Poster No:
130
Submission Type:
Abstract Submission
Authors:
Yating Ming1, Jinming Xiao1, Lei Li1, Xujun Duan2
Institutions:
1University of Electronic Science and Technology of China, Chengdu, Sichuan, 2UESTC, Chengdu, Sichuan
First Author:
Yating Ming
University of Electronic Science and Technology of China
Chengdu, Sichuan
Co-Author(s):
Jinming Xiao
University of Electronic Science and Technology of China
Chengdu, Sichuan
Lei Li
University of Electronic Science and Technology of China
Chengdu, Sichuan
Introduction:
Transcranial Magnetic Stimulation (TMS), a non-invasive neuromodulation technique, shows promise in alleviating severe core symptoms of Autism Spectrum Disorder (ASD). Conventional TMS interventions, with fixed stimulation targets, overlook the heterogeneity in the ASD community. To address this, we propose an individualized approach based on amygdala functional connectivity for optimized stimulation targets. A clinical double-blind randomized controlled trial revealed significant improvements with 20 sessions of continuous theta-burst stimulation (cTBS) in the Amygdala-Optimized Functional Connectivity (AOFC) group. Previous research suggests electrophysiological effects of TMS reach deep nuclei via bundles, but specifics involved bundles, impacted nuclei, and their correlation with therapeutic outcomes remain unclear.
Methods:
Forty-four children with ASD were randomly assigned to AOFC and NO groups. After excluding incomplete sessions or poor T1 and diffusion-weighted image quality, 32 subjects underwent data analysis. Initial diffusion data preprocessing included head motion denoising, Gibbs artifacts removal, and bias field correction through FSL. Non-diffusion weighted reference images were registered to corresponding T1 weighted images, and the displacement field was applied to other diffusion weighted images. T1 weighted images were segmented using Freesurfer for fiber tracking and constructing a fiber structural network through MRtrix. Graph theory analysis and tract-based morphometry detected changes influenced by TMS in the global and local structural network and specific fiber bundles. Further investigation explored changes in the amygdala-seed structural network pre- and post-intervention.
Results:
Global and local efficiency of the structural network and hippocampuslocal efficiency significantly improved in the AOFC group (P_{FDR}<0.05), along with enhanced small-world properties, while these results were not observed in the NO group. Additionally, the AOFC group exhibited increased diameter, volume, and total surface area of the left arcuate fasciculus fiber, as well as the mean length of the superior longitudinal fasciculus fiber (P_{FDR}<0.05). In contrast, the NO group showed increased fractional anisotropy (FA) in several fibers, particularly the posterior corticostriatal tract (P_{FDR}<0.05). Moreover, the mean length of the superior longitudinal fasciculus was significantly correlated with the symptomatic improvement level in the AOFC group (R^2=0.48, P_{FDR}<0.05), with no similar findings in the NO group. Lastly, the investigation of amygdala-seed structural network changes in the AOFC group revealed a significant increase in FA between the anterior transverse temporal gyrus and the amygdala (P_{FDR}<0.05).
Conclusions:
Our study introduced personalized precision targeting, revealing distinct effects on deep nuclei compared to traditional TMS. Optimizing the amygdala target enhanced brain-wide influence from the DLPFC, significantly correlating with the superior longitudinal fasciculus length and therapeutic outcomes. This influence extended to the amygdala's connectivity network, particularly in the anterior transverse temporal gyrus region.
Brain Stimulation:
TMS 1
Disorders of the Nervous System:
Neurodevelopmental/ Early Life (eg. ADHD, autism) 2
Modeling and Analysis Methods:
Diffusion MRI Modeling and Analysis
Physiology, Metabolism and Neurotransmission :
Neurophysiology of Imaging Signals
Keywords:
Autism
Transcranial Magnetic Stimulation (TMS)
White Matter
Other - Graph Theory Analysis; Tract-based Morphometry Analysis
1|2Indicates the priority used for review
Provide references using author date format
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