The effect of repetitive transcranial magnetic stimulation on social cognition in autism spectrum disorder: preliminary analysis of a pilot clinical trial

Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a promising tool for modulating the cortical activity in individuals with autism spectrum disorder (ASD), however there is currently no consensus regarding the optimal cortical targets or stimulation paradigms. One prevailing theory in ASD attributes the core social deficits to dysfunction of the mirror neurons located in the inferior parietal lobule (IPL) and inferior frontal gyrus. This is an ongoing pilot clinical trial which aims to explore the effects of excitatory modulation of the IPL via rTMS on social cognition in ASD. At the time of drafting this manuscript, 11 subjects with ASD, 10 boys and 1 girl with the mean age of 13.27 years had completed the study, receiving 10 sessions of high frequency rTMS on the left or right IPL and sham stimulation on the contralateral IPL. None of the 11 subjects experienced any adverse effects. This preliminary analysis on the 11 subjects shows a favorable response to high frequency rTMS modulation of the mirror neurons at IPL on measures of social awareness. Our observations indicate that subjects with ASD levels I and II are more likely to have a favorable response to this intervention.