High-Frequency Repetitive Transcranial Magnetic Stimulation Applied to the Parietal Cortex for Low-Functioning Children With Autism Spectrum Disorder: A Case Series

Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique to stimulate specific areas of cortical dysfunction in several neuropsychiatric diseases; however, it is not known whether high-frequency rTMS (HF-rTMS) over the left inferior parietal lobule, in low functioning children with autism spectrum disorder (ASD), improves core symptoms. Method: Eleven low-functioning children with ASD completed two separate HF-rTMS treatment courses, 6 weeks apart. Each treatment course involved five 5-s trains at 20 Hz, with 10-min inter-train intervals, on left inferior parietal lobule each consecutive weekday for a 3-week period (15 treatments per course). Subjects were assessed at five time points: immediately before and after the first HF-rTMS course, immediately before and after the second HF-rTMS course, and 6 weeks after the second rTMS treatment course. Treatment effectiveness was evaluated using the Verbal Behavior Assessment Scale (VerBAS) and Autism Treatment Evaluation Checklist (ATEC). The latter test consists of four subtest scales: Language, Sociability, Sensory, and Behavior. In addition, daily treatment logbooks completed by parents were considered as one of the outcome measures. Results: Participants showed a significant reduction in language- and social-related symptoms measured by ATEC from pretreatment to the 6-week follow-up after the second treatment course. Moreover, some possible improvements in imitation and cognition were reported by caregivers. Conclusions: Our findings suggest that HF-rTMS over the left parietal cortex might improve core deficits in low-functioning children with ASD.

Study of the role of the transcranial magnetic stimulation on language progress in autism spectrum disorder

“…In comparison to our research, Yang et al [13] and Assadi [14] stimulated the left lower parietal lobule (left-IPL), which is closely linked to other cortical regions by white matter tracts like the upper longitudinal fascicle, which plays an important role in the processing of affective faces, as well as the arcuate fasciculus, which is very important for the visuospatial and language. Targeting the left-IPL region in this way provides the potential of treating instability in the mirror neuron system as well as language and affective processing impairments [13,14].…”

“…It is widely understood that a child's brain is not only a smaller version of an adult brain, and clinical treatments such as rTMS may have unique, unexpected, and possibly longlasting impact on neurodevelopment [15]. Unlike our study, Yang et al [13] and Assadi [14] used high frequency rTMS and 80% strength of stimulatory production, but in older age groups ranging from 17 years of age [13,14]. With respect to concentration and adherence to basic commands, there is no substantial gap in relation between the two groups, and that was predicted since our research did not target their particular brain regions.…”

“…As reported by Fecteau et al [11], using rTMS to the left pars triangularis significantly improved the naming output of ASP volunteers [9]. Even Yang et al [13] and Assadi [14] have enhanced language abilities, while they used high frequency rTMS targeting mirror neurons in the left lower parietal lobule (left-IPL) with possibly improved social responsiveness [13,14]. Additionally, Marachev and Grigorieva [18] demonstrated quicker dynamic [18].…”

Predictors of Change in Play-Based Communication and Behavior Intervention for High-Risk ASD: The Role of Mother-Child Dyadic Synchrony

“…The Autism Treatment Evaluation Checklist [ATEC, ( 28 )] was used to measure the efficacy of PCBI. It has been successfully used to assess the effectiveness of treatments and progress after intervention in ASD ( 29 – 31 ). The ATEC is designed to be self-administered by parents and elicits parent concerns in four domains: speech/language/communication (14 items, scores range from 0 to 28), health/physical behavior (25 items, scores range from 0 to 75), sensory/cognitive awareness (18 items, scores range from 0 to 36), and sociability (20 items, scores range from 0 to 40) ( 32 ).…”

The Dopamine Hypothesis of Autism Spectrum Disorder Revisited: Current Status and Future Prospects

“…Experimental therapies have emerged as well. Yang et al [83] applied high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) to low-functioning children with ASD, which led to an improvement in social behavior. Given the earlier observed dopamine-releasing effect of HF-rTMS, the authors speculate that this approach might lead to behavioral improvement by altering dopamine activity in the same brain regions we hypothesized as faulty.…”