Improving social cognition and skills in adult ASD: a tDCS pilot study

Abstract

Abstract Introduction: Social cognition and social skills deficits are core to Autism Spectrum Disorder (ASD). Challenges include establishing shared and meaningful relationships with others, a socioemotional process often facilitated by the ability to accurately categorize facial expressions. Existing therapies are extremely time- and labor-intensive. We hypothesized that combining transcranial direct current stimulation (tDCS) with computer-based social skill and cognition interventions would improve measures of empathy and facial expression in high-functioning adults with ASD. Participants & Stimulation: Seven right-handed, English-speaking adults with normal or higher cognitive function and a score of 32 or higher on the Autism Quotient (AQ) participated in two experimental (verum/sham) sessions in a randomized, within-subjects, double-blinded design. The anodal electrode was over right temporoparietal (rTPJ: CP6), a region known to play an important role in social cognition. Stimulation was at 2.0 mA (verum 30 minutes, sham 30 seconds) with a cathodal electrode on the ipsilateral deltoid. During stimulation, participants viewed photos of human and dog faces followed by training videos on facial emotion detection, emotion and empathy identification, and social skills and interactions. Results: Participants were tested before (baseline) and after each stimulation session on the Empathy Quotient (EQ), a global trait/state measure that includes cognitive empathy, empathetic concern and perspective taking. Changes in facial emotion recognition was assessed from responses to multiple-choice questionnaires of emotional facial expressions in static images. Participants scored significantly higher on the EQ, Z = -2.366, p < 0.02, r = 0.68, and had significantly less inaccurate identifications of threatening facial emotion expressions, Z= -1.90, p < 0.02, r = 0.55, after receiving verum compared to sham tDCS. Conclusion: Anodal tDCS applied over rTPJ and paired with computer-based training on social skills and cognition shows promise as a potential treatment method for improving social skills and social cognition in high-functioning adults with ASD. Keywords: Autism Spectrum Disorder (ASD), tDCS, social skills, social cognition