rTMS Modulates Static and Dynamic Brain Functional Networks in Children with Autism Spectrum Disorder: An EEG...

Repetitive Transcranial Magnetic Stimulation (rTMS) shows promise for treating Autism Spectrum Disorder (ASD), but its impact on the temporal dynamics of large-scale brain networks remains unclear. This study investigated the modulatory effects of rTMS on static and dynamic brain functional networks in children with ASD. Thirty-two children were randomized into an active rTMS group (1 Hz over the dorsolateral prefrontal cortex) and a sham control group. Resting-state EEG and behavioral assessments were conducted before and after a 9-week intervention. We employed a multi-dimensional analysis approach, combining microstate temporal parameters, static functional connectivity based on the weighted Phase Lag Index (wPLI), and dynamic complexity measured by Fuzzy Entropy. Results indicated that intrinsic features of Microstate B were significantly correlated with social relating deficits. Although rTMS did not induce significant interaction effects in standard microstate temporal parameters, it significantly enhanced static functional connectivity strength and increased the dynamic complexity of brain networks across all microstates. These findings suggest that rTMS exerts its therapeutic effects by strengthening network integration and restoring neural flexibility rather than simply altering the duration of brain states. The study underscores the value of network-based EEG metrics in elucidating the neuroplastic changes induced by neuromodulation in ASD.