rTMS Modulates Static and Dynamic Brain Functional Networks in Children with Autism Spectrum Disorder: An EEG Microstate Study

Clinical Snapshot

Key Findings

• P Value: Significant effects reported but specific values not given

• Effect Size: Not reported

• Primary Outcome: EEG microstate parameters and functional connectivity measures

• Nnt Or Sensitivity: Not calculable from available data

• Confidence Interval: Not provided

Clinical Application

Requires specialized rTMS equipment and EEG analysis expertise; 9-week protocol may challenge compliance rTMS for ASD not currently PBS-funded; would require private practice or research setting; TGA approval needed for pediatric rTMS devices Children with autism spectrum disorder suitable for rTMS intervention

Abstract

Repetitive Transcranial Magnetic Stimulation (rTMS) shows promise for treating Autism Spectrum Disorder (ASD), but its impact on the temporal dynamics of large-scale brain networks remains unclear. This study investigated the modulatory effects of rTMS on static and dynamic brain functional networks in children with ASD. Thirty-two children were randomized into an active rTMS group (1 Hz over the dorsolateral prefrontal cortex) and a sham control group. Resting-state EEG and behavioral assessments were conducted before and after a 9-week intervention. We employed a multi-dimensional analysis approach, combining microstate temporal parameters, static functional connectivity based on the weighted Phase Lag Index (wPLI), and dynamic complexity measured by Fuzzy Entropy. Results indicated that intrinsic features of Microstate B were significantly correlated with social relating deficits. Although rTMS did not induce significant interaction effects in standard microstate temporal parameters, it significantly enhanced static functional connectivity strength and increased the dynamic complexity of brain networks across all microstates. These findings suggest that rTMS exerts its therapeutic effects by strengthening network integration and restoring neural flexibility rather than simply altering the duration of brain states. The study underscores the value of network-based EEG metrics in elucidating the neuroplastic changes induced by neuromodulation in ASD.

References

1. 1.Kang, J., Wu, J., Li, Y., Mao, W., Li, X., Zhou, T., & Chen, H. (2026). rTMS modulates static and dynamic brain functional networks in children with autism spectrum disorder: An EEG microstate study. Brain Topography. https://doi.org/10.1001/jama.2013.281053