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Hensel L, Lüdtke J, Brouzou KO, Eickhoff SB, Kamp D, Schilbach L. Noninvasive brain stimulation in autism: review and outlook for personalized interventions in adult patients. Cereb Cortex 2024; 34:8-18. [PMID: 38696602 DOI: 10.1093/cercor/bhae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 05/04/2024] Open
Abstract
Noninvasive brain stimulation (NIBS) has been increasingly investigated during the last decade as a treatment option for persons with autism spectrum disorder (ASD). Yet, previous studies did not reach a consensus on a superior treatment protocol or stimulation target. Persons with ASD often suffer from social isolation and high rates of unemployment, arising from difficulties in social interaction. ASD involves multiple neural systems involved in perception, language, and cognition, and the underlying brain networks of these functional domains have been well documented. Aiming to provide an overview of NIBS effects when targeting these neural systems in late adolescent and adult ASD, we conducted a systematic search of the literature starting at 631 non-duplicate publications, leading to six studies corresponding with inclusion and exclusion criteria. We discuss these studies regarding their treatment rationale and the accordingly chosen methodological setup. The results of these studies vary, while methodological advances may allow to explain some of the variability. Based on these insights, we discuss strategies for future clinical trials to personalize the selection of brain stimulation targets taking into account intersubject variability of brain anatomy as well as function.
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Affiliation(s)
- Lukas Hensel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Department of General Psychiatry 2, LVR-Klinikum Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
| | - Jana Lüdtke
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Department of General Psychiatry 2, LVR-Klinikum Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
| | - Katia O Brouzou
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Department of General Psychiatry 2, LVR-Klinikum Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Wilhelm-Johnen-Straße 1, 52428 Jülich, Germany
| | - Daniel Kamp
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Department of General Psychiatry 2, LVR-Klinikum Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
| | - Leonhard Schilbach
- Department of General Psychiatry 2, LVR-Klinikum Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Nußbaumstraße 7, 80336 Munich, Germany
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2
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Brunoni AR, Santos JM. Anodal transcranial direct-current stimulation for autism spectrum disorder: A promising approach? Dev Med Child Neurol 2024. [PMID: 38357963 DOI: 10.1111/dmcn.15884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Affiliation(s)
- André Russowsky Brunoni
- Service of Interdisciplinary Neuromodulation (SIN), Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil
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Li Y, Li R, Gu J, Yi H, He J, Lu F, Gao J. Enhanced group-level dorsolateral prefrontal cortex subregion parcellation through functional connectivity-based distance-constrained spectral clustering with application to autism spectrum disorder. Cereb Cortex 2024; 34:bhae020. [PMID: 38300216 DOI: 10.1093/cercor/bhae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 02/02/2024] Open
Abstract
The dorsolateral prefrontal cortex (DLPFC) assumes a central role in cognitive and behavioral control, emerging as a crucial target region for interventions in autism spectrum disorder neuroregulation. Consequently, we endeavor to unravel the functional subregions within the DLPFC to shed light on the intricate functions of the brain. We introduce a distance-constrained spectral clustering (SC-DW) methodology that leverages functional connection to identify distinctive functional subregions within the DLPFC. Furthermore, we verify the relationship between the functional characteristics of these subregions and their clinical implications. Our methodology begins with principal component analysis to extract the salient features. Subsequently, we construct an adjacency matrix, which is constrained by the spatial properties of the brain, by linearly combining the distance matrix and a similarity matrix. The quality of spectral clustering is further optimized through multiple cluster evaluation coefficient. The results from SC-DW revealed four uniform and contiguous subregions within the bilateral DLPFC. Notably, we observe a substantial positive correlation between the functional characteristics of the third and fourth subregions in the left DLPFC with clinical manifestations. These findings underscore the unique insights offered by our proposed methodology in the realms of brain subregion delineation and therapeutic targeting.
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Affiliation(s)
- Yanling Li
- School of Electrical Engineering and Electronic Information, Xihua University, 9999 Hongguang Avenue, Pixian District, Chengdu City, Sichuan Province, Chengdu 610039, China
| | - Rui Li
- School of Electrical Engineering and Electronic Information, Xihua University, 9999 Hongguang Avenue, Pixian District, Chengdu City, Sichuan Province, Chengdu 610039, China
| | - Jiahe Gu
- School of Electrical Engineering and Electronic Information, Xihua University, 9999 Hongguang Avenue, Pixian District, Chengdu City, Sichuan Province, Chengdu 610039, China
| | - Hongtao Yi
- School of Electrical Engineering and Electronic Information, Xihua University, 9999 Hongguang Avenue, Pixian District, Chengdu City, Sichuan Province, Chengdu 610039, China
| | - Junbiao He
- School of Electrical Engineering and Electronic Information, Xihua University, 9999 Hongguang Avenue, Pixian District, Chengdu City, Sichuan Province, Chengdu 610039, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, 2006 Xiyuan Avenue, High-tech Zone (West Zone), Chengdu City, Sichuan Province, Chengdu 610054, China
| | - Jingjing Gao
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, 2006 Xiyuan Avenue, High-tech Zone (West Zone), Chengdu City, Sichuan Province, Chengdu 611731, China
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4
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Jimenez-Gomez A, Nguyen MX, Gill JS. Understanding the role of AMPA receptors in autism: insights from circuit and synapse dysfunction. Front Psychiatry 2024; 15:1304300. [PMID: 38352654 PMCID: PMC10861716 DOI: 10.3389/fpsyt.2024.1304300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Autism spectrum disorders represent a diverse etiological spectrum that converge on a syndrome characterized by discrepant deficits in developmental domains often highlighted by concerns in socialization, sensory integration, and autonomic functioning. Importantly, the incidence and prevalence of autism spectrum disorders have seen sharp increases since the syndrome was first described in the 1940s. The wide etiological spectrum and rising number of individuals being diagnosed with the condition lend urgency to capturing a more nuanced understanding of the pathogenic mechanisms underlying the autism spectrum disorders. The current review seeks to understand how the disruption of AMPA receptor (AMPAr)-mediated neurotransmission in the cerebro-cerebellar circuit, particularly in genetic autism related to SHANK3 or SYNGAP1 protein dysfunction function and autism associated with in utero exposure to the anti-seizure medications valproic acid and topiramate, may contribute to the disease presentation. Initially, a discussion contextualizing AMPAr signaling in the cerebro-cerebellar circuitry and microstructural circuit considerations is offered. Subsequently, a detailed review of the literature implicating mutations or deletions of SHANK3 and SYNGAP1 in disrupted AMPAr signaling reveals how bidirectional pathogenic modulation of this key circuit may contribute to autism. Finally, how pharmacological exposure may interact with this pathway, via increased risk of autism diagnosis with valproic acid and topiramate exposure and potential treatment of autism using AMPAr modulator perampanel, is discussed. Through the lens of the review, we will offer speculation on how neuromodulation may be used as a rational adjunct to therapy. Together, the present review seeks to synthesize the disparate considerations of circuit understanding, genetic etiology, and pharmacological modulation to understand the mechanistic interaction of this important and complex disorder.
