Abstract:

Objective　Investigating the application and observation of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with behavioral analysis therapy (ABA) in children with autism spectrum disorder (ASD). Methods　A total of 68 children with ASD who were admitted to Anyang No.7 People's Hospital from June 2022 to June 2024 were selected for a prospective study. They were randomly divided into two groups according to the random number table method, with 34 cases in each group.In the control group, there were 19 males and 15 females, with an average age of (9.94±0.65) years and a disease duration of (2.56±0.33) years. They received conventional intervention.In the observation group, there were 18 males and 16 females, with an average age of (9.98±0.68) years and a disease duration of (2.59±0.31) years. They received low-frequency rTMS combined with ABA treatment.Both groups were continuously observed and intervened for 12 weeks.The autism behaviors, cognitive functions and quality of life of the two groups of children were compared [using the Autism Treatment Evaluation Checklist (ATEC)], [using the Montreal Cognitive Assessment Scale (MoCA)], and [using the Pediatric Quality of Life Inventory 4.0 (PedsQL4.0)].The statistical method employed was the t-test. Results　Before the intervention, there was no statistically significant difference in the ATEC, MoCA and PedsQL4.0 scores between the two groups of children (all P>0.05).After the intervention, the scores of social ability [(27.35±1.09) points], perception/cognitive ability [(22.38±1.07) points], health/physiological behavior [(31.18±1.29) points], and expression/language communication [(17.77±1.10) points] in the observation group were all lower than those in the control group [(30.74±1.22) points, (26.76±1.11) points, (35.53±1.74) points, (20.92±1.13) points],The MoCA score [(19.92±1.78) points], as well as the scores for physiological function [(23.36±1.81) points], emotional function [(14.74±1.53) points], social function [(15.65±1.62) points], and role function [(15.75±1.40) points] were all higher than those of the control group [(15.74±1.63) points, (18.97±1.44) points, (11.94±1.65) points, (11.09±1.54) points, (11.54±1.35) points].The differences were all statistically significant (t=12.083、16.565、11.710、11.647、10.099、11.067、7.256、11.896, and 12.622，all P<0.05). Conclusion　Low-frequency rTMS combined with ABA can accelerate the recovery of symptoms in children with ASD, improve their cognitive function levels, help them return to family and society earlier, and contribute to enhancing their quality of life.

Key words:

Autism spectrum disorder, Repeated transcranial magnetic stimulation, Behavioral analysis therapy, Autism,  , Cognitive function

摘要：

目的　探讨低频重复经颅磁刺激（rTMS）联合行为分析疗法（ABA）在孤独症谱系障碍（ASD）患儿中的应用效果。方法　选取2022年6月至2024年6月安阳市第七人民医院收治的68例ASD患儿进行前瞻性研究，按随机数字表法分为两组，每组34例。对照组：男19例、女15例，年龄（9.94±0.65）岁，病程（2.56±0.33）年，采取常规干预；观察组：男18例、女16例，年龄（9.98±0.68）岁，病程（2.59±0.31）年，采取低频rTMS联合ABA治疗。两组均持续干预12周。对比两组患儿孤独症行为［采用孤独症治疗评定量表（ATEC）］、认知功能［采用蒙特利尔认知评估量表（MoCA）］及生活质量［采用儿童普适性生活质量量表（PedsQL4.0）］。统计学方法采用t检验。结果　干预前，两组患儿ATEC、MoCA及PedsQL4.0评分比较，差异均无统计学意义（均P>0.05）。干预后，观察组社交能力［（27.35±1.09）分］、感知/认知能力［（22.38±1.07）分］、健康/生理行为［（31.18±1.29）分］、表达/语言沟通评分［（17.77±1.10）分］均低于对照组［（30.74±1.22）分、（26.76±1.11）分、（35.53±1.74）分、（20.92±1.13）分］， MoCA评分［（19.92±1.78）分］及生理功能［（23.36±1.81）分］、情感功能［（14.74±1.53）分］、社会功能［（15.65±1.62）分］、角色功能评分［（15.75±1.40）分］均高于对照组［（15.74±1.63）分、（18.97±1.44）分、（11.94±1.65）分、（11.09±1.54）分、（11.54±1.35）分］ ，差异均有统计学意义（t=12.083、16.565、11.710、11.647、10.099、11.067、7.256、11.896、12.622，均P<0.05）。结论　低频rTMS联合ABA可加快ASD患儿病症康复，提高其认知功能水平，帮助患儿早日回归家庭和社会，提升患儿生活质量。

关键词:

孤独症谱系障碍, 重复经颅磁刺激, 行为分析疗法, 孤独症, 认知功能