Efficacy of transcranial direct current stimulation in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis
- Forfatter(e)
- Amjad, M. M., Javed, H., Azeem, M. Z., Anwer, T., Khan, B. W., Khattak, M. H., Khan, U. Z., Zahoor, M. A., Tabassum, Z., Ehsan, M., Sidra, H., Ahmad, H., Nazir, S., Khan, K.
- År
- 2025
- Tidsskrift
- Brain Research
- Volum
- 1873
- Sider
- 150114
- Kategori(er)
- Autismespekter Atferdsproblemer, antisosial atferd og atferdsforstyrrelser Språk og motorikkSosiale ferdigheter (inkl. vennerelasjoner)
- Tiltakstype(r)
- Antidepressiva
- Abstract
BACKGROUND
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication, repetitive behaviors, and loss of interests. Despite the use of conventional treatment such as medication and behavioral therapy, many children and adolescents still experience significant functional impairments. Recent advances in noninvasive brain stimulation have raised the interest of transcranial direct current stimulation (tDCS) in addressing core symptoms of ASD.
METHODS
A comprehensive literature search of databases PubMed, Cochrane Library, and Google Scholar for relevant studies was conducted until March 28, 2025. A total of 1,443 records were identified. After duplicate removal and application of inclusion and exclusion criteria, 11 studies contributed to the Meta-analyses, while 28 studies were eligible for the systematic review.
RESULTS
In addressing clinical outcomes, tDCS yielded significant improvement in social communication, the pooled data from 4 studies showed significant improvement in social communication (SMD = - 0.66, 95 % CI [-0.94, -0.39] and p < 0.00001), social awareness was also improved with tDCS (SMD = -0.60; 95 % CI [-1.12, -0.07] and p = 0.03) however, language skill showed no significant improvement (SMD = -0.11; 95 % CI [-0.44, 0.21] and p = 0.50). Moreover, tDCS also showed enhancement in restrictive repetitive behaviors (SMD = -0.60, 95 % CI [-0.85, -0.34] and p < 0.00001). In addition, tDCS generated robust improvements in behavioral symptoms and regulations (SMD = -0.65; 95 % CI [-0.98, -0.32] and p < 0.001). Finally, for overall symptom severity reduction in ASD by tDCS, assessed by SRS score, exhibited statistical improvements (SMD = -0.64; 95 % CI [-0.89, -0.39] and p < 0.00001). However, the pooled analysis of 5 studies assessing ATEC score demonstrated no statistically significant difference (SMD = -0.61; 95 % CI [-1.34, 0.11] and p = 0.10) with high heterogeneity (p = 0.0006, I2 = 80 %). To overcome heterogeneity, we performed a sensitivity analysis, which made the result significant (SMD = -0.95; 95 % CI [-1.41, -0.49] and p < 0.0001) with low heterogeneity (p = 0.16, I2 = 42 %).
CONCLUSION
tDCS appears to be a promising noninvasive therapy for improving social and behavioral symptoms of ASD. However, large-scale, multi-center RCTs with standardized protocols and longer follow-up durations are essential to determine optimal stimulation parameters and to identify which patients will benefit the most from it.