Применение транскраниальной магнитной стимуляции в лечении аутизма у детей

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.

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