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Amidfar M, Ko YH, Kim YK. Neuromodulation and Cognitive Control of Emotion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:545-564. [DOI: 10.1007/978-981-32-9721-0_27] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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52
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Hanaie R, Mohri I, Kagitani-Shimono K, Tachibana M, Matsuzaki J, Hirata I, Nagatani F, Watanabe Y, Katayama T, Taniike M. Aberrant Cerebellar-Cerebral Functional Connectivity in Children and Adolescents With Autism Spectrum Disorder. Front Hum Neurosci 2018; 12:454. [PMID: 30483084 PMCID: PMC6243023 DOI: 10.3389/fnhum.2018.00454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/24/2018] [Indexed: 11/13/2022] Open
Abstract
The cerebellum, which forms widespread functional networks with many areas in the cerebral cortices and subcortical structures, is one of the brain regions most consistently reported to exhibit neuropathological features in patients with autism spectrum disorder (ASD). However, cerebellar functional connectivity (FC) studies in patients with ASD have been very sparse. Using resting state functional connectivity (rsFC) analysis, we investigated the FC of the hemispheric/vermal subregions and the dentate nucleus of the cerebellum with the cerebral regions in 36 children and adolescents [16 participants with ASD, 20 typically developing (TD) participants, age: 6–15 years]. Furthermore, an independent larger sample population (42 participants with ASD, 88 TD participants, age: 6–15 years), extracted from the Autism Brain Imaging Data Exchange (ABIDE) II, was included for replication. The ASD group showed significantly increased or decreased FC between “hubs” in the cerebellum and cerebral cortices, when compared with the TD group. Findings of aberrant FCs converged on the posterior hemisphere, right dentate nucleus, and posterior inferior vermis of the cerebellum. Furthermore, these aberrant FCs were found to be related to motor, executive, and socio-communicative functions in children and adolescents with ASD when we examined correlations between FC and behavioral measurements. Results from the original dataset were partially replicated in the independent larger sample population. Our findings suggest that aberrant cerebellar–cerebral FC is associated with motor, socio-communicative, and executive functions in children and adolescents with ASD. These observations improve the current knowledge regarding the neural substrates that underlie the symptoms of ASD.
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Affiliation(s)
- Ryuzo Hanaie
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
| | - Ikuko Mohri
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kuriko Kagitani-Shimono
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masaya Tachibana
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Junko Matsuzaki
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
| | - Ikuko Hirata
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Fumiyo Nagatani
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
| | - Yoshiyuki Watanabe
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taiichi Katayama
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Japan
| | - Masako Taniike
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
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Esse Wilson J, Trumbo MC, Wilson JK, Tesche CD. Transcranial direct current stimulation (tDCS) over right temporoparietal junction (rTPJ) for social cognition and social skills in adults with autism spectrum disorder (ASD). J Neural Transm (Vienna) 2018; 125:1857-1866. [PMID: 30341695 DOI: 10.1007/s00702-018-1938-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/02/2018] [Indexed: 12/17/2022]
Abstract
Social deficits are core to autism spectrum disorder (ASD). Current treatments are extremely time- and labor-intensive. Transcranial direct current stimulation (tDCS) may be a promising treatment modality to safely enhance treatments targeting social cognition and social skills. This pilot study investigates the effectiveness of social skills treatment interventions paired with anodal tDCS for six adults 18-58 years with ASD. Differences were predicted on the verbal fluency (VF) test and a test of social skills (TASSK-M) for verum (2.0 mA) vs. sham tDCS, which was randomly assigned in a within-subjects, double-blinded design in adults with ASD with normal or higher cognitive functioning. The anode electrode was placed over right temporoparietal (CP6) and cathode over ipsilateral deltoid. Wilcoxon signed-rank tests for paired data indicated that participants received a significantly higher score on the VF test after receiving verum tDCS compared to sham tDCS, with no significant differences found on the TASSK-M. Post-hoc analysis showed that the emotion-word portion of the VF test, specifically, indicated significant differences when comparing verum to sham tDCS conditions. These findings provide optimism for the use of tDCS as delivered in the current study paired with social skills treatment interventions for ASD, particularly for improving skills of emotion verbal fluency.
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Affiliation(s)
- Joan Esse Wilson
- Department of Linguistics, University of New Mexico, MSC03 2130 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Michael C Trumbo
- Cognitive Science and Applications, Sandia National Laboratory, 1611 Innovation Pkwy SE, Albuquerque, NM, 87123, USA
| | - J Kevin Wilson
- Department of Psychology, University of New Mexico, MSC03 2220 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Claudia D Tesche
- Department of Psychology, University of New Mexico, MSC03 2220 1 University of New Mexico, Albuquerque, NM, 87131, USA.
