Zeinab Mohamed Ahmed El Nagar
ASD is a neurodevelopmental disorder, characterized by social and communication difficulties, repetitive behaviors, sensory issues and cognitive delays. ASD is diagnosed clinically, based on behavioral symptoms and unfortunately currently exists no cure. Transcranial magnetic stimulation TMS is a noninvasive method for cortical excitability modulation that may aid to physiology and therapeutic prospects. TMS acts on synapse level to obtain balance between glutamate mediated excitation and GABA mediated inhibition for optimal level of neuroplasticity. This is a single blinded sham controlled interventional study assessing therapeutic effect of repetitive TMS in patients with ASD during the period from September 2016 to February 2017, throughout this period patients received active and sham intervention of rTMS over 12 weeks. Participants recruited from rehabilitation units at the Institute of Psychiatry, Ain Shams University, Cairo, Egypt, included 30 patients aged from 4 to 10 years old (26 males, 4 females) diagnosed ASD as defined in DSM-5 with mild to moderate severity by Childhood Autistic Rating Scale CARS. Fifteen participants received active rTMS intervention over left and right Dorsolateral Prefrontal Cortex and 15 received sham interventions to assess the Placebo effect. After sessions documented follow up notes of any side effects or clinical findings. Study results showed after intervention, significant differences in eye to eye contact, relating to people, emotional reciprocity, verbal and nonverbal communication, restricted interests, adaptation to change, stereotypy, while increase in activity level and irritability in 21% and no change in 50% of active group compared to non-change in sham group.