基于多模态神经调控的音乐疗法改善孤独症谱系障碍儿童共同注意功能的眼动机制

The oculomotor mechanism of joint attention in children with autism spectrum disorder based on multimodal neuromodulation music therapy

摘要

目的：探讨音乐治疗对孤独症谱系障碍（autism spectrum disorder，ASD）儿童共同注意眼动特征的改善效果，为临床干预提供客观依据。方法：采用随机交叉设计，纳入26例3~10岁ASD儿童，随机分为A、B两组，分别接受音乐治疗干预和静坐对照实验，间隔7 d洗脱期后交换实验条件。通过眼动追踪技术记录儿童在共同注意范式任务（眼睛注视、眼睛-头部、眼睛-头-手势三种条件）中的首次注视时间（time to first fixation，TFF），并采用配对样本t检验比较音乐干预效果。结果：音乐治疗后，ASD儿童在所有条件总分的TFF显著短于静坐对照（t=-2.24，P=0.035，Cohen’s d=-0.458），眼睛-头-手势条件下的TFF显著短于静坐对照（t=-2.32，P=0.030，Cohen’s d=-0.485），仅眼睛注视和眼睛-头部条件下虽差异无统计学意义，但TFF均值短于对照条件。结论：音乐治疗可显著缩短ASD儿童对共同注意目标的首次注视时间，提示其可能通过优化神经信息处理效率改善社交核心缺陷。眼动特征可作为评估音乐治疗疗效的客观指标。

Abstract

Objective：To investigate the effect of music therapy on eye movement characteristics of joint attention（JA）in children with autism spectrum disorder（ASD），providing an objective basis for clinical intervention. Methods：A randomized crossover design was employed. Twenty-six ASD children aged 3-10 years were enrolled and randomly assigned to group A or B. They first received either a music therapy intervention or a quiet-sitting control condition，and after a 7-day washout period，crossed over to the alternate condition. Eye-tracking technology was used to record the time to first fixation（TFF）during a joint attention paradigm task（comprising three conditions：Eye Gaze，Eye-Head，and Eye-Head-Gesture）. Paired samplet-tests were applied to compare the effects of the music intervention. Results：Following music therapy，the TFF for the total score across all conditions was significantly shorter compared to the quiet-sitting control condition（t=-2.24，P=0.035，Cohen’s d=-0.458）. Specifically，the TFF in the Eye-Head-Gesture condition was significantly shorter than in the control condition（t=-2.32，P=0.030，Cohen’s d=-0.485）. Although the TFF in the Eye Gaze and Eye-Head conditions alone showed no statistically significant difference，the mean TFF was shorter than in the control condition. Conclusion：Music therapy can significantly shorten the time to first fixation on joint attention targets in children with ASD，suggesting that it may improve core social deficits by enhancing neural information processing efficiency. Eye movement characteristics may serve as an objective indicator for evaluating the efficacy of music therapy.

关键词

孤独症谱系障碍 / 音乐治疗 / 共同注意 / 眼动追踪 / 首次注视时间

Key words

autism spectrum disorder / music therapy / joint attention / eye tracking / time to first fixation

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基金资助

南京市卫生科技发展专项基金项目一般性课题(YKK22169)