Prefrontal neuromodulation using rTMS improves error monitoring and correction function in autism

Area of Science:

• Neuroscience
• Developmental Psychology
• Neuromodulation

Background:

• Autism spectrum disorder (ASD) is associated with compromised executive functions, specifically in error monitoring and post-error correction.
• Children with ASD often exhibit reduced error processing and deficient behavioral adjustments following errors.
• Event-related potentials (ERPs), including the error-related negativity (ERN) and error-related positivity (Pe), are sensitive measures of error processing.

Purpose of the Study:

• To investigate the effects of slow-frequency repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) on behavioral and ERP measures of error monitoring in high-functioning children with ASD.
• To determine if 12 sessions of 1 Hz rTMS applied bilaterally over the DLPFC can lead to improvements in reaction time (RT), error rate, post-error RT change, ERN, and Pe.

Main Methods:

• Participants with high-functioning ASD were randomly assigned to either an active rTMS treatment group or a wait-list (WTL) control group.
• A 12-week intervention involved 1 Hz rTMS applied bilaterally over the DLPFC.
• High-density electroencephalography (EEG) was used to record ERPs during a visual discrimination task assessing error monitoring before and after the intervention.

Main Results:

• The rTMS treatment group showed a significantly more negative ERN and a decrease in omission errors post-intervention.
• Post-error reaction times became slower in the rTMS group, suggesting enhanced error awareness and correction.
• No significant changes in RT, error rate, post-error RT slowing, ERN, or Pe were observed in the wait-list group.

Conclusions:

• Twelve weeks of bilateral DLPFC rTMS significantly improved error monitoring and correction functions in children with ASD, as evidenced by changes in ERN and behavioral measures.
• ERN and Pe, alongside behavioral performance metrics, serve as valuable functional outcome measures for assessing the efficacy of neuromodulation interventions like rTMS in children with autism.
• These findings highlight the potential practical implications of rTMS for enhancing cognitive functions in individuals with ASD.