Prefrontal Neuromodulation Using rTMS Improves Error Monitoring and Correction Function in Autism |
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Authors: | Estate M Sokhadze Joshua M Baruth Lonnie Sears Guela E Sokhadze Ayman S El-Baz Manuel F Casanova |
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Institution: | (1) Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40202, USA;(2) Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA;(3) Department of Psychology and Brain Sciences, University of Louisville, Louisville, KY, USA;(4) Department of Bioengineering, University of Louisville, Louisville, KY, USA |
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Abstract: | One important executive function known to be compromised in autism spectrum disorder (ASD) is related to response error monitoring
and post-error response correction. Several reports indicate that children with ASD show reduced error processing and deficient
behavioral correction after an error is committed. Error sensitivity can be readily examined by measuring event-related potentials
(ERP) associated with responses to errors, the fronto-central error-related negativity (ERN), and the error-related positivity
(Pe). The goal of our study was to investigate whether reaction time (RT), error rate, post-error RT change, ERN, and Pe will
show positive changes following 12-week long slow frequency repetitive TMS (rTMS) over dorsolateral prefrontal cortex (DLPFC)
in high functioning children with ASD. We hypothesized that 12 sessions of 1 Hz rTMS bilaterally applied over the DLPFC will
result in improvements reflected in both behavioral and ERP measures. Participants were randomly assigned to either active
rTMS treatment or wait-list (WTL) groups. Baseline and post-TMS/or WTL EEG was collected using 128 channel EEG system. The
task involved the recognition of a specific illusory shape, in this case a square or triangle, created by three or four inducer
disks. ERN in TMS treatment group became significantly more negative. The number of omission errors decreased post-TMS. The
RT did not change, but post-error RT became slower. There were no changes in RT, error rate, post-error RT slowing, nor in
ERN/Pe measures in the wait-list group. Our results show significant post-TMS differences in the response-locked ERP such
as ERN, as well as behavioral response monitoring measures indicative of improved error monitoring and correction function.
The ERN and Pe, along with behavioral performance measures, can be used as functional outcome measures to assess the effectiveness
of neuromodulation (e.g., rTMS) in children with autism and thus may have important practical implications. |
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