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Affiliation(s)
- Andres Jimenez-Gomez
- Neurodevelopmental Disabilities Program, Department of Neurology, Joe DiMaggio Children’s Hospital, Hollywood, FL, United States
| | - Megan X. Nguyen
- Department of Pediatrics, Division of Neurology & Developmental Neurosciences, Baylor College of Medicine, Houston, TX, United States
- Jan & Dan Duncan Neurologic Research Institute, Texas Children’s Hospital, Houston, TX, United States
| | - Jason S. Gill
- Department of Pediatrics, Division of Neurology & Developmental Neurosciences, Baylor College of Medicine, Houston, TX, United States
- Jan & Dan Duncan Neurologic Research Institute, Texas Children’s Hospital, Houston, TX, United States
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5
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Oberman LM, Francis SM, Lisanby SH. The use of noninvasive brain stimulation techniques in autism spectrum disorder. Autism Res 2024; 17:17-26. [PMID: 37873560 PMCID: PMC10841888 DOI: 10.1002/aur.3041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/15/2023] [Indexed: 10/25/2023]
Abstract
Noninvasive brain stimulation (NIBS) techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have recently emerged as alternative, nonpharmacological interventions for a variety of psychiatric, neurological, and neurodevelopmental conditions. NIBS is beginning to be applied in both research and clinical settings for the treatment of core and associated symptoms of autism spectrum disorder (ASD) including social communication deficits, restricted and repetitive behaviors, irritability, hyperactivity, depression and impairments in executive functioning and sensorimotor integration. Though there is much promise for these targeted device-based interventions, in other disorders (including adult major depressive disorder (MDD) and obsessive compulsive disorder (OCD) where rTMS is FDA cleared), data on the safety and efficacy of these interventions in individuals with ASD is limited especially in younger children when neurodevelopmental interventions typically begin. Most studies are open-label, small scale, and/or focused on a restricted subgroup of individuals with ASD. There is a need for larger, randomized controlled trials that incorporate neuroimaging in order to develop predictive biomarkers of treatment response and optimize treatment parameters. We contend that until such studies are conducted, we do not have adequate estimates of the safety and efficacy of NIBS interventions in children across the spectrum. Thus, broad off-label use of these techniques in this population is not supported by currently available evidence. Here we discuss the existing data on the use of NIBS to treat symptoms related to ASD and discuss future directions for the field.
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Affiliation(s)
- Lindsay M Oberman
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Sunday M Francis
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Sarah H Lisanby
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Han YM, Chan MM, Shea CK, Mo FY, Yiu KW, Chung RC, Cheung MC, Chan AS. Effects of prefrontal transcranial direct current stimulation on social functioning in autism spectrum disorder: A randomized clinical trial. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2465-2482. [PMID: 37151094 DOI: 10.1177/13623613231169547] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
LAY ABSTRACT Currently available pharmacological and behavioral interventions for adolescents and young adults with autism spectrum disorder (ASD) yield only modest effect in alleviating their core behavioral and cognitive symptoms, and some of these treatment options are associated with undesirable side effects. Hence, developing effective treatment protocols is urgently needed. Given emerging evidence shows that the abnormal connections of the frontal brain regions contribute to the manifestations of ASD behavioral and cognitive impairments, noninvasive treatment modalities that are capable in modulating brain connections, such as transcranial direct current stimulation (tDCS), have been postulated to be potentially promising for alleviating core symptoms in ASD. However, whether tDCS can reduce behavioral symptoms and enhance cognitive performance in ASD remains unclear. This randomized controlled trial involving 105 adolescents and young adults with ASD showed that multiple sessions of a tDCS protocol, which was paired up with computerized cognitive training, was effective in improving social functioning in adolescents and young adults with ASD. No prolonged and serious side effects were observed. With more future studies conducted in different clinical settings that recruit participants from a wider age range, this tDCS protocol may be potentially beneficial to a broad spectrum of individuals with autism.
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Affiliation(s)
| | - Melody My Chan
- The Hong Kong Polytechnic University, Hong Kong
- The University of Queensland, Australia
| | - Caroline Ks Shea
- Hospital Authority, Hong Kong
- The Chinese University of Hong Kong, Hong Kong
| | - Flora Ym Mo
- Hospital Authority, Hong Kong
- The Chinese University of Hong Kong, Hong Kong
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7
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Wang Y, Wang F, Kong Y, Gao T, Zhu Q, Han L, Sun B, Guan L, Zhang Z, Qian Y, Xu L, Li Y, Fang H, Jiao G, Ke X. High definition transcranial direct current stimulation of the Cz improves social dysfunction in children with autism spectrum disorder: A randomized, sham, controlled study. Autism Res 2023; 16:2035-2048. [PMID: 37695276 DOI: 10.1002/aur.3018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Abstract
The purpose of this study was to determine the effect of the Cz of high-definition 5-channel tDCS (HD-tDCS) on social function in 4-12 years-old children with autism spectrum disorder (ASD). This study was a randomized, double-blind, pseudo-controlled trial in which 45 ASD children were recruited and divided into three groups with sex, age, and rehabilitation treatment as control variables. Each group of 15 children with ASD was randomly administered active HD-tDCS with the Cz as the central anode, active HD-tDCS with the left dorsolateral prefrontal cortex (F3) as the central anode, and sham HD-tDCS with the Cz as the central anode with 14 daily sessions in 3 weeks. The Social Responsiveness Scale Chinese Version (SRS-Chinese Version) was compared 1 week after stimulation with values recorded 1 week prior to stimulation. At the end of treatment, both the anodal Cz and anodal left DLFPC tDCS decreased the measures of SRS-Chinese Version. The total score of SRS-Chinese Version decreased by 13.08%, social cognition decreased by 18.33%, and social communication decreased by 10.79%, which were significantly improved over the Cz central anode active stimulation group, especially in children with young age, and middle and low function. There was no significant change in the total score and subscale score of SRS-Chinese Version over the Cz central anode sham stimulation group. In the F3 central anode active stimulation group, the total score of SRS-Chinese Version decreased by 13%, autistic behavior decreased by 19.39%, and social communication decreased by 14.39%, which were all significantly improved. However, there was no significant difference in effect between the Cz and left DLPFC stimulation conditions. HD-tDCS of the Cz central anode may be an effective treatment for social dysfunction in children with ASD.
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Affiliation(s)
- Yonglu Wang
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Fei Wang
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Kong
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Tianshu Gao
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qingyao Zhu
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Han
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Bei Sun
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Luyang Guan
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ziyi Zhang
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yuxin Qian
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lingxi Xu
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Li
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Fang
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Gongkai Jiao
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyan Ke
- Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Prillinger K, Radev ST, Amador de Lara G, Werneck-Rohrer S, Plener PL, Poustka L, Konicar L. Effects of Transcranial Direct Current Stimulation on Social Attention Patterns and Emotion Recognition Ability in Male Adolescents with Autism Spectrum Disorder. J Clin Med 2023; 12:5570. [PMID: 37685637 PMCID: PMC10489141 DOI: 10.3390/jcm12175570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is characterized by impairments in social cognition including emotion recognition (ER) abilities. Common symptoms include unusual patterns of visual social attention, which are investigated as early developmental biomarkers for ASD. Transcranial Direct Current Stimulation (tDCS) has shown promising results in influencing social functioning in individuals with ASD. However, the effects of tDCS on social attention patterns and ER ability in adolescents with ASD remain unclear. This double-blind, sham-controlled, randomized clinical trial examined the effects of repeated sessions of tDCS on gaze behavior and ER ability in 22 male adolescents diagnosed with ASD. Participants received either 20 min of 2 mA active tDCS or sham stimulation for 10 days and an intra-stimulation training. Social allocation patterns were assessed using eye-tracking paradigms, including ER tasks. Our results indicated no tDCS-specific effects. Both groups showed improvements in ER and more frequent, faster, and longer fixations on the eyes than the mouth, and on social than nonsocial areas. In tasks with low social content, fixating the mouth seemed to increase ER accuracy. Understanding the effects of tDCS on social functioning in adolescents with ASD holds promise for the development of targeted interventions to improve their social cognition abilities.
