Poster No:
313
Submission Type:
Abstract Submission
Authors:
Hsiang-Yuan Lin1, Hsing-Chang Ni2
Institutions:
1Centre for Addiction and Mental Health, Toronto, Ontario, 2Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
First Author:
Co-Author:
Introduction:
Recent studies have demonstrated that the lateral cerebellum, especially Crus I/II, is associated with social functions, language and emotion and thus may serve as a potential target in alleviating autistic symptoms. The reduction of cerebellar Purkinje cells in autistic people leads to impaired inhibitory function and causes excitation/inhibition imbalance in the brain. This imbalance alters functional connectivity between the cerebellum and other brain regions, especially the default mode network (DMN) in autistic people. Despite these facts, no study has investigated the effect of repetitive transcranial magnetic stimulation (rTMS) on the lateral cerebellum in autistic people. Our study aimed to explore the safety, feasibility and impacts of theta burst stimulation (TBS, a modified form of rTMS) applied to the right Crus I/II (lateral cerebellum) on intrinsic brain functional connectivity in autistic adults.
Methods:
In this open-label trial, we enrolled ten intellectually able autistic adults (7 males and 3 females, assigned sex at birth, aged 18- years). Participants underwent a single session of neuro-navigated intermittent TBS (iTBS; 600 x 2 pulses spaced with a 15-minute interval at 80% of the active motor threshold) over the right Crus I/II. The right Crus I/II was individually localized using resting-state functional MRI. Resting-state functional MRI scans were scheduled before and immediately after the TBS intervention.
Results:
All of the autistic adults could tolerate a single iTBS session over the right Crus I/II without severe adverse events. The retention rate is 100%. We found intrinsic functional connectivity within the default mode network and somatosensory motor network significantly decreased post-iTBS 1200, while other networks remained unchanged. Moreover, our exploratory analysis showed the inter-individual variability (idiosyncrasy) post-TBS over the ventral attention, frontoparietal, default mode network and visual networks significantly decreased.
Conclusions:
Our pilot study demonstrated the safety and feasibility of applying iTBS over the lateral cerebellum in autistic adults. Moreover, we found that iTBS could modulate several functional networks in autistic adults. Our findings provide the pilot data for a neuroscience-informed, larger-scale, randomized controlled trial in the future.
Brain Stimulation:
Non-invasive Magnetic/TMS 2
Disorders of the Nervous System:
Neurodevelopmental/ Early Life (eg. ADHD, autism) 1
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling
Keywords:
Autism
FUNCTIONAL MRI
Transcranial Magnetic Stimulation (TMS)
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Resting state
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Patients
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
NOTE: Any human subjects studies without IRB approval will be automatically rejected.
Yes
Were any animal research approved by the relevant IACUC or other animal research panel?
NOTE: Any animal studies without IACUC approval will be automatically rejected.
Not applicable
Please indicate which methods were used in your research:
Functional MRI
TMS
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
AFNI
SPM
Provide references using APA citation style.
Van Overwalle F, Ma Q, Heleven E. The posterior crus II cerebellum is specialized for social mentalizing and emotional self-experiences: a meta-analysis. Soc Cogn Affect Neurosci. 2020;15(9):905-928.
D'Mello AM, Crocetti D, Mostofsky SH, Stoodley CJ. Cerebellar gray matter and lobular volumes correlate with core autism symptoms. Neuroimage Clin. 2015;7:631-639.
Huang YZ, Lu MK, Antal A, et al. Plasticity induced by non-invasive transcranial brain stimulation: A position paper. Clin Neurophysiol. 2017;128(11):2318-2329.
Huang YZ, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC. Theta burst stimulation of the human motor cortex. Neuron. 2005;45(2):201-206.
Ni HC, Chao YP, Tseng RY, et al. Lack of effects of four-week theta burst stimulation on white matter macro/microstructure in children and adolescents with autism. Neuroimage Clin. 2023;37:103324.
No