昆明医科大学学报2026，Vol.47Issue(8)：137-145,9.DOI:10.12259/j.issn.2095-610X.S20260814
基于行为与神经生理证据支持的经颅直流电刺激与计算机认知训练协同增强孤独症谱系障碍疗效的随机对照
Transcranial Direct Current Stimulation Combined with Computerized Cognitive Training Synergistically Enhances Efficacy in Autism Spectrum Disorder:A Randomized Controlled Trial Based on Behavioral and Neurophysiological Evidence
摘要
Abstract
Objective To investigate the efficacy of transcranial direct current stimulation(tDCS)combined with computerized cognitive training(CCT)in treating autism spectrum disorder(ASD).Methods A total of 208 children with ASD admitted to Longgang District Maternal and Child Health Hospital,Shenzhen from January 2021 to August 2024 were selected,and randomly divided into four groups using a random number table:CCT group(n=52),tDCS group(n=52),combination group(n=52),and sham stimulation group(n=52).All four groups received standard rehabilitation treatment.Additionally,the CCT group received CCT,the tDCS group received tDCS,the combination group received tDCS combined with CCT,and the sham stimulation group received sham tDCS combined with CCT.Therapeutic efficacy,Childhood Autism Rating Scale(CARS),Aberrant Behavior Checklist(ABC),Chinese Version of Psychoeducational Profile-3(C-PEP-3),and Children's Neuro-psychological Behavioral Scale(abbreviated as China Children Development Scale)scores,electroence-phalographic parameters[latency and amplitude of mismatch negativity(MMN)at Fz and Cz leads,frontal lobe relative θ power,sleep discharge index]before and after treatment,and the incidence of adverse reactions were compared among the four groups.Results The overall therapeutic efficacy rate showed no significant difference among the four groups(x2=6.811,P=0.078).After 3 months of treatment,the combination group showed significantly lower scores on ABC scale dimensions(somatic motor,language,sensory,social interaction,self-care)and CARS total scores compared with the CCT,tDCS,and sham stimulation groups,and significantly higher C-PEP-3 total scores and Child Neuropsychological Behavior Examination Scale scores in language,social behavior,developmental quotient,mental age,adaptive ability,gross motor,and fine motor dimensions compared with the other three groups(F=7.575,14.741,7.616,6.817,6.896,21.804,12.175,13.034,17.661,11.925,12.690,9.691,8.777,13.485,P＜0.05).No significant differences were found among the CCT,tDCS,and sham stimulation groups in ABC dimensions,CARS scores,C-PEP-3 scores,or Child Neuropsychological Behavior Examination Scale dimensions(P＞0.05).After 3 months of treatment,the combination group showed significantly lower MMN latency in Fz and Cz leads,relative frontal theta power,and sleep discharge index,and significantly higher MMN amplitude in Fz and Cz leads compared with the other three groups(F=15.593,12.714,12.072,48.912,6.901,5.723,P＜0.05).No significant differences were found among the CCT,tDCS,and sham stimulation groups in these EEG parameters(P＞0.05).The overall incidence of adverse reactions showed no significant difference among the four groups(P=0.123).Conclusion tDCS combined with CCT demonstrates significant therapeutic efficacy in treating ASD,potentially improving cognitive and social functioning,reducing aberrant behaviors,and improving cerebral electrical activity in affected children.关键词
经颅直流电刺激/计算机认知训练/孤独症谱系障碍/脑电图/失匹配负波Key words
Transcranial direct current stimulation/Computerized cognitive training/Autism spectrum disorder/Electroencephalogram/Mismatched negative waves分类
医药卫生引用本文复制引用
杨顺波,赖燕媚,李庆红,杨金狄,吕智海..基于行为与神经生理证据支持的经颅直流电刺激与计算机认知训练协同增强孤独症谱系障碍疗效的随机对照[J].昆明医科大学学报,2026,47(8):137-145,9.基金项目
广东省医学科研基金(A20210353) （A20210353）