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Affiliation(s)
- Karin Prillinger
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
- Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan T. Radev
- Cluster of Excellence STRUCTURES, Heidelberg University, 69120 Heidelberg, Germany;
| | - Gabriel Amador de Lara
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
- Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, 1090 Vienna, Austria
| | - Sonja Werneck-Rohrer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
- Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, 1090 Vienna, Austria
| | - Paul L. Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
- Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, 1090 Vienna, Austria
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, 89073 Ulm, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Lilian Konicar
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
- Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, 1090 Vienna, Austria
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Sato M, Nakai N, Fujima S, Choe KY, Takumi T. Social circuits and their dysfunction in autism spectrum disorder. Mol Psychiatry 2023; 28:3194-3206. [PMID: 37612363 PMCID: PMC10618103 DOI: 10.1038/s41380-023-02201-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
Social behaviors, how individuals act cooperatively and competitively with conspecifics, are widely seen across species. Rodents display various social behaviors, and many different behavioral paradigms have been used for investigating their neural circuit bases. Social behavior is highly vulnerable to brain network dysfunction caused by neurological and neuropsychiatric conditions such as autism spectrum disorders (ASDs). Studying mouse models of ASD provides a promising avenue toward elucidating mechanisms of abnormal social behavior and potential therapeutic targets for treatment. In this review, we outline recent progress and key findings on neural circuit mechanisms underlying social behavior, with particular emphasis on rodent studies that monitor and manipulate the activity of specific circuits using modern systems neuroscience approaches. Social behavior is mediated by a distributed brain-wide network among major cortical (e.g., medial prefrontal cortex (mPFC), anterior cingulate cortex, and insular cortex (IC)) and subcortical (e.g., nucleus accumbens, basolateral amygdala (BLA), and ventral tegmental area) structures, influenced by multiple neuromodulatory systems (e.g., oxytocin, dopamine, and serotonin). We particularly draw special attention to IC as a unique cortical area that mediates multisensory integration, encoding of ongoing social interaction, social decision-making, emotion, and empathy. Additionally, a synthesis of studies investigating ASD mouse models demonstrates that dysfunctions in mPFC-BLA circuitry and neuromodulation are prominent. Pharmacological rescues by local or systemic (e.g., oral) administration of various drugs have provided valuable clues for developing new therapeutic agents for ASD. Future efforts and technological advances will push forward the next frontiers in this field, such as the elucidation of brain-wide network activity and inter-brain neural dynamics during real and virtual social interactions, and the establishment of circuit-based therapy for disorders affecting social functions.
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Affiliation(s)
- Masaaki Sato
- Department of Neuropharmacology, Hokkaido University Graduate School of Medicine, Kita, Sapporo, 060-8638, Japan
| | - Nobuhiro Nakai
- Department of Physiology and Cell Biology, Kobe University School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Shuhei Fujima
- Department of Physiology and Cell Biology, Kobe University School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Katrina Y Choe
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Toru Takumi
- Department of Physiology and Cell Biology, Kobe University School of Medicine, Chuo, Kobe, 650-0017, Japan.
- RIKEN Center for Biosystems Dynamics Research, Chuo, Kobe, 650-0047, Japan.
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Liu A, Gong C, Wang B, Sun J, Jiang Z. Non-invasive brain stimulation for patient with autism: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1147327. [PMID: 37457781 PMCID: PMC10338880 DOI: 10.3389/fpsyt.2023.1147327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To comprehensively evaluate the efficacy of non-invasive brain stimulation (NIBS) in patients with autism spectrum disorder (ASD) in randomized controlled trials (RCT), providing a reference for future research on the same topic. Methods Five databases were searched (Pubmed, Web of Science, Medline, Embase, and Cochrane library) and tracked relevant references, Meta-analysis was performed using RevMan 5.3 software. Results Twenty-two references (829 participants) were included. The results of the meta-analysis showed that NIBS had positive effects on repetitive and stereotypical behaviors, cognitive function, and executive function in autistic patients. Most of the included studies had a moderate to high risk of bias, Mainly because of the lack of blinding of subjects and assessors to treatment assignment, as well as the lack of continuous observation of treatment effects. Conclusion Available evidence supports an improvement in some aspects of NIBS in patients with ASD. However, due to the quality of the original studies and significant publication bias, this evidence must be treated with caution. Further large multicenter randomized double-blind controlled trials and appropriate follow-up observations are needed to further evaluate the specific efficacy of NIBS in patients with ASD.
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Affiliation(s)
- Annan Liu
- Jiamusi University Affiliated No.3 Hospital, Jiamusi, China
| | - Chao Gong
- Jiamusi Medical College, Jiamusi, Heilongjiang, China
| | - Bobo Wang
- Jiamusi Medical College, Jiamusi, Heilongjiang, China
| | - Jiaxing Sun
- Jiamusi Medical College, Jiamusi, Heilongjiang, China
| | - Zhimei Jiang
- Jiamusi University College of Rehabilitation Medicine, Jiamusi, Heilongjiang, China
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11
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Yen C, Lin CL, Chiang MC. Exploring the Frontiers of Neuroimaging: A Review of Recent Advances in Understanding Brain Functioning and Disorders. Life (Basel) 2023; 13:1472. [PMID: 37511847 PMCID: PMC10381462 DOI: 10.3390/life13071472] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Neuroimaging has revolutionized our understanding of brain function and has become an essential tool for researchers studying neurological disorders. Functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) are two widely used neuroimaging techniques to review changes in brain activity. fMRI is a noninvasive technique that uses magnetic fields and radio waves to produce detailed brain images. An EEG is a noninvasive technique that records the brain's electrical activity through electrodes placed on the scalp. This review overviews recent developments in noninvasive functional neuroimaging methods, including fMRI and EEG. Recent advances in fMRI technology, its application to studying brain function, and the impact of neuroimaging techniques on neuroscience research are discussed. Advances in EEG technology and its applications to analyzing brain function and neural oscillations are also highlighted. In addition, advanced courses in neuroimaging, such as diffusion tensor imaging (DTI) and transcranial electrical stimulation (TES), are described, along with their role in studying brain connectivity, white matter tracts, and potential treatments for schizophrenia and chronic pain. Application. The review concludes by examining neuroimaging studies of neurodevelopmental and neurological disorders such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), Alzheimer's disease (AD), and Parkinson's disease (PD). We also described the role of transcranial direct current stimulation (tDCS) in ASD, ADHD, AD, and PD. Neuroimaging techniques have significantly advanced our understanding of brain function and provided essential insights into neurological disorders. However, further research into noninvasive treatments such as EEG, MRI, and TES is necessary to continue to develop new diagnostic and therapeutic strategies for neurological disorders.
