Khaleghi Ali, Zarafshan Hadi, Vand Safa Rafiei, Mohammadi Mohammad Reza
Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
Clin Psychopharmacol Neurosci. 2020 Nov 30;18(4):527-552. doi: 10.9758/cpn.2020.18.4.527.
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by major impairments in social communication, stereotyped and ritualistic behaviors and deficits in sensory reactivity. Recently, noninvasive brain stimulation (NIBS) methods, namely transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), have been examined as possible new therapeutic options for modifying the pathological neuroplasticity involved in neuropsychiatric disorders including ASD. Therefore, we conducted a systematic review on the therapeutic uses of tDCS and repetitive TMS (rTMS) in ASD patients. A systematic search was performed on Scopus, Web of Science, PubMed, Cochrane and Embase. Original articles reporting the use of tDCS or rTMS to treat ASD were screened and studied by two researchers independently based on PRISMA guidelines. We found 32 eligible studies including 8 tDCS reports, 23 rTMS reports and one report with both tDCS and rTMS. These studies comprised 6 case-reports, 9 non-controlled trials and 17 controlled trials which assessed NIBS effects on the three cognitive, behavioral and biological dimensions in ASD. Existing evidence demonstrates that NIBS methods could be helpful for treating some dimensions of ASD such as repetitive behavior, sociability or some aspects of executive and cognitive functions. However, such evidence should be regarded with care because of the quality of original researches and serious publication bias as well as the heterogeneity of data. Further randomized, double-blind, sham-controlled trials with appropriate follow-up periods should be designed to assess the efficacy of NIBS methods for ASD treatment.
自闭症谱系障碍（ASD）是一种复杂的神经发育障碍，其特征是社交沟通存在重大缺陷、刻板和仪式化行为以及感觉反应缺陷。最近，非侵入性脑刺激（NIBS）方法，即经颅直流电刺激（tDCS）和经颅磁刺激（TMS），已被作为可能的新治疗选择进行研究，以改变包括ASD在内的神经精神疾病中涉及的病理性神经可塑性。因此，我们对tDCS和重复经颅磁刺激（rTMS）在ASD患者中的治疗用途进行了系统评价。在Scopus、科学网、PubMed、Cochrane和Embase上进行了系统检索。两名研究人员根据PRISMA指南独立筛选和研究了报告使用tDCS或rTMS治疗ASD的原始文章。我们发现了32项符合条件的研究，包括8篇tDCS报告、23篇rTMS报告和1篇同时使用tDCS和rTMS的报告。这些研究包括6篇病例报告、9篇非对照试验和17篇对照试验，评估了NIBS对ASD患者认知、行为和生物学三个维度的影响。现有证据表明，NIBS方法可能有助于治疗ASD的某些维度，如重复行为、社交能力或执行和认知功能的某些方面。然而，由于原始研究的质量、严重的发表偏倚以及数据的异质性，应谨慎看待此类证据。应设计进一步的随机、双盲、假对照试验，并设置适当的随访期，以评估NIBS方法治疗ASD的疗效。
