Transcranial direct current stimulation for hyperactivity and noncompliance in autistic disorder

Abstract

Objectives. To evaluate the safety, efficacy, and feasibility of inhibitory transcranial direct current stimulation (tDCS) for the treatment of behavioural abnormalities of autistic patients. Methods. Twelve young adult patients with autistic disorder were enrolled. All subjects presented intellectual disability and most of them had speech impairment. The Aberrant Behavior Checklist (ABC) was administered as the primary outcome measure before and after a 2-week tDCS course. All subjects received 10 daily applications of 20 min/1.5 mA/cathodal (inhibitory) tDCS over the left dorso-lateral pre-frontal cortex. Results. Eight out of 10 study completers improved in their abnormal behaviours, reaching an average reduction of 26.7% of the total ABC score. The remaining two patients showed no changes. In the whole group of completers, among the five subscales contributing to the significant reduction of the total score, the most remarkable and statistically significant change was seen in the subscale assessing hyperactivity and non-compliance (–35.9%, P = 0.002). No adverse effects were reported. Conclusions. Inhibitory tDCS improved the ABC rating scores for autistic behaviours. Owing to its ease of use, cost-effectiveness and the limited availability of specific treatment strategies, tDCS might be a valid therapeutic option to be tested in autistic patients.

Key words::

• tDCS
• autism
• pervasive developmental disorders
• intellectual disability
• TMS

Acknowledgements

We wish to thank Prof. Giovanni Salvati, Dr. Maria Iaderosa, and Dr. Dario Frascadore of the Serapide Centre of Villaricca (Naples, Italy), as well as Prof. Giuseppe Miranda, Dr. Gianfranca Auricchio, Dr. Felice Del Genio, Dr. Giuseppina Nappi, Dr. Paola Di Franco, and Mr. Carmelo Fabrizio of the AIAS of Nola (Naples, Italy) for their collaboration. In particular, we thank them for providing their support in raising parents’ awareness on the potential effectiveness of tDCS in autism. Indeed, thanks to their time and dedication, we were able to recruit the subjects for our pilot study. Furthermore, we thank them for providing us with professional operators, as well as facilities and stimulation devices for the treatments. Finally, we truly thank Dr Paola Merolla for her precious help in editing the manuscript.

Statement of Interest

Giordano D’Urso, Dario Bruzzese, Antonio Pascotto, and Carmela Bravaccio report no financial interests or potential conflicts of interest relevant to the subject matter of the manuscript over the last two years, at present, and in the foreseeable future. Roberta Ferrucci and Alberto Priori are stakeholders of Newronika s.r.l., a spin-off company of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and of the Università degli Studi di Milano. Alfredo Carlo Altamura has served as a consultant for Roche, Lundbeck, Merck, Astra Zeneca, Bristol-Myers Squibb, Janssen-Cilag, Otsuka and received fees from the speaker Bureau of Sanofi, Eli Lilly, and Pfizer. Silvana Galderisi received fees for educational programs or advisory boards from Amgen Dompé, AstraZeneca, Bristol-Myers Squibb, Eli-Lilly, Otsuka, Innova-Pharma, and Janssen-Cilag.