Pilot Study of Personalized Transcranial Magnetic Stimulation with Spectral Electroencephalogram Analyses for Assessing and Treating Persons with Autism

Makale, M. T.; Nybo, C.; Blim, K.; Blum, K.; Dennen, C. A.; Elman, I.; Murphy, K. T.

Abstract:

NAutism spectrum condition (ASC) is a neurodevelopmental condition that is only partly responsive to prevailing interventions. ASC manifests core challenges in social skills, communication, and sensory function and by repetitive stereotyped behaviors, along with imbalances in the brain’s excitatory (E) and inhibitory (I) signaling. Repetitive transcranial magnetic stimulation (rTMS) has shown promise in ASC and may be a useful addition to applied behavioral analysis (ABA), a gold-standard psychotherapeutic intervention. We report an open-label clinical pilot (initial) study in which ABA-treated ASC persons (n = 123) received our personalized rTMS protocol (PrTMS). PrTMS uses low TMS pulse intensities and continuously updates multiple cortical stimulation locales and stimulation frequencies based on the spectral EEG and psychometrics. No adverse effects developed, and 44% of subjects had ASC scale scores reduced to below diagnostic cutoffs. Importantly, in PrTMS responders, the spectral EEG regression flattened, implying a more balanced E/I ratio. Moreover, with older participants, alpha peak frequency increased, a positive correlate of non-verbal cognition. PrTMS may be an effective ASC intervention, offering improved cognitive function and overall symptomatology. This warrants further research into PrTMS mechanisms and specific types of subjects who may benefit, along with validation of the present results and exploration of broader clinical applicability.

Patologie/Applicazioni:

• Stimolazione Magnetica Transcranica (TMS)
• Autismo

Anno:

2024

Tipo di pubblicazione:

Articolo

Parola chiave:

TMS; stimolazione magnetica transcranica; disturbo dello spettro autistico; EEG spettrale; autismo

Testata scientifica:

MDPI

Mese:

08

Nota:

Questo lavoro esplora la possibilità di trattare i soggetti affetti da disturbo dello spettro autistico tramite un trattamento TMS personalizzato, chiamato personalized rTMS (PrTMS). Rispetto alla rTMS tradizionale questa tecnica stimola diverse aree della corteccia, con trattamenti variabili per numero di treni, durata, intensità di stimolazione, monitorando i progressi tramite EEG ogni 5-7 sedute. In particolare, la stimolazione è stata concentrata sui pathway che comprendono la default mode network (DMN), fortemente alterata nel disturbo dello spettro autistico. Lo studio evidenzia come metà dei soggetti che mostrano una risposta alla PrTMS hanno miglioramenti tali da scendere sotto un punteggio di 50 nel test ASQ, valore diagnostico di cutoff.

DOI:

10.3390/jpm14080857