title: Transcranial magnetic stimulation in autism spectrum disorder: Challenges, promise, and roadmap for future research.
abstract: Autism Spectrum Disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by impairments in social communication, by the presence of restricted and repetitive behaviors, interests and activities, and by abnormalities in sensory reactivity. Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study and potential treatment of ASD. Recent studies suggest that TMS measures provide rapid and noninvasive pathophysiological ASD biomarkers. Furthermore, repetitive TMS (rTMS) may represent a novel treatment strategy for reducing some of the core and associated ASD symptoms. However, the available literature on the TMS use in ASD is preliminary, composed of studies with methodological limitations. Thus, off-label clinical rTMS use for therapeutic interventions in ASD without an investigational device exemption and outside of an IRB approved research trial is premature pending further, adequately powered and controlled trials. Leaders in this field have gathered annually for a two-day conference (prior to the 2014 and 2015 International Meeting for Autism Research, IMFAR) to share recent progress, promote collaboration across laboratories, and establish consensus on protocols. Here we review the literature in the use of TMS in ASD in the context of the unique challenges required for the study and exploration of treatment strategies in this population. We also suggest future directions for this field of investigations. While its true potential in ASD has yet to be delineated, TMS represents an innovative research tool and a novel, possibly transformative approach to the treatment of neurodevelopmental disorders.
authors.affiliation: Neuroplasticity and Autism Spectrum Disorder Program and Department of Psychiatry and Human Behavior, E.P. Bradley Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode, Island.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Oberman
authors.affiliation: Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, Victoria, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Enticott
authors.affiliation: Department of Psychiatry and Behavioral Science, University of Louisville, Louisville, Kentucky.
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Casanova
authors.affiliation: Neuromodulation Program, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rotenberg
authors.affiliation: Neuromodulation Program, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.|Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual-Leone
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: James T
authors.initials: JT
authors.lastname: McCracken
mesh_terms: D000067877:Autism Spectrum Disorder / Q000628:therapy*; D006801:Humans; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: autism spectrum disorder; consensus; review; transcranial magnetic stimulation; treatment