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经皮电神经调节治疗高功能自闭症谱系障碍的焦虑和睡眠问题:可行性及初步研究结果

Transdermal Electrical Neuromodulation for Anxiety and Sleep Problems in High-Functioning Autism Spectrum Disorder: Feasibility and Preliminary Findings.

作者信息

Foldes Stephen T, Jensen Amanda R, Jacobson Austin, Vassall Sarah, Foldes Emily, Guthery Ann, Brown Danni, Levine Todd, Tyler William James, Frye Richard E

机构信息

Division of Research, Barrow Neurologic Institute at Phoenix Children's Hospital, Phoenix, AZ 85016, USA.

Division of Neurology, Barrow Neurologic Institute, Phoenix, AZ 85013, USA.

出版信息

J Pers Med. 2021 Dec 6;11(12):1307. doi: 10.3390/jpm11121307.

Abstract

BACKGROUND

Autism spectrum disorder (ASD) is associated with anxiety and sleep problems. We investigated transdermal electrical neuromodulation (TEN) of the cervical nerves in the neck as a safe, effective, comfortable and non-pharmacological therapy for decreasing anxiety and enhancing sleep quality in ASD.

METHODS

In this blinded, sham-controlled study, seven adolescents and young adults with high-functioning ASD underwent five consecutive treatment days, one day of the sham followed by four days of subthreshold TEN for 20 min. Anxiety-provoking cognitive tasks were performed after the sham/TEN. Measures of autonomic nervous system activity, including saliva α-amylase and cortisol, electrodermal activity, and heart rate variability, were collected from six participants.

RESULTS

Self-rated and caretaker-rated measures of anxiety were significantly improved with TEN treatment as compared to the sham, with effect sizes ranging from medium to large depending on the rating scale. Sleep scores from caretaker questionnaires also improved, but not significantly. Performance on two of the three anxiety-provoking cognitive tasks and heart rate variability significantly improved with TEN stimulation as compared to the sham. Four of the seven (57%) participants were responders, defined as a ≥ 30% improvement in self-reported anxiety. Salivary α-amylase decreased with more TEN sessions and decreased from the beginning to the end of the session on TEN days for responders. TEN was well-tolerated without significant adverse events.

CONCLUSIONS

This study provides preliminary evidence that TEN is well-tolerated in individuals with ASD and can improve anxiety.

摘要

背景

自闭症谱系障碍(ASD)与焦虑和睡眠问题有关。我们研究了颈部颈神经的经皮电神经调节(TEN)作为一种安全、有效、舒适且非药物的疗法,用于降低ASD患者的焦虑并提高睡眠质量。

方法

在这项双盲、假对照研究中,7名高功能ASD青少年和青年连续接受5天治疗,先进行1天的假治疗,然后进行4天的阈下TEN治疗,每次20分钟。在假治疗/TEN治疗后进行诱发焦虑的认知任务。从6名参与者中收集自主神经系统活动的测量指标,包括唾液α-淀粉酶和皮质醇、皮肤电活动以及心率变异性。

结果

与假治疗相比,TEN治疗后自我评定和照料者评定的焦虑测量指标均有显著改善,根据评定量表,效应大小从中等至大不等。照料者问卷中的睡眠评分也有所改善,但不显著。与假治疗相比,TEN刺激后三项诱发焦虑的认知任务中的两项表现以及心率变异性显著改善。7名参与者中有4名(57%)为反应者,定义为自我报告的焦虑改善≥30%。对于反应者,唾液α-淀粉酶随着TEN治疗次数的增加而降低,并且在TEN治疗日从治疗开始到结束有所下降。TEN耐受性良好,无显著不良事件。

结论

本研究提供了初步证据,表明TEN在ASD个体中耐受性良好且可改善焦虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3866/8704341/494783a68cbd/jpm-11-01307-g001.jpg

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