Meds don’t treat autism’s core symptoms. Brain stimulation might.
STUDY: https://doi.org/10.1038/s41380-026-03596-2
STUDY TYPE: Randomized, double-blind, sham-controlled trial
FUNDING: Changping Laboratory, Beijing Bytedance Foundation, China Disabled Persons’ Federation
Background
No medication improves the core symptoms of autism, and it’s not clear that transcranial magnetic stimulation (TMS) does either. Early metaanalyses were positive, but a recent one came up null. So this new trial, with a robust design, is a step forward.
The Study
This trial tested intermittent theta burst stimulation (iTBS), a version of TMS that delivers the magnetic pulse over a briefer period. The magnet targeted the fronto-parietal network, and fMRI was used to target the area more accurately.
Sixty-seven children and adults with ASD (ages 6–30, all with cognitive or adaptive delays) were randomized 2:1 to active or sham (fake) iTBS over 12 weeks. Each day included three stimulation sessions totaling 5,400 pulses, interspersed with behavioral therapy.
Responses built gradually over 12 weeks, and by trial end the response rates were 55% for iTBS vs. 29% for sham, a moderate effect size (0.53) on the autism severity scale (ADOS-2). Responses were slightly greater with more profound autism, and that group showed language gains as well.
Side effects were mild: local pain in 5%, no seizures, no treatment discontinuations.
Practice Implications
- This study may tip the evidence in favor of TMS for autism, but more data is needed to figure out whether it works and the best way to deliver it.
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
