rTMS to Improve Motor Function in Autism

What this study is about

In the current project, investigators have two main goals: i) Testing whether an excessive plasticity, i.e. hyperplasticity in the motor cortex underlies motor function difficulties in autistic adults, and ii) Using repetitive Transcranial Magnetic Stimulation (rTMS) with autistic adults to examine whether resulting reduced hyperplasticity in the motor cortex will be associated with clinical improvements in the motor function.

Who can join (things the study team will check)

✅ You may be able to join if…

• Aged between 18 and 40 years old. 40 years is chosen as the cut-off because of the report of high rates of Parkinsonism in autistic adults > 39years;
• Have IQ>70;
• Are able to read, write and communicate effectively in English;
• Are able to provide informed consent. We will recruit only intellectually-able autistic adults. The intellectual ability will be determined using WASI-II. The ability to provide consent will be determined using clinical assessment.
• Have no prior history of seizure;
• Must sign and date the informed consent form;
• Stated willingness to comply with all study procedures;
• Agreement to adhere to Lifestyle Considerations, that is: refrain from consumption of alcohol, tobacco, marijuana, or caffeine on the day of study visits. All ASD participants:
• Will have DSM-5 diagnosis of ASD without intellectual disability, confirmed by clinical assessment and the Autism Diagnostic Observation Schedule - 2 (ADOS-2);
• Will have significant motor function difficulties defined as a standard composite score <40 (i.e., >1 standard deviation below the mean) on either fine or gross motor composite scores of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition or BOT-2;
• Are clinically stable as determined by clinical assessment, with no medication changes over the past 4 weeks. Given the high variability of handedness in ASD, we will include participants with left, right or mixed handedness.

🚫 You may not be able to join if…

• Current pregnancy;
• Current or past history of co-morbid medical condition that may require urgent medical intervention;
• DSM-5 substance use disorder (other than tobacco) within the past 6 months; however, all participants will be asked to refrain from smoking or taking caffeine four hours prior to the iTBS session;
• Significant hearing or visual impairment interfering with the ability to read or hear instructions;
• Significantly debilitating medical or neurologic illness (e.g., encephalitis, aneurysms, tumors, central nervous system infections), or acute or unstable medical illnesses as determined by project physician (e.g., uncontrolled diabetes);
• Metal implants or a pace-maker;
• Prior rTMS treatment; In addition, ASD participants will be excluded if they report taking benzodiazepines or anticonvulsants currently. NT controls will be excluded if they have:
• Presence of psychopathology other than specific phobia, as screened by Personality Assessment Inventory and;
• A known diagnosis of Pervasive Developmental Disorder or ASD among any biologically related family members.

Where this trial is running

• Center for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada

Who to contact

Pushpal Desarkar, MD · 4165358501 · Pushpal.Desarkar@camh.ca

It's completely normal to call and ask questions before deciding anything. Mention the study ID: NCT06497920.