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Transcranial direct current stimulation (tDCS) as an add-on treatment for restricted repetitive behaviors in autism spectrum disorder - An open-label prospective feasibility study.

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Τίτλος: Transcranial direct current stimulation (tDCS) as an add-on treatment for restricted repetitive behaviors in autism spectrum disorder - An open-label prospective feasibility study.
Συγγραφείς: Atmaram SK; Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India., Manohar H; Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India. Electronic address: harshinimanohar1990@gmail.com., Pathak H; Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India., Sreeraj VS; Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India., Venkatasubramanian G; Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India., Kommu JVS; Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India.
Πηγή: Psychiatry research [Psychiatry Res] 2026 Oct; Vol. 364, pp. 117321. Date of Electronic Publication: 2026 Jul 01.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Ireland NLM ID: 7911385 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7123 (Electronic) Linking ISSN: 01651781 NLM ISO Abbreviation: Psychiatry Res Subsets: MEDLINE
Imprint Name(s): Publication: Limerick : Elsevier/North-Holland Biomedical Press
Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press.
Ιατρικοί όροι (MeSH): Transcranial Direct Current Stimulation*/methods , Executive Function*/physiology , Autism Spectrum Disorder*/therapy , Autism Spectrum Disorder*/complications , Stereotyped Behavior*/physiology, Humans ; Adolescent ; Feasibility Studies ; Female ; Male ; Prospective Studies ; Child ; Treatment Outcome ; Dorsolateral Prefrontal Cortex
Περίληψη: Introduction: Restricted and repetitive behaviors (RRBs) among autistic individuals can lead to significant distress and functional impairment and may include self-injurious behaviors. The study aimed to assess the feasibility, tolerability, and impact of transcranial direct current stimulation (tDCS) on RRBs and executive functioning.
Methods: We conducted an open-label feasibility trial of add-on tDCS involving 10 sessions of anodal stimulation over the left dorsolateral prefrontal cortex and cathodal stimulation over the supplementary motor area in autistic adolescents with clinically significant and/or dysfunctional RRBs. RRBs were assessed using the Repetitive Behavior Scale-Revised (RBS-R), and executive functioning using the Behavior Rating Inventory of Executive Function-2nd edition (BRIEF-2)-parent report. Data were analysed using linear mixed-effect models.
Results: The intervention was feasible, with 16 of 17 adolescents completing the protocol and follow-up assessments. No serious adverse effects were reported. At 1-week post-intervention, there was a significant reduction in RBS-R overall scores (β = -4.00, p < 0.001, ES = -1.60, 95% CI = -2.43, -0.78), with further improvement at 1-month (β = -7.13, p < .001, ES= -2.85, 95% CI = -3.81, -1.90), and sustained effects at 3-months (β = -7.00, p < .001, ES= -2.80, 95% CI = -3.77, -1.84). Executive functioning also showed significant improvement at 1- and 3-months.
Conclusion: These preliminary findings suggest that add-on tDCS may improve RRBs and executive functioning in autistic adolescents. The large ES warrants cautious interpretation, given the open-label design, reliance on parent-rated measures, small sample size, and needs to be examined in randomised controlled designs.
(Copyright © 2026 Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no financial or non-financial conflicts of interest related to this study.
