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Updated: Sep 12, 2026
Probing the Brain in Autism Using fMRI and Diffusion Tensor Imaging
Published on: September 12, 2011
Effects of rTMS intervention on resting-state functional brain activityin children with autism spectrum disorders: a
1Department of Pediatrics, the Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, P.R. China.
Background:
Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with widespread neurobiological alterations. Repetitive transcranial magnetic stimulation (rTMS) is a potential neuromodulation intervention, but its neural mechanisms remain unclear in preschool-aged children with ASD. This study aimed to use resting-state fMRI (rs-fMRI) metrics-ALFF and ReHo and behavioral assessments to investigate neural mechanisms underlying clinical response to low-frequency (1 Hz) rTMS over the left dorsolateral prefrontal cortex (DLPFC) in this population.
Methods:
Thirty-four preschool-aged children with ASD (aged 2-6 years) were recruited and randomly assigned to rTMS group (n = 17) or control group (n = 17). After dropout exclusions, 32 children completed the study (16 per group). The rTMS group received 12 weeks of low-frequency (1 Hz) rTMS over the left DLPFC in addition to conventional rehabilitation, while the control group received sham stimulation. Behavioral assessments (ABC, CARS, RBS-R, ATEC) and rs-fMRI scans for ReHo/ALFF were conducted at baseline and post-treatment.
Results:
The rTMS group showed significantly greater improvements in CARS (t = 2.111, P = 0.043), RBS-R (Z = - 2.175, P = 0.030), and ATEC (t = 2.093, P = 0.044) scores compared with the control group. Post-treatment rs-fMRI analysis revealed increased ReHo in the right caudate nucleus, right angular gyrus, and left anterior cingulate gyrus, and decreased ReHo in the left cerebellar Crus II, left inferior occipital gyrus, and left middle temporal gyrus. Increased ALFF was observed in the right inferior orbital frontal gyrus, right angular gyrus, and right dorsolateral superior frontal gyrus. After controlling for age, sex, and mean frame-wise displacement, the right angular gyrus ALFF remained significantly correlated with ATEC (rₚ = -0.710, P = 0.002), ABC (rₚ = -0.578, P = 0.019), and CARS (rₚ = -0.625, P = 0.009); the right caudate nucleus ReHo remained significantly correlated with ATEC (rₚ = -0.572, P = 0.020).
Conclusions:
Low-frequency rTMS targeting the left DLPFC is safe and effective in improving core symptoms in preschool-aged children with ASD, possibly by enhancing spontaneous neuronal activity in cognitive/executive function-related regions. The right angular gyrus and right caudate nucleus may serve as potential neuroimaging biomarkers for treatment response.