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Affiliation(s)
- Chiahui Yen
- Department of International Business, Ming Chuan University, Taipei 111, Taiwan
| | - Chia-Li Lin
- Department of International Business, Ming Chuan University, Taipei 111, Taiwan
| | - Ming-Chang Chiang
- Department of Life Science, College of Science and Engineering, Fu Jen Catholic University, New Taipei City 242, Taiwan
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Wang L, Wang B, Wu C, Wang J, Sun M. Autism Spectrum Disorder: Neurodevelopmental Risk Factors, Biological Mechanism, and Precision Therapy. Int J Mol Sci 2023; 24:ijms24031819. [PMID: 36768153 PMCID: PMC9915249 DOI: 10.3390/ijms24031819] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Autism spectrum disorder (ASD) is a heterogeneous, behaviorally defined neurodevelopmental disorder. Over the past two decades, the prevalence of autism spectrum disorders has progressively increased, however, no clear diagnostic markers and specifically targeted medications for autism have emerged. As a result, neurobehavioral abnormalities, neurobiological alterations in ASD, and the development of novel ASD pharmacological therapy necessitate multidisciplinary collaboration. In this review, we discuss the development of multiple animal models of ASD to contribute to the disease mechanisms of ASD, as well as new studies from multiple disciplines to assess the behavioral pathology of ASD. In addition, we summarize and highlight the mechanistic advances regarding gene transcription, RNA and non-coding RNA translation, abnormal synaptic signaling pathways, epigenetic post-translational modifications, brain-gut axis, immune inflammation and neural loop abnormalities in autism to provide a theoretical basis for the next step of precision therapy. Furthermore, we review existing autism therapy tactics and limits and present challenges and opportunities for translating multidisciplinary knowledge of ASD into clinical practice.
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13
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Auvichayapat P, Intayot K, Udomchat C, Suphakunpinyo C, Patjanasoontorn N, Keeratitanont K, Tunkamnerdthai O, Jensen MP, Humbert AT, Auvichayapat N. Long-term effects of transcranial direct current stimulation in the treatment of autism spectrum disorder: A randomized controlled trial. Dev Med Child Neurol 2022; 65:811-820. [PMID: 36394093 DOI: 10.1111/dmcn.15457] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
AIM To compare the efficacy of 0, 5, and 20 sessions of transcranial direct current stimulation (tDCS) for reducing symptoms of autism spectrum disorder (ASD). METHOD Thirty-six male children with ASD (mean age 2 years 3 months, SD 4 months, age range 1 years 6 months-2 years 11 months) were balanced and stratified by age, sex, and baseline severity of ASD, to: (1) a control group that received 20 sessions of sham tDCS; (2) a 5-session tDCS group (5-tDCS) that received 5 sessions of active tDCS followed by 15 sessions of sham tDCS; and (3) a 20-session tDCS group (20-tDCS) that received 20 sessions of active tDCS. All groups participated in the special school activity of Khon Kaen Special Education Center, Thailand. The primary outcome was autism severity as measured by the Childhood Autism Severity Scale. RESULTS The 5-tDCS and 20-tDCS groups evidenced greater reductions in autism severity than the control group at days 5 and 14, and months 6 and 12. There were no significant differences in the outcome between the 5- and 20-tDCS groups at any time point. Within-group analysis showed clinically meaningful improvements starting at month 6 for the participants in the control group, and clinically meaningful improvements starting on day 5 in both active tDCS groups, all of which were maintained to month 12. INTERPRETATION The 5- and 20-session tDCS seems to reduce autism severity faster than sham tDCS. These effects maintained at least for 1 year.
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Affiliation(s)
- Paradee Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Krittiya Intayot
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chavisa Udomchat
- Khon Kaen Special Education Center Region 9, Khon Kaen, Thailand
| | - Chanyut Suphakunpinyo
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Niramol Patjanasoontorn
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Division of Child Psychiatry, Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Keattichai Keeratitanont
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Radiology, Faculty of Medicine, Burapha University, Thailand
| | - Orathai Tunkamnerdthai
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Mark P Jensen
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Andrew T Humbert
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Narong Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Khon Kaen Special Education Center Region 9, Khon Kaen, Thailand
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14
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Moyal M, Plaze M, Baruchet A, Attali D, Cravero C, Raffin M, Consoli A, Cohen D, Haroche A, Chaumette B. Efficacity of tDCS in catatonic patients with Phelan McDermid syndrome, a case series. Brain Stimul 2022; 15:1432-1434. [PMID: 36309344 DOI: 10.1016/j.brs.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 12/30/2022] Open
Affiliation(s)
- Mylène Moyal
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014, Paris, France; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM, UMR S1266, Paris, France.
| | - Marion Plaze
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014, Paris, France; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM, UMR S1266, Paris, France
| | - Ambre Baruchet
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014, Paris, France
| | - David Attali
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014, Paris, France; Physics for Medicine Paris, INSERM U1273, CNRS UMR 8063, ESPCI Paris, PSL University, F-75012, Paris, France
| | - Cora Cravero
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France; Interdepartmental Mobile Unit for Complex Situations in Autism (UMI 75-92), Elan Retrouvé Foundation, F-75015, Paris, France
| | - Marie Raffin
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France; GRC-15, Dimensional Approach of Child and Adolescent Psychotic Episodes, Faculté de Médecine, Sorbonne Université, Paris, France
| | - Angèle Consoli
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France; GRC-15, Dimensional Approach of Child and Adolescent Psychotic Episodes, Faculté de Médecine, Sorbonne Université, Paris, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France; CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne Université, UPMC, Paris, France
| | - Alexandre Haroche
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014, Paris, France
| | - Boris Chaumette
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014, Paris, France; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM, UMR S1266, Paris, France; Department of Psychiatry, McGill University, Montreal, Canada
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15
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Zemestani M, Hoseinpanahi O, Salehinejad MA, Nitsche MA. The impact of prefrontal transcranial direct current stimulation (tDCS) on theory of mind, emotion regulation and emotional-behavioral functions in children with autism disorder: A randomized, sham-controlled, and parallel-group study. Autism Res 2022; 15:1985-2003. [PMID: 36069668 DOI: 10.1002/aur.2803] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 08/10/2022] [Indexed: 11/12/2022]
Abstract
Advances in our knowledge about the neuropsychological mechanisms underlying core deficits in autism spectrum disorder (ASD) have produced several novel treatment modalities. One of these approaches is modulation of activity of the brain regions involved in ASD symptoms. This study examined the effects of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) on autism symptom severity, theory of mind, emotion regulation strategies, and emotional-behavioral functions in children with ASD. Thirty-two children (Mage = 10.16, SD = 1.93, range 7-12 years) diagnosed with ASD were randomly assigned to active (N = 17) or sham stimulation (N = 15) groups in a randomized, sham-controlled, parallel-group design. Participants underwent 10 sessions of active (1.5 mA, 15 min, bilateral left anodal/right cathodal DLPFC, 2 sessions per week) or sham tDCS. Autism symptom severity, theory of mind, emotion regulation strategies, and emotional-behavioral functioning of the patients were assessed at baseline, immediately after the intervention, and 1 month after the intervention. A significant improvement of autism symptom severity (i.e., communication), theory of mind (i.e., ToM 3), and emotion regulation strategies was observed for the active as compared to the sham stimulation group at the end of the intervention, and these effects were maintained at the one-month follow-up. The results suggest that repeated tDCS with anodal stimulation of left and cathodal stimulation of right DLPFC improves autism symptom severity as well as social cognition and emotion regulation in ASD.
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Affiliation(s)
- Mehdi Zemestani
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | | | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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16
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Salehinejad MA, Ghanavati E, Glinski B, Hallajian AH, Azarkolah A. A systematic review of randomized controlled trials on efficacy and safety of transcranial direct current stimulation in major neurodevelopmental disorders: ADHD, autism, and dyslexia. Brain Behav 2022; 12:e2724. [PMID: 35938945 PMCID: PMC9480913 DOI: 10.1002/brb3.2724] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/09/2022] [Accepted: 07/12/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Among the target groups in child and adolescent psychiatry, transcranial direct current stimulation (tDCS) has been more applied in neurodevelopmental disorders specifically, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and dyslexia. This systematic review aims to provide the latest update on published randomized-controlled trials applying tDCS in these disorders for evaluating its efficacy and safety. METHODS Based on a pre-registered protocol (PROSPERO: CRD42022321430) and using the PRISMA approach, a literature search identified 35 randomized controlled trials investigating the effects of tDCS on children and adolescents with ADHD (n = 17), ASD (n = 11), and dyslexia (n = 7). RESULTS In ADHD, prefrontal anodal tDCS is reported more effective compared to stimulation of the right inferior frontal gyrus. Similarly in ASD, prefrontal anodal tDCS was found effective for improving behavioral problems. In dyslexia, stimulating temporoparietal regions was the most common and effective protocol. In ASD and dyslexia, all tDCS studies found an improvement in at least one of the outcome variables while 64.7% of studies (11 of 17) in ADHD found a similar effect. About 88% of all tDCS studies with a multi-session design in 3 disorders (16 of 18) reported a significant improvement in one or all outcome variables after the intervention. Randomized, double-blind, controlled trials consisted of around 70.5%, 36.3%, and 57.1% of tDCS studies in ADHD, ASD, and dyslexia, respectively. tDCS was found safe with no reported serious side effects in 6587 sessions conducted on 745 children and adolescents across 35 studies. CONCLUSION tDCS was found safe and partially effective. For evaluation of clinical utility, larger randomized controlled trials with a double-blind design and follow-up measurements are required. Titration studies that systematically evaluate different stimulation intensities, duration, and electrode placement are lacking.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Benedikt Glinski
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Psychology, Ruhr-University Bochum, Bochum, Germany
| | | | - Anita Azarkolah
- Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Atieh Clinical Neuroscience Center, Tehran, Iran
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17
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Keeratitanont K, Theerakulpisut D, Auvichayapat N, Suphakunpinyo C, Patjanasoontorn N, Tiamkao S, Tepmongkol S, Khiewvan B, Raruenrom Y, Srisuruk P, Paholpak S, Auvichayapat P. Brain laterality evaluated by F-18 fluorodeoxyglucose positron emission computed tomography in autism spectrum disorders. Front Mol Neurosci 2022; 15:901016. [PMID: 36034502 PMCID: PMC9399910 DOI: 10.3389/fnmol.2022.901016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background and rationale Autism spectrum disorder (ASD) is a neuropsychiatric disorder that has no curative treatment. Little is known about the brain laterality in patients with ASD. F-18 fluorodeoxyglucose positron emission computed tomography (F-18 FDG PET/CT) is a neuroimaging technique that is suitable for ASD owing to its ability to detect whole brain functional abnormalities in a short time and is feasible in ASD patients. The purpose of this study was to evaluate brain laterality using F-18 FDG PET/CT in patients with high-functioning ASD. Materials and methods This case-control study recruited eight ASD patients who met the DSM-5 criteria, the recorded data of eight controls matched for age, sex, and handedness were also enrolled. The resting state of brain glucose metabolism in the regions of interest (ROIs) was analyzed using the Q.Brain software. Brain glucose metabolism and laterality index in each ROI of ASD patients were compared with those of the controls. The pattern of brain metabolism was analyzed using visual analysis and is reported in the data description. Results The ASD group’s overall brain glucose metabolism was lower than that of the control group in both the left and right hemispheres, with mean differences of 1.54 and 1.21, respectively. We found statistically lower mean glucose metabolism for ASD patients than controls in the left prefrontal lateral (Z = 1.96, p = 0.049). The left laterality index was found in nine ROIs for ASD and 11 ROIs for the control. The left laterality index in the ASD group was significantly lower than that in the control group in the prefrontal lateral (Z = 2.52, p = 0.012), precuneus (Z = 2.10, p = 0.036), and parietal inferior (Z = 1.96, p = 0.049) regions. Conclusion Individuals with ASD have lower brain glucose metabolism than control. In addition, the number of ROIs for left laterality index in the ASD group was lower than control. Left laterality defects may be one of the causes of ASD. This knowledge can be useful in the treatment of ASD by increasing the left-brain metabolism. This trial was registered in the Thai Clinical Trials Registry (TCTR20210705005).
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Affiliation(s)
- Keattichai Keeratitanont
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daris Theerakulpisut
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Narong Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chanyut Suphakunpinyo
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Niramol Patjanasoontorn
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somsak Tiamkao
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supatporn Tepmongkol
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chulalongkorn University Biomedical Imaging Group (CUBIG), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Benjapa Khiewvan
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yutapong Raruenrom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Piyawan Srisuruk
- Department of Educational Psychology and Counseling, Faculty of Education, Khon Kaen University, Khon Kaen, Thailand
- Research and Service Institute for Autism, Khon Kaen University, Khon Kaen, Thailand
| | - Suchat Paholpak
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Service Institute for Autism, Khon Kaen University, Khon Kaen, Thailand
| | - Paradee Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Service Institute for Autism, Khon Kaen University, Khon Kaen, Thailand
- *Correspondence: Paradee Auvichayapat,
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18
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Jiang CC, Lin LS, Long S, Ke XY, Fukunaga K, Lu YM, Han F. Signalling pathways in autism spectrum disorder: mechanisms and therapeutic implications. Signal Transduct Target Ther 2022; 7:229. [PMID: 35817793 PMCID: PMC9273593 DOI: 10.1038/s41392-022-01081-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 02/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is a prevalent and complex neurodevelopmental disorder which has strong genetic basis. Despite the rapidly rising incidence of autism, little is known about its aetiology, risk factors, and disease progression. There are currently neither validated biomarkers for diagnostic screening nor specific medication for autism. Over the last two decades, there have been remarkable advances in genetics, with hundreds of genes identified and validated as being associated with a high risk for autism. The convergence of neuroscience methods is becoming more widely recognized for its significance in elucidating the pathological mechanisms of autism. Efforts have been devoted to exploring the behavioural functions, key pathological mechanisms and potential treatments of autism. Here, as we highlight in this review, emerging evidence shows that signal transduction molecular events are involved in pathological processes such as transcription, translation, synaptic transmission, epigenetics and immunoinflammatory responses. This involvement has important implications for the discovery of precise molecular targets for autism. Moreover, we review recent insights into the mechanisms and clinical implications of signal transduction in autism from molecular, cellular, neural circuit, and neurobehavioural aspects. Finally, the challenges and future perspectives are discussed with regard to novel strategies predicated on the biological features of autism.
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Affiliation(s)
- Chen-Chen Jiang
- International Joint Laboratory for Drug Target of Critical Illnesses; Key Laboratory of Cardiovascular & Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Li-Shan Lin
- Department of Physiology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, 211166, China
| | - Sen Long
- Department of Pharmacy, Hangzhou Seventh People's Hospital, Mental Health Center Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Xiao-Yan Ke
- Child Mental Health Research Center, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Kohji Fukunaga
- Department of CNS Drug Innovation, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, 980-8578, Japan
| | - Ying-Mei Lu
- Department of Physiology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, 211166, China.
| | - Feng Han
- International Joint Laboratory for Drug Target of Critical Illnesses; Key Laboratory of Cardiovascular & Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China. .,Institute of Brain Science, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China. .,Gusu School, Nanjing Medical University, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215002, China.
