A Double-blind, Randomized Trial of Deep Repetitive Transcranial Magnetic Stimulation (rTMS) for Autism Spectrum Disorder

Journal: Brain Stimulation 7:206-211 (2013)

Authors: P.G Enticott, B.M Fitzgibbon, H.A Kennedy, S.L Arnold, D Elliot, A Peachey, A Zangen, P.B Fitzgerald

Background:

Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited.Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions.

Objective:

The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontalcortex improves social relating in ASD.

Methods:

28 adults diagnosed with either autistic disorder (high-functioning) or Asperger’s disordercompleted a prospective, double-blind, randomized, placebo-controlled design with 2weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment.

Results:

Participants in the active condition showed a near significant reduction in self-reported socialrelating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition.

Conclusions:

Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relatingimpairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response.

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