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...

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Bibliographic Details
Published in:Applied psychophysiology and biofeedback 2014-12, Vol.39 (3-4), p.237-257
Main Authors: Sokhadze, Estate M., El-Baz, Ayman S., Tasman, Allan, Sears, Lonnie L., Wang, Yao, Lamina, Eva V., Casanova, Manuel F.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Autism
Behavioral Science and Psychology
Biofeedback training
Brain Waves - physiology
Child
Child Development Disorders, Pervasive - physiopathology
Child Development Disorders, Pervasive - therapy
Drug therapy
Electroencephalography
Enterprise resource planning
Evoked Potentials - physiology
Executive Function - physiology
Female
Health Psychology
Humans
Male
Medical research
Medicine, Experimental
Neurofeedback - methods
Neurophysiology
Pilot Projects
Psychology
Psychotherapy and Counseling
Public Health
Social aspects
Transcranial Magnetic Stimulation - methods
Treatment Outcome
Young Adult
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Summary: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.
ISSN:1090-0586
1573-3270
DOI:10.1007/s10484-014-9264-7