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54
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Habib S, Hamid U, Jamil A, Zainab AZ, Yousuf T, Habib S, Tariq SM, Ali F. Transcranial Magnetic Stimulation as a Therapeutic Option for Neurologic and Psychiatric Illnesses. Cureus 2018; 10:e3456. [PMID: 30564535 PMCID: PMC6298622 DOI: 10.7759/cureus.3456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/16/2018] [Indexed: 12/27/2022] Open
Abstract
In recent years, transcranial magnetic stimulation has become an area of interest in the field of neurosciences due to its ability to non-invasively induce sufficient electric current to depolarize superficial axons and networks in the cortex and can be used to explore brain functioning. Evidence shows that transcranial magnetic stimulation could be used as a diagnostic and therapeutic tool for various neurological and psychiatric illnesses. The aim of this review is to introduce the basics of this technology to the readers and to bring together an overview of some of its clinical applications investigated thus far.
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Affiliation(s)
- Sara Habib
- Neurology, Thomas Jefferson University, Philadelphia, USA
| | - Umair Hamid
- Internal Medicine, The Indus Hospital, Lahore, PAK
| | - Ayesha Jamil
- Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK
| | - Aariz Z Zainab
- Radiology, Mayo Hospital King Edward Medical College, Lahore, PAK
| | - Tooba Yousuf
- Family Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Sana Habib
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Syed Maaz Tariq
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Faryal Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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55
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Excitation-inhibition dysbalance as predictor of autistic phenotypes. J Psychiatr Res 2018; 104:96-99. [PMID: 30015265 DOI: 10.1016/j.jpsychires.2018.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 11/20/2022]
Abstract
Autistic traits are normally distributed across health and disease, with autism spectrum disorders (ASD) at the extreme end. As we learned from mutations of synaptic or synapse regulating genes, leading to monogenetic forms of autism, the heterogeneous etiologies of ASD converge at the synapse. They result in a mild synaptic dysfunction as the final common pathway, also addressed as synaptopathy. Based on genetic rodent models and EEG/MEG findings in autists, a neuronal excitation-inhibition dysbalance is considered autism-pathognomonic. We hypothesized that this objectively measurable consequence is not restricted to the diagnosis of ASD but transcends disease borders and is of quantitative rather than qualitative nature. For proof-of-principle, we conducted a transcranial magnetic stimulation (TMS) study, monitoring corticospinal excitability and intracortical inhibition of the motor cortex. Employing the GRAS data collection of N > 1200 deep-phenotyped schizophrenic subjects, we had the chance to select for this study N = 20 perfectly matched men. They differed highly significantly by autistic trait severity, as assessed using PANSS autism severity score (PAUSS), capturing the continuum of autistic behaviors. Applying TMS to these men, we provide first intriguing hints of a positive correlation of autistic phenotype severity with functional cortical correlates, mainly alterations in GABAergic system and ion channels. This 'dose-response relationship' between severity of autistic traits and excitation-inhibition ratio in non-ASD subjects underlines the biological basis of this continuous trait. Based on these data, TMS may evolve as new add-on biomarker of autistic traits across disease groups. Finally, common treatment strategies targeting the excitation-inhibition dysbalance in humans may develop. To ultimately achieve this goal, however, replication studies with larger numbers of individuals would be desirable.
