#AutismWithoutIntellectualDisability #TMS #SocialCognition #iTBS #Neuroimaging
Autism spectrum disorders (ASD) are primarily
characterized by persistent
difficulties in social interaction, communication,
and understanding others' intentions. In adults, these social challenges are
often pronounced and impact interpersonal relationships, professional life, and
overall quality of life. Despite the availability of various educational,
behavioral, and psychotherapeutic approaches,
there is currently no specific
and effective treatment to sustainably address these social deficits.
Recent neuroimaging studies have identified
functional abnormalities within the brain network involved in social cognition,
particularly in a region called the
right temporoparietal junction (rTPJ). This
area plays a key role in an individual’s ability to represent others’ mental
states — a function often impaired in people with autism.
In this context, the study introduces an
innovative approach to
personalized neuromodulation, using
intermittent
high-frequency transcranial magnetic stimulation (iTBS). The concept? To
p
recisely target each participant’s rTPJ, identified via
functional MRI, in
order to temporarily and specifically enhance its activity. The aim is to
assess whether this individualized stimulation can
improve the ability to
process social information and lead to a better understanding of others.
Rebooting the social brain?
The study involved 104 participants — 52 adults with ASD without intellectual
disability and 52 control subjects — who were randomly assigned to two groups
(real stimulation vs. placebo). Each participant underwent a functional MRI
while performing a social task to accurately locate the brain region to be
stimulated. This area was then targeted using neuronavigated guidance, and iTBS
was applied. After the session, participants completed a series of tests
assessing social perception, emotion recognition, working memory, and motor
coordination.
Only the social task was repeated before and
after stimulation to measure its
direct effect. The main goal was to evaluate
how much the stimulation improved the use of social information for
decision-making. Computational modeling tools (like HGF) were used to analyze
the cognitive processes involved.
Results showed the approach is
feasible and
well tolerated. It can also
induce measurable neurocognitive effects,
particularly
improving the integration of social cues in decision-making. These
findings support the idea that it is possible to act directly on the brain
networks involved in social interaction.
Read next: “SPACE”: A Simple Framework to Better Meet the Needs of Patients with Autism
Neuromodulation: a first step toward social
understanding?
Autism spectrum disorders are marked by persistent impairments in social
communication, significantly impacting patients’ daily lives. In adults without
intellectual disability, these difficulties often remain without any targeted
therapeutic solution.
One major challenge is to directly target brain
areas involved in social cognition, such as the right temporoparietal junction,
which is frequently impaired in ASD. The goal of this study was to explore an
innovative strategy:
combining transcranial magnetic stimulation (iTBS) with
fMRI-guided personalization to modulate this region in a precise way.
Early results are promising. For the first time
at this scale, the protocol integrates
individualized stimulation, brain
imaging, stereotaxic neuronavigation, and cognitive modeling, within a rigorous
and controlled framework. While the clinical effects remain modest, the study
demonstrates
the feasibility, tolerability, and measurable biological impact of
such an intervention in adults with ASD.
However, several limitations remain, opening
the door to
larger trials involving
repeated stimulation sessions,
longer-term
follow-up, and
more diverse cohorts, in order to validate the clinical value of
this strategy.
What if tomorrow we could personalize
neuromodulation…
to better reconnect the social brain?Read next: How about recharging the batteries?
