A double-blind, randomized trial of deep Repetitive Transcranial Magnetic Stimulation (rTMS) for autism spectrum disorder

Peter Gregory Enticott, Bernadette Fitzgibbon, Hayley Ann Kennedy, Sara Arnold, David Elliott, Amy Peachey, Abraham Zangen, Paul Bernard Fitzgerald

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

Background: Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited. Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions. Objective: The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontal cortex improves social relating in ASD. Methods: 28 adults diagnosed with either autistic disorder (high-functioning) or Asperger s disorder completed a prospective, double-blind, randomized, placebo-controlled design with 2 weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment. Results: Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition. Conclusion: Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response. ? 2013 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)206 - 211
Number of pages6
JournalBrain Stimulation
Volume7
Issue number2
DOIs
Publication statusPublished - 2014

Cite this

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title = "A double-blind, randomized trial of deep Repetitive Transcranial Magnetic Stimulation (rTMS) for autism spectrum disorder",
abstract = "Background: Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited. Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions. Objective: The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontal cortex improves social relating in ASD. Methods: 28 adults diagnosed with either autistic disorder (high-functioning) or Asperger s disorder completed a prospective, double-blind, randomized, placebo-controlled design with 2 weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment. Results: Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition. Conclusion: Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response. ? 2013 Elsevier Inc. All rights reserved.",
author = "Enticott, {Peter Gregory} and Bernadette Fitzgibbon and Kennedy, {Hayley Ann} and Sara Arnold and David Elliott and Amy Peachey and Abraham Zangen and Fitzgerald, {Paul Bernard}",
year = "2014",
doi = "10.1016/j.brs.2013.10.004",
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A double-blind, randomized trial of deep Repetitive Transcranial Magnetic Stimulation (rTMS) for autism spectrum disorder. / Enticott, Peter Gregory; Fitzgibbon, Bernadette; Kennedy, Hayley Ann; Arnold, Sara; Elliott, David; Peachey, Amy; Zangen, Abraham; Fitzgerald, Paul Bernard.

In: Brain Stimulation, Vol. 7, No. 2, 2014, p. 206 - 211.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A double-blind, randomized trial of deep Repetitive Transcranial Magnetic Stimulation (rTMS) for autism spectrum disorder

AU - Enticott, Peter Gregory

AU - Fitzgibbon, Bernadette

AU - Kennedy, Hayley Ann

AU - Arnold, Sara

AU - Elliott, David

AU - Peachey, Amy

AU - Zangen, Abraham

AU - Fitzgerald, Paul Bernard

PY - 2014

Y1 - 2014

N2 - Background: Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited. Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions. Objective: The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontal cortex improves social relating in ASD. Methods: 28 adults diagnosed with either autistic disorder (high-functioning) or Asperger s disorder completed a prospective, double-blind, randomized, placebo-controlled design with 2 weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment. Results: Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition. Conclusion: Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response. ? 2013 Elsevier Inc. All rights reserved.

AB - Background: Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited. Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions. Objective: The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontal cortex improves social relating in ASD. Methods: 28 adults diagnosed with either autistic disorder (high-functioning) or Asperger s disorder completed a prospective, double-blind, randomized, placebo-controlled design with 2 weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment. Results: Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition. Conclusion: Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response. ? 2013 Elsevier Inc. All rights reserved.

UR - http://www.sciencedirect.com/science/article/pii/S1935861X13002994

U2 - 10.1016/j.brs.2013.10.004

DO - 10.1016/j.brs.2013.10.004

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VL - 7

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JO - Brain Stimulation

JF - Brain Stimulation

SN - 1935-861X

IS - 2

ER -