Aperçu: G.M.
Les
troubles anxieux touchent un grand pourcentage de personnes avec un
diagnostic de trouble du spectre de l'autisme (dTSA). Chez les enfants
avec un dTSA, une anxiété excessive est également liée à des problèmes
gastro-intestinaux, à des comportements d'automutilation et à des
symptômes dépressifs. Les thérapies cognitivo-comportementales basées
sur l'exposition sont des traitements efficaces pour les troubles
anxieux chez les enfants avec un dTSA, mais des taux de rechute élevés
indiquent la nécessité de stratégies de traitement supplémentaires.
Cette
perspective discute des preuves issues de la recherche préclinique, qui
indiquent que la stimulation du nerf vague (SNV) associée à
l'exposition à des stimuli et à des situations provoquant la peur
pourrait offrir des avantages en tant que traitement adjuvant des
troubles anxieux qui coexistent avec les TSA.
La
stimulation du nerf vague est approuvée pour une utilisation dans le
traitement de l'épilepsie, de la dépression et, plus récemment, comme
adjuvant dans l'entraînement de réadaptation après un AVC.
Dans les modèles précliniques, la SNV
semble prometteuse pour améliorer simultanément la consolidation des
souvenirs d'extinction et réduire l'anxiété. Dans cette revue, nous
présenterons les mécanismes potentiels par lesquels la SNV pourrait traiter la peur et l'anxiété dans les TSA.
Nous discutons également des utilisations potentielles de la SNV pour traiter la dépression et l'épilepsie dans le contexte des TSA, et des méthodes non invasives pour stimuler le nerf vague.
Cliquer ICI pour accéder à l'intégralité de l'article en anglais
doi: 10.20900/jpbs.20220007.
Epub 2022 Sep 23.
Affiliations
Abstract
Anxiety disorders affect a large percentage of individuals who
have an autism spectrum disorder (ASD). In children with ASD, excessive
anxiety is also linked to gastrointestinal problems, self-injurious
behaviors, and depressive symptoms. Exposure-based cognitive behavioral
therapies are effective treatments for anxiety disorders in children
with ASD, but high relapse rates indicate the need for additional
treatment strategies. This perspective discusses evidence from
preclinical research, which indicates that vagus nerve stimulation (VNS)
paired with exposure to fear-provoking stimuli and situations could
offer benefits as an adjuvant treatment for anxiety disorders that
coexist with ASD. Vagus nerve stimulation is approved for use in the
treatment of epilepsy, depression, and more recently as an adjuvant in
rehabilitative training following stroke. In preclinical models, VNS
shows promise in simultaneously enhancing consolidation of extinction
memories and reducing anxiety. In this review, we will present potential
mechanisms by which VNS could treat fear and anxiety in ASD. We also
discuss potential uses of VNS to treat depression and epilepsy in the
context of ASD, and noninvasive methods to stimulate the vagus nerve.
Keywords:
behavioral therapy; exposure therapy; neurodevelopmental disorders; neuromodulation; rehabilitation.
Conflict of interest statement
CONFLICTS
OF INTEREST CT Engineer is married to an employee of MicroTransponder,
Inc. CK McIntyre is an author of a patent entitled “Methods for
Enhancing Exposure Therapy using Vagus Nerve Stimulation”.
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