Enhanced cognition and emotional recognition, and reduced obsessive compulsive symptoms in two adults with high-functioning autism as a result of deep Transcranial Magnetic Stimulation (dTMS): a case report

Background:

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in interpersonal relations, communication, cognition, and behavior. The mPFCis an important node within functional networks supporting mentalizing abilities which are crucial for social interactions, and were found to be impaired in adults with ASD.

Objective:

This study aimed at comprehensively and objectively measuring the modulation of emotional and cognitive functioning in response to 5-week daily deep transcranial magnetic stimulation (dTMS) intwo high-functioning ASD patients.

Methods:

The patients received daily high-frequency (5 Hz) dTMS with H3-coil over the mPFCfor a period of 5–6 weeks. A computerized cognitive battery, tasks for testing emotional recognition, and clinical questionnaires were used to measure the effects of treatment.

Results:

Both patients improved in a variety of cognitive functions, with a global improvement of 20% (for P1) and 30% (for P2) in the neuropsychological battery. Patientsreported to experience increasing attention and decisiveness along the treatment. The emotional recognition tasks also revealed that recognizing emotions in others became easier. Patients reported to be more aware of emotional and social cues already during the first 2 weeks of treatment. The self-report questionnaires showed slight improvement in autistic symptoms (AQ) and empathy (IRI). The most noticeable effect was the decrease in OCD-like symptoms at the end of the treatment as measured by the Y-BOCS scale. This decrease was already reported by the patients during the first two weeks of treatment. Follow-up assessment indicated that OCD-related symptoms are still significantly lower than baseline even 2 months after the end of dTMS treatment.

Conclusions:

The current case report suggests that 5–6 weeks of daily deepTMS to the mPFC may show beneficial effects in high-functioning ASD patients with OCD symptoms. Although placebo-controlled studies are required to determine if the observed effects are indeed significant against placebo, this report might encourage to further study the role of the mPFC in ASD patients with OCD symptoms.

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