Middle Eastern Journal of Disability Studies
مجله مطالعات ناتوانی
MEJDS
Medical Sciences
http://jdisabilstud.org
1
admin
2322-2840
2322-2840
10.29252/mejds
14
8888
13
fa
jalali
1403
12
1
gregorian
2025
3
1
0
In Press
online
1
fulltext
fa
بررسی اثربخشی نوروفتوبیومدولاسیون بر کارکردهای اجرایی و تحمل پریشانی بیماران مبتلا به وسواس فکری - عملی
Effectiveness of Transcranial Photobiomodulation on Executive Functions and Distress Tolerance in Patients with Obsessive-Compulsive Disorder
روانشناسی
Psychology
مقاله پژوهشی اصیل
Original Research Article
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">اهداف</span></span></b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">: </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نقص در کارکردهای اجرایی و تحمل پریشانی از مؤلفههای کلیدی در تداوم اختلال وسواس فکری - عملی</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> (OCD) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هستند که به درمانهای رایج پاسخ ضعیفی میدهند</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">.</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> این مطالعه </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">باهدف بررسی اثربخشی نوروفوتوبیومدولاسیون فرا جمجمهای</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> (TPBM) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بر بهبود کارکردهای اجرایی و تحمل پریشانی در بیماران مبتلا به</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> OCD </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">انجام شد</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">.</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روشها</span></span></b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">: </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این کارآزمایی بالینی تصادفی شده با گروه کنترل، روی </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۳۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بیمار مبتلا به</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> OCD </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(محدوده سنی </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۸-۶۵</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> سال) انجام شد که بهصورت تصادفی ساده در دو گروه آزمایش (</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۵</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">n=</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و کنترل (</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۵</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">n=</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) قرار گرفتند. گروه آزمایش، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> جلسه</span></span> <span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">TPBM </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">با طولموج </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۸۱۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نانومتر (توان خروجی </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۰۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> میلیوات، چگالی تابش </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۰-۱۰۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> میلیوات/سانتیمتر مربع، دوز انرژی </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۶-۱۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> ژول/سانتیمتر مربع، هر جلسه </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۲۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> دقیقه، دو بار در هفته) را روی نواحی پیشانی</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> FP1</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">FP2</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">F3</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">F4</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">F7</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> F8 </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">و</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> FZ </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">دریافت کردند. گروه کنترل هیچ مداخلهای دریافت نکرد. کارکردهای اجرایی با پرسشنامه نقصهای کارکرد اجرایی بارکلی</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> (BDEFS) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">و تحمل پریشانی با مقیاس تحمل پریشانی سیمونز و گاهر</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> (DTS) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در مراحل پیشآزمون و پسآزمون ارزیابی شد. دادهها با استفاده از تحلیل کوواریانس</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> (ANCOVA) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">تحلیل شدند</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">یافتهها</span></span></b><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">:</span></span></b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> دو گروه از نظر متغیرهای جمعیتشناختی و نمرات پیشآزمون همگن بودند (</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۰۵/۰</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">p</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"><</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) پس از تعدیل نمرات پیشآزمون، گروه آزمایش نسبت به گروه کنترل کاهش معناداری در نقص کارکردهای اجرایی</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۶۶/۱۲</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">F=</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۰۰۲/</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">=</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۰</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">p</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۳۵/۰</span></span><span dir="LTR" style="font-size:11.0pt"><span cambria="" style="font-family:">η</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">²= </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و افزایش معناداری در تحمل پریشانی(</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۲۹/</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">=</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۶</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">F</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۰۰۱/۰</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">p=</span></span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> ، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۴۱/۰</span></span><span dir="LTR" style="font-size:11.0pt"><span cambria="" style="font-family:">η</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">²=</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) </span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نشان داد. اندازه اثر مداخله برای هر دو متغیر در حد متوسط تا بزرگ بود</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجهگیری</span></span></b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">:</span></span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نو رو فوتو بیو مدولاسیون فرا جمجمهای با بهبود کارکردهای اجرایی و افزایش تحمل پریشانی در بیماران مبتلا به</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra"> OCD </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مؤثر است. این روش غیرتهاجمی و ایمن میتواند بهعنوان یک مداخله درمانی مکمل در کنار درمانهای استاندارد برای این بیماران، بهویژه آنهایی که به درمانهای رایج پاسخ نمیدهند، موردتوجه قرار گیرد. انجام مطالعات با پیگیری بلندمدت و حجم نمونه بیشتر پیشنهاد میشود</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:Mitra">.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Objectives</span></span></span></b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">: Deficits in executive functions and distress tolerance are key components in the maintenance of obsessive-compulsive disorder (OCD) that respond poorly to conventional treatments. This study aimed to investigate the efficacy of transcranial photobiomodulation (tPBM) in improving executive functions and distress tolerance in patients with OCD.</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Methods</span></span></span></b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">:</span></span></span> <span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">This randomized controlled trial was conducted on 30 patients with OCD (age range 18–65 years) who were randomly assigned to either experimental (n=15) or control (n=15) groups using simple randomization. The experimental group received 10 sessions of tPBM with 810 nm wavelength (output power: 100 mW, irradiance: 10–100 mW/cm², energy density: 6–10 J/cm², 20 minutes per session, twice weekly) applied to frontal areas (FP1, FP2, F3, F4, F7, F8, and FZ). The control group received no intervention. Executive functions were assessed using the Barkley Deficits in Executive Functioning Scale (BDEFS), and distress tolerance was measured using the Simons and Gaher Distress Tolerance Scale (DTS) at pre-test and post-test stages. Data were analyzed using analysis of covariance (ANCOVA).</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Results</span></span></span></b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">:</span></span></span> <span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">The two groups were homogeneous regarding demographic variables and pre-test scores (p>0.05). After adjusting for pre-test scores, the experimental group showed a significant reduction in executive function deficits (F=12.66, p=0.002, η²=0.35) and a significant increase in distress tolerance (F=16.29, p=0.001, η²=0.41) compared to the control group. The effect sizes for both variables were moderate to large.</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> Transcranial photobiomodulation is effective in improving executive functions and increasing distress tolerance in patients with OCD. This non-invasive and safe method can be considered as an adjunctive therapeutic intervention alongside standard treatments for these patients, particularly those who do not respond to conventional therapies. Further studies with long-term follow-up and larger sample sizes are recommended.</span></span></span></span></span></span><br>
کلیدواژهها: نوروفوتوبیومدولاسیون فرا جمجمهای, وسواس فکری - عملی, کارکردهای اجرایی, تحمل پریشانی
Transcranial photobiomodulation, Obsessive-compulsive disorder, Executive functions, Distress tolerance
22
0
http://jdisabilstud.org/browse.php?a_code=A-12-4207-1&slc_lang=fa&sid=1
Masoud
Bagheri
مسعود
باقری
Mbagheri@uk.ac.ir
100319475328460069312
100319475328460069312
No
Ministry of Science and Research
وزارت علوم و تحقیقات و فناوری
Shima
Ferdosi
شیما
فردوسی
Shima.Ferdosi@ens.uk.ac.ir
100319475328460069313
100319475328460069313
Yes
Ministry of Science and Research
وزارت علوم و تحقیقات
azam
kermanian
اعظم
کرمانیان
azamkermanian@gmail.com
100319475328460069314
100319475328460069314
No
Ministry of Science and Research
وزارت علوم و تحقیقات و فناوری