经颅直流电刺激改善孤独症谱系障碍儿童社交认知:基于图片命名的脑电图研究

Improvements of social cognition in children with autism spectrum disorder by transcranial direct current stimulation:evidence from picture naming tasks in electroencephalogram

目的:探索经颅直流电刺激(tDCS)在孤独症谱系障碍(ASD)康复治疗中的疗效机制。方法:招募12例ASD儿童接受tDCS干预。干预前后行为学评估采用孤独症行为量表(ABC),治疗评定量表(ATEC)、儿童孤独症评估量表(CARS)和孤独症儿童心理教育评核修订第3版(PEP-3),分析tDCS治疗前后行为学改变。同时,5例ASD组患儿和9例典型发育儿童接受社交场景图片命名任务下的高密度脑电检测,并接受头颅磁共振扫描,从而对信号溯源水平的脑电活动,进行患儿治疗前后比较,以及患儿和典型发育儿童的比较。结果:在接受tDCS治疗后,ABC、ATEC、CARS和PEP-3总分均改善,PEP-3除情感表达外,其他分项目均有显著改善。高密度脑电分析提示接受tDCS治疗后热点脑区激活模式更接近于正常命名模式。tDCS治疗前后,热点脑区在激活程度上未出现显著差异,但热点位置和热点的功能系统分布存在差异性。结论:在常规康复干预基础上,t DCS治疗可改善ASD患儿临床症状及行为学评价指标,并促使其处理社交信息脑功能活动转向与正常发育儿童相似的模式。

Objective:To explore the therapeutic mechanism of transcranial direct current stimulation(tDCS)in the rehabilitation of autism spectrum disorder(ASD).Method:Twelve children with ASD were recruited for tDCS intervention.Autism Behavior Checklist(ABC),Autism Treatment Evaluation Checklist(ATEC),Childhood Autism Rating Scale(CARS),and the Psychoeducational Profile-Third Edition(PEP-3)were used for behavioral assessment.The scores of behavioral assessments were compared before and after treatment.Five children in the ASD group and 9 typically-developing children were tested with high-density EEG under the task of social scene picture naming.They also received head magnetic resonance image scanning for source reconstruction.On the source level,the EEG activity characteristics were analyzed by comparing the ASD group and the typically-developing group.The brain activities of source level were also compared before and after therapy.Result:After tDCS treatment,the score of ABC,ATEC,CARS,and the total score of PEP-3 were all improved,and the components of PEP-3 were significantly improved except for the expression of emotion.Highdensity EEG analysis suggested that the activation pattern of hot brain regions after tDCS treatment was more similar with the normal naming pattern.The comparison of hot spots before and after tDCS treatment showed no significant difference in activation,but there were differences in hot spot location and functional system distribution.Conclusion:Based on routine rehabilitation,tDCS therapy can improve the clinical symptoms and behavioral measurements of children with ASD and promote the transferring of their brain functional activation to the mode as typically-developing children.