Repetitive Transcranial Magnetic Stimulation (rTMS)
Research Papers
Neuromodulation Based on rTMS Affects Behavioral Measures and Autonomic Nervous System Activity in Children with Autism
Many children with autism spectrum disorder (ASD) exhibit symptoms associated with autonomic nervous system (ANS) dysfunction indicative of low psychophysiological flexibility. It is suggested that ASD symptoms are associated with generalized abnormalities in the central nervous system, including structures and networks involved in the top-down regulation of the ANS. Repetitive transcranial magnetic stimulation (rTMS) has been suggested as a possible therapy to target ANS regulation deficits in ASD. In the current study we used neuromodulation based on rTMS over the dorsolateral prefrontal cortex (DLPFC) to reduce sympathetic arousal and increase parasympathetic activity in children with ASD. In a study on 27 children with autism we administered weekly 0.5 Hz rTMS bilaterally over the DLPFC with concurrent recording of autonomic activity. Statistical analysis of time and frequency domain heart rate variability (HRV) indices and skin conductance level (SCL) revealed a strong linear regression of most HRV and SCL measures. Several parental behavioral rating scores improved post-TMS and showed a correlation with autonomic outcomes; in particular, parasympathetic indices of HRV negatively correlated with repetitive and stereotyped behaviors, while sympathetic arousal indices showed positive correlation with the same behaviors. The paper discusses potential neurobiological mechanisms involved in post-TMS autonomic balance and aberrant behavior improvements
View Full Paper →Neuromodulation Integrating rTMS and Neurofeedback for the Treatment of Autism Spectrum Disorder: An Exploratory Study
Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 years). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N = 20) and waitlist (WTL, N = 22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the WTL group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control WTL group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the WTL group
View Full Paper →Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Evoked-Gamma Frequency Oscillations in Autism Spectrum Disorder (ASD)
Introduction It has been reported that individuals with Autism Spectrum Disorder (ASD) have abnormal reactions to the sensory environment and visuo-perceptual abnormalities. Electrophysiological research has provided evidence that gamma band activity (30-80 Hz) is a physiological indicator of the co-activation of cortical cells engaged in processing visual stimuli and integrating different features of a stimulus. A number of studies have found augmented and indiscriminative gamma band power at early stages of visual processing in ASD; this may be related to decreased inhibitory processing and an increase in the ratio of cortical excitation to inhibition. Low frequency or ‘slow’ (≤1HZ) repetitive transcranial magnetic stimulation (rTMS) has been shown to increase inhibition of stimulated cortex by the activation of inhibitory circuits.
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