Efeitos da neuroestimulação na cognição social e correlatos psicofisiológicos em crianças com transtorno do espectro autista

• Autor(a) principal: Silva, Jéssica Bruna Santana
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/24240
• topic: Transtorno autístico; Neuromodulação; Cognição social; Funcionamento executivo; Rastreamento ocular; Autistic disorder; Neuromodulation; Social cognition; Executive functioning; Eye tracking; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA

Autistic Spectrum Disorder (ASD) is a condition of neurological development that is characterized by deficits in communication and social interaction and restricted and repetitive patterns of behavior. Transcranial Direct Current Stimulation (ETCC) has been shown to be a promising technique for neural modulation of social cognition domains. The present study aimed to characterize the therapeutic effects of anodic ETCC on the social cognition of children with mild ASD. To achieve this goal, this thesis is organized in three articles. The first article aimed to systematize evidence on the use of ETCC in the social cognitive rehabilitation of patients with ASD. A systematic review of the electronic databases PubMed, Web of Science and SCOPUS was carried out, resulting in five articles. Studies suggest beneficial effects of ETCC on the social rehabilitation of individuals with ASD. The second article consists of a protocol that aims to assess the safety and therapeutic effects of ETCC in the treatment of social deficits in children with ASD. The protocol describes a randomized, double-blind, placebo-controlled clinical trial. Patients will receive five consecutive sessions of ETCC for 20 minutes, with anode current of 1.5 mA over the left dorsolateral prefrontal cortex (F3) and the cathode placed in the right supraorbital region. Patients will undergo three functional assessments: baseline (T0); week following the intervention with ETCC (T2); and 1 month after the intervention (T4). Participants will be randomly divided into 02 groups: Active - participants who will receive active current; and Placebo - participants who will receive simulated currents. All participants will receive cognitive intervention, along with neurostimulation. Instruments that assess social cognition (primary outcome) will be used: the subtest theory of mind - Nepsy II and the emotional face recognition test; and executive function tests (secondary outcome measures): Trail Making Test A and B, Digit Span and the Seven Error Test. This protocol was used in the execution of the subsequent studies. In the third article, the objective was to investigate the effectiveness of anodic ETCC on the social cognition of children diagnosed with ASD. A total of 18 male children participated in the study, with mild ASD and aged between 9 and 12 years (M = 10.9; SD = 1.72). The results suggest that participants who received active ETCC over the left CPFDL had significantly lower scores (p = 0.05) in the number and duration of fixations in the recognition of the emotions of happy, anger, fear and neutral. However, there was no significant effect on the number of emotions recognized, as well as on the Theory of Mind subtest - Nepsy-II (p> 0.05). The fourth article aims to investigate the effectiveness of anodic ETCC in the executive functioning of children with mild ASD. The results suggest that there was no significant effect of active ETCC on the left CPFDL on the parameters of eye movements during the Seven Errors Test (p = 0.26), showing a significant effect only on the total time for identifying the errors in the elephant stimulus (p = 0.02). The results of eye tracking suggest that the anodic ETCC over the left CPFDL seems to act selectively improving the psychophysiological processing involved in the recognition of facial expressions, but it did not have significant effects on executive functions, central to social cognition. In this sense, the findings should be analyzed with caution, requiring additional studies on the use of ETCC as a complementary strategy in the cognitive and social rehabilitation of ASD.