The Potential of Repetitive Transcranial Magnetic Stimulation for Autism Spectrum Disorder: A Consensus Statement

Cole, Eleanor; Enticott, Peter G.; Oberman, Lindsay M.; Gwynette, McLeod F.; Casanova, Manuel F.; Jackson, Scott; Jannati, Ali; McPartland, James C.; Naples, Adam; Puts, Nicolaas A.J.

doi:10.1016/j.biopsych.2018.06.003

Cited by 29 publications

(25 citation statements)

References 27 publications

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“…Consistent with the general consensus on cortical stimulation sites for ASD (10,12), we identified the bilateral dlPFC, IFG, and AG as potential NIBS targets. The effectiveness of stimulating these three regions for ASD has been tested in previous studies (7,30,31).…”

Section: Discussionsupporting

confidence: 82%

“…Refining stimulation targets may be a promising way to improve the treatment effect of NIBS. Currently, multiple NIBS targets for ASD treatment have been explored, including the dorsal lateral prefrontal cortex (DLPFC), motor cortex, inferior frontal gyrus (IFG), dorsal medial prefrontal cortex (dmPFC), and temporoparietal junction (TPJ) (9,10,(12)(13)(14). However, the rationale for choosing these areas is often ambiguous, significantly limiting the optimization of NIBS and its application in ASD.…”

Section: Introductionmentioning

confidence: 99%

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Potential Locations for Noninvasive Brain Stimulation in Treating Autism Spectrum Disorders—A Functional Connectivity Study

et al. 2020

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Objectives: Noninvasive brain stimulation (NIBS) is an emerging tool for treating autism spectrum disorder (ASD). Exploring new stimulation targets may improve the efficacy of NIBS for ASD. Materials and Methods:We first conducted a meta-analysis on 170 functional magnetic resonance imaging studies to identify ASD-associated brain regions. We then performed resting state functional connectivity analysis on 70 individuals with ASD to investigate brain surface regions correlated with these ASD-associated regions and identify potential NIBS targets for ASD. Results:We found that the medial prefrontal cortex, angular gyrus, dorsal lateral prefrontal cortex, inferior frontal gyrus, superior parietal lobe, postcentral gyrus, precentral gyrus, middle temporal gyrus, superior temporal sulcus, lateral occipital cortex, and supplementary motor area/paracentral gyrus are potential locations for NIBS in ASD. Conclusion:Our findings may shed light on the development of new NIBS targets for ASD.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Potential Locations for Noninvasive Brain Stimulation in Treating Autism Spectrum Disorders—A Functional Connectivity Study

et al. 2020

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“…Similarly, bumetanide treatment may mitigate core ASD symptoms in children and adolescents (Lemonnier et al, 2017). We thus suggest that cTBS measures of M1 plasticity in ASD can be used to assess baseline cortico-motor reactivity, probe-target engagement, and monitor therapeutic response to experimental pharmacotherapy (e.g., bumetanide; Lemonnier et al, 2017) and, potentially, future rTMS treatments for ASD (Cole et al, 2019). Moreover, differential cTBS responses within the pediatric ASD population can form the physiologic basis for a clinical endophenotype that improves classification and understanding of the pathophysiology of ASD.…”

Section: Ctbs As a Biomarker For Children And Adolescents With Asdmentioning

confidence: 95%

Continuous Theta-Burst Stimulation in Children With High-Functioning Autism Spectrum Disorder and Typically Developing Children

Jannati

Block

Ryan

et al. 2020

Front. Integr. Neurosci.

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Objectives: A neurophysiologic biomarker for autism spectrum disorder (ASD) is highly desirable and can improve diagnosis, monitoring, and assessment of therapeutic response among children with ASD. We investigated the utility of continuous theta-burst stimulation (cTBS) applied to the motor cortex (M1) as a biomarker for children and adolescents with high-functioning (HF) ASD compared to their age-and gender-matched typically developing (TD) controls. We also compared the developmental trajectory of long-term depression-(LTD-) like plasticity in the two groups. Finally, we explored the influence of a common brain-derived neurotrophic factor (BDNF) polymorphism on cTBS aftereffects in a subset of the ASD group.Methods: Twenty-nine children and adolescents (age range 10-16) in ASD (n = 11) and TD (n = 18) groups underwent M1 cTBS. Changes in MEP amplitude at 5-60 min post-cTBS and their cumulative measures in each group were calculated. We also assessed the relationship between age and maximum cTBS-induced MEP suppression (∆MEP Max ) in each group. Finally, we compared cTBS aftereffects in BDNF Val/Val (n = 4) and Val/Met (n = 4) ASD participants.Results: Cumulative cTBS aftereffects were significantly more facilitatory in the ASD group than in the TD group (P FDR 's < 0.03). ∆MEP Max was negatively correlated with age in the ASD group

