| 王敏,王秋爽,仇爱珍,鲍克秀,郑会敏.右颞顶交界区低频经颅磁刺激对孤独症儿童刻板行为的影响[J].中国康复,2025,40(11):660-664 |
| 右颞顶交界区低频经颅磁刺激对孤独症儿童刻板行为的影响 |
| Effects of low-frequency transcranial magnetic stimulation of right temporoparietal junction on stereotyped behavior in autistic children |
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| DOI：10.3870/zgkf.2025.11.004 |
| 中文关键词: 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 |
| 英文关键词: low-frequency repetitive transcranial magnetic stimulation autism right temporoparietal junction resting electroencephalogram power spectral density |
| 基金项目:徐州市重点研发计划（社会发展）项目-医药卫生面上项目（KC22197） |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| 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 the θ frequency 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 of θ waves 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). |
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