Auvichayapat Narong, Patjanasoontorn Niramol, Phuttharak Warinthorn, Suphakunpinyo Chanyut, Keeratitanont Keattichai, Tunkamnerdthai Orathai, Aneksan Benchaporn, Klomjai Wanalee, Boonphongsathian Wuttisak, Sinkueakunkit Akkharawat, Punjaruk Wiyada, Tiamkao Somsak, Auvichayapat Paradee
Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Front Mol Neurosci. 2020 Jun 4;13:70. doi: 10.3389/fnmol.2020.00070. eCollection 2020.
Previous research has provided evidence that transcranial direct current stimulation (tDCS) can reduce severity of autism spectrum disorder (ASD); however, the exact mechanism of this effect is still unknown. Magnetic resonance spectroscopy has demonstrated low levels of brain metabolites in the anterior cingulate cortex (ACC), amygdala, and left dorsolateral prefrontal cortex (DLPFC) in individuals with ASD. The aim of this study was to investigate the effects of anodal tDCS on social functioning of individuals with ASD, as measured by the social subscale of the Autism Treatment Evaluation Checklist (ATEC), through correlations between pretreatment and posttreatment concentrations of brain metabolites in the areas of interest (DLPFC, ACC, amygdala, and locus coeruleus) and scores on the ATEC social subscale.
Ten participants with ASD were administered 1 mA anodal tDCS to the left DLPFC for 20 min over five consecutive days. Measures of the ATEC social subscale and the concentrations of brain metabolites were performed before and immediately after the treatment.
The results showed a significant decrease between pretreatment and immediately posttreatment in the ATEC social subscale scores, significant increases in N-acetylaspartate (NAA)/creatine (Cr) and myoinositol (mI)/Cr concentrations, and a decrease in choline (Cho)/Cr concentrations in the left DLPFC and locus coeruleus after tDCS treatment. Significant associations between decreased ATEC social subscale scores and changed concentrations in NAA/Cr, Cho/Cr, and mI/Cr in the locus coeruleus were positive.
Findings suggest that beneficial effects of tDCS in ASD may be due to changes in neuronal and glia cell activity and synaptogenesis in the brain network of individuals with ASD. Further studies with larger sample sizes and control groups are warranted.
先前的研究已提供证据表明，经颅直流电刺激（tDCS）可减轻自闭症谱系障碍（ASD）的严重程度；然而，这种效应的确切机制仍不清楚。磁共振波谱显示，ASD患者前扣带回皮质（ACC）、杏仁核和左侧背外侧前额叶皮质（DLPFC）中的脑代谢物水平较低。本研究的目的是通过比较治疗前和治疗后感兴趣区域（DLPFC、ACC、杏仁核和蓝斑）的脑代谢物浓度与自闭症治疗评估清单（ATEC）社交子量表得分之间的相关性，来研究阳极tDCS对ASD患者社交功能的影响。
10名ASD参与者连续5天接受1 mA阳极tDCS刺激左侧DLPFC，持续20分钟。在治疗前和治疗后立即进行ATEC社交子量表测量和脑代谢物浓度检测。
结果显示，治疗后ATEC社交子量表得分较治疗前显著降低，左侧DLPFC和蓝斑中N-乙酰天门冬氨酸（NAA）/肌酸（Cr）和肌醇（mI）/Cr浓度显著升高，胆碱（Cho）/Cr浓度降低。蓝斑中ATEC社交子量表得分降低与NAA/Cr、Cho/Cr和mI/Cr浓度变化之间存在显著正相关。
研究结果表明，tDCS对ASD的有益作用可能归因于ASD患者脑网络中神经元和神经胶质细胞活动及突触形成的变化。有必要进行更大样本量和对照组的进一步研究。