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Barahona-Corrêa JB, Velosa A, Chainho A, Lopes R, Oliveira-Maia AJ. Repetitive Transcranial Magnetic Stimulation for Treatment of Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Front Integr Neurosci 2018; 12:27. [PMID: 30038561 PMCID: PMC6046620 DOI: 10.3389/fnint.2018.00027] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/06/2018] [Indexed: 12/05/2022] Open
Abstract
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder manifesting as lifelong deficits in social communication and interaction, as well as restricted repetitive behaviors, interests and activities. While there are no specific pharmacological or other physical treatments for autism, in recent years repetitive Transcranial Magnetic Stimulation (rTMS), a technique for non-invasive neuromodulation, has attracted interest due to potential therapeutic value. Here we report the results of a systematic literature review and meta-analysis on the use of rTMS to treat ASD. Methods: We performed a systematic literature search on PubMed, Web of Science, Science Direct, Bielefeld Academic Search, and Educational Resources Information Clearinghouse. Search terms reflected diagnoses and treatment modalities of interest. Studies reporting use of rTMS to treat core ASD or cognitive symptoms in ASD were eligible. Two researchers performed article selection and data extraction independently, according to PRISMA guidelines. Changes in ASD clinical scores or in cognitive performance were the main outcomes. Random effects meta-analysis models were performed. Results: We found 23 eligible reports, comprising 4 case-reports, 7 non-controlled clinical trials, and 12 controlled clinical trials, comparing the effects of real TMS with waiting-list controls (n = 6) or sham-treatment (n = 6). Meta-analyses showed a significant, but moderate, effect on repetitive and stereotyped behaviors, social behavior, and number of errors in executive function tasks, but not other outcomes. Most studies had a moderate to high risk of bias, mostly due to lack of subject- and evaluator-blinding to treatment allocation. Only 5 studies reported stability of these gains for periods of up 6 months, with descriptions that improvements were sustained over time. Conclusions: Existing evidence supports that TMS could be useful to treat some dimensions of ASD. However, such evidence must be regarded with care, as most studies did not adequately control for placebo effects. Moreover, little is known regarding the most effective stimulation parameters, targets, and schedules. There is an urgent need for further randomized, double-blind, sham-controlled trials, with adequate follow-up periods, to test the efficacy of transcranial magnetic stimulation to treat these disorders. Available evidence must be regarded as preliminary and insufficient, at present, to support offering TMS to treat ASD.
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Affiliation(s)
- J Bernardo Barahona-Corrêa
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,NOVA Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,CADIN-Neurodesenvolvimento e Inclusão, Cascais, Portugal
| | - Ana Velosa
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Ana Chainho
- Centro de Investigação e de Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Ricardo Lopes
- CADIN-Neurodesenvolvimento e Inclusão, Cascais, Portugal.,Centro de Investigação e de Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,NOVA Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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Sokhadze EM, Lamina EV, Casanova EL, Kelly DP, Opris I, Tasman A, Casanova MF. Exploratory Study of rTMS Neuromodulation Effects on Electrocortical Functional Measures of Performance in an Oddball Test and Behavioral Symptoms in Autism. Front Syst Neurosci 2018; 12:20. [PMID: 29892214 PMCID: PMC5985329 DOI: 10.3389/fnsys.2018.00020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/02/2018] [Indexed: 12/17/2022] Open
Abstract
There is no accepted pathology to autism spectrum disorders (ASD) but research suggests the presence of an altered excitatory/inhibitory (E/I) bias in the cerebral cortex. Repetitive transcranial magnetic stimulation (rTMS) offers a non-invasive means of modulating the E/I cortical bias with little in terms of side effects. In this study, 124 high functioning ASD children (IQ > 80, <18 years of age) were recruited and assigned using randomization to either a waitlist group or one of three different number of weekly rTMS sessions (i.e., 6, 12, and 18). TMS consisted of trains of 1.0 Hz frequency pulses applied over the dorsolateral prefrontal cortex (DLPFC). The experimental task was a visual oddball with illusory Kanizsa figures. Behavioral response variables included reaction time and error rate along with such neurophysiological indices such as stimulus and response-locked event-related potentials (ERP). One hundred and twelve patients completed the assigned number of TMS sessions. Results showed significant changes from baseline to posttest period in the following measures: motor responses accuracy [lower percentage of committed errors, slower latency of commission errors and restored normative post-error reaction time slowing in both early and later-stage ERP indices, enhanced magnitude of error-related negativity (ERN), improved error monitoring and post-error correction functions]. In addition, screening surveys showed significant reductions in aberrant behavior ratings and in both repetitive and stereotypic behaviors. These differences increased with the total number of treatment sessions. Our results suggest that rTMS, particularly after 18 sessions, facilitates cognitive control, attention and target stimuli recognition by improving discrimination between task-relevant and task-irrelevant illusory figures in an oddball test. The noted improvement in executive functions of behavioral performance monitoring further suggests that TMS has the potential to target core features of ASD.
