THE first clinical trial aimed at boosting social skills in people with autism using magnetic brain stimulation has been completed 鈥� and the results are encouraging.
鈥淎s a first clinical trial, this is an excellent start,鈥� says Lindsay Oberman of the Beth Israel Deaconess Medical Centre in Boston, who was not part of the study.
People diagnosed with autism spectrum disorder often find social interactions difficult. Previous studies have shown that a region of the brain called the dorsomedial prefrontal cortex (dmPFC) is underactive in people with autism. 鈥淚t鈥檚 also the part of the brain linked with understanding others鈥� thoughts, beliefs and intentions,鈥� says Peter Enticott of Monash University in Melbourne, Australia.
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Enticott and his colleagues wondered whether boosting the activity of the dmPFC using repetitive transcranial magnetic stimulation (rTMS), which involves delivering brief but strong magnetic pulses through the scalp, could help individuals with autism deal with social situations. So the team carried out a randomised, double-blind clinical trial 鈥� the first of its kind 鈥� involving 28 adults diagnosed with either high-functioning autism or Asperger鈥檚 syndrome.
Some participants received 15 minutes of rTMS for 10 days, while others had none, but experienced all other aspects, such as having coils placed on their heads and being subjected to the same sounds and vibrations.
The participants carried out a number of tests of their social skills before the start of the therapy and at the end of the therapy. These showed that those who received rTMS had significantly improved social skills a month later. For instance, one woman began making tea for her sibling who was studying for an exam, suggesting that she understood her sibling鈥檚 emotional state and wanted to help. 鈥淎s far as her family were concerned, this was completely foreign to her,鈥� says Enticott. 鈥淪he had never shown any inclination toward that sort of activity in her life.鈥�
聯One woman made tea for her sibling who had an exam, suggesting she knew their emotions聰
The therapy also reduced anxiety, as judged by a standard questionnaire that measures reactions in difficult, emotionally charged interactions with others. No such changes were observed in people who received the placebo ().
However, participants showed no improvement in computer tasks designed to test whether they could infer the mental states of others, or mentalise. 鈥淚t surprises me,鈥� says Enticott. 鈥淲e are stimulating the region of the brain that is most closely associated with these tasks.鈥� Given this, it is unclear why the volunteers showed an improvement in social skills. 鈥淲e need to figure out whether this is underpinned by changes to mentalising ability, or whether there is some other thing at play,鈥� he says.
Oberman points out that the dmPFC is not near the surface of the brain, so it is hard to target with great accuracy. The rTMS would have stimulated brain regions between the scalp and the dmPFC. This lack of specificity may have driven the changes without affecting mentalising. The next step is to increase the duration and intensity of stimulation and to monitor how long the observed improvements last.
鈥淲hile the findings are interesting, the research is still in its very early stages,鈥� cautions Carol Povey, at the UK鈥檚 National Autistic Society. She adds that it is essential that people with autism receive the support they need to reach their full potential.
This article appeared in print under the headline 鈥淏rain stimulation brings social side to autism鈥�
