Repetitive Transcranial Magnetic Stimulation as a possible new treatment strategy to improve social skills in Autism Spectrum Disorder

Abstract

Autism spectrum disorder (ASD) is one of the most common child psychiatric disorders. Despite the long history of research on ASD, not much is known yet about the exact biological causes and how the disorder can be effectively treated. Behavioral interventions and pharmacological treatments aim to reduce symptoms. These treatments are often non-specific and the effectiveness is limited. It is therefore of great importance to search for alternative treatment strategies. Several studies have suggested that social skill deficits might lie at the core of other symptoms in ASD. Furthermore, neuroimaging studies have shown that social skill deficits in ASD are associated with hypoactivation of in particular the frontal lobes. Repetitive transcranial magnetic stimulation (rTMS) is a technique that is capable of directly influencing neural excitability in a relative focal fashion and might provide a minimally invasive somatic treatment strategy. Increasing excitability in the frontal lobe with rTMS may improve social skills in ASD. The aim of the present review is to examine whether there is a theoretical basis for applying rTMS to improve social skills in ASD. Meta-analyses have shown that rTMS treatments are effective in some disorders, such as depression and schizophrenia. However, safety limits and ethical considerations make it challenging to conduct rTMS treatment in children with ASD. Currently, there is not enough evidence to conclusively support rTMS treatment in children with ASD and further research is needed. To this end, this review proposes a protocol for a pilot study which could provide proof of principle.