戈根Taleghani儿科医院2020年冬季多奈哌齐对自闭症儿童认知和行为影响的调查。

IF 0.8 Q4 CLINICAL NEUROLOGY Iranian Journal of Child Neurology Pub Date : 2023-01-01 Epub Date: 2023-07-01 DOI:10.22037/ijcn.v17i2.37324
Yamin Ghahreman, Seyed Ahmad Hosseini, Saeed Hassani, Firouzeh Derakhshanpour, Mohammad Javad Hassani, Parnian Hosseini
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引用次数: 0

摘要

目的:鉴于目前对多奈哌齐治疗自闭症的研究不多,本研究旨在研究多奈哌嗪对自闭症儿童的行为影响。材料与方法:对20名4-17岁的自闭症患者进行了横断面和分析性描述性研究,这些患者于2019年至2020年访问了伊朗Gorgan’s Taleghani儿科医院和Yasha儿科自闭症诊所的神经科诊所。人口统计信息,包括性别、年龄、父亲的教育、母亲的教育、患者的教育、家庭状况、其他问题和种族,都使用检查表进行记录,并在与父母面谈时填写。试验前,进行了ABC认知和行为测试,以确定儿童的当前状态。测试结束后,这些儿童在睡前接受每日剂量的多奈哌齐(10mg),为期三个月。三个月后,再次对孩子们进行认知和行为测试。为了分析不同因素对所研究变量的影响,包括患者服用多奈哌齐前后的易怒、嗜睡、刻板行为、多动和言语不当,采用广义线性模型,并使用配对t检验来检验多奈哌齐对所研究变元的影响。结果:在这项研究中,20名患者登记参加调查,其中12名(60%)为男性,8名(40%)为女性。5-6岁年龄组发病率最高,17岁年龄组最低。在父母的教育中,学士学位的频率最高,高中以下学历和硕士学位的频率最低。患者接受教育的频率最高的是幼儿园(60%),其次是未接受教育的组(20%)和小学教育的组。大多数被研究的患者(80%)除了自闭症没有其他问题,只有20%的患者除了自闭症还有其他问题。15%的家庭是“分离”的,从种族上看,大多数患者(80%)是法尔人,而其余患者(20%)是土库曼人。服用多奈哌齐后,所有分析因素(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。在多奈哌齐给药前的研究变量和分析的因素中,父亲的教育、患者的教育、其他问题和家庭状况对刻板印象行为只有显著影响。本研究的研究结果表明,所有研究变量,包括易怒、嗜睡、刻板行为、多动和不当言语,都朝着预期目标显著减少。多奈哌齐给药后,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%,这些行为平均减少了46%,以及不恰当的言语在达到预期目标方面显著减少了46%。这种显著的下降表明多奈哌齐治疗自闭症患者的有效性,因此,这种药物可以作为自闭症医学治疗的重要组成部分。
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An Investigation on Cognitive and Behavioral Effects of Donepezil on Autistic Children in Winter 2020 in Gorgan's Taleghani Pediatric Hospital.

Objectives: 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.

Results: 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%.

Conclusion: 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.

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