Clinical Trial Examines TPS in Autism Spectrum Disorders

Transcranial Pulse Stimulation (TPS) as a possible treatment option also for autism

Autism spectrum disorders (ASD) are neurodevelopmental abnormalities. They are manifested by impaired social interactions and communication skills, repetitive behaviors, and stereotyped patterns. In addition, mental development may be irregular and in some cases may be associated with intellectual impairment. The first signs appear in early childhood. For people with autism, situations that overwhelm them – and that may not be recognized by outsiders – can lead to intense and sometimes prolonged crises. These can take the form of anxiety and panic attacks, complete paralysis in their actions, withdrawal from social relationships, depression, personality problems, burnout, or even aggression toward self or others.

According to estimates, autism spectrum disorders affect at least 1 percent of the population in Germany as well as in the USA, and around 0.4 percent in the Asian region. The prevalence rates show an upward trend. However, it remains an open question whether the cases of the disorder are actually increasing or whether improved diagnostics are the reason for the rising ASD numbers.

The exact underlying pathophysiology of ASD remains unknown. An effective and specific pharmacological treatment for the core symptoms of ASD remains unavailable. Therefore, new treatment options that are effective and well tolerated for children are needed.

University of Hong Kong: Significant Results of TPS Influence in ASA

A double-blind, randomized, sham-controlled study conducted by the Hong Kong Polytechnic University has now investigated whether the neuromodulation procedure transcranial pulse stimulation (TPS) can also be used as an additive therapy procedure for autism spectrum disorders as it is for Alzheimer’s disease and other neurological as well as neuropsychiatric disorders, which are being researched in terms of the mode of action and safety of TPS shock waves.

The aim of the study was to investigate the efficacy and tolerability of TPS in young adolescents with ASD and to analyze the effects of Transcranial Pulse Stimulation (TPS) on the right temporoparietal junction – a central point for social cognition processes in autism spectrum disorders. In addition, the relationship between TPS and executive and social skills was investigated.

In this double-blind, randomized, placebo-controlled study, 32 subjects (including 27 males) aged 12 to 17 years with autism spectrum disorder were screened. Based on the Childhood Autism Rating Scale screening score, eligible participants were assigned in a 1:1 ratio to either the true treatment group or the Transcranial Pulse Stimulation (TPS) control group. Sixteen subjects received six real TPS applications (energy level: 0.2-0.25 mJ/mm2; frequency: 2.5-4.0 Hz, 800 pulses per session) on alternate days spread over the two-week period. The remaining 16 subjects received sham pulse stimulation.

Primary outcome measures included parent-rated changes on the Childhood Autism Rating Scale from baseline to follow-up three months later. Secondary outcomes included a parent-answered self-report questionnaire and cognitive tests answered by participant:s. Licensed mental health professionals assessed overall clinical impression, including severity, improvements noted, efficacy, and summarized results in an overall rating.

Results showed significant interactions in the Childhood Autism Rating Scale and other secondary outcomes. Significant group and time effects were found for most secondary outcomes. In addition, significant differences were found between the group with true TPS applications and the group with sham TPS treatment in terms of improvement in Childhood Autism Rating Scale and Clinical Overall Impression and Total Score immediately after 2 weeks of Transcranial Pulse Stimulation (all P < 0.05). Effects were sustained at one-month and three-month follow-up compared with baseline.

Encouraging: Transcranial Pulse Stimulation (TPS) was effective in reducing core symptoms of ASD

Childhood Autism Rating Scale effect size (d = 0.83-0.95) and overall clinical impression improvement (d = 4.12-4.37) were large to moderate immediately after intervention and persisted 1 month after shock wave stimulation; however, effects were small at 3 months after stimulation (d = 2.31). These results suggest that Transcranial Pulse Stimulation (TPS) over the right temporoparietal junction was effective in reducing core symptoms of autism spectrum disorder, as evidenced by a 24% reduction in total Childhood Autism Rating Scale score in the verum TPS group.

In addition, the total clinical impression score in the verum-TPS group decreased by 53.7 percent at the three-month follow-up compared with baseline. Participants in the verum-TPS group showed significant improvement at one- and three-month follow-up compared with baseline, although some of the neuropsychological test results were not found to be statistically significant.

Researchers recommend further studies to enable TPS as an additive therapy for ASD in the near future

The author:s led by lead study author Teris Cheung conclude that six TPS sessions are effective and well-tolerated for treating core symptoms in older children and adolescents with ASD. The researchers recommend that future replications of similar studies should include a larger sample from multiple countries to determine whether Transcranial Pulse Stimulation (TPS) could soon be considered as a top-on treatment for autism spectrum disorders in neuropsychiatry.

Link to the study:

Current studies on the non-invasive brain stimulation procedure Transcranial Pulse Stimulation (TPS) for various indications in neurology and psychiatry can be found here:

Transcranial Pulse Stimulation (TPS) – Studies