Transcranial Magnetic Stimulation Implementation in Management of Children with Autism. Research Digest

Autism spectrum disorders (ASD) are neurodevelopmental disorders of polyetiological nature. The leading role in their development belongs to genetic and environmental factors. Nowadays, the main treatment landscapes are methods of psychological and pedagogical correction. Over the past decades, there has been an active search for biological causes and pathogenetic mechanisms in order to develop additional treatments approaches. One of the methods of hardware neuromodulation used in ASD is transcranial magnetic stimulation (TMS). This article provides the analytical review of modern research on TMS implementation in ASD. Neurobiological hypotheses of ASD pathogenesis that underlie the use of hardware neuromodulation, are considered. Special emphasis is paid to targeted approach in using TMS according to the clinical signs of patients. The purpose of this review is to analyze and summarize modern scientific studies on TMS usage in ASD in various clinical groups, as well as to determine further research directions. Analysis of 39 publications, including double-blind, placebo-controlled studies, has shown TMS safety and good efficacy in patients with autism. However, there is no uniform approaches in selection of stimulation protocols, in definition of clinical groups of ASD patients, as well as in methods for monitoring the dynamics of clinical indicators. The profound clinical and biological heterogeneity of ASD, as well as indicated heterogeneity in studies, lead to the absence of TMS protocols that can be included in clinical guidelines, which necessitates further research.

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