The short-term effects of transcranial direct current stimulation on electroencephalography in children with autism: a randomized crossover controlled trial

Anuwat Amatachaya, Mark P Jensen, Niramol Patjanasoontorn, Narong Auvichayapat, Chanyut Suphakunpinyo, Suparerk Janjarasjitt, Niran Ngernyam, Benchaporn Aree-uea, Paradee Auvichayapat, Anuwat Amatachaya, Mark P Jensen, Niramol Patjanasoontorn, Narong Auvichayapat, Chanyut Suphakunpinyo, Suparerk Janjarasjitt, Niran Ngernyam, Benchaporn Aree-uea, Paradee Auvichayapat

Abstract

Abnormal synaptic maturation and connectivity are possible etiologies of autism. Previous studies showed significantly less alpha activity in autism than normal children. Therefore, we studied the effects of anodal tDCS on peak alpha frequency (PAF) related to autism treatment evaluation checklist (ATEC). Twenty male children with autism were randomly assigned in a crossover design to receive a single session of both active and sham tDCS stimulation (11 mA) over F3 (left dorsolateral prefrontal cortex). Pre- to postsession changes in a measure of cortical activity impacted by tDCS (PAF) and ATEC were compared between groups. We also examined the associations between pre- and postsession changes in the PAF and ATEC. The results show significant pre- to postsession improvements in two domains of ATEC (social and health/behavior domains) following active tDCS, relative to sham treatment. PAF also significantly increased at the stimulation site, and an increase in PAF was significantly associated with improvements in the two domains of ATEC impacted by tDCS. The findings suggest that a single session of anodal tDCS over the F3 may have clinical benefits in children with autism and that those benefits may be related to an increase in PAF.

Figures

Figure 1
Figure 1
Changes in peak alpha frequency (PAF) at 18 electrode sites (referenced to Cz) after active and sham tDCS stimulation over dorsolateral prefrontal cortex (F3), relative to baseline. In the active condition, significant differences in PAF were found at 5 electrode sites: Fp1, Fp2, F7, F3, and Fc. Immediately after stimulation, PAF significantly increased at Fp1, F7, and Fc; significant increases in PAF at Fp2 were found at 72 hours after stimulation. At the stimulation site (F3), increases in PAF were found immediately and at 24 hours after stimulation. In the sham condition, PAF did not have any significant changes at any time point at any of the 18 electrode sites. Red = increase; blue = decrease; white = no changes; ∗ significant different main effect of time; *P < 0.05; **P < 0.01; ***P < 0.001.
Figure 2
Figure 2
Power spectrum density at baseline relative to immediately after stimulation and 24 hours after stimulation for the two treatment conditions. (a) In the active condition, the results show significant increases in peak alpha frequency (PAF) between baseline (black dashed line) and immediately after stimulation (blue line) (P < 0.001). Significant increases in PAF from baseline were also found at 24 hours after stimulation (P = 0.004). (b) In the sham condition, no significant changes in PAF were found at either assessment point. Significant differences following active treatment, relative to baseline, are indicated by **P < 0.01; ***P < 0.001. Significant differences following sham treatment, relative to baseline, are indicated by †P < 0.05; ††P < 0.01.
Figure 3
Figure 3
Correlation between change in peak alpha frequency (PAF) and autism treatment evaluation checklist (ATEC) subscale scores. (a) An increase in PAF at 24 hours after stimulation and change in the ATEC social scale at 7 days after stimulation (r = −0.47, P = 0.037). (b) An increase in PAF immediately after stimulation and change in the ATEC health and behavioral problem scale at 7 days after stimulation (r = −0.46, P = 0.039).

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