Neuromodulation for treatment resistant autism: systematic review

Area of Science:

• Neuroscience
• Psychiatry
• Neurosurgery

Background:

• Autism spectrum disorder (ASD) presents with social-communication challenges and repetitive behaviors.
• Severe aggression, self-injurious behavior (SIB), and obsessive-compulsive symptoms occur in some individuals with ASD.
• Conventional treatments for ASD often yield limited efficacy.

Purpose of the Study:

• To systematically review clinical literature on neuromodulatory and neurosurgical interventions for ASD.
• To assess outcomes of deep brain stimulation (DBS), rTMS, iTBS, tDCS, and radiosurgery for ASD.

Main Methods:

• Comprehensive literature search of PubMed, Embase, and Cochrane Library up to December 2025.
• Inclusion of studies reporting clinical outcomes for individuals with ASD undergoing neuromodulation or ablative procedures.

Main Results:

• Sixteen studies indicated DBS, rTMS, iTBS, tDCS, and radiosurgery yielded positive outcomes.
• Interventions reduced aggression, SIB, and obsessive-compulsive symptoms, improving social and executive functions.
• Adverse events were generally mild and transient across all modalities.

Conclusions:

• Neuromodulatory and ablative interventions show therapeutic potential for treatment-resistant ASD.
• These methods are particularly beneficial for individuals with aggression, SIB, and social-cognitive deficits.