Patients with autism spectrum disorder (ASD) are at high risk for comorbid major depressive disorder (MDD), which can severely impair functioning and quality of life. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique, which is Food and Drug Administration (FDA) cleared for the treatment of MDD in adults. Despite demonstrated efficacy in the treatment of depression, there are limited data on the use of rTMS in patients with ASD and comorbid MDD. We hypothesized that a standard rTMS protocol for MDD would reduce depressive symptoms for adults with ASD and MDD. Secondarily, we investigated whether this treatment would also reduce core ASD symptoms. Participants of 18–65 years old with ASD and MDD without any medication changes in the last month were eligible for this open‐label trial. Participants underwent 25 sessions of rTMS (figure‐of‐eight coil, 100–120% resