups significantly decreased compared to those before treatment(P<0.05),with the observation group showing a more significant decrease(P<0.05).The fNIRS testing revealed that the RSFC within and between the ROI of ASD children in the observation group was higher than that in the control group after treatment.Among them,there were significant differences in the RSFC within the left and right prefrontal cortex,as well as between the left and right prefrontal lobes and between the left temporal lobe and the left anterior and middle frontal lobes(P<0.05).Conclusion rTMS can effectively improve the core symptoms and brain functional connectivity of children with ASD.

关 键 词：孤独症谱系障碍 重复经颅磁刺激 功能性近红外光谱技术 脑功能连接 

分 类 号：R749.94[医药卫生—神经病学与精神病学]