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19
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Auvichayapat N, Auvichayapat P. Transcranial Direct Current Stimulation in Treatment of Child Neuropsychiatric Disorders: Ethical Considerations. Front Hum Neurosci 2022; 16:842013. [PMID: 35874159 PMCID: PMC9304992 DOI: 10.3389/fnhum.2022.842013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive electrical stimulation performed using low electric currents passing through two electrodes. The provided current passes from the anode to the cathode and induces electric fields in the surface neurons. It then modulates synaptic plasticity and finally changes cortical excitability or improves clinical outcomes, which outlast after a duration of stimulation. Meta-analyses have supported the beneficial effects of tDCS treatments in child neuropsychiatric disorders. However, the study of vulnerable children remains controversial and is a great deal for ethical considerations. Because the developing brain has some important physiological differences from the matured brain, specifically less γ-aminobutyric acid (GABA)ergic inhibition and more myelination, the opportunity to modify neurological disorders to be close to the normal level in childhood after tDCS is likely to be higher than in adults. In contrast, these physiological differences may result in unexpected excitability in children's brains and were criticized to have an unsafe effect, specifically seizures, which is a serious adverse events. As mentioned above, using tDCS in children appears to be a double-edged sword and should be ethically considered prior to wide use. Assessing between benefits of tDCS treatment within the golden period of brain development and the risk of seizure provocation is important. Thus, this perspective article is aimed to exhibit broad concepts about the developing brain, tDCS in children, pathophysiology of neuropsychiatric disorders and tDCS beneficence, tDCS safety and tolerability in children, and missing good opportunities or taking risks in tDCS.
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Affiliation(s)
- Narong Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Khon Kaen University, Khon Kaen, Thailand
- Division of Pediatric Neurology, Department of Pediatrics, Khon Kaen University, Khon Kaen, Thailand
| | - Paradee Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Khon Kaen University, Khon Kaen, Thailand
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- *Correspondence: Paradee Auvichayapat
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20
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Rosson S, de Filippis R, Croatto G, Collantoni E, Pallottino S, Guinart D, Brunoni AR, Dell'Osso B, Pigato G, Hyde J, Brandt V, Cortese S, Fiedorowicz JG, Petrides G, Correll CU, Solmi M. Brain stimulation and other biological non-pharmacological interventions in mental disorders: An umbrella review. Neurosci Biobehav Rev 2022; 139:104743. [PMID: 35714757 DOI: 10.1016/j.neubiorev.2022.104743] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The degree of efficacy, safety, quality, and certainty of meta-analytic evidence of biological non-pharmacological treatments in mental disorders is unclear. METHODS We conducted an umbrella review (PubMed/Cochrane Library/PsycINFO-04-Jul-2021, PROSPERO/CRD42020158827) for meta-analyses of randomized controlled trials (RCTs) on deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), electro-convulsive therapy (ECT), and others. Co-primary outcomes were standardized mean differences (SMD) of disease-specific symptoms, and acceptability (for all-cause discontinuation). Evidence was assessed with AMSTAR/AMSTAR-Content/GRADE. RESULTS We selected 102 meta-analyses. Effective interventions compared to sham were in depressive disorders: ECT (SMD=0.91/GRADE=moderate), TMS (SMD=0.51/GRADE=moderate), tDCS (SMD=0.46/GRADE=low), DBS (SMD=0.42/GRADE=very low), light therapy (SMD=0.41/GRADE=low); schizophrenia: ECT (SMD=0.88/GRADE=moderate), tDCS (SMD=0.45/GRADE=very low), TMS (prefrontal theta-burst, SMD=0.58/GRADE=low; left-temporoparietal, SMD=0.42/GRADE=low); substance use disorder: TMS (high frequency-dorsolateral-prefrontal-deep (SMD=1.16/GRADE=moderate), high frequency-left dorsolateral-prefrontal (SMD=0.77/GRADE=very low); OCD: DBS (SMD=0.89/GRADE=moderate), TMS (SMD=0.64/GRADE=very low); PTSD: TMS (SMD=0.46/GRADE=moderate); generalized anxiety disorder: TMS (SMD=0.68/GRADE=low); ADHD: tDCS (SMD=0.23/GRADE=moderate); autism: tDCS (SMD=0.97/GRADE=very low). No significant differences for acceptability emerged. Median AMSTAR/AMSTAR-Content was 8/2 (suggesting high-quality meta-analyses/low-quality RCTs), GRADE low. DISCUSSION Despite limited certainty, biological non-pharmacological interventions are effective and safe for numerous mental conditions. Results inform future research, and guidelines. FUNDING None.
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Affiliation(s)
- Stella Rosson
- Department of Mental Health, Azienda ULSS 3 Serenissima, Venice, Italy; Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA; Department of Neurosciences, University of Padua, Padua, Italy
| | - Renato de Filippis
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA; Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giovanni Croatto
- Department of Mental Health, Azienda ULSS 3 Serenissima, Venice, Italy; Department of Neurosciences, University of Padua, Padua, Italy
| | | | | | - Daniel Guinart
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Institut Hospital del Mard'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation (SIN), Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da USP, Brazil; Departamentos de Clínica Médica e Psiquiatria, Faculdade de Medicina da USP, Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da USP, Brazil
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA; Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Giorgio Pigato
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Joshua Hyde
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
| | - Valerie Brandt
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA
| | - Jess G Fiedorowicz
- Department of Psychiatry, University of Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada
| | - Georgios Petrides
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Division of ECT, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Germany
| | - Marco Solmi
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK; Department of Psychiatry, University of Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Germany; Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program University of Ottawa, Ottawa, Ontario, Canada.
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21
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Elumalai P, Yadav Y, Williams N, Saucan E, Jost J, Samal A. Graph Ricci curvatures reveal atypical functional connectivity in autism spectrum disorder. Sci Rep 2022; 12:8295. [PMID: 35585156 PMCID: PMC9117309 DOI: 10.1038/s41598-022-12171-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/04/2022] [Indexed: 11/20/2022] Open
Abstract
While standard graph-theoretic measures have been widely used to characterize atypical resting-state functional connectivity in autism spectrum disorder (ASD), geometry-inspired network measures have not been applied. In this study, we apply Forman–Ricci and Ollivier–Ricci curvatures to compare networks of ASD and typically developing individuals (N = 1112) from the Autism Brain Imaging Data Exchange I (ABIDE-I) dataset. We find brain-wide and region-specific ASD-related differences for both Forman–Ricci and Ollivier–Ricci curvatures, with region-specific differences concentrated in Default Mode, Somatomotor and Ventral Attention networks for Forman–Ricci curvature. We use meta-analysis decoding to demonstrate that brain regions with curvature differences are associated to those cognitive domains known to be impaired in ASD. Further, we show that brain regions with curvature differences overlap with those brain regions whose non-invasive stimulation improves ASD-related symptoms. These results suggest the utility of graph Ricci curvatures in characterizing atypical connectivity of clinically relevant regions in ASD and other neurodevelopmental disorders.
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Affiliation(s)
| | - Yasharth Yadav
- The Institute of Mathematical Sciences (IMSc), Chennai, India.,Indian Institute of Science Education and Research (IISER), Pune, India
| | - Nitin Williams
- Department of Computer Science, Helsinki Institute of Information Technology, Aalto University, Espoo, Finland. .,Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland.
| | - Emil Saucan
- Department of Applied Mathematics, ORT Braude College, Karmiel, Israel
| | - Jürgen Jost
- Max Planck Institute for Mathematics in the Sciences, Leipzig, Germany.,The Santa Fe Institute, Santa Fe, NM, USA
| | - Areejit Samal
- The Institute of Mathematical Sciences (IMSc), Chennai, India. .,Homi Bhabha National Institute (HBNI), Mumbai, India.
