Tian Li, Ma Shuai, Li Yin, Zhao Meng-Fei, Xu Chang, Wang Chen, Zhang Xin, Gao Lei
Tianjin Anding Hospital, Tianjin, China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China.
Front Neurosci. 2023 Jul 20;17:1188648. doi: 10.3389/fnins.2023.1188648. eCollection 2023.
Transcranial magnetic stimulation (TMS) has been introduced into the intervention of autism spectrum disorders (ASD) as a possible new therapeutic option for modifying pathological neuroplasticity. However, the stimulating protocols of rTMS for ASD have not been approved unanimously, which affects the clinical popularization and application of rTMS. In addition, there is little research on the improvement of social processing of autistic children by rTMS.
We explored the clinical efficacy of rTMS and improvement of face processing with the protocol of left high-frequency and right low-frequency on bilateral dorsolateral prefrontal cortex (DLPFC), with a sample of 45 ASD participants aged 2-18.
Our results showed that both the score on the Childhood Autism Rating Scale (CARS) and the fixations on the eyes of the human faces improved by two-session rTMS intervention, except for the percentage of eyes fixation. The mediation analysis indicated the item of "Adaptation to Change" of CARS mediated dominantly the improvement of eye-gaze behavior of ASD participants by rTMS.
Our study revealed the mechanism of rTMS in improving the eye-gaze behavior of the autism population, deepened the understanding of the function of rTMS in treating autistic social disorders, and provided a reference for combined treatment for ASD.
经颅磁刺激（TMS）已被引入自闭症谱系障碍（ASD）的干预中，作为一种可能用于改变病理性神经可塑性的新治疗选择。然而，rTMS用于ASD的刺激方案尚未得到一致认可，这影响了rTMS的临床推广和应用。此外，关于rTMS对自闭症儿童社会加工能力改善的研究较少。
我们采用左高频、右低频刺激双侧背外侧前额叶皮质（DLPFC）的方案，对45名年龄在2至18岁的ASD参与者进行研究，探讨rTMS的临床疗效及对面孔加工的改善情况。
我们的结果显示，除了注视眼睛的百分比外，两阶段的rTMS干预使儿童自闭症评定量表（CARS）得分及对面孔眼睛的注视次数均有所改善。中介分析表明，CARS量表中“对变化的适应”这一项在rTMS改善ASD参与者目光注视行为方面起主要中介作用。
我们的研究揭示了rTMS改善自闭症人群目光注视行为的机制，加深了对rTMS治疗自闭症社会障碍功能的理解，并为ASD的联合治疗提供了参考。
