The use of noninvasive brain stimulation techniques in autism spectrum disorder

Noninvasive brain stimulation (NIBS) techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have recently emerged as alternative, nonpharmacological interventions for a variety of psychiatric, neurological, and neurodevelopmental...

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Bibliographic Details
Published in:Autism research 2024-01, Vol.17 (1), p.17-26
Main Authors: Oberman, Lindsay M., Francis, Sunday M., Lisanby, Sarah H.
Format: Article
Language:English
Subjects:
Adult
Autism
autism Spectrum disorder
Autism Spectrum Disorder - therapy
Biomarkers
Brain
Brain - diagnostic imaging
Child
clinical translation
Clinical trials
Depressive Disorder, Major - therapy
Direct current
Effectiveness
Electrical stimulation of the brain
ESB
Executive function
Humans
Hyperactivity
Labels
Magnetic fields
Medical imaging
neurodevelopment
Neuroimaging
noninvasive brain stimulation
Obsessive compulsive disorder
Safety
Sensorimotor integration
Signs and symptoms
Subgroups
transcranial direct current stimulation
Transcranial Direct Current Stimulation - methods
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - methods
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Summary:Noninvasive brain stimulation (NIBS) techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have recently emerged as alternative, nonpharmacological interventions for a variety of psychiatric, neurological, and neurodevelopmental conditions. NIBS is beginning to be applied in both research and clinical settings for the treatment of core and associated symptoms of autism spectrum disorder (ASD) including social communication deficits, restricted and repetitive behaviors, irritability, hyperactivity, depression and impairments in executive functioning and sensorimotor integration. Though there is much promise for these targeted device‐based interventions, in other disorders (including adult major depressive disorder (MDD) and obsessive compulsive disorder (OCD) where rTMS is FDA cleared), data on the safety and efficacy of these interventions in individuals with ASD is limited especially in younger children when neurodevelopmental interventions typically begin. Most studies are open‐label, small scale, and/or focused on a restricted subgroup of individuals with ASD. There is a need for larger, randomized controlled trials that incorporate neuroimaging in order to develop predictive biomarkers of treatment response and optimize treatment parameters. We contend that until such studies are conducted, we do not have adequate estimates of the safety and efficacy of NIBS interventions in children across the spectrum. Thus, broad off‐label use of these techniques in this population is not supported by currently available evidence. Here we discuss the existing data on the use of NIBS to treat symptoms related to ASD and discuss future directions for the field. Lay Summary Noninvasive Brain Stimulation techniques are currently being studied in research centers and being offered in clinical settings to treat individuals with autism spectrum disorder. In this commentary, we discuss the evidence base for the use of these techniques. We also highlight the limitations and caution against broad expedited translation of these tools to the clinic without properly powered and controlled studies that provide sufficient data to inform their safety and efficacy in this population.
ISSN:1939-3792
1939-3806
DOI:10.1002/aur.3041