Effects of repetitive transcranial magnetic stimulation on children with low‐function autism

Abstract

Background Autism spectrum disorder (ASD) is a very complex neurodevelopmental disorder, characterized by social difficulties and stereotypical or repetitive behavior. Some previous studies using low‐frequency repetitive transcranial magnetic stimulation (rTMS) have proven of benefit in ASD children. Methods In this study, 32 children (26 males and six females) with low‐function autism were enrolled, 16 children (three females and 13 males; mean ± SD age: 7.8 ± 2.1 years) received rTMS treatment twice every week, while the remaining 16 children (three females and 13 males; mean ± SD age: 7.2 ± 1.6 years) served as waitlist group. This study investigated the effects of rTMS on brain activity and behavioral response in the autistic children. Results Peak alpha frequency (PAF) is an electroencephalographic measure of cognitive preparedness and might be a neural marker of cognitive function for the autism. Coherence is one way to assess the brain functional connectivity of ASD children, which has proven abnormal in previous studies. The results showed significant increases in the PAF at the frontal region, the left temporal region, the right temporal region and the occipital region and a significant increase of alpha coherence between the central region and the right temporal region. Autism Behavior Checklist (ABC) scores were also compared before and after receiving rTMS with positive effects shown on behavior. Conclusion These findings supported our hypothesis by demonstration of positive effects of combined rTMS neurotherapy in active treatment group as compared to the waitlist group, as the rTMS group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group.

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“…et al 2018[122] Dickinson et al 2018[123] Kang et al 2019[124] Williams et al 2001[57] Zhang et al 2019[125] Dombrowe et al 2015[126] …”

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“…Low-frequency rTMS can increase cardiac vagal control and reduce sympathetic arousal, alleviating behavioral problems post-TMS improvement ( 59 , 60 ). One study adopted low-frequency rTMS in children with low-functioning autism and found that it can increase the peak alpha frequency in different brain regions and alleviate behavioral symptoms assessed by the ABC ( 61 ). Furthermore, meta-analyses and systematic reviews indicated that rTMS could help treat some dimensions of ASD, such as repetitive and stereotyped behavior, sociability, or some aspects of executive and cognitive functions ( 62 , 63 ).…”

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“…Current thinking regarding ASD suggests that there may be aberrant synaptic plasticity and an abnormal excitation/inhibition ratio in the brain. Most TMS studies in autism have used low-frequency (1 Hz) stimulation (which is thought to be inhibitory) to the dorsolateral prefrontal cortex (DLPFC) due to the notion that an imbalance of excitatory to inhibitory activity is important in the causation of the disorder [26, 27]. GABAergic dysfunction, leading to decreased inhibition and excess frontal activation and abnormal connectivity to other regions of the brain, may be occurring in ASD [26].…”