تاثیر درمان تحریک الکتریکی جمجمه‌ای و بازتوانی شناختی رایانه‌ای بر تغییرات هموداینامیکی منطقه پیش پیشانی مغز کودکان دارای اختلال بیش‌فعالی

نویسندگان
ندا قدمگاهی ثانی
علیرضا مرادی
رضا شالباف
میثم صادقی
چکیده
مقدمه: اختلال کمبود توجه بیش فعالی نوعی اختلال رشدی عصبی است که با نقایصی در مهارتهای شناختی و خودکنترلی هیجانی مشخص می‌شود. مطالعات بسیاری به عملکرد ضعیف ناحیه پیشانی در بیماران بیش‌فعال اشاره کرده‌‌اند. افزایش تغییرات همودینامیک در منطقه پیشانی این کودکان می‌تواند باعث کاهش علائم اختلال می‌شود. هدف: پژوهش حاضر با هدف بررسی تغییرات غلظت هموگلوبین(Hb) منطقه پیش پیشانی این کودکان در حین انجام فعالیت‏ شناختی آزمون عملکرد پیوسته رایانه‏ای می‌باشد. روش‌: پژوهش حاضر از نوع مطالعات کارآزمایی بالینی با طرح پیش آزمون-پس آزمون-پیگیری است. از 30 کودک بیش‌فعال شش تا هشت سال ثبت fNIRS به همراه آزمون عملکرد پیوسته رایانه‏ای به صورت پیش آزمون انجام شد. سپس به روش تصادفی ساده در دو گروه 15 نفری جایگزین شدند. گروه اول تحت مداخله تحریک الکتریکی جمجمه‌ای و گروه دوم تحت مداخله شناختی رایانه‌ای کاپیتان لاگ به تعداد 14 جلسه نیم ساعته قرار گرفتند. پس از اجرای مداخله‌ها مجددا میزان تغییرات هموداینامیک ناحیه پیشانی از همه شرکت‌کننده‌ها به وسیله fNIRS به همراه آزمون عملکرد پیوسته رایانه‏ای به صورت پس آزمون ثبت گرفته شد. سرانجام پس از اتمام دوره مداخله با 4 هفته فاصله ، از شرکت کننده‌ها آزمون پیگیری گرفته شد. یافته‌ها: نتایج نشان داد تفاوت میانگین میزان جذب اکسیژن از مرحله پیش آزمون تا پس آزمون در گروه CES، معنادار بوده اند (01/0p<) ولی این تفاوت از مرحله پس آزمون تا پیگیری معنادار نبود (05/0p>). در گروه کاپیتان لاگ تفاوت میانگین میزان جذب اکسیژن از مرحله پیش آزمون تا پیگیری بر اساس نتایج آزمون t، معنادار بوده اند (05/0p<). نتایج بیانگر عدم معناداری اثر تعامل گروه در زمان برای متغیر میزان جذب اکسیژن می‌باشد. بین دو گروه CES و کاپیتان لاگ در میزان تغییر جذب اکسیژن از جلسه پیش آزمون تا جلسه پس آزمون و پیگیری تفاوت معناداری وجود ندارد(05/0p>). نتیجه‌گیری: بر مبنای یافته‌های این پژوهش، می‌توان نتیجه گرفت که مداخله CES و مداخله نرم افزار شناختی کاپیتان لاگ، درمان‌های موثری به منظور افزایش تغییرات هموداینامیک در منطقه پیش پیشانی کودکان بیش‌فعال هستند و نیز می‌توانند باعث بهبود نقص توجه پایدار بینایی در این کودکان شوند.
کلیدواژه‌ها
اختلال بیش‌فعالی
آزمون عملکرد پیوسته کامپیوتری
تحریک الکتریکی جمجمه‌ای
تمرینات رایانه‌ای شناختی
طیف‌سنجی نزدیک مادون قرمز مغزی

عنوان مقاله English

The Effect of Cranial Electrical Stimulation Treatment and Computerized Cognitive Rehabilitation on the Hemodynamic Changes of the Prefrontal Brain Region of Children with ADHD

نویسندگان English

Neda Gadamagahi Sani
Alireza Moradi
Reza Shalbaf
چکیده English

Attention Deficit Hyperactivity Disorder is a type of neurodevelopmental disorder characterized by deficits in cognitive skills and emotional self-control. Many studies have pointed out the poor functioning of the frontal region in hyperactive patients. Increasing hemodynamic changes in the frontal region of these children can reduce the symptoms of the disorder. Goal: The purpose of this research is to investigate the changes in the concentration of hemoglobin (Hb) in the frontal region of these children during the cognitive activity of the computerized continuous performance test. Method: The current research is a clinical trial study with a pre-test-post-test-follow-up design. From 30 hyperactive children six to eight years old, fNIRS recording was performed along with computerized continuous performance test as a pre-test. Then they were divided into two groups of 15 people by simple random method. The first group underwent CES intervention and the second group underwent Captain Log's computerized cognitive intervention for 14 half-hour sessions, and after the interventions, the amount of hemodynamic changes in the frontal area of all participants was recorded by fNIRS along with computerized continuous performance test as a post-test. was taken Finally, after completing the intervention period 4 weeks later, the participants were followed up with the above tests. Findings: The average difference in oxygen uptake from pre-test to post-test in CES group was significant (p<0.01), but this difference was not significant from post-test to follow-up (p>0.05). In the captain log group, the difference in the average amount of oxygen absorption from pre-test to follow-up was significant based on the results of the t-test (p<0.05). The results indicate the non-significance of the effect of group interaction on time for the oxygen uptake variable, there is no significant difference between the CES and Captain Log groups in the amount of change in oxygen uptake from the pre-test session to the post-test session and follow-up (p>0.05).Conclusion: Based on the findings of this research, it can be concluded that CES intervention and Captain Log cognitive software intervention are effective treatments to increase the hemodynamic changes in the prefrontal region of hyperactive children and can also improve persistent visual attention deficit in these children.

کلیدواژه‌ها English

attention deficit hyperactivity disorder
continuous performance test
cranial electrical stimulation
computerized cognitive exercises
near-infrared brain spectroscopy‎
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