孙长城,王春方,田蓉,等.基于失匹配负波的经颅直流电刺激治疗自闭症儿童的疗效观察[J].中华物理医学与康复杂志,2021,43(8):729-734
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| 基于失匹配负波的经颅直流电刺激治疗自闭症儿童的疗效观察 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.08.014 |
| 中文关键词: 自闭症儿童 经颅直流电刺激 脑电 失匹配负波 行为能力 |
| 英文关键词: Autism Transcranial direct current stimulation Electroencephalography Mismatch negativity Behavior |
| 基金项目:天津市卫生健康委员会科技项目（QN20029） |
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| 中文摘要: |
| 目的 探讨经颅直流电刺激（tDCS）对自闭症儿童行为学特征及听觉诱发电位-失匹配负波（MMN）成分的影响。 方法 选取自闭症儿童34例，按照随机数字表法将其分为阳极刺激组（19例）和伪刺激组（16例）。阳极刺激组采用阳极tDCS加常规康复的治疗方法，伪刺激组采用tDCS伪刺激加常规康复的治疗方法。tDCS治疗每周3次，每次20 min，常规康复治疗每周5次，每次1 h，共4周。治疗前和所有治疗完成后，评估每位患儿的行为学能力和听觉诱发脑电信号的特征变化。 结果 治疗前两组患儿各项评估指标比较无统计学差异（P>0.05）。治疗后，两组患儿的行为能力评估均显著改善（P<0.05），除学习能力外，阳极刺激组较伪刺激组的改善更加显著（P<0.05）；阳极刺激组MMN的幅值显著增高（P<0.05），潜伏期显著减小（P<0.05）；伪刺激组的幅值和潜伏期无显著性变化（P>0.05）；治疗后两组患儿之间比较，阳极刺激组MMN的幅值显著高于伪刺激组（P<0.05）、潜伏期显著小于伪刺激组（P<0.05）。治疗前后MMN成分的潜伏期变化与ABC量表、前庭功能、触觉防御及本体感的改善存在显著线性相关（P<0.05）。 结论 阳极tDCS联合常规康复治疗方法可有效提高自闭症儿童听觉诱发MMN成分的幅值，缩短潜伏期，改善行为能力。 |
| 英文摘要: |
| Objective To investigate the effect of transcranial direct current stimulation (tDCS) on the behavior and the mismatch negativity (MMN) component of the auditory evoked potential of autistic children. Methods Thirty-four autistic children were randomly divided into an anode stimulation group (n=19) and a pseudo-stimulation group (n=16). Both groups were given one hour of routine rehabilitation five times a week for 4 weeks, while the anode stimulation group was additionally provided with 20 minutes of tDCS 3 times a week. Before and after the treatment, both groups′ behavior was evaluated by using autism behavior checklist (ABC) as well as any changes in MMN of the auditory evoked EEG signals. Results There were no significant differences between the two groups in any of the measurements before the treatment. Afterwards behavior had improved significantly in both groups, with significantly greater improvement in the stimulated group. In the stimulated group the average MMN amplitude had increased significantly and the average latency had decreased significantly. However, no such significant changes were observed in the pseudo-stimulation group. There was a significant linear correlation between the changes in the incubation period of MMN components and the improvements in ABC, vestibular functioning, tactile defense and proprioception. Conclusion Anodal tDCS combined with conventional rehabilitation therapy can effectively increase the MMN amplitude and shorten the latency in autistic children, improving their brain function. |
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