Non-Invasive Brain Stimulation Reduces Symptoms in Autistic Children

by | May 31, 2019 | 2017, Autism, Brain Health, Infant and Children's Health

Written by Joyce Smith, BS. Twenty sessions of Non-Invasive Brain Stimulation over the left dorsolateral prefrontal cortex of the twenty-four participating autistic children significantly improved autistic symptoms, with a lasting effect of six months.

infant and children's healthNon-Invasive Brain Stimulation (NIBS) is a form of neurostimulation (also known as neuromodulation) that involves the delivery of a constant very low level current to specifically targeted areas of the brain to improve cognitive performance on a variety of tasks. It is transient with little side effects, well-tolerated by children, affordable and readily accessible, making it an appealing treatment option for autism spectrum disorder (ASD).

Previous studies in ASD children show that Repetitive Transcranial Magnetic Stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) improved autistic behavior one week after 20 sessions of transcranial stimulation. 1 Unfortunately, most of the trials are limited to a low number of sessions (not more than 15 in the best-case scenario), and it is not known how long the modulatory effect would last 2.  This study was a controlled, randomized trial including 24 children with ASD. Group G1 (15 patients) received intervention after one month of clinical evaluations: Group G2 (9 patients) received intervention after two months of clinical evaluations. The authors hypothesized that 20 sessions of NIBS over the left dorsolateral prefrontal cortex (DLPRC) would facilitate learning and enhanced processing speed and improve cognitive functioning in the intervention group compared to the control group and that the measured clinical response after 20 sessions would have a lasting positive neuromodulatory effect (at least 6 months) in the participating autistic children 3.

Twenty sessions of NIBS was administered once daily Monday through Friday. Transcranial Direct Current Stimulation (tDCS) was used only in patients 10 years old or younger. The procedure allowed them to watch TV cartoons, etc.  to encourage sitting still and staying focused while Repetitive Transcranial Magnetic Stimulation (rTMS) was used in patients older than 10 years and 11 months. A child psychiatrist, not involved in the NIBS therapy, evaluated the children at one, three, and six months post -treatment. Follow-up at 6 months occurred for both groups. Short term outcome was evaluated based on three main clinical scales: the total scores on the Autism Behavior Checklist (ABC) 3, Autism Treatment Evaluation Checklist (ATEC) 4, and the Global Clinical Impression Scale (GCIS) 5 as well as the Autism Diagnostic Interview. Intra or between group comparisons were also done. Observation points were at 1, 3, and 6 months after completing all three sessions of NIBS.

Compared to pre-treatment values,  all autistic behaviors improved in both groups G1 and G2 of autistic children, as seen by a significant decrease in the total scores for ABC, ADI-R, and ATEC one month following NIBS: (Wilcoxon matched pair test; ABC, p = 0.000131; ADI-R, p = 0.000846; ATEC, p = 0.000196). Also, a comparison between the change in the total score of clinical scales did not show any significant differences correlated with the use of tDCS and rTMS (Mann–Whitney U Test, p > 0.05). The clinical response appeared to be independent of group age and type of intervention.

For both groups G1 and G2, NIBS, the significant change in clinical scores was maintained until the sixth month, then increased a small amount, but were still lower than pre-treatment values. In this study, the number of stimuli per session and the total number of sessions were considerably higher than in previous studies, which, the authors suggest, might account for the additional significant clinical improvement seen in social aspects and communication. The authors conclude that twenty session of NIBS over L-DLPFC improves autistic symptoms in ASD children, with a lasting effect of six months and speculate whether NIBS, if repeated at 6 month intervals, would provide long term effects. Additional research will be required to make that determination.

Source: Gómez, Lázaro, Belkis Vidal, Carlos Maragoto, Lilia Morales, Sheyla Berrillo, Héctor Vera Cuesta, Margarita Baez et al. “Non-invasive brain stimulation for children with autism spectrum disorders: a short-term outcome study.” Behavioral Sciences 7, no. 3 (2017): 63.

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)

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Posted May 31, 2019.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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