Transcranial Magnetic and Direct Current Stimulation in Children

Abstract

Promising results in adult neurologic and psychiatric disorders are driving active research into transcranial brain stimulation techniques, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), in childhood and adolescent syndromes. TMS has realistic utility as an experimental tool tested in a range of pediatric neuropathologies such as perinatal stroke, depression, Tourette syndrome, and autism spectrum disorder (ASD). tDCS has also been tested as a treatment for a number of pediatric neurologic conditions, including ASD, attention-deficit/hyperactivity disorder, epilepsy, and cerebral palsy. Here, we complement recent reviews with an update of published TMS and tDCS results in children, and discuss developmental neuroscience considerations that should inform pediatric transcranial stimulation.

Keywords: Cortical excitability; Cortical inhibition; GABA; TMS; Transcranial stimulation in children; tDCS.

Conflict of interest statement

Compliance with Ethical Standards

Conflict of Interest Mustafa Q. Hameed, Sameer C. Dhamne, Roman Gersner, Harper L. Kaye, and Lindsay M. Oberman declare that they have no conflict of interest.

Figures

Fig. 1. Investigational and diagnostic utility of transcranial magnetic stimulation

A–C, representative hand motor map in a child. A, abductor pollicis brevis (APB) MEP obtained by motor cortex single-pulse TMS. B, multiple MEPs are color-coded by amplitude, with white corresponding to maximum and gray corresponding to minimum, and projected onto the patient’s brain MRI. C, enlarged motor map shows APB localizing to the “hand knob” region of the precentral gyrus (unpublished data). D, correlation of age to resting motor threshold. Pearson correlation test shows significant negative correlation between rMT (in hemisphere contralateral to seizure focus) and age in children (N = 48) with epilepsy [148]. E, modulatory effect of continuous theta burst stimulation in ASD. Corticospinal excitability was assessed every 5–10 minutes to determine the duration of cTBS induced modulation in children with ASD (N = 27) and healthy controls (N = 4). Pearson correlation test in the ASD group shows significant positive correlation between age and duration of modulation. Only 4 healthy control participants have been assessed thus far, but there is currently no age-related correlation in this group (unpublished data)