A single session of navigation-guided repetitive transcranial magnetic stimulation over the right anterior temporoparietal junction in autism spectrum disorder

Abstract

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by altered social interactions and atypical interests [[1]Ameis S.H. Blumberger D.M. Croarkin P.E. Mabbott D.J. Lai M.-C. Desarkar P. et al.Treatment of Executive Function Deficits in autism spectrum disorder with repetitive transcranial magnetic stimulation: a double-blind, sham-controlled, pilot trial.Brain Stimul. 2020; 13: 539-547Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar,[2]Oberman L.M. Enticott P.G. Casanova M.F. Rotenberg A. Pascual-Leone A. McCracken J.T. et al.Transcranial magnetic stimulation in autism spectrum disorder: challenges, promise, and roadmap for future research.Autism Res. 2016; 9: 184-203Crossref PubMed Scopus (47) Google Scholar]. Although the neuropathology of ASD has been extensively studied, our understanding of this atypical neurodevelopment is still limited. In recent years, repetitive transcranial magnetic stimulation (rTMS) technology has been developed rapidly and used as an investigational and therapeutic tool in psychiatric research [[2]Oberman L.M. Enticott P.G. Casanova M.F. Rotenberg A. Pascual-Leone A. McCracken J.T. et al.Transcranial magnetic stimulation in autism spectrum disorder: challenges, promise, and roadmap for future research.Autism Res. 2016; 9: 184-203Crossref PubMed Scopus (47) Google Scholar]. Along this line, the application of rTMS in ASD has been recently studied. However, most rTMS studies on ASD focused on prefrontal cortices such as dorsolateral prefrontal cortex, and other brain areas have rarely been studied [[1]Ameis S.H. Blumberger D.M. Croarkin P.E. Mabbott D.J. Lai M.-C. Desarkar P. et al.Treatment of Executive Function Deficits in autism spectrum disorder with repetitive transcranial magnetic stimulation: a double-blind, sham-controlled, pilot trial.Brain Stimul. 2020; 13: 539-547Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar,[2]Oberman L.M. Enticott P.G. Casanova M.F. Rotenberg A. Pascual-Leone A. McCracken J.T. et al.Transcranial magnetic stimulation in autism spectrum disorder: challenges, promise, and roadmap for future research.Autism Res. 2016; 9: 184-203Crossref PubMed Scopus (47) Google Scholar]. The right temporoparietal junction (rTPJ) is critical for multisensory integration and processing [[3]Donaldson P.H. Rinehart N.J. Enticott P.G. Noninvasive stimulation of the temporoparietal junction: a systematic review.Neurosci Biobehav Rev. 2015; 55: 547-572Crossref PubMed Scopus (74) Google Scholar]. Especially, the anterior part of rTPJ is causally involved in various cognitive functions, as seen on rTMS studies on healthy subjects [[4]Krall S.C. Volz L.J. Oberwelland E. Grefkes C. Fink G.R. Konrad K. The right temporoparietal junction in attention and social interaction: a transcranial magnetic stimulation study.Hum Brain Mapp. 2016; 37: 796-807Crossref PubMed Scopus (56) Google Scholar]. Thus, in ASD, investigating the effects of rTMS over the aforementioned brain area could provide useful information to better understand the disorder. However, this topic is still largely unknown. In this pilot study, we compared the effects of intermittent theta burst stimulation (iTBS), continuous theta burst stimulation (cTBS), and sham stimulation over the anterior rTPJ in ASD. Fifteen right-handed adults with ASD were enrolled. The diagnostic procedure was the same as in our previous studies [[5]Fujino J. Tei S. Hashimoto R.I. Itahashi T. Ohta H. Kanai C. et al.Attitudes toward risk and ambiguity in patients with autism spectrum disorder.Mol Autism. 2017; 8: 45Crossref PubMed Scopus (20) Google Scholar]. Three participants were excluded during data collection (Supplementary Methods). Therefore, data obtained from 12 participants were analyzed [mean age: 31.4 ± 9.7 (SD) years; all males; IQ: 105.5 ± 13.5]. This study was approved by the institutional review board of Showa University Karasuyama Hospital and was conducted in accordance with