rTMS结合脑电生物反馈对孤独症谱系障碍儿童刻板行为的疗效

目的:探讨重复经颅磁刺激(rTMS)结合脑电生物反馈(NFB)对孤独症谱系障碍(ASD)儿童刻板行为的疗效分析。方法:ASD儿童60例,随机分成4组各15例:对照组(常规康复训练),rTMS组(常规康复训练+rTMS),NFB组(常规康复训练+NFB),rTMS-NFB组(常规康复训练+rTMS+NFB,且NFB紧随rTMS之后),疗程12周,治疗前后用重复刻板行为量表(RBS-R)及孤独症行为检查量表(ABC)进行评估。结果:治疗12周后,4组RBS-R评分及ABC评分均较治疗前明显减少(均P0.05);且TMS组、NFB组、rTMS-NFB组RBS-R评分及ABC评分均明显低于对照组(均P0.05),rTMS-NFB组RBS-R评分及ABC评分均明显低于rTMS组及NFB组(均P0.05),rTMS组及NFB组RBS-R评分及ABC评分2组间比较差异无统计学意义。结论:常规康复训练、rTMS、NFB及rTMS-NFB对ASD儿童刻板行为的改善均有一定的促进作用;rTMS与NFB对其疗效相当;但rTMS-NFB的疗效明显优于rTMS、NFB单独治疗。

rTMS and neurofeedback treatment on stereotyped behavior of children with autism spectrum disorder

Objective: To explore the effectiveness of transcranial magnetic stimulation (rTMS) combined with neurofeedback (NFB) on stereotyped behavior of children with autism spectrum disorder (ASD). Methods: Sixty children with ASD were randomly divided into four groups (n=15 for each group): the control group receiving conventional rehabilitation training, the rTMS group receiving rTMS treatment additionally, the NFB group receiving NFB treatment additionally, and the rTMS-NFB group receiving rTMS and NFB treatment additionally. The rTMS was followed by NFB in rTMS-NFB group. After 12 weeks of treatment, all patients were assessed by repetitive behavior scale-revised (RBS-R) and autism behavior checklist (ABC). Results: The scores of RBS-R and ABC were decreased in each group after treatment (P<0.05). There was no significant differences between the rTMS group and the NFB group (P>0.05). The scores of RBS-R and ABC in the rTMS-NFB group were decreased more significantly than the NFB group and rTMS group (P<0.05). Conclusion: The conventional rehabilitation training, rTMS, NFB and rTMS-NFB may have some effects on stereotyped behavior of children with ASD. There is no significant differences between the rTMS and NFB groups. And the effect of the rTMS-NFB is better than the rTMS or NFB alone.