事件相关电位指导下重复经颅磁刺激治疗孤独症儿童的疗效观察

An Observation of the Therapeutic Effect of Repeated Transcranial MagneticStimulation Guided by Event-Related Potentials on Children with Autism Spectrum Disorder

目的:分析事件相关电位(ERP)指导下的高频和低频重复经颅磁刺激(rTMS)联合综合康复训练治疗孤独症谱系障碍(ASD)患儿的临床疗效。方法:选取2018年1月至2019年2月在郑州大学第五附属医院住院治疗的ASD儿童60例,随机分为实验组(n=30)和对照组(n=30)。两组患儿均接受综合康复治疗,在此基础上,对照组接受常规rTMS治疗,实验组根据ERP指导下的脑功能异常区域进行对应的高频和低频rTMS治疗。采用儿童孤独症评定量表(CARS)、孤独症儿童行为检查量表(ABC)、孤独症治疗评估表(ATEC)比较两组患儿治疗后的疗效。结果:治疗前两组CARS评分、ABC评分及ATEC评分均无显著差异(P>0.05);治疗3个月后,实验组CARS评分(34.63±1.94)显著低于对照组(35.73±1.96,P<0.05),ABC总分(50.10±4.55)显著低于对照组(54.53±5.43,P<0.05),ATEC总分(53.53±4.70)显著低于对照组(59.07±5.95,P<0.05);治疗6个月后,实验组CARS评分(33.87±2.49)显著低于对照组(31.50±2.05,P<0.05),ABC总分(50.00±5.13)显著低于对照组(40.01±4.86,P<0.05),ATEC总分(47.00±5.08)显著低于对照组(54.93±6.70,P<0.05)。结论:ERP指导下rTMS治疗方案在ASD治疗上较常规rTMS疗效更显著,可以为ASD患儿的rTMS治疗方案提供一定参考。

Objective:To analyze the clinical efficacy of high-low frequency repetitive transcranial magnetic stimulation(rTMS)under the guidance of event-related potential(ERP)combined with comprehensive rehabilitation training in the treatment of children with autism spectrum disorder(ASD).Methods:60 ASD children who visited the fifth affiliated hospital of Zhengzhou University from January 2018 to February 2019 were selected and randomly divided into the experimental group(n=30)and the control group(n=30).Both the two groups received comprehensive rehabilitation treatment.On this basis,the control group were treated with conventional rTMS treatment,while the experimental group were treated with high-frequency and low-frequency rTMS treatment in the abnormal brain areas according to the guidance of ERP.The children’s autism rating scale(CARS),autistic children’s behavior checklist(ABC),and autism treatment evaluation scale(ATEC)were used to compare the efficacy of the two groups after treatment.Results:Before treatment,there were no significant differences in CARS,ABC and ATEC scores between the two groups(P>0.05).After 3 months of treatment,the CARS score of the experimental group(34.63±1.94)was significantly lower than that of the control group(35.73±1.96,P<0.05),the total score of ABC(50.10±4.55)was significantly lower than that of control group(54.53±5.43,P<0.05),and the ATEC score(53.53±4.70)was significantly lower than that of the control group(59.07±5.95,P<0.05).After 6 months of treatment,the CARS score of the experimental group(33.87±2.49)was significantly lower than that of the control group(31.50±2.05,P<0.05),the total score of ABC(50.00±5.13)was significantly lower than that of control group(40.01±4.86,P<0.05),and the ATEC score(47.00±5.08)was significantly lower than that of the control group(54.93±6.70,P<0.05).Conclusion:The rTMS treatment plan under the guidance of ERP has a more significant improvement effect in the treatment of ASD than the conventional rTMS,which can provide a certain reference for the treatment of children with ASD by rTMS.