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Casanova MF, Shaban M, Ghazal M, El-Baz AS, Casanova EL, Opris I, Sokhadze EM. Effects of Transcranial Magnetic Stimulation Therapy on Evoked and Induced Gamma Oscillations in Children with Autism Spectrum Disorder. Brain Sci 2020; 10:E423. [PMID: 32635201 PMCID: PMC7408068 DOI: 10.3390/brainsci10070423] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
Autism spectrum disorder (ASD) is a behaviorally diagnosed neurodevelopmental condition of unknown pathology. Research suggests that abnormalities of elecltroencephalogram (EEG) gamma oscillations may provide a biomarker of the condition. In this study, envelope analysis of demodulated waveforms for evoked and induced gamma oscillations in response to Kanizsa figures in an oddball task were analyzed and compared in 19 ASD and 19 age/gender-matched neurotypical children. The ASD group was treated with low frequency transcranial magnetic stimulation (TMS), (1.0 Hz, 90% motor threshold, 18 weekly sessions) targeting the dorsolateral prefrontal cortex. In ASD subjects, as compared to neurotypicals, significant differences in evoked and induced gamma oscillations were evident in higher magnitude of gamma oscillations pre-TMS, especially in response to non-target cues. Recordings post-TMS treatment in ASD revealed a significant reduction of gamma responses to task-irrelevant stimuli. Participants committed fewer errors post-TMS. Behavioral questionnaires showed a decrease in irritability, hyperactivity, and repetitive behavior scores. The use of a novel metric for gamma oscillations. i.e., envelope analysis using wavelet transformation allowed for characterization of the impedance of the originating neuronal circuit. The results suggest that gamma oscillations may provide a biomarker reflective of the excitatory/inhibitory balance of the cortex and a putative outcome measure for interventions in autism.
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Affiliation(s)
- Manuel F. Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine-Greenville, 701 Grove Rd., Greenville, SC 29605, USA; (M.F.C.); (E.L.C.)
- Department of Psychiatry & Behavioral Sciences, University of Louisville, 401 E Chestnut Str., #600, Louisville, KY 40202, USA
| | - Mohamed Shaban
- Department of Electrical and Computer Engineering, University of South Alabama, Mobile, AL 36688, USA;
| | - Mohammed Ghazal
- BioImaging Research Lab, Electrical and Computer Engineering Abu Dhabi University, Abu Dhabi 59911, UAE;
| | - Ayman S. El-Baz
- Department of Bioengineering, University of Louisville, Louisville, KY 40202, USA;
| | - Emily L. Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine-Greenville, 701 Grove Rd., Greenville, SC 29605, USA; (M.F.C.); (E.L.C.)
| | - Ioan Opris
- School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Estate M. Sokhadze
- Department of Biomedical Sciences, University of South Carolina School of Medicine-Greenville, 701 Grove Rd., Greenville, SC 29605, USA; (M.F.C.); (E.L.C.)
- Department of Psychiatry & Behavioral Sciences, University of Louisville, 401 E Chestnut Str., #600, Louisville, KY 40202, USA
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Sokhadze EM, Lamina EV, Casanova EL, Kelly DP, Opris I, Tasman A, Casanova MF. Exploratory Study of rTMS Neuromodulation Effects on Electrocortical Functional Measures of Performance in an Oddball Test and Behavioral Symptoms in Autism. Front Syst Neurosci 2018; 12:20. [PMID: 29892214 PMCID: PMC5985329 DOI: 10.3389/fnsys.2018.00020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/02/2018] [Indexed: 12/17/2022] Open
Abstract
There is no accepted pathology to autism spectrum disorders (ASD) but research suggests the presence of an altered excitatory/inhibitory (E/I) bias in the cerebral cortex. Repetitive transcranial magnetic stimulation (rTMS) offers a non-invasive means of modulating the E/I cortical bias with little in terms of side effects. In this study, 124 high functioning ASD children (IQ > 80, <18 years of age) were recruited and assigned using randomization to either a waitlist group or one of three different number of weekly rTMS sessions (i.e., 6, 12, and 18). TMS consisted of trains of 1.0 Hz frequency pulses applied over the dorsolateral prefrontal cortex (DLPFC). The experimental task was a visual oddball with illusory Kanizsa figures. Behavioral response variables included reaction time and error rate along with such neurophysiological indices such as stimulus and response-locked event-related potentials (ERP). One hundred and twelve patients completed the assigned number of TMS sessions. Results showed significant changes from baseline to posttest period in the following measures: motor responses accuracy [lower percentage of committed errors, slower latency of commission errors and restored normative post-error reaction time slowing in both early and later-stage ERP indices, enhanced magnitude of error-related negativity (ERN), improved error monitoring and post-error correction functions]. In addition, screening surveys showed significant reductions in aberrant behavior ratings and in both repetitive and stereotypic behaviors. These differences increased with the total number of treatment sessions. Our results suggest that rTMS, particularly after 18 sessions, facilitates cognitive control, attention and target stimuli recognition by improving discrimination between task-relevant and task-irrelevant illusory figures in an oddball test. The noted improvement in executive functions of behavioral performance monitoring further suggests that TMS has the potential to target core features of ASD.
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Affiliation(s)
- Estate M. Sokhadze
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, United States
| | - Eva V. Lamina
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Emily L. Casanova
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Desmond P. Kelly
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Department of Pediatrics, Greenville Health System, Greenville, SC, United States
| | - Ioan Opris
- Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Allan Tasman
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, United States
| | - Manuel F. Casanova
- Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, United States
- Department of Pediatrics, Greenville Health System, Greenville, SC, United States
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