ppharmПедиатрическая фармакологияPediatric pharmacology1727-57762500-3089Издательство «ПедиатрЪ»10.15690/pf.v22i6.2987ppharm-2735Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWПрименение транскраниальной магнитной стимуляции в лечении аутизма у детей. Обзор научных исследованийTranscranial Magnetic Stimulation Implementation in Management of Children with Autism. Research Digesthttps://orcid.org/0000-0002-2798-5511КузьмичГ. В.KuzmichGrigory V.

Кузьмич Григорий Викторович - кандидат медицинских наук, научный сотрудник отдела развития мозга в онтогенезе, формирования когнитивных функций и нейробиологии НИИ педиатрии и охраны здоровья детей НКЦ №2 «РНЦХ им. акад. Б.В. Петровского».

119333, Москва, ул. Фотиевой, д. 10, стр. 1, тел.: +7 (909) 691-04-05

MD, PhD.

10, Fotievoy Str., Moscow, 119333

kuzmihcgv@mail.ruhttps://orcid.org/0000-0002-8540-3858КаркашадзеГ. А.KarkashadzeGeorge A.

Каркашадзе Георгий Арчилович - к.м.н.

Москва

MD, PhD.

Moscow

karkaga@mail.ruhttps://orcid.org/0000-0002-7775-1692НикитинаС. Г.NikitinaSvetlana G.

Никитина Светлана Геннадьевна - к.м.н.

Москва

MD, PhD.

Moscow

nikitina.svt@mail.ruhttps://orcid.org/0000-0002-0596-631XНестероваЮ. В.NesterovaYuliya V.

Нестерова Юлия Викторовна - к.м.н.

Москва

MD, PhD.

Moscow

ermolina_jv@mail.ruhttps://orcid.org/0000-0003-0892-3726ЯцыкЛ. М.YatsykLeonid M.

Яцык Леонид Михайлович

Москва

MD.

Moscow

leonid2rgmu@rambler.ruhttps://orcid.org/0000-0002-3167-082XУстиноваН. В.UstinovaNataliya V.

MD, PhD.

Москва

MD, PhD.

Moscow

ust-doctor@mail.ruhttps://orcid.org/0009-0001-0440-2715ГорбуноваЕ. А.GorbunovaElena A.

Горбунова Елена Алексеевна - к.м.н.

Москва

MD, PhD.

Moscow

lema020817@gmail.comНИИ педиатрии и охраны здоровья детей НКЦ №2 ФГБНУ «РНЦХ им. акад. Б.В. Петровского»РоссияPediatrics and Child Health Research Institute in Petrovsky National Research Centre of SurgeryRussian FederationНИИ педиатрии и охраны здоровья детей НКЦ №2 ФГБНУ «РНЦХ им. акад. Б.В. Петровского»; Научно-практический центр психического здоровья детей и подростков им. Г.Е. СухаревойРоссияPediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. SukharevaRussian Federation202520012026226739751Copyright © Кузьмич Г.В., Каркашадзе Г.А., Никитина С.Г., Нестерова Ю.В., Яцык Л.М., Устинова Н.В., Горбунова Е.А., 20262026Кузьмич Г.В., Каркашадзе Г.А., Никитина С.Г., Нестерова Ю.В., Яцык Л.М., Устинова Н.В., Горбунова Е.А.Kuzmich G.V., Karkashadze G.A., Nikitina S.G., Nesterova Y.V., Yatsyk L.M., Ustinova N.V., Gorbunova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pedpharma.ru/jour/article/view/2735

Расстройства аутистического спектра (РАС) — нарушение нейро развития полиэтиологичного характера, ведущее значение в возникновении которого принадлежит генетическим и средовым факторам. Основными направлениями лечения в настоящее время являются методики психолого-педагогической коррекции. Последние десятилетия ведется активный поиск биологических причин и патогенетических механизмов с целью разработки подходов к дополнительным методам лечения. Одним из методов аппаратной нейромодуляции, применяемой при РАС, является транскраниальная магнитная стимуляция (ТМС). В статье представлен аналитический обзор текущих научных исследований, посвященных применению ТМС при РАС. Рассмотрены нейробиологические гипотезы патогенеза РАС, являющиеся обоснованием применения аппаратной нейромодуляции. Особое внимание уделено возможности таргетного подхода применения ТМС в зависимости от клинических характеристик пациентов. Цель обзора — проанализировать и обобщить современные научные исследования применения ТМС при РАС в различных клинических группах, а также определить направления дальнейших исследований. Анализ 39 публикаций, включая двойные слепые плацебо-контролируемые исследования, показывает безопасность и хорошую эффективность применения ТМС у пациентов с аутизмом. Наряду с чем отмечается отсутствие единых подходов в выборе протоколов стимуляции, в определении клинических групп пациентов с РАС, а также в методах контроля динамики клинических показателей. Выраженная клиническая и биологическая гетерогенность РАС, а также указанная разнородность исследований приводят к отсутствию протоколов ТМС, которые могут быть включены в клинические рекомендации, что обусловливает необходимость дальнейших исследований.

Autism spectrum disorders (ASD) are neurodevelopmental disorders of polyetiological nature. The leading role in their development belongs to genetic and environmental factors. Nowadays, the main treatment landscapes are methods of psychological and pedagogical correction. Over the past decades, there has been an active search for biological causes and pathogenetic mechanisms in order to develop additional treatments approaches. One of the methods of hardware neuromodulation used in ASD is transcranial magnetic stimulation (TMS). This article provides the analytical review of modern research on TMS implementation in ASD. Neurobiological hypotheses of ASD pathogenesis that underlie the use of hardware neuromodulation, are considered. Special emphasis is paid to targeted approach in using TMS according to the clinical signs of patients. The purpose of this review is to analyze and summarize modern scientific studies on TMS usage in ASD in various clinical groups, as well as to determine further research directions. Analysis of 39 publications, including double-blind, placebo-controlled studies, has shown TMS safety and good efficacy in patients with autism. However, there is no uniform approaches in selection of stimulation protocols, in definition of clinical groups of ASD patients, as well as in methods for monitoring the dynamics of clinical indicators. The profound clinical and biological heterogeneity of ASD, as well as indicated heterogeneity in studies, lead to the absence of TMS protocols that can be included in clinical guidelines, which necessitates further research.

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The authors declare that there are no conflicts of interest present.