Brain Stimulation Technique Promising for Social Functioning in Children With Autism

A groundbreaking study published in JAMA Network Open offers evidence that the non-invasive brain stimulation method transcranial pulsed current stimulation, or tPCS, may significantly improve social functioning in children with autism spectrum disorder. 

According to a 2020 survey, one in 36 U.S. children aged eight years has ASD. Children with autism often display differences in social interaction, communication, and repetitive behaviors. They also frequently experience sleep disruptions, which can contribute to daytime behavioral challenges and caregiver burnout.

The study, “Transcranial Pulsed Current Stimulation and Social Functioning in Children with Autism Spectrum Disorder: A Randomized Clinical Trial,” involved a randomized, double-blind, sham-controlled trial with 312 children aged three to 14 years with ASD who underwent 20 sessions of tPCS, which delivers low-intensity electrical pulses to the scalp to influence brain activity and support neural network regulation, over four weeks. Participants received either active tPCS or sham (non-tPCS) stimulation. Results indicated that children in the active tPCS group exhibited significant improvements in social responsiveness, adaptive behaviors, and sleep compared to the control group receiving sham stimulation.

Social functioning was assessed using the Autism Treatment Evaluation Checklist as the primary outcome. Secondary outcomes included the Autism Behavior Checklist and the Childhood Sleep Habits Questionnaire, a parent report tool to assess children’s sleep patterns. Volunteers who received tPCS showed a 3.50 difference on the ATEC checklist compared to the control group. There was a 7.3% positive improvement in sleep based on the ABC for those receiving tPCS compared to those receiving sham stimulation.

“Our experience treating older Americans has amply demonstrated the potential of non-invasive brain stimulation to modulate activity in specific brain circuits and reduce brain-related disability. tPCS is a particularly exciting method of non-invasive brain stimulation, for it enables us to target high-frequency activity in the brain, which plays a critical role in normal function. This study represents a significant step forward in our understanding of non-invasive brain stimulation as a therapeutic tool for autism in children and an important advance in the utility and safety of tPCS,” said Alvaro Pascual-Leone, MD, PhD, senior scientist at the Hinda and Arthur Marcus Institute for Aging Research and medical director at the Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, a leading neurologist and co-author of the study. “This is the largest study on non-invasive brain stimulation in children with autism disorders completed to date. The findings demonstrate that tPCS can modulate neural circuits associated with social behavior, offering a new avenue for intervention in children with ASD, and promising extension to other conditions.”

The research team emphasized the safety and tolerability of tPCS, noting minimal side effects reported during the trial. They advocate for larger-scale studies to further explore the long-term benefits and potential integration of tPCS into standard autism treatment protocols.

The researchers included:  

• Zhenhuan Liu, MD, PhD, Department of Paediatrics, Nanhai Maternity and Children’s Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan, Guangdong, China
• Sandra Zhong, MSc, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London
• Roger C. M. Ho, MD, PhD, Professor and Senior Consultant Psychiatrist at the Department of Psychological Medicine, National University of Singapore (NUS)
• Xuguang Qian, MD, Institute for Health Innovation and Technology (iHealthtech), National University of Singapore
• Yan Tang, MD, PhD, Assistant Professor, Yunnan University of Chinese Medicine, Kunming, Yunnan Province, China
• Hui Tian, MD, PhD, Department of Paediatrics, Nanhai Maternity and Children’s Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan, Guangdong
• Chuntao Zhang, MD, Department of Paediatrics, Nanhai Maternity and Children’s Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan, Guangdong
• Nuo Li, MD, Department of Paediatrics, Nanhai Maternity and Children’s Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan, Guangdong
• Yong Zhao, MD,, Department of Paediatrics, Nanhai Maternity and Children’s Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan, Guangdong
• Yuqiong Zhang, MD, Department of Paediatrics, Dongguan Maternal and Child Health Hospital, Dongguan, Guangdong
• Huituan Liu, MD, Department of Paediatrics, Dongguan Maternal and Child Health Hospital, Dongguan, Guangdong
• Meifeng Wu, MD, Department of Paediatrics, Guangzhou Angel Children Hospital, Guangzhou, Guangdon
• Yingjie Zhan, MD, Department of Paediatrics, Zhanjiang Maternal and Child Health Hospital, Zhanjiang, Guangdong
• Min Li, MD, Department of Paediatrics, Meixian District Hospital of Chinese Medicine, Meizhou, Guangdong
• Zhihai Lv, MD, Department of Paediatrics, Shenzhen Luogang Maternal and Child Health Hospital, Guangdong
• Fengyi Hao, MD, PhD, Sleep Medicine Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, China
• Wilson Tam, MD, PhD, Alice Lee Centre for Nursing Studies, National University of Singapore
  Jeremy Lin Bingyuan, MBBS, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore
• Alvaro Pascual-Leone, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife; Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife; Harvard Medical School, Boston, MA

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across seven campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; Jack Satter House, Revere; and Leyland Community, Dorchester. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $98 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 500 geriatric care providers each year. For more information about Hebrew SeniorLife, follow us on our blog, Facebook, Instagram, Threads, and LinkedIn.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.