Long-term effects of repetitive transcranial magnetic stimulation on a sample of children with autism spectrum disorder

Abstract

Introduction Autism spectrum disorder (ASD) is one of the most common child psychiatric disorders, with a prevalence estimated at 1.1% of the population. Children diagnosed with ASD differ from typically developing children on many cognitive and behavioral dimensions, and therefore the term ‘spectrum’ is used to emphasize its full scope. Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study and potential treatment of ASD. Aim To study long-term effects of repetitive transcranial magnetic stimulation (rTMS) on a sample of children with ASD. Patients and methods The included sample consisted of 30 children with ASD, and their ages ranged from 4 to 10 years old. They were diagnosed clinically according to Diagnostic and statistical manual of mental disorders, fifth edition through a designed semistructured interview and through application of Childhood Autistic Rating Scale (CARS). There were five female children, representing a percentage of 16.7%, whereas 25 children were males, representing a percentage of 83.3%. All patients in the sample did not stop their medical or behavioral therapy for ASD. After 3-month follow-up, 24 children were reassessed again by CARS after stoppage of rTMS sessions. Results The results of the study after the completion of 12 sessions of the rTMS showed that there is a significant difference and improvement in the severity of the clinical symptoms for ASD, except for the level of activity, listening response, and use of the body, by comparing the severity of symptoms before and after rTMS. On conducting statistical tests, the average measures of problems with respect to relationship with people, sensory responses, and verbal communication after sessions were relatively reduced. This relative decrease was found to be highly significant. The average measurements of problems such as imitation, emotional response and object use and visual response, fear or nervousness, nonverbal communication, level of consistency of intellectual response, general impression, as well as the total CARS score after conducting rTMS have relatively decreased, and it was found to be statistically significant. The average score in the CARS scale changed from 40.2 to 31.4 after 3 months of follow-up, and there was a change in the aforementioned results. Conclusion This study concluded that rTMS over left dorsolateral prefrontal cortex may be a safe and effective way of providing temporarily relief of ASD symptoms, so maintenance therapy is recommended.