EEG-guided transcranial magnetic stimulation shows correlative reduction in core restrictive and repetitive behavioral symptoms for children and adolescents with autism spectrum disorder: A systematic review.

Abstract

This exploratory study investigates the effectiveness of EEG-guided Transcranial Magnetic Stimulation (TMS) in treating children with Autism Spectrum Disorder (ASD). ASD is a neurodevelopmental disorder affecting about 1 in 36 children , with neuroimaging studies revealing brain abnormalities, particularly in the frontal and temporal lobes, along with changes in gray and white matter volumes. These neuroanatomical differences are linked to challenges in emotional regulation, motor skills, and cognitive functions. Although TMS has been proven effective for adult psychiatric conditions, especially depression, its potential for ASD treatment is still under investigation. We conducted a systematic review of the literature on EEG-guided TMS for children with ASD, following PRISMA guidelines. Out of 3,133 studies screened, 43 were selected, including 3 additional grey literature records. Seven studies met the final inclusion criteria. The majority of these studies used standardized assessments such as the Social Responsiveness Scale (SRS), Aberrant Behavior Checklist (ABC), and Repetitive Behavior Scale-Revised (RBS-R) to evaluate outcomes. Findings from these studies suggest that TMS significantly improved behavioral issues, accompanied by EEG changes, specifically gamma band oscillations in the dorsolateral prefrontal cortex (DLPFC), an area critical for executive function, resulting in reduced irritability and hyperactivity. Importantly, no serious adverse effects were reported, supporting TMS as a safe alternative treatment option.