Ghahreman Yamin, Hosseini Seyed Ahmad, Hassani Saeed, Derakhshanpour Firouzeh, Hassani Mohammad Javad, Hosseini Parnian
Neonatal and Children's Health Research Center Taleghani Medicine Educational Center Golestan University of Medical Sciences Gorgan, Iran.
Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran.
Iran J Child Neurol. 2023 Summer;17(3):55-67. doi: 10.22037/ijcn.v17i2.37324. Epub 2023 Jul 1.
The present investigation has been done to study the behavioral effects of donepezil in autistic children, given that not much research has been carried out concerning using this drug for treating autism.
MATERIALS & METHODS: A cross-sectional and analytic-descriptive study was done on twenty patients with autism, aged 4-17, who visited the neurology clinic of Gorgan's Taleghani Pediatric Hospital and Yasha Pediatric Autism Clinic, Iran from 2019 to 2020. Demographic information, including sex, age, father's education, mother's education ,patient's education, family status, other problems, and ethnicity, were documented using a checklist, having been filled in during interviews with the parents. Before the trial, ABC cognitive and behavioral tests were taken to determine the children's current status. After the tests, these children received a daily dose of donepezil (10mg) before sleep for three months. At the end of the three months, the cognitive and behavioral tests were taken from the children once again. In order to analyze the effects of different factors on the studied variables, including irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech before and after the administration of donepezil in patients, a generalized linear model and to test the effects of donepezil on the studied variables, paired t-test was used.
In this study, twenty patients were registered for the investigation, 12 (60%) male and eight (40%) female. Age groups 5-6 had the highest frequency, and age group 17 had the lowest. Regardingthe parents' education, the highest frequency was for bachelor's degrees, and the lowest was for less-than-high school education and master's degree. The highest frequency for the patients' education was kindergarten (60%), and then groups without education (20%) and elementary school-level education (15%). Most of the studied patients (80%) did not have other problems besides autism, and only 20% had other problems besides autism. The family status of 15% of the families was 'separated,' and ethnically, most patients (80%) were Fars, while the rest (20%) were Turkmen. None of the analyzed factors (age, sex, father's education, mother's education, patient's education, other problems, family status, and ethnicity) had a significant effect on the studied variables after the administration of donepezil. Among the studied variables prior to the administration of donepezil and among the analyzed factors, the father's education, the patient's education, other problems, and family status had only a significant effect on stereotypic behavior. The present research findings of the present research indicated that all the studied variables, including irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech, were significantly decreased toward the desired goal. The decreased amounts in irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech after the administration of donepezil were, respectively, 38%, 44%, 54%, 41%, and 54% and on average, these behaviors were reduced by 46%.
The present investigation has shown that all the studied variables, including irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech, were significantly decreased towards the desired goal by 46%. This significant decrease is indicative of the effectiveness of the treatment of autism patients with donepezil, and therefore, this drug can be placed as a prominent and essential part of the medical therapy of autism.
鉴于针对多奈哌齐治疗自闭症的研究较少，本研究旨在探讨多奈哌齐对自闭症儿童行为的影响。
对20例年龄在4至17岁的自闭症患者进行了一项横断面分析描述性研究，这些患者于2019年至2020年期间前往伊朗戈尔甘的塔莱加尼儿童医院神经科诊所和亚沙儿科自闭症诊所就诊。通过访谈父母时填写的清单记录人口统计学信息，包括性别、年龄、父亲教育程度、母亲教育程度、患者教育程度、家庭状况、其他问题和种族。在试验前，进行ABC认知和行为测试以确定儿童的当前状况。测试后，这些儿童在睡前每日服用一剂多奈哌齐（10毫克），持续三个月。在三个月结束时，再次对儿童进行认知和行为测试。为了分析不同因素对研究变量的影响，包括服用多奈哌齐前后患者的易怒、嗜睡、刻板行为、多动和不当言语，使用广义线性模型，并使用配对t检验来测试多奈哌齐对研究变量的影响。
本研究中，20例患者登记参与调查，其中男性12例（60%），女性8例（40%）。5至6岁年龄组的频率最高，17岁年龄组的频率最低。关于父母的教育程度，本科学历的频率最高，高中以下学历和硕士学历的频率最低。患者教育程度频率最高的是幼儿园（6�%），其次是未接受教育组（20%）和小学学历组（15%）。大多数研究患者（80%）除自闭症外没有其他问题，只有20%除自闭症外还有其他问题。15%的家庭状况为“分居”，在种族方面，大多数患者（80%）是波斯人，其余（20%）是土库曼人。在服用多奈哌齐后，分析的所有因素（年龄、性别、父亲教育程度、母亲教育程度、患者教育程度、其他问题、家庭状况和种族）对研究变量均无显著影响。在服用多奈哌齐之前的研究变量以及分析的因素中，父亲教育程度、患者教育程度、其他问题和家庭状况仅对刻板行为有显著影响。本研究的结果表明，所有研究变量，包括易怒、嗜睡、刻板行为、多动和不当言语，均朝着预期目标显著降低。服用多奈哌齐后，易怒、嗜睡、刻板行为、多动和不当言语的减少量分别为38%、44%、54%、41%和54%，平均而言，这些行为减少了46%。
本研究表明，所有研究变量，包括易怒、嗜睡、刻板行为、多动和不当言语，均朝着预期目标显著降低了46%。这一显著降低表明多奈哌齐治疗自闭症患者是有效的，因此，这种药物可成为自闭症药物治疗的重要且关键的一部分。
