中国康复理论与实践2025，Vol.31Issue(8)：979-986,8.DOI:10.3969/j.issn.1006-9771.2025.08.015
团体认知训练叠加重复经颅磁刺激对高功能孤独症谱系障碍共病注意缺陷多动障碍的增效作用及脑电机制
Effect of repetitive transcranial magnetic stimulation augmentation on group cognitive training for high-function-ing autism spectrum disorder comorbided with attention-deficit/hyperactivity disorder,and electrophysiological mechanisms
摘要
Abstract
Objective To examine the effect and electrophysiological mechanism of repetitive transcranial magnetic stimulation(rT-MS)augmentated to group cognitive training(GCT)on children with high-functioning autism spectrum disorder(ASD)comorbided with attention-deficit/hyperactivity disorder(ADHD). Methods From March to December,2023,70 children diagnosed with ASD+ADHD were recruited from the Affiliated Xuzhou Children's Hospital of Xuzhou Medical University and partnering special education centers.They were randomly divided into control group(n=35)and experimental group(n=35).Both groups received standard-ized GCT,twice a week,for ten weeks.During the same period,the control group received sham stimulation,while the experimental group additionally received 1 Hz rTMS over the right temporoparietal junction at 80%of resting motor threshold,five times a week,for ten weeks.Core symptoms were assessed before and after treat-ment with the Social Responsiveness Scale-2(SRS-2),Repetitive Behavior Scale-Revised(RBS-R)and Conners Parent Rating Scale-3(CPRS-3)attention-deficit and hyperactivity/impulsivity subscales.Resting-state EEG was simultaneously recorded to obtain θ and β power spectral density(PSD)and the θ/β ratio at Fz,Cz and Pz. Results Two cases in the control group and one in the experimental group dropped down.After treatment,SRS-2 scores(|Z|>4.876,P<0.001)and RBS-R scores(|Z|>4.329,P<0.001)decreased in both groups.CPRS-3 attention-deficit scores(|Z|>4.940,P<0.001)and hyperactivity/impulsivity scores(|t|>16.273,P<0.001)decreased in both groups,and they were lower in the experimental group(Z=4.732,P<0.001;t=-3.169,P<0.01).In the experimental group,Fz θ-PSD decreased significantly(Z=-4.830,P<0.001),and it was lower than that in the control group(Z=-2.609,P=0.009);and the θ/β ratio likewise fell(t=4.754,P<0.001),and it was lower than that in the control group(t=-2.256,P=0.027). Conclusion Adding rTMS to GCT can further alleviate attention deficits and hyperactive-impulsive symptoms in chil-dren with ASD comorbided with ADHD,which may associate with the inhibit of power of θ wave in profrontal contex.关键词
重复经颅磁刺激/团体认知训练/孤独症谱系障碍/注意缺陷多动障碍Key words
repetitive transcranial magnetic stimulation/group cognitive training/autism spectrum disorder/attention deficit/hyperactivity disorder分类
医药卫生引用本文复制引用
仇爱珍,王敏,王秋爽,吴野,鲍克秀..团体认知训练叠加重复经颅磁刺激对高功能孤独症谱系障碍共病注意缺陷多动障碍的增效作用及脑电机制[J].中国康复理论与实践,2025,31(8):979-986,8.基金项目
1.徐州市重点研发计划(社会发展)项目-医药卫生面上(No.KC22197) （社会发展）
2.江苏省卫生健康委科研项目(No.Z2023002) Supported by Xuzhou City Key Research and Development Program(Social Development)General Medicine and Health Project(No.KC22197),and Research Project of the Health Commission of Jiangsu Province(No.Z2023002) （No.Z2023002）
