Клинические случаи курсового применения транскраниальной микрополяризации как поддерживающей стратегии при терапии модификации искаженного внимания у подростков

В данной статье представлены клинические случаи прохождения курсов транскраниальной микрополяризации (tDCS) с целью оценки обоснованности, приемлемости и клинических перспектив данного метода в качестве поддерживающей стратегии у подростков, направленных в клинику. Терапия модификации искаженного внимания (Attention Bias Modification Treatment, ABMT) – это компьютерный протокол тренировки внимания, разработанный для снижения непроизвольного переключения внимания на источники кажущейся угрозы и, соответственно, для уменьшения тяжести симптомов тревоги. Исследования эффективности ABMT демонстрируют его умеренную общую результативность. Достижения в исследованиях нейронных механизмов внимания к угрозам и протоколов тренировки внимания указывают на высокий потенциал транскраниальной микрополяризации применительно к дорсолатеральной префронтальной коре в качестве новой поддерживающей стратегии повышения эффективности ABMT (ABMT + tDCS). Однако метод tDCS никогда не проверялся на выборке подростков с тревожными расстройствами. Шесть подростков с первичным тревожным расстройством прошли все четыре сеанса ABMT + tDCS. Побочные эффекты были легкими и временными. Подростки и родители независимо друг от друга сообщали о среднем или высоком уровне удовлетворенности результатами терапии. У подростков, прошедших курс ABMT + tDCS, значимо снизились первичные симптомы тревожного расстройства. Кроме того, электрофизиологические данные (в частности, результаты ЭЭГ) свидетельствовали об уменьшении нейронной активности, вызванной ситуацией воспринимаемой угрозы. Полученные результаты подтверждают обоснованность и перспективность применения tDCS в качестве поддерживающей стратегии у подростков с тревожными расстройствами, что дает импульс для дальнейших исследований контрольных групп с более крупными выборками.

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