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“…The stimulated areas also varied across studies (Ameis et al, 2020;Anninos et al, 2016;Enticott et al, 2012Enticott et al, , 2014Fecteau et al, 2011;Ni et al, 2017;Panerai et al, 2014). Among one of three promising target regions for ASD based on experts' consensus (Cole et al, 2019), unlike the DLPFC, the posterior superior temporal sulcus (pSTS) receives limited attention in rTMS studies (Ni et al, 2017).…”

mentioning

confidence: 99%

Intermittent theta burst stimulation over the posterior superior temporal sulcus for children with autism spectrum disorder: A 4-week randomized blinded controlled trial followed by another 4-week open-label intervention

Chen

Chao

et al. 2021

Autism

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The posterior superior temporal sulcus is a potential therapeutic target of brain stimulation for autism spectrum disorder. We conducted a 4-week randomized, single-blind parallel sham-controlled trial, followed by additional 4-week open-label intervention to evaluate the feasibility and efficacy regarding intermittent theta burst stimulation over the bilateral posterior superior temporal sulcus in autism spectrum disorder. In total, 78 intellectually able children and adolescents were randomized to the active ( n = 40) and sham groups ( n = 38). During the first 4 weeks, the active group received two-session/week intermittent theta burst stimulation, whereas the sham group received the same number of sham stimulation. After unblinding, both groups received eight-session real stimulation over the additional 4 weeks. In total, 91% participants completed the protocol with mild and transitory side-effects. There was no significant group-by-time interaction for active versus sham group on clinical symptoms and social cognitive performances in the first 4 weeks. The within-group analysis revealed 8 weeks (including a 4-week blind trial and a 4-week open-label intervention) of intermittent theta burst stimulation achieved greater efficacy than 4-week interventions. Participants with higher intelligence, better social cognitive performances, alongside less attention-deficit hyperactivity disorder severity at baseline, were more likely to be responders. Our study demonstrated the feasibility of long-term intermittent theta burst stimulation over the posterior superior temporal sulcus in children and adolescents with autism spectrum disorder. However, the findings from the first 4-week blind trial do not support the therapeutic efficacy of intermittent theta burst stimulation over the posterior superior temporal sulcus on the clinical symptoms and cognitive performance of social impairment, given the current stimulation protocol. The exploratory analyses suggest that the therapeutic efficacy might be moderated by several individual characteristics and more intermittent theta burst stimulation sessions. Lay abstract Intermittent theta burst stimulation is a varied form of repetitive transcranial magnetic non-invasive brain stimulation technique used to treat several neurological and psychiatric disorders. Its feasibility and therapeutic effects on the bilateral posterior superior temporal sulcus in children with autism are unknown. We conducted a single-blind, sham-controlled parallel randomized clinical trial in a hitherto largest sample of intellectually able children with autism ( N = 78). Participants randomized to the active group received two-session/week intermittent theta burst stimulation for continuous 8 weeks. Those in the sham group received two-session/week sham stimulations in the first 4 weeks and then active intervention for the following 4 weeks after unblinding. First, we found that continuous 8-week intermittent theta burst stimulation on the bilateral posterior superior temporal sulcus in children with autism is safe and tolerable. Second, we found that 8-week intermittent theta burst stimulation produced greater therapeutic efficacy, although we did not find any significant effects of 4-week intermittent theta burst stimulation on core symptoms and social cognitive performances in autism. Further analysis revealed that participants with higher intelligence and better social cognitive performance, alongside less attention-deficit hyperactivity disorder severity at baseline, were more likely to be responders. This study identified that the factors contribute to responders and the results suggest that longer courses of non-invasive brain stimulation may be needed to produce therapeutic benefits in autism, with consideration of heterogeneous responses.

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The Potential of Repetitive Transcranial Magnetic Stimulation for Autism Spectrum Disorder: A Consensus Statement

Cited by 29 publications

References 27 publications

Potential Locations for Noninvasive Brain Stimulation in Treating Autism Spectrum Disorders—A Functional Connectivity Study

Potential Locations for Noninvasive Brain Stimulation in Treating Autism Spectrum Disorders—A Functional Connectivity Study

Continuous Theta-Burst Stimulation in Children With High-Functioning Autism Spectrum Disorder and Typically Developing Children

Intermittent theta burst stimulation over the posterior superior temporal sulcus for children with autism spectrum disorder: A 4-week randomized blinded controlled trial followed by another 4-week open-label intervention

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