Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, The Netherlands.
J Psychiatr Res. 2011 Jun;45(6):796-802. doi: 10.1016/j.jpsychires.2010.11.006. Epub 2010 Dec 4.
In an earlier study the Auditory Startle Response (ASR) of anxiety disordered (AD) children proved to be enlarged. This study examines in a controlled design to what extent this increase is responsive to symptom reduction during Cognitive Behavioral Therapy (CBT) METHODS: The activity of 6 muscles following 104 dB tones in 20 patients (M = 12,7 years; SD = 2.5) and 25 matched controls was measured with an electromyogram (EMG). In addition, the sympathetic skin response was investigated. Response to treatment was investigated with the Anxiety Disorder Interview Schedule for Children (ADIS-C) and the Spence Children's Anxiety Scale (SCAS).
Treatment responders (n = 12) showed a significant ASR decrease over time, whereas non-responders (n = 8) showed a significant ASR increase or no significant ASR difference. In controls, the ASR was not significantly different at follow up compared to baseline. The sympathetic skin response was stable in controls and treatment responders but significantly increased over time in treatment non-responders. Linear regression suggested that one of the ASR pre-treatment parameters (multiple muscle EMG magnitude) predicts treatment response.
The ASR decreases in AD children when anxiety symptoms diminish. In addition, the ASR may be useful in predicting response to CBT in AD children.
在早期的研究中，焦虑障碍（AD）儿童的听觉惊跳反应（ASR）被证明增大。本研究采用对照设计，考察在认知行为治疗（CBT）过程中，症状减轻的程度对 ASR 增加有多大的影响。
通过肌电图（EMG）测量 20 名患者（M=12.7 岁，SD=2.5）和 25 名匹配对照者在 104dB 音调后的 6 块肌肉的活动。此外，还研究了交感皮肤反应。采用儿童焦虑障碍访谈表（ADIS-C）和斯宾塞儿童焦虑量表（SCAS）来评估治疗反应。
治疗反应者（n=12）的 ASR 随时间显著降低，而非反应者（n=8）的 ASR 显著增加或无显著差异。在对照组中，随访时的 ASR 与基线相比无显著差异。在对照组和治疗反应者中，交感皮肤反应是稳定的，但在治疗无反应者中随时间显著增加。线性回归表明，ASR 治疗前的一个参数（多块肌肉 EMG 幅度）可以预测治疗反应。
AD 儿童的焦虑症状减轻时，ASR 会降低。此外，ASR 可能有助于预测 AD 儿童对 CBT 的反应。
