Imagine reaching deep into the skull, touching the brain, and fixing the parts that aren't working right. For some people with autism, a TMS/autism combination seems to achieve that goal.
TMS, or transcranial magnetic stimulation, involves the application of electromagnetic fields to stimulate brain cells. It's an experimental autism therapy in 2020. If you're considering it, you must weigh the pros and cons carefully.
What Is TMS?
TMS is a painless, noninvasive therapy performed in a doctor's office by trained professionals. You can't use the treatment at home, and at the moment, you can't use it as an approved form of autism treatment.
TMS devices have standard components, including:
- Capacitors. These devices store energy.
- Controllers. Switchboards control when energy is released and how much moves out.
- Conductive devices. These handheld elements allow for direct application of electricity.
During a session, you sit quietly while a doctor waves the device around your head. Currents flow from the device into your scalp, past your skull, and into your brain cells. They respond to the energy by moving or heating up. This added activity should help to awaken sleepy or malfunctioning portions of your brain, and that could help to improve your mood, enhance your behavior, or both.
The average brain has about 120 billion neurons, and they send and receive information as electrical impulses. Researchers use electrical studies to understand what part of your brain is at work during common activities. If you're wired to their equipment, for example, they might ask you to read, and they will watch their panels to see what part of your brain lights up.
Only recently have researchers taken this idea further. Now, rather than just watching the currents flash by, they'd like to apply electrical activity to your brain and see what happens.
Given that autism is a developmental disorder that causes brain changes, it makes sense that electrical stimulation could change the course of the disease. But there's still a lot we don't know about transcranial magnetic stimulation and how it works in people with autism.
Does a TMS/Autism Combination Make Sense?
TMS treatment isn't new. Doctors have used electricity to study and treat the brain for decades. But a book published in 2016 about TMS and autism caused quite a stir. After reading it, many people wanted to try the technique to see if it would help their autism.
Studies, including one published in 2019, seem enticing. Researchers find that using electricity on brain cells of people with autism could reduce troublesome symptoms such as:
Unfortunately, these studies come with significant drawbacks, explains Autism Speaks, such as:
- Small numbers. Tiny sample sizes of just a dozen or so people don't give researchers a lot of data about how the treatment really works.
- Limited inclusion. Researchers focus on subgroups, such as men with autism. It's unclear how the therapy works in other people, such as women or children.
- Dosage data. How much TMS do people need before they see results? Researchers haven't considered that point yet.
- Location details. Where should doctors aim their wands to deliver the most benefit? How do people getting therapy in one spot compare to those working in another spot? Researchers don't know.
- Placebo effect. Few studies split people into treatment/placebo groups. Everyone who signs up gets TMS. Studies like this make assumptions difficult.
Studies are published every day, and it's quite possible that one talented researcher will crack the code tomorrow and detail just how transcranial magnetic stimulation works in the brain of someone with autism. For now, in 2020, the work remains incomplete.
TMS & Other Illnesses
Research on transcranial magnetic stimulation and other forms of mental illness is different. In fact, efficacy data is so strong that the U.S. Food and Drug Administration (FDA) has approved TMS as an intervention for obsessive-compulsive disorder (OCD) and major depression. Doctors can also use TMS as a therapy for some types of migraine headaches.
FDA approval is critical. With it, patients can petition their insurance companies for payment. If authorities recognize the efficacy, they reason, companies should pay for their care. Often, patients win these arguments.
Even though TMS isn't an approved autism therapy, some people with autism may benefit from this treatment.
For example, in a small study of 13 adults with depression and autism, 70% had a decrease in depression symptoms, and a full 40% had depression remission. The participants said their autism symptoms were the same, although their friends and family members disagreed and said they did see autism changes.
Depression is a serious illness, and researchers say it's hard to both identify and treat in people with autism. Your symptoms might be chalked up to autism, or you might not be able to express how you feel and how well therapies work.
If you have autism and depression, or you have autism and OCD, adding TMS to your treatment plan might be wise. If these co-existing conditions come under control, you might:
- Participate in autism therapy more effectively. Treatments such as applied behavior analysis (ABA) require plenty of practice and hard work. Depression could thwart those plans. If TMS eases depression, you could get more benefit from each ABA therapy session.
- Feel less stigmatized. Depression forces social isolation, and each tough day puts a larger distance between you and others. If symptoms ease, you could reach out for help from others.
- Focus clearly on autism. It's hard to address multiple issues at the same time. Soothing one illness could help you put your efforts into autism alone.
Only your doctor can tell you if transcranial magnetic stimulation is a wise addition to your treatment plan. For some people with autism and another condition, it can be quite helpful. Talk to your doctor about your particular situation and whether it is a good choice.
When Will the TMS/Autism Benefits Become Clear?
Researchers won't say that transcranial magnetic stimulation doesn't help people with autism. Instead, they say they need to do more work to understand how electrical stimulation changes an autistic brain. The research timeline isn't firm.
In 2016, researchers started asking one another when they thought the answers would become clear. They're still not sure. They say they need more time to determine:
- Which brain region should be a therapeutic focus.
- What type of machine and conductive device work best.
- How much electrical stimulation should be applied in each session.
Some families don't wait to wait for those research results. They'd like to know more about TMS and autism right now, and they're willing to visit clinics to ask for that information.
Using TMS for autism right now comes with risks, including:
- High cost. You'll probably have to pay for the treatment yourself, even if you have insurance.
- Worsening symptoms. Use the wrong type of machine or stimulate the wrong portion of the brain, and your autism symptoms could worsen.
- Reduced effectiveness. A clinician who plays it safe could give you weak treatments that don't help. You may end up paying a lot for treatments that give few, or even no, results.
TMS isn't your only autism therapy option. Counseling, behavior therapy, physical therapy, occupational therapy, and speech therapy are all proven autism interventions that may ease symptoms and soothe difficulties. Before you leap into treatments that might be ineffective and/or expensive, try the treatments experts recommend.
While experimental treatments can be tempting, they should never be used in place of traditional, evidence-based autism treatments.
Behavior therapy, specifically applied behavior analysis (ABA) therapy, is the backbone of autism treatment. It has been proven to be successful in reducing autism symptoms and improving positive behavior. Make this kind of care the foundation of your treatment plan.
Use of Transcranial Magnetic Stimulation in Autism Spectrum Disorders. (February 2016). Journal of Autism and Developmental Disorders.
A New Way to Capture the Brain's Electrical Symphony. (September 2018). Nature.
Transcranial Magnetic Stimulation Shows Promise in Autism Spectrum Disorder. (July 2017). Clinical Psychiatry News.
Transcranial Magnetic Stimulation for Autism: Evidence of Benefit? (March 2016). Autism Speaks.
FDA Permits Marketing of Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder. (August 2018). U.S. Food and Drug Administration.
TMS Shows Promise as Treatment for Adults With Both Depression and Autism. (April 2020). News-Medical.net.
Challenges in the Diagnosis and Treatment of Depression in Autism Spectrum Disorders Across the Lifespan. (June 2015). Dialogues in Clinical Neuroscience.
How Likely Is It That TMS Will Be Approved by FDA for Treatment of Autism Within a Decade? (April 2016). ResearchGate.
Magnetic Promise: Can Brain Stimulation Treat Autism? (September 2015). Spectrum.
Experimental Autism Treatments Put to Test in Real World. (January 2017). Spectrum.