Table 1.
Published Reports of Investigational Use of TMS in ASD
| Paper | Diagnosis | Intellectual Disability |
n (ASD) | Mean age (years) |
Gender | Medication | Site | Frequency | Intensity |
|---|---|---|---|---|---|---|---|---|---|
|
Theoret et al. [2005], Current Biology |
ASD | None | 10 | Age Range: 23–58 |
M/F | – | L M1 | Single Pulse and Paired Pulse (1, 2, 3, 6, 9, 12, 15 msec ISI) |
Single Pulse590%, 100%, 105%, 110%, 115%, 120%, 130%, 140%, 150%, 160% RMT; Paired Pulse = 80% and 120% RMT |
|
Minio-Paluello et al. [2009], Bio- logical Psychiatry |
AS | None | 16 | 28 | M | – | L M1 | Single Pulse | 120% RMT |
|
Oberman et al. [2010], Frontiers in Synaptic Neuroscience |
AS | None | 5 | 41 | M/F | – | L M1 | TBS | 80% AMT |
|
Enticott et al. [2010], Develop- mental Medicine and Child Neurology |
ASD (11 HFA, 14 AS) |
None | 25 | 16.67 | M/F | clomipramine, risperidone, que- tiapine, venlafaxine, flouxe- tine, valproate |
L and R M1 | Single Pulse and Paired Pulse (2 and 15 msec ISI) |
Single Pulse=115% RMT; Paired Pulse=90% and 115% RMT |
| Jung et al. [2012], Developmen- tal Medicine and Child Neurology |
ASD (7 HFA, 6 AS, 2 PDD- NOS) |
None | 15 | 18 | M/F | None | R M1 (PAS) | PAS, Single Pulse and Paired Pulse (2 and 3 msec ISI) |
Lowest intensity producing aver- age 1 mV motor-evoked potential |
|
Oberman et al. [2012], European Journal of Neuroscience |
AS | None | 35 (cTBS), of which 9 also iTBS |
36 | M/F | – | L M1 | TBS | 80% AMT |
|
Enticott et al. [2012], Biological Psychiatry |
ASD | None | 34 | 26 | M/F | SSRI, atypical antipsychotic, benzodiazapine, antidepressant |
L M1 | Single Pulse | 120% RMT |
|
Enticott et al. [2013], Frontiers in Human Neuroscience |
ASD | None | 32 | 25 | M/F | SSRI, atypical antipsychotic, benzodiazapine, antidepressant |
L M1 | Single Pulse | 120% RMT |
|
Enticott et al. [2013], Neuropharmacology |
ASD | None | 36 | 26 | M/F | fluoxetine, citalopram, sertraline, lorazepam, olanzapine, venlafaxine, risperidone, mirtazapine, quetiapine |
L and R M1 | Single Pulse and Paired Pulse (2, 15 and 100 msec ISI) |
Single Pulse=115% and 130% RMT; 115% and 130% AMT; Paired Pulse=90% RMT and 120% RMT |
|
Oberman et al. [2014], Frontiers in Human Neuroscience |
ASD | None | 19 | 12 | M | citalopram, atomoxetine, buspirone, sertraline, methylphenidate, risperidone, guanfacine |
L M1 | TBS | 80% AMT |
|
Oberman et al., [2014], Medical Hypotheses |
ASD | None | 35 | 36 | M/F | – | L M1 | TBS | 80% AMT |
| Paper | Duration | Trains | Pulses Delivered |
Sessions | Blinding | Assessment Times |
Reported Effects | Side Effects |
|---|---|---|---|---|---|---|---|---|
|
Theoret et al. [2005], Current Biology |
n/a | n/a | 264 | 1 | None | Online | No group difference in RMT or response to ppTMS. Impaired corticospinal facil- itation in response to finger move- ments viewed from the egocetnric point of view in the ASD group. |
Not Indicated |
|
Minio-Paluello et al. [2009], Bio- logical Psychiatry |
n/a | n/a | 72 | 1 | None | Online | No modulation of corticospinal excitabil- ity in response to the observation of painful stimuli affecting another indi- vidual in the Asperger’s Group. |
Not Indicated |
|
Oberman et al. [2010], Frontiers in Synaptic Neuroscience |
190 s (iTBS), 47 s (cTBS) |
iTBS: 20 × 2 s, 10 s ISI; cTBS 1 train of 47 s |
600 | 2 (1 cTBS, 1 iTBS) |
None | Before, 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, 120 min after cTBS |
Longer lasting facilitation (enhanced MEP) following iTBS in ASD Longer lasting inhibition (suppressed MEP) following cTBS in ASD No effect the following day using opposite protocol for ASD (suggesting enhanced metaplasticity) |
None |
|
Enticott et al. [2010], Develop- mental Medicine and Child Neurology |
n/a | n/a | 120 | 1 | None | Online | Reduced intracortical inhibition in the HFA group as compared to the AS or control group |
Not Indicated |
| Jung et al. [2012], Developmen- tal Medicine and Child Neurology |
13.3 min (PAS) | n/a | 200 | 1 | None | Before, after, 30 min after, 60 min after PAS |
No LTP-like MEP facilitation in ASD (group difference significant at 60 min). No group difference in response to ppTMS. |
– |
|
Oberman et al. [2012], European Journal of Neuroscience |
190 s (iTBS), 40 s (cTBS) |
iTBS: 20 × 2 s, 10 s ISI; cTBS 1 train of 40 s |
600 | 1 or 2 | Data analysis (patient group) |
Before, 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, 120 min after cTBS |
Longer lasting facilitation (enhanced MEP) following iTBS in ASD Longer lasting inhibition (suppressed MEP) following TBS in ASD |
None |
|
Enticott et al. [2012], Biological Psychiatry |
n/a | n/a | 50 | 1 | None | Online | No group difference in degree of corticospinal excitability in response to observation of single static hand stimuli. Impaired corticospinal facilitaiton in response to single hand transitive hand actions in the ASD group. |
Not Indicated |
|
Enticott et al. [2013], Frontiers in Human Neuroscience |
n/a | n/a | 50 | 1 | None | Online | No group difference in degree of corticospinal excitability in response to single static hand stimuli or two person interactive hands. |
Not Indicated |
|
Enticott et al. [2013], Neuropharmacology |
n/a | n/a | 170 | 1 | None | Online | No group difference in RMT. Heterogeneous response to paired pulse TMS in the ASD group. |
Not Indicated |
|
Oberman et al. [2014], Frontiers in Human Neuroscience |
40 s cTBS | 1 train of 40 s | 600 | 1 | Data analysis (patient group) |
Before, 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, 120 min after cTBS |
Positive linear relationship between age and duration of modulation of TBS after effects in children and adolescents with ASD. A subgroup of the ASD participants showed paradoxical facilitation. |
mild headache, mild fatigue. |
|
Oberman et al., [2014], Medical Hypotheses |
40 s cTBS | 1 train of 40 s | 600 | 1 | Data analysis (patient group) |
Before, 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, 120 min after cTBS |
Longer lasting inhibition (suppressed MEP) and greater degree of inhibition (area under the curve) following TBS in ASD. Age did not significantly contribute to the model. |
None |
All studies used TMS-evoked MEP amplitude as outcome measures. All Studies used Figure of 8 coils. ASD, Autism Spectrum Disorder; HFA, High Functioning Autism; PDD-NOS, Pervasive Developmental Disorder, Not Otherwise Specified; AS, Asperger’s Syndrome; M1, Primary Motor Cortex; Fo8, Figure of 8 coil; ISI, Interstimulus Interval; ppTMS, Paired Pulse TMS; rTMS, Repetitive Transcranial Magnetic Stimulation; PAS, Paired Associative Stimulation; iTBS, Intermittant Theta Burst Stimulation; cTBS, Continuous Theta Burst Stimulation; RMT, Resting Motor Threshold; AMT, Active Motor Threshold; MEP, Motor Evoked Potential; LTP, Long Term Potentiation; SSRI, Selective Serotonin Reuptake Inhibitor.