Theory of Mind (ToM) is the ability to attribute subjective mental states to oneself and others and is significantly impaired in Autism Spectrum Disorder (ASD). A frontal-posterior network of regions including the ventromedial prefrontal cortex (vmPFC) and temporoparietal junction (TPJ) is involved in ToM. Previous studies show an underactivation of these regions in ASD.Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method for causally investigating brain-behavior relationships via induction of cortical excitability alterations. tDCS, mostly over the dorsolateral prefrontal cortex, has been increasingly applied for improving behavioral problems in ASD leaving other potentially interesting regions untouched. Here we investigated the contribution of the vmPFC and right TPJ in ToM abilities of ASD children via tDCS in a pilot study. Sixteen children with ASD (mean age = 10.7±1.9) underwent three tDCS sessions (1 mA, 20 min) in a randomized, double-blind, sham-controlled design. Stimulation protocols included: i) anodal vmPFC tDCS, ii) anodal r-TPJ tDCS, and iii) sham tDCS. ToM abilities were explored during tDCS using the Theory of Mind Test (TOMT). Our results show that activation of the vmPFC with anodal tDCS significantly improved ToM in children with ASD compared to both, r-TPJ tDCS and sham stimulation. Specifically, precursors of ToM (e.g. emotion recognition, perception and imitation) and elementary ToM skills (e.g. first-order mental state reasoning) were significantly improved by anodal vmPFC tDCS. Based on these results, the vmPFC could be a potential target region for the reduction of ASD symptoms via non-invasive brain stimulation, which should be examined in larger detail in future studies.
Theory of Mind (ToM) is the ability to attribute subjective mental states to oneself and others and is significantly impaired in Autism Spectrum Disorder (ASD). A frontal-posterior network of regions including the ventromedial prefrontal cortex (vmPFC) and temporoparietal junction (TPJ) is involved in ToM. Previous studies show an underactivation of these regions in ASD. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method for causally investigating brain-behavior relationships via induction of cortical excitability alterations. tDCS, mostly over the ventromedial prefrontal cortex, has been increasingly applied for improving behavioral problems in ASD. Here we investigated the contribution of the vmPFC and right TPJ in ToM abilities of ASD children via tDCS in a pilot study. Sixteen children with ASD (mean age = 10.7±1.9) underwent three tDCS sessions (1 mA, 20 min) in a randomized, double-blind, sham-controlled design. Stimulation protocols included: i) anodal vmPFC tDCS, ii) anodal r-TPJ tDCS, and iii) sham tDCS. ToM abilities were explored during tDCS using the Theory of Mind Test (TOMT). Our results show that activation of the vmPFC with anodal tDCS significantly improved ToM in children with ASD compared to both, r-TPJ tDCS and sham stimulation. Specifically, precursors of ToM (e.g. emotion recognition, perception and imitation) and elementary ToM skills (e.g. first-order mental state reasoning) were significantly improved by anodal vmPFC tDCS. Based on these results, the vmPFC is a potential target region for the reduction of ASD symptoms via non-invasive brain stimulation, which should be examined in larger detail in future studies
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