CC BY
10
Medical science
Madzhidova Y. N.., Donierova F. A., Ergasheva N. N.., Tashkent Pediatric Medical Institute E-mail: [email protected]
ELECTROENCEPHALOGRAPHIC FEATURES IN CHILDREN WITH EARLY AUTISM
Abstract: Analysis of electroencephalography data taking into account the clinical condition of the patients allowed to identify the relationship of individual EEG characteristics with the features of the structure of clinical manifestations, which can be used as additional markers in the diagnosis of early childhood autism. Keywords: early childhood autism, diagnosis, clinical manifestations, electroencephalography.
Introduction. Autism is a widespread disease in which there is a defect in inborn behavioral programs that determine speech and social skills, as well as perception and cognitive development. One of the characteristic manifestations of this disorder is the difficulty of social communications. Current epidemiological data estimate the prevalence of autism at 1-2 per 1000 child population [3; 7]. Despite the fact that the electroencephalography method is not the main, but an supplimentary method in the diagnosis of mental and neurological pathology, EEG data in children with autistic disorders in most cases have certain disorders in both typology and the amplitude-frequency structure of basic rhythms [2; 6; 8]. The success of the treatment and rehabilitation of patients depends largely on the early diagnosis ofthis disease. It is reliably known that at the moment there is no sufficiently effective method to diagnose autism in the very early stages of a child's development. An analysis of the results of electroencephalography is possible for use as an early diagnostic method, since the changes identified during the study appear before the first clinical symptoms appear. In addition, the lack of sufficient social rehabilitation measures in Uzbekistan with regard to patients with childhood autism makes this problem very topical.
Electrophysiological study of children with mental disorders, which is included in the obligatory set of diagnostic procedures, is often reduced only to the identification of epileptic activity. However, electroencephalography (EEG) contains a much larger amount of information, which is extremely useful for assessing the condition of the child, compliance of its EEG with the age norm, for diagnosing syndromic forms of mental disorders, but this information is almost completely ignored in the analysis [1; 4].
Early childhood autism is a serious developmental disorder that is difficult to correct. Nowadays the key moment in the development of autism syndrome is considered as a violation ofthe normal functioning of ontogenesis of the brain. Distortions of the temporal parameters ofthe maturation ofthe nervous system, impaired development of separate zones, as well as the pathol-
ogy of the white matter were shown. According to the research data of the last decade, it was concluded that in autism there is an underdevelopment of systemic, integrative connections that unite various functional areas of the brain among themselves. The consequence of this is the phenomenon of disintegration of mental processes, which occurs in autism at all levels [4]. Difficulties in diagnosis, insufficient knowledge ofthe pathogenesis of the disease dictate the need to search for biological markers that indicate the clinical features of patients.Nowadays, numerous data confirming the existence of EEG disorders associated with autism spectrum disorders have been obtained [5].
It is known that age-related changes in EEG in normal conditions are reduced to a decrease in the spectral density (amplitude and index) of the delta and theta rhythms and to an increase in the spectral power of alpha and beta oscillations [3]. In this paper, we analyzed the changes in the amplitude-frequency structure of the main EEG rhythms in children with a diagnosis of early childhood autism.
The purpose of the study is to study the relationship of EEG data with the clinical manifestations in children diagnosed with early childhood autism.
Materials and research methods. The study was conducted using clinical, psychopathological and neurophysi-ological methods.
In a neurophysiological study, a qualitative analysis of the background EEG was performed. To identify the features of EEG rhythms, a group of 24 patients aged 3-15 years were diagnosed with early childhood autism (F84). The average age of the subjects was 10.5 ± 0.2 years.
EEG was recorded in the state of quiet wakefulness with the help of hardware-software complex "Encephalan-131-03". EEG recording was carried out in a monopolar manner using the international system "10% -20%" of the frontal (F3, F4), central (C3, C4), parietal (P3, P4), occipital (O1, O2), front temporal (F7, F8), middle temporal (T3, T4) and posterior temporal (T5, T6) cortical zones (areas of the left hemisphere are indicated by odd numbers, and even areas are the right).
ELECTROENCEPHALOGRAPHIC FEATURES IN CHILDREN WITH EARLY AUTISM
Research findings and their discussion. In the examined group in 100% of cases there was observed a clinical picture in the form of a decrease in psychoverbal activity, lack of eye contact with the interlocutor, emotional lability, inability to establish relationships with peers, lack of socio-emotional reciprocity, absorption of stereotyped and limited interests, increased motor activity.
When the distribution of the dominant EEG rhythm in the group of patients examined, attention is drawn to the absence of the dominant alpha rhythm in all the subjects, the activity index is less than 50%, the disorganized nature of the activity. In 58.33% of cases theta activity in the frequency range of 4-5 Hz is dominated, which may indicate a difficulty in social adaptation.
It is worth noting that there was a relationship between the quantitative measure of the theta rhythm and the seriousness of the condition.
At the height of the clinical manifestations on the EEG, the theta rhythm was expressed in all areas of the cortex and the occipital alpha rhythm was reduced. The appearance of the positive dynamics of the disease was accompanied by a significant reduction of the theta rhythm and a significant increase in alpha rhythm expression.
It was found out that in 16.67% of cases (2 patients) there was an increase in beta activity in the anterior-peloid area, and in the clinical picture this was expressed as the follow-
ing symptoms: anxiety, marked restlessness, walking around the room during the examination. The beta-2 activity index was increased in all areas of the cortex with a frequency range of 27-34 Hz. The amplitude of the dominant beta rhythm in these patients was 94 ^V
Thus, analysis of EEG data, taking into account the clinical condition of the patients, made it possible to identify the relationship of individual EEG characteristics with the features of the structure of clinical manifestations, which can be used as additional markers in the diagnosis of early childhood autism.
Conclusion:
1. In children with early autism, electroencephalographic data are characterized by the absence of a dominant alpha rhythm, the activity index is less than 50%, which indicates the disorganized nature of the activity.
2. In 58.33% of cases, theta activity dominates in the frequency range of 4-5 Hz, which may indicate a difficulty in social adaptation.
3. In 16.67% of cases (2 patients) there was an increase in beta activity in the anterior periofacial region, and in the clinical picture this was expressed as the following symptoms: anxiety, marked restlessness, walking around the room during the examination.
4. Established EEG characteristics, taking into account the clinical status of patients, can be used as additional markers in the diagnosis of early childhood autism.
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