连续脉冲爆发刺激模式经颅磁刺激对孤独症谱系障碍儿童合并睡眠障碍的影响

关键词：经颅磁刺激  孤独症谱系障碍  睡眠障碍  推拿  连续脉冲爆发刺激模式

Keywords:transcranial magnetism  autism spectrum disorder  sleep disorders  massage  continuous pulse burst stimulation mode

摘要：

      摘要 目的：探讨连续脉冲爆发刺激模式经颅磁刺激对孤独症谱系障碍儿童合并睡眠障碍的影响。 方法：纳入2024年4—9月期间我院（徐州市儿童医院）接诊的50例合并睡眠障碍的孤独症谱系障碍儿童作为研究对象，按照随机数表法分为观察组和对照组，对照组25例合并睡眠障碍的孤独症谱系障碍儿童接受常规康复训练及推拿治疗，观察组25例除给予常规康复训练及推拿治疗外，再采用连续脉冲爆发刺激模式（continuous Theta burst stimulation，cTBS）的经颅磁刺激。治疗前和治疗后两组分别采用儿童睡眠习惯问卷（children's sleep habits questionnaire，CSHQ）、儿童孤独症评定量表（childhood autism rating scale，CARS）、长处和困难问卷-情绪（strengths and difficulties questionnaire，SDQ-情绪）进行评估。 结果：治疗前，两组之间一般资料及相关量表评定均无显著性差异（P>0.05）。治疗后，两组CSHQ评分低于治疗前，观察组明显低于对照组，差异有显著性意义（P＜0.05）；治疗后，两组CARS总分及人际关系等各维度得分均低于治疗前，差异有显著性意义（P＜0.05）；治疗后，两组SDQ-情绪评分低于治疗前，且观察组明显低于对照组，差异有显著性意义（P＜0.05）。 结论：连续脉冲爆发刺激模式经颅磁刺激可以改善孤独症谱系障碍儿童睡眠及情绪行为问题。

Abstract:

      Abstract Objective： To investigate the effects of continuous pulse burst transcranial magnetic stimulation on children with autism spectrum disorder with sleep disorders. Method： A total of 50 children with autism spectrum disorder （ASD） and sleep disorders who were admitted to our hospital （Xuzhou Children's Hospital） from April 2024 to September 2024 were included. They were randomly divided into an observation group and a control group (n=25 each). The control group received conventional rehabilitation training and massage therapy. The observation group received the same treatments as the control group， plus transcranial magnetic stimulation （TMS） with continuous theta burst stimulation （cTBS） mode. Before and after the treatment， both groups were evaluated on the children's sleep habits questionnaire（CSHQ）， the childhood autism rating scale （CARS）， and the strengths and difficulties questionnaire - emotional （SDQ-Emotional）. Result：At baseline， there were no significant differences in demongraphics and all scale evaluations between the two groups （P>0.05）. After treatment， the CSHQ scores of both groups were lower than those before treatment， and the observation group was significantly lower than the control group， with a significant difference （P<0.05）. After treatment， the total scores of CARS and the scores of each dimension such as interpersonal relationships in both groups were lower than those before treatment， with significant differences （P<0.05）. After treatment， the SDQ-emotion scores of both groups were lower than those before treatment， and the observation group was significantly lower than the control group， with a significant difference （P<0.05）. Conclusion：Continuous pulse burst stimulation mode transcranial magnetic stimulation was found to improve sleep and emotional behavior problems in children with autism spectrum disorder.