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Affiliation(s)
- Estate M. Sokhadze
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, United States
| | - Eva V. Lamina
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Emily L. Casanova
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Desmond P. Kelly
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Department of Pediatrics, Greenville Health System, Greenville, SC, United States
| | - Ioan Opris
- Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Allan Tasman
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, United States
| | - Manuel F. Casanova
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, United States
- Department of Pediatrics, Greenville Health System, Greenville, SC, United States
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Ni HC, Hung J, Wu CT, Wu YY, Chang CJ, Chen RS, Huang YZ. The Impact of Single Session Intermittent Theta-Burst Stimulation over the Dorsolateral Prefrontal Cortex and Posterior Superior Temporal Sulcus on Adults with Autism Spectrum Disorder. Front Neurosci 2017; 11:255. [PMID: 28536500 PMCID: PMC5423353 DOI: 10.3389/fnins.2017.00255] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/20/2017] [Indexed: 12/19/2022] Open
Abstract
Intermittent theta burst stimulation (iTBS), a patterned repetitive transcranial magnetic stimulation, was applied over the posterior superior temporal sulcus (pSTS) or dorsolateral prefrontal cortex (DLPFC) to explore its impact in adults with autism spectrum disorder (ASD). Among 25 adults with ASD, 19 (mean age: 20.8 years) completed the randomized, sham-controlled, crossover trial. Every participant received iTBS over the bilateral DLPFC, bilateral pSTS and inion (as a sham control stimulation) in a randomized order with a 1-week interval. Neuropsychological functions were assessed using the Conners' Continuous Performance Test (CCPT) and the Wisconsin Card Sorting Test (WCST). Behavioral outcomes were measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Social Responsiveness Scale (SRS). In comparison to that in the sham stimulation, the reaction time in the CCPT significantly decreased following single DLPFC session (p = 0.04, effect size = 0.71) while there were no significant differences in the CCPT and WCST following single pSTS session. Besides, the results in behavioral outcomes were inconsistent and had discrepancy between reports of parents and patients. In conclusion, a single session of iTBS over the bilateral DLPFC may alter the neuropsychological function in adults with ASD. The impacts of multiple-sessions iTBS over the DLPFC or pSTS deserve further investigations.
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Affiliation(s)
- Hsing-Chang Ni
- Department of Psychiatry, Chang Gung Memorial Hospital at LinkouLinkou, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of MedicineTaipei, Taiwan
| | - June Hung
- Department of Neurology, Neuroscience Research Center, Chang Gung Memorial Hospital at LinkouTaipei, Taiwan
| | - Chen-Te Wu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at LinkouTaipei, Taiwan
| | - Yu-Yu Wu
- Department of Psychiatry, Chang Gung Memorial Hospital at LinkouLinkou, Taiwan
| | - Chee-Jen Chang
- Graduate Institute of Clinical Medical Science, Chang Gung UniversityTaoyuan, Taiwan.,Clinical Informatics and Medical Statistics Research Center, Chang Gung UniversityTaoyuan, Taiwan.,Research Services Center for Health Information, Chang Gung UniversityTaoyuan, Taiwan
| | - Rou-Shayn Chen
- Department of Neurology, Neuroscience Research Center, Chang Gung Memorial Hospital at LinkouTaipei, Taiwan
| | - Ying-Zu Huang
- Department of Neurology, Neuroscience Research Center, Chang Gung Memorial Hospital at LinkouTaipei, Taiwan.,Medical School, Chang Gung UniversityTaoyuan, Taiwan.,Institute of Cognitive Neuroscience, National Central UniversityTaoyuan, Taiwan
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60
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Hameed MQ, Dhamne SC, Gersner R, Kaye HL, Oberman LM, Pascual-Leone A, Rotenberg A. Transcranial Magnetic and Direct Current Stimulation in Children. Curr Neurol Neurosci Rep 2017; 17:11. [PMID: 28229395 PMCID: PMC5962296 DOI: 10.1007/s11910-017-0719-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Promising results in adult neurologic and psychiatric disorders are driving active research into transcranial brain stimulation techniques, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), in childhood and adolescent syndromes. TMS has realistic utility as an experimental tool tested in a range of pediatric neuropathologies such as perinatal stroke, depression, Tourette syndrome, and autism spectrum disorder (ASD). tDCS has also been tested as a treatment for a number of pediatric neurologic conditions, including ASD, attention-deficit/hyperactivity disorder, epilepsy, and cerebral palsy. Here, we complement recent reviews with an update of published TMS and tDCS results in children, and discuss developmental neuroscience considerations that should inform pediatric transcranial stimulation.
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Affiliation(s)
- Mustafa Q Hameed
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Neurosurgery, Boston Children's Hospital Harvard Medical School, Boston, MA, 02115, USA
| | - Sameer C Dhamne
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Roman Gersner
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Harper L Kaye
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Lindsay M Oberman
- Neuroplasticity and Autism Spectrum Disorder Program and Department of Psychiatry and Human Behavior, E.P. Bradley Hospital and Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division for Cognitive Neurology, Beth Israel Deaconness Medical Center Harvard Medical School, Boston, MA, USA
- Institut Guttmann, Universitat Autonoma, Barcelona, Spain
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
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