摘要
目的:探讨低频重复经颅磁刺激(LF-rTMS)靶向刺激右侧颞顶联合区(rTPJ)对孤独症谱系障碍(ASD)儿童核心症状、刻板行为及静息态脑电θ频段功率谱密度(PSD)的调控效应。方法:将70例ASD患儿随机分为研究组与对照组各35例,2组均接受常规康复干预课程,研究组同步实施rTPJ靶向LF-rTMS,对照组进行rTPJ的伪刺激。分别于治疗前和治疗8周后采用儿童孤独症评定量表(CARS)、孤独症行为量表(ABC)、重复行为量表修订版(RBS-R)评估行为学改变,并同步采集静息态脑电数据,通过θ频段(4~7 Hz)PSD值量化神经振荡特征。结果:干预8周后,2组CARS总分、ABC总分及RBS-R总分均较治疗前降低(P<0.01),研究组CARS总分、ABC总分较对照组差异无统计学意义,RBS-R总分较对照组降低(P<0.05)。干预8周后,研究组较治疗前在θ频段上的P4(右顶区)、C4(右中央区)位点上PSD值降低(P<0.01),研究组较对照组在θ波的各个位点上PSD值差异无统计学意义。结论:在常规康复基础上联合rTPJ靶向LF-rTMS干预,虽未显著改善ASD核心社交缺陷,但可有效缓解重复刻板行为,其作用可能与调节右侧感觉运动皮层(C4/P4)θ频段的激活有关。
Objective:To investigate the regulatory effects of low frequency repetitive transcranial magnetic stimulation(LF-rTMS)targeting right temporoparietal junction(rTPJ)on core symptoms,stereotyped behavior and resting state theta band power spectral density(PSD)in children with autism spectrum disorder(ASD).Methods:A randomized controlled design was adopted.A total of 70 children with ASD admitted were divided into study group(n=35)and control group(n=35).Both groups received standardized behavioral intervention courses.The study group simultaneously implemented rTPJ-targeted LF-rTMS,and control group implemented rTPJ-targeted sham stimulation.The behavioral changes were assessed with the child autism rating scale(CARS),autism behavior scale(ABC),and repetitive behavior scale revised(RBS-R)at baseline and 8 weeks after treatment,respectively,and resting EEG data were collected simultaneously to quantify the characteristics of neural oscillations by theta band(4-7Hz)PSD values.Results:After 8 weeks of intervention,the total scores of CARS,ABC,and RBS-R in both groups decreased compared to those before treatment(P<0.01).There was no statistically significant difference in the total scores of CARS and ABC between the study group and the control group,but the total RBS-R score in the study group was lower than that in the control group(P<0.05).After 8 weeks of intervention,the PSD values at the P4(right parietal region)and C4(right central region)sites in theθfrequency band decreased in the study group compared to those before treatment(P<0.01).However,there was no statistically significant difference in the PSD values ofθwaves at any site between the study group and the control group.Conclusion:The rTPJ-targeted LF-rTMS intervention on the basis of conventional rehabilitation did not significantly improve ASD core social defi-cits,but it could effectively alleviate repetitive stereotyped behavior,which may be related to the regulation of theta band overactivation in right hemisphere sensorimotor integration cortex(C4/P4).
作者
王敏
王秋爽
仇爱珍
鲍克秀
郑会敏
Wang Min;Wang Qiushuang;Qiu Aizhen;Bao Kexiu;Zheng Huimin(Department of Rehabilitation,the Affiliated Xuzhou Children’s Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Epidemiology and Health Statistics,School of Public Health,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China)
出处
《中国康复》
2025年第11期660-664,共5页
Chinese Journal of Rehabilitation
基金
徐州市重点研发计划(社会发展)项目-医药卫生面上项目(KC22197)。
关键词
低频重复经颅磁刺激
孤独症
右侧颞顶交界区
静息态脑电图
功率谱密度
low-frequency repetitive transcranial magnetic stimulation
autism
right temporoparietal junction
resting electroencephalogram
power spectral density
