Abstract
Intermittent theta burst stimulation (iTBS), a patterned repetitive transcranial magnetic stimulation, was applied over the posterior superior temporal sulcus (pSTS) or dorsolateral prefrontal cortex (DLPFC) to explore its impact in adults with autism spectrum disorder (ASD). Among 25 adults with ASD, 19 (mean age: 20.8 years) completed the randomized, sham-controlled, crossover trial. Every participant received iTBS over the bilateral DLPFC, bilateral pSTS and inion (as a sham control stimulation) in a randomized order with a 1-week interval. Neuropsychological functions were assessed using the Conners' Continuous Performance Test (CCPT) and the Wisconsin Card Sorting Test (WCST). Behavioral outcomes were measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Social Responsiveness Scale (SRS). In comparison to that in the sham stimulation, the reaction time in the CCPT significantly decreased following single DLPFC session (p = 0.04, effect size = 0.71) while there were no significant differences in the CCPT and WCST following single pSTS session. Besides, the results in behavioral outcomes were inconsistent and had discrepancy between reports of parents and patients. In conclusion, a single session of iTBS over the bilateral DLPFC may alter the neuropsychological function in adults with ASD. The impacts of multiple-sessions iTBS over the DLPFC or pSTS deserve further investigations.
Highlights
Autism spectrum disorder (ASD) is characterized by an early onset of difficulties with social-communication, and repetitive, restricted, stereotyped behaviors, and interests (Lai et al, 2014)
Crossover, and sham-controlled study design, we investigated the impact of Intermittent theta burst stimulation (iTBS) over the bilateral dorsolateral prefrontal cortex (DLPFC) and bilateral posterior superior temporal sulcus (pSTS) compared to the sham-control condition
Omission errors and reaction time decreased after iTBS over the DLPFC, while commission errors increased after iTBS over the pSTS in the Conners’ Continuous Performance Test (CCPT)
Summary
Autism spectrum disorder (ASD) is characterized by an early onset of difficulties with social-communication, and repetitive, restricted, stereotyped behaviors, and interests (Lai et al, 2014). Repetitive transcranial magnetic stimulation (rTMS), a noninvasive technique of repetitive stimulation of the neural circuits, is capable of producing long-lasting changes in cortical excitability beyond the period of stimulation (Fang et al, 2010; Pell et al, 2011). The precise mechanism of action of rTMS is still unclear, recent studies found that rTMS can induce changes similar to long-term potentiation (LTP) or long-term depression (LTD) via modulation of synaptic plasticity (Huang et al, 2007; Pell et al, 2011). RTMS has shown some potential clinical benefits in several psychiatric disorders such as major depressive disorder (Gaynes et al, 2014), schizophrenia (Rajji et al, 2013), post-traumatic stress disorder (Cohen et al, 2004; Watts et al, 2012), and ASD (Enticott et al, 2012, 2014)
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