Accelerated Theta Burst Transcranial Magnetic Stimulation for Refractory Depression in Autism Spectrum Disorder

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• Major depressive disorder (MDD) frequently co-occurs with autism spectrum disorder (ASD), leading to substantial impairment.
• Treatment for MDD in ASD is often challenging, with high rates of treatment resistance.

Purpose of the Study:

• To evaluate the efficacy and tolerability of accelerated theta burst stimulation (ATBS) for treating refractory MDD in adults with ASD.
• To assess the impact of ATBS on depressive symptoms, cognition, and sleep quality in this population.

Main Methods:

• A prospective, open-label, 12-week trial involving 10 participants with ASD and MDD.
• Participants received either unilateral or bilateral accelerated theta burst stimulation (ATBS) of the dorsolateral prefrontal cortex over 10 days (3 treatments daily).
• Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and self-report measures.

Main Results:

• One participant withdrew due to intolerability; no serious adverse events were reported.
• Significant and sustained reduction in HDRS scores was observed post-treatment.
• Full remission was achieved in 50% of participants, and partial remission in 30% at 12 weeks.
• Improvements were also noted in secondary outcomes, including fluid cognition and sleep quality.

Conclusions:

• Accelerated theta burst stimulation (ATBS) is a highly effective and well-tolerated treatment for major depressive disorder (MDD) in individuals with autism spectrum disorder (ASD).
• The findings support further investigation through larger, sham-controlled randomized trials to confirm ATBS efficacy in this specific population.