Esse Wilson Joan, Quinn Davin K, Wilson J Kevin, Garcia Christopher M, Tesche Claudia D
J ECT. 2018 Mar;34(1):e10-e13. doi: 10.1097/YCT.0000000000000445.
While there is evidence of improved social functioning after applying transcranial direct current stimulation (tDCS) at the right temporoparietal junction (rTPJ) in individuals who are healthy, no current studies have investigated the use of tDCS at the rTPJ to improve social functioning in individuals with autism spectrum disorder (ASD). This case investigates the use of tDCS applied to the rTPJ to target social functioning in a high-functioning adult with ASD.
The authors present a case of an 18-year old patient with ASD treated successfully with tDCS; 1.5 mA of tDCS was applied once a day for 30 minutes for 8 consecutive days with the anode electrode over rTPJ (CP6 in the 10/10 electroencephalogram system) and the cathode electrode placed on the ipsilateral deltoid. Behavioral outcome was assessed using the Autism Treatment Evaluation Checklist prior to tDCS, after the final tDCS session, and at 2 months after tDCS. An additional, informal follow-up was also made 1 year after tDCS.
Autism Treatment Evaluation Checklist showed substantial improvement in social functioning from baseline to post-tDCS, which was maintained at 2 months. The patient also reported lessened feelings of anger and frustration over social disappointments. Informal follow-up 1 year after stimulation indicates that the patient continues to maintain many improvements.
Anodal tDCS to the rTPJ may represent an effective treatment for improving social functioning in ASD, with a larger clinical trial needed to validate this effect.
虽然有证据表明,对健康个体在右侧颞顶联合区(rTPJ)施加经颅直流电刺激(tDCS)后其社会功能有所改善,但目前尚无研究调查在自闭症谱系障碍(ASD)个体中使用rTPJ区域的tDCS来改善社会功能的情况。本病例研究了对一名患有ASD的高功能成年患者使用rTPJ区域的tDCS来改善其社会功能的情况。
作者报告了一例18岁ASD患者成功接受tDCS治疗的病例;每天一次施加1.5 mA的tDCS,持续30分钟,连续8天,阳极置于rTPJ(10/10脑电图系统中的CP6),阴极置于同侧三角肌。在tDCS治疗前、最后一次tDCS治疗后以及tDCS治疗后2个月,使用《自闭症治疗评估清单》评估行为结果。在tDCS治疗1年后还进行了一次额外的非正式随访。
《自闭症治疗评估清单》显示,从基线到tDCS治疗后社会功能有显著改善,且在2个月时仍保持改善。患者还报告称,因社交失望而产生的愤怒和沮丧情绪有所减轻。刺激后1年的非正式随访表明,患者继续保持了许多改善。
对rTPJ进行阳极tDCS可能是改善ASD患者社会功能的一种有效治疗方法,需要更大规模的临床试验来验证这种效果。