Contributed Indexing: Keywords: Adolescent; Autism spectrum disorder; Executive function; RRBs; Stereotyped behavior; Transcranial direct current stimulation
Entry Date(s): Date Created: 20260708 Date Completed: 20260810 Latest Revision: 20260810
Update Code: 20260811
DOI: 10.1016/j.psychres.2026.117321
PMID: 42418906
Βάση Δεδομένων: MEDLINE
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  Data: Transcranial direct current stimulation (tDCS) as an add-on treatment for restricted repetitive behaviors in autism spectrum disorder - An open-label prospective feasibility study.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Atmaram+SK%22&quot;&gt;Atmaram SK&lt;/searchLink&gt;; Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Manohar+H%22&quot;&gt;Manohar H&lt;/searchLink&gt;; Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India. Electronic address: harshinimanohar1990@gmail.com.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Pathak+H%22&quot;&gt;Pathak H&lt;/searchLink&gt;; Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Sreeraj+VS%22&quot;&gt;Sreeraj VS&lt;/searchLink&gt;; Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Venkatasubramanian+G%22&quot;&gt;Venkatasubramanian G&lt;/searchLink&gt;; Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kommu+JVS%22&quot;&gt;Kommu JVS&lt;/searchLink&gt;; Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hombegowda Nagar, Hosur Road, Bengaluru, India.
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  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Transcranial+Direct+Current+Stimulation%22&quot;&gt;Transcranial Direct Current Stimulation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Transcranial+Direct+Current+Stimulation+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Executive+Function%22&quot;&gt;Executive Function*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Executive+Function+physiology%22&quot;&gt;physiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder%22&quot;&gt;Autism Spectrum Disorder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder+therapy%22&quot;&gt;therapy&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder%22&quot;&gt;Autism Spectrum Disorder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder+complications%22&quot;&gt;complications&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Stereotyped+Behavior%22&quot;&gt;Stereotyped Behavior*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Stereotyped+Behavior+physiology%22&quot;&gt;physiology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Adolescent%22&quot;&gt;Adolescent&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Feasibility+Studies%22&quot;&gt;Feasibility Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Prospective+Studies%22&quot;&gt;Prospective Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Child%22&quot;&gt;Child&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Treatment+Outcome%22&quot;&gt;Treatment Outcome&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Dorsolateral+Prefrontal+Cortex%22&quot;&gt;Dorsolateral Prefrontal Cortex&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
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  Data: Introduction: Restricted and repetitive behaviors (RRBs) among autistic individuals can lead to significant distress and functional impairment and may include self-injurious behaviors. The study aimed to assess the feasibility, tolerability, and impact of transcranial direct current stimulation (tDCS) on RRBs and executive functioning.&lt;br /&gt;Methods: We conducted an open-label feasibility trial of add-on tDCS involving 10 sessions of anodal stimulation over the left dorsolateral prefrontal cortex and cathodal stimulation over the supplementary motor area in autistic adolescents with clinically significant and/or dysfunctional RRBs. RRBs were assessed using the Repetitive Behavior Scale-Revised (RBS-R), and executive functioning using the Behavior Rating Inventory of Executive Function-2nd edition (BRIEF-2)-parent report. Data were analysed using linear mixed-effect models.&lt;br /&gt;Results: The intervention was feasible, with 16 of 17 adolescents completing the protocol and follow-up assessments. No serious adverse effects were reported. At 1-week post-intervention, there was a significant reduction in RBS-R overall scores (β = -4.00, p &amp;lt; 0.001, ES = -1.60, 95% CI = -2.43, -0.78), with further improvement at 1-month (β = -7.13, p &amp;lt; .001, ES= -2.85, 95% CI = -3.81, -1.90), and sustained effects at 3-months (β = -7.00, p &amp;lt; .001, ES= -2.80, 95% CI = -3.77, -1.84). Executive functioning also showed significant improvement at 1- and 3-months.&lt;br /&gt;Conclusion: These preliminary findings suggest that add-on tDCS may improve RRBs and executive functioning in autistic adolescents. The large ES warrants cautious interpretation, given the open-label design, reliance on parent-rated measures, small sample size, and needs to be examined in randomised controlled designs.&lt;br /&gt; (Copyright &#169; 2026 Elsevier B.V. All rights reserved.)
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  Data: Declaration of competing interest The authors declare that they have no financial or non-financial conflicts of interest related to this study.
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Adolescent; Autism spectrum disorder; Executive function; RRBs; Stereotyped behavior; Transcranial direct current stimulation
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        Text: English
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