经颅直流电刺激对孤独症谱系障碍儿童认知功能的影响

Effect of Transcranial Direct Current Stimulation on Cognitive Function in Children with Autism Spectrum Disorder

目的探讨经颅直流电刺激对孤独症谱系障碍(ASD)儿童认知功能的影响。方法回顾性分析了自2020年10月至2022年1月在郑州大学第五附属医院儿童康复科收住入院且符合纳入标准的60例孤独症谱系障碍患儿的临床资料,按照治疗方案分为观察组(30例,经颅直流电刺激联合常规康复治疗)和对照组(30例,常规康复治疗)。在治疗前、治疗3个月和治疗6个月采用失匹配负波(MMN)潜伏期、波幅和0~6岁儿童发育行为评估量表各项评分评估两组患儿的认知功能。结果相比于治疗前,治疗后两组患儿的0~6岁儿童发育行为评估量表各项评分均呈增高趋势,MMN潜伏期呈降低趋势,波幅呈增高趋势(P<0.05)。在治疗3、6个月后,观察组的各项指标的变化幅度均较对照组更为明显,尤其是语言、社交能力、发育商的增高(P<0.05)。此外,Fz、Cz导联MMN的潜伏期缩短水平及波幅的增高水平也较对照组的改变更为明显(P<0.05)。Spearman相关性分析结果表明:Fz、Cz导联的MMN的波形的改变与智龄和发育商的变化具有一致性(P<0.05)。结论经颅直流电联合常规康复治疗可以更加有效地改善孤独症患儿认知水平,并且可以有效改善异常的脑电活动。

Objective To investigate the effect of transcranial direct current stimulation on cognitive function in children with autism spectrum disorder(ASD).Methods The clinical data of 60 children with ASD who were admitted to the Department of Child Rehabilitation Medicine,the Fifth Affiliated Hospital of Zhengzhou University from October 2020 to January 2022 who met the inclusion criteria were retrospectively analyzed.According to the treatment plan,they were divided into the observation group(30 cases,transcranial direct current stimulation combined with conventional rehabilitation treatment)and the control group(30 cases,conventional rehabilitation treatment).The cognitive function of the two groups was evaluated before treatment,3 months after treatment and 6 months after treatment by the mismatched negative wave(MMN)latency,amplitude and the scores of developmental behavior assessment scale for children aged 0-6 years.Results Compared with before treatment,after treatment,the scores of developmental behavior assessment scale for children in the two groups showed an increasing trend,the MMN latency showed a decreasing trend,and the amplitude showed an increasing trend(P<0.05).After 3 and 6 months of treatment,the changes of various indexes in the observation group were more obvious than those in the control group,especially the language,social ability,development quotient(P<0.05).In addition,the shortened latency level and increased amplitude of MMN in Fz and Cz leads were more obvious than those in the control group(P<0.05).Spearman correlation analysis showed that the changes of MMN waveforms in Fz and Cz leads were consistent with the changes of mental age and developmental quotient(P<0.05).Conclusion Transcranial direct current combined with conventional rehabilitation can be more effective in improving the cognitive level of autistic children,and can effectively improve abnormal brain electrical activity.