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早期行为干预与自闭症幼儿大脑活动的正常化有关。

Early behavioral intervention is associated with normalized brain activity in young children with autism.

机构信息

University of North Carolina at Chapel Hill, the University of Washington (UW), and Autism Speaks.

出版信息

J Am Acad Child Adolesc Psychiatry. 2012 Nov;51(11):1150-9. doi: 10.1016/j.jaac.2012.08.018.

Abstract

OBJECTIVE

A previously published randomized clinical trial indicated that a developmental behavioral intervention, the Early Start Denver Model (ESDM), resulted in gains in IQ, language, and adaptive behavior of children with autism spectrum disorder. This report describes a secondary outcome measurement from this trial, EEG activity.

METHOD

Forty-eight 18- to 30-month-old children with autism spectrum disorder were randomized to receive the ESDM or referral to community intervention for 2 years. After the intervention (age 48 to 77 months), EEG activity (event-related potentials and spectral power) was measured during the presentation of faces versus objects. Age-matched typical children were also assessed.

RESULTS

The ESDM group exhibited greater improvements in autism symptoms, IQ, language, and adaptive and social behaviors than the community intervention group. The ESDM group and typical children showed a shorter Nc latency and increased cortical activation (decreased α power and increased θ power) when viewing faces, whereas the community intervention group showed the opposite pattern (shorter latency event-related potential [ERP] and greater cortical activation when viewing objects). Greater cortical activation while viewing faces was associated with improved social behavior.

CONCLUSIONS

This was the first trial to demonstrate that early behavioral intervention is associated with normalized patterns of brain activity, which is associated with improvements in social behavior, in young children with autism spectrum disorder.

摘要

目的

先前发表的一项随机临床试验表明,发展行为干预,即早期丹佛模式(ESDM),可使自闭症谱系障碍儿童的智商、语言和适应行为得到提高。本报告描述了该试验的次要结果测量,即脑电图活动。

方法

48 名 18 至 30 个月大的自闭症谱系障碍儿童被随机分配接受 ESDM 或转介到社区进行 2 年干预。干预后(48 至 77 个月龄),在呈现面孔与物体时测量脑电图活动(事件相关电位和光谱功率)。还对年龄匹配的典型儿童进行了评估。

结果

ESDM 组在自闭症症状、智商、语言、适应和社会行为方面的改善优于社区干预组。ESDM 组和典型儿童在观看面孔时表现出较短的 Nc 潜伏期和增加的皮质激活(减少的α功率和增加的θ功率),而社区干预组则表现出相反的模式(观看物体时潜伏期较短的事件相关电位[ERP]和更大的皮质激活)。观看面孔时更大的皮质激活与社会行为的改善有关。

结论

这是第一项表明早期行为干预与自闭症谱系障碍儿童大脑活动正常化模式相关的试验,而这种正常化模式与社会行为的改善有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3388/3607427/8f5388139a10/nihms404612f1.jpg

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