Zhongguo quanke yixue (Apr 2023)

Effect of Non-invasive Brain Stimulation on Autism Spectrum Disorder: a Systematic Review and Network Meta-analysis

  • LI Lingling, HUANG Hailiang, YU Ying, JIA Yuqi, LIU Zhiyao, SHI Xin, WANG Fangqi, LIU Xinyue

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0675
Journal volume & issue
Vol. 26, no. 11
pp. 1389 – 1397

Abstract

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Background Previous studies have shown various improvement effects of non-invasive brain stimulation (NIBS) on autism spectrum disorder (ASD), and there is a lack of comparison of the efficacy of different types of NIBS. Objective To systematically evaluate the effect of NIBS on ASD, and to compare the curative effects of two types of NIBS. Methods Randomized controlled trials (RCTs) about the effect of NIBS on ASD〔both experimental and control groups received conventional treatments, and the experimental group additionally received transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) 〕 were retrieved from databases of PubMed, Embase, Cochrane Library, Scopus, Web of Science, CNKI, Wanfang Data, CQVIP, and SinoMed from inception to December 2021. Two researchers independently implemented literature screening and data extraction, and used the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0) to assess the risk of bias of the included studies. The statistical analysis was performed using RevMan 5.3 and R 4.0.2. Results Ultimately, 22 studies involving 661 patients were included. Meta-analysis showed that NIBS could reduce Autism Behavior Checklist (ABC) score 〔MD=-8.80, 95%CI (-10.98, -6.62), P<0.05〕, Childhood Autism Rating Scale score〔MD=-2.93, 95%CI (-3.63, -2.24), P<0.05〕, Autism Treatment Evaluation Checklist score〔MD=-9.13, 95%CI (-12.79, -5.47), P<0.05〕, Self-rating Anxiety Scale score〔MD=-7.20, 95%CI (-10.55, -3.85), P<0.05〕, Self-rating Depression Scale score〔MD=-8.89, 95%CI (-13.21, -4.57), P<0.05〕 and mismatch negativity latency period 〔MD=-5.97, 95%CI (-9.42, -2.53), P<0.05〕, and increase development quotient score 〔MD=5.22, 95%CI (3.41, 7.04), P<0.05〕 and mismatch negativity amplitude〔MD=1.54, 95%CI (0.57, 2.51), P<0.05〕. No obvious asymmetry was detected in the inverted funnel plot measuring publication bias, but could not exclude the potential for publication bias. Network meta-analysis showed that the best probabilistic ranking of the effects of two different NIBS on the ABC score is tDCS (P=0.931) >rTMS (P=0.069) . Conclusion Existing evidence shows that NIBS can improve ASD, and the effect of tDCS is better than that of rTMS.

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