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22
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Abstract
PURPOSE OF REVIEW There are currently no approved medications for the core symptoms of autism spectrum disorder (ASD), and only limited data on the management of co-occurring mental health and behavioural symptoms. The purpose of this review is to synthesize recent trials on novel treatments in ASD, with a focus on research trends in the past 2 years. RECENT FINDINGS No new pharmacologic agents received regulatory approval for use in ASD. Several large randomized controlled trials (RCTs) had negative or ambiguous results (e.g. fluoxetine, oxytocin). A cross-over RCT of an oral cannabinoid suggested possible benefits for disruptive behaviours. Two large-scale multicentre trials of bumetanide were terminated early for lack of efficacy. Multicenter trials using repetitive transcranial magnetic stimulation are underway. Recent meta-analyses indicate that specific behavioural and psychological interventions can support social communication and treat anxiety. Numerous novel treatment targets informed by biological mechanisms are under investigation. SUMMARY Recent data support the use of behavioural and psychological interventions for social communication and anxiety in ASD; data are more limited regarding pharmacotherapy for core and associated symptoms. Next steps include replication of early findings, trials of new molecular targets, and the identification of novel biomarkers, including genetic predictors, of treatment response.
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Affiliation(s)
- Danielle Baribeau
- University of Toronto
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jacob Vorstman
- University of Toronto
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- University of Toronto
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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23
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Han YMY, Chan MMY, Shea CKS, Lai OLH, Krishnamurthy K, Cheung MC, Chan AS. Neurophysiological and behavioral effects of multisession prefrontal tDCS and concurrent cognitive remediation training in patients with autism spectrum disorder (ASD): A double-blind, randomized controlled fNIRS study. Brain Stimul 2022; 15:414-425. [PMID: 35181532 DOI: 10.1016/j.brs.2022.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The clinical effects and neurophysiological mechanisms of prefrontal tDCS and concurrent cognitive remediation training in individuals with autism spectrum disorder (ASD) remain unclear. OBJECTIVE This two-armed, double-blind, randomized, sham-controlled trial aimed to investigate the beneficial effects of tDCS combined with concurrent cognitive remediation training on adolescents and young adults with ASD. METHODS Participants were randomly assigned to either active or sham tDCS groups and received 1.5 mA prefrontal tDCS with left dorsolateral prefrontal cortex cathode placement and right supraorbital region anode placement for 20 min over two consecutive weeks. tDCS was delivered concurrently with a computerized cognitive remediation training program. Social functioning and its underlying cognitive processes, as well as prefrontal resting-state functional connectivity (rsFC), were measured. RESULTS The results from 41 participants indicated that multisession prefrontal tDCS, compared to sham tDCS, significantly enhanced the social functioning of ASD individuals [F(1,39) = 4.75, p = .035, ηp2 = 0.11]. This improvement was associated with enhanced emotion recognition [F(1,39) = 8.34, p = .006, ηp2 = 0.18] and cognitive flexibility [F(1,39) = 4.91, p = .033, ηp2 = 0.11]. Specifically, this tDCS protocol optimized information processing efficiency [F(1,39) = 4.43, p = .042, ηp2 = 0.10], and the optimization showed a trend to be associated with enhanced rsFC in the right medial prefrontal cortex (ρ = 0.339, pFDR = .083). CONCLUSION Multisession tDCS with left dlPFC cathode placement and right supraorbital region anode placement paired with concurrent cognitive remediation training promoted social functioning in individuals with ASD. This appeared to be associated with the enhancement of the functional connectivity of the right medial PFC, a major hub for flexible social information processing, allowing these individuals to process information more efficiently in response to different social situations. TRIAL REGISTRATION ClinicalTrials.gov (ID: NCT03814083).
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Affiliation(s)
- Yvonne M Y Han
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Hong Kong, China.
| | - Melody M Y Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Caroline K S Shea
- Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Hong Kong, China; Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Oscar Long-Hin Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Mei-Chun Cheung
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
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24
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Zhang J, Zhang H. Effects of non-invasive neurostimulation on autism spectrum disorder: A systematic review. Front Psychiatry 2022; 13:989905. [PMID: 36405911 PMCID: PMC9666381 DOI: 10.3389/fpsyt.2022.989905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
UNLABELLED Non-invasive neurostimulation techniques (NIBS) have shown benefits in psychiatric conditions. While in ASD patients, no guideline has so-far been recommended on these techniques due to a lack of high-quality synthetic evidence. Here, a comprehensive search from database inception onward was conducted in PubMed, EMBASE, and Cochrane library. Sham-controlled studies assessing the effects of NIBS in ASD patients were identified. After screening, twenty-two studies were included. A total of 552 patients were involved, and the sample size ranged from 5 to 78 patients. Although an iteration from exploratory attempts to more strictly designed trials has been seen to evaluate the efficacy of NIBS on ASD, further trials should also be needed to enable the clinicians and researchers to reach any consensus. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021292434], identifier [CRD42021292434].
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Affiliation(s)
- Jiawei Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China.,Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Hao Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China.,Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.,Cheeloo College of Medicine, Shandong University, Jinan, China.,University of Health and Rehabilitation Sciences, Qingdao, China
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25
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Camacho‐Conde JA, Gonzalez‐Bermudez MDR, Carretero‐Rey M, Khan ZU. Brain stimulation: a therapeutic approach for the treatment of neurological disorders. CNS Neurosci Ther 2022; 28:5-18. [PMID: 34859593 PMCID: PMC8673710 DOI: 10.1111/cns.13769] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/28/2021] [Accepted: 11/09/2021] [Indexed: 01/14/2023] Open
Abstract
Brain stimulation has become one of the most acceptable therapeutic approaches in recent years and a powerful tool in the remedy against neurological diseases. Brain stimulation is achieved through the application of electric currents using non-invasive as well as invasive techniques. Recent technological advancements have evolved into the development of precise devices with capacity to produce well-controlled and effective brain stimulation. Currently, most used non-invasive techniques are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), whereas the most common invasive technique is deep brain stimulation (DBS). In last decade, application of these brain stimulation techniques has not only exploded but also expanded to wide variety of neurological disorders. Therefore, in the current review, we will provide an overview of the potential of both non-invasive (rTMS and tDCS) and invasive (DBS) brain stimulation techniques in the treatment of such brain diseases.
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Affiliation(s)
- Jose Antonio Camacho‐Conde
- Laboratory of NeurobiologyCIMESUniversity of MalagaMalagaSpain
- Department of MedicineFaculty of MedicineUniversity of MalagaMalagaSpain
| | | | - Marta Carretero‐Rey
- Laboratory of NeurobiologyCIMESUniversity of MalagaMalagaSpain
- Department of MedicineFaculty of MedicineUniversity of MalagaMalagaSpain
| | - Zafar U. Khan
- Laboratory of NeurobiologyCIMESUniversity of MalagaMalagaSpain
- Department of MedicineFaculty of MedicineUniversity of MalagaMalagaSpain
- CIBERNEDInstitute of Health Carlos IIIMadridSpain
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26
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Padrón I, García-Marco E, Moreno I, Birba A, Silvestri V, León I, Álvarez C, López J, de Vega M. Multisession Anodal tDCS on the Right Temporo-Parietal Junction Improves Mentalizing Processes in Adults with Autistic Traits. Brain Sci 2021; 12:brainsci12010030. [PMID: 35053774 PMCID: PMC8773564 DOI: 10.3390/brainsci12010030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/21/2021] [Accepted: 12/25/2021] [Indexed: 11/16/2022] Open
Abstract
Persons with autism spectrum disorder (ASD) have impaired mentalizing skills. In this study, a group of persons with ASD traits (high-AQ scores) initially received sham tDCS before completing a pre-test in two mentalizing tasks: false belief and self-other judgments. Over the next week, on four consecutive days, they received sessions of anodal electrical stimulation (a-tDCS) over the right temporo-parietal junction (rTPJ), a region frequently associated with the theory of mind. On the last day, after the stimulation session, they completed a new set of mentalizing tasks. A control group (with low-AQ scores) matched in age, education and intelligence received just sham stimulation and completed the same pre-test and post-test. The results showed that the high-AQ group improved their performance (faster responses), after a-tDCS, in the false belief and in the self-other judgments of mental features, whereas they did not change performance in the false photographs or the self-other judgments of physical features. These selective improvements cannot be attributed to increased familiarity with the tasks, because the performance of the low-AQ control group remained stable about one week later. Therefore, our study provides initial proof that tDCS could be used to improve mentalizing skills in persons with ASD traits.
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Affiliation(s)
- Iván Padrón
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
| | - Enrique García-Marco
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
- Facultad de Ciencias de la Salud, Universidad Europea de Canarias, 38300 La Orotava, Spain
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
| | - Iván Moreno
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
| | - Agustina Birba
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires B1644BID, Argentina;
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1033AAJ, Argentina
| | - Valentina Silvestri
- Department of Psychology, University of Milan-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy;
| | - Inmaculada León
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
| | - Carlos Álvarez
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
| | - Joana López
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
- Department of Psychology, Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK
| | - Manuel de Vega
- Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain; (I.P.); (E.G.-M.); (I.M.); (I.L.); (C.Á.); (J.L.)
- Correspondence: ; Tel.: +34-630027293
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27
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Parmar D, Enticott PG, Albein-Urios N. Anodal HD-tDCS for cognitive inflexibility in autism spectrum disorder: A pilot study. Brain Stimul 2021; 14:1298-1300. [PMID: 34450360 DOI: 10.1016/j.brs.2021.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Dinisha Parmar
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Natalia Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia.
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28
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Salehinejad MA, Paknia N, Hosseinpour AH, Yavari F, Vicario CM, Nitsche MA, Nejati V. Contribution of the right temporoparietal junction and ventromedial prefrontal cortex to theory of mind in autism: A randomized, sham-controlled tDCS study. Autism Res 2021; 14:1572-1584. [PMID: 34018333 DOI: 10.1002/aur.2538] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/28/2021] [Accepted: 04/20/2021] [Indexed: 12/29/2022]
Abstract
Theory of mind (ToM) is the ability to attribute subjective mental states to oneself and others and is significantly impaired in autism spectrum disorder (ASD). A frontal-posterior network of regions including the ventromedial prefrontal cortex (vmPFC) and temporoparietal junction (TPJ) is involved in ToM. Previous studies show an underactivation of these regions in ASD. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation method for causally investigating brain-behavior relationships via induction of cortical excitability alterations. tDCS, mostly over the dorsolateral prefrontal cortex, has been increasingly applied for improving behavioral problems in ASD leaving other potentially interesting regions untouched. Here we investigated contribution of the vmPFC and right TPJ in ToM abilities of ASD children via tDCS in a pilot study. Sixteen children with ASD (mean age = 10.7 ± 1.9) underwent three tDCS sessions (1 mA, 20 min) in a randomized, sham-controlled design. Stimulation protocols included: (a) anodal vmPFC tDCS, (b) anodal r-TPJ tDCS, and (c) sham tDCS. ToM abilities were explored during tDCS using the theory of mind test (TOMT). Our results show that activation of the vmPFC with anodal tDCS significantly improved ToM in children with ASD compared with both, r-TPJ tDCS, and sham stimulation. Specifically, precursors of ToM (e.g., emotion recognition, perception, and imitation) and elementary ToM skills (e.g., first-order mental state reasoning) were significantly improved by anodal vmPFC tDCS. Based on these results, the vmPFC could be a potential target region for the reduction of ASD symptoms via noninvasive brain stimulation, which should be examined in larger detail in future studies. LAY SUMMARY: Theory of mind (ToM) is the ability to infer mental states of oneself and others, which is impaired in autism. Brain imaging studies have shown involvement of two brain regions in ToM (ventromedial prefrontal cortex, temporoparietal junction) which are underactivated in autism. We increased activation of these regions via noninvasive brain stimulation in this experiment to see how it would affect ToM abilities in autism. We found that increased activation of the ventromedial prefrontal cortex improved ToM abilities in children with autism.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany
| | - Nasim Paknia
- Department of Rehabilitation Counseling, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Amir Hossein Hosseinpour
- Department of Rehabilitation Counseling, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Fatemeh Yavari
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany
| | - Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Universita' di Messina, Messina, Italy
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany.,University Medical Hospital Bergmannsheil, Department of Neurology, Bochum, Germany
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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29
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Prillinger K, Radev ST, Amador de Lara G, Klöbl M, Lanzenberger R, Plener PL, Poustka L, Konicar L. Repeated Sessions of Transcranial Direct Current Stimulation on Adolescents With Autism Spectrum Disorder: Study Protocol for a Randomized, Double-Blind, and Sham-Controlled Clinical Trial. Front Psychiatry 2021; 12:680525. [PMID: 34526918 PMCID: PMC8435587 DOI: 10.3389/fpsyt.2021.680525] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/26/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Social-emotional difficulties are a core symptom of autism spectrum disorder (ASD). Accordingly, individuals with ASD have problems with social cognition such as recognizing emotions from other peoples' faces. Various results from functional magnetic resonance imaging and electroencephalography studies as well as eye-tracking data reveal a neurophysiological basis of these deficits by linking them to abnormal brain activity. Thus, an intervention targeting the neural origin of ASD impairments seems warranted. A safe method able to influence neural activity is transcranial direct current stimulation (tDCS). This non-invasive brain stimulation method has already demonstrated promising results in several neuropsychiatric disorders in adults and children. The aim of this project is to investigate the effects of tDCS on ASD symptoms and their neural correlates in children and adolescents with ASD. Method: This study is designed as a double-blind, randomized, and sham-controlled trial with a target sample size of 20 male participants (aged 12-17 years) diagnosed with ASD. Before randomization, the participants will be stratified into comorbid depression, comorbid ADHS/conduct disorder, or no-comorbidity groups. The intervention phase comprises 10 sessions of anodal or sham tDCS applied over the left prefrontal cortex within 2 consecutive weeks. To engage the targeted brain regions, participants will perform a social cognition training during the stimulation. TDCS-induced effects on ASD symptoms and involved neural circuits will be investigated through psychological, neurophysiological, imaging, and behavioral data at pre- and post-measurements. Tolerability will be evaluated using a standardized questionnaire. Follow-up assessments 1 and 6 months after the intervention will examine long-lasting effects. Discussion: The results of this study will provide insights into the changeability of social impairments in ASD by investigating social and emotional abilities on different modalities following repeated sessions of anodal tDCS with an intra-simulation training. Furthermore, this trial will elucidate the tolerability and the potential of tDCS as a new treatment approach for ASD in adolescents. Clinical Trial Registration: The study is ongoing and has been registered in the German Registry of Clinical Trials (DRKS00017505) on 02/07/2019.
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Affiliation(s)
- Karin Prillinger
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Stefan T Radev
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Gabriel Amador de Lara
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Manfred Klöbl
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Lilian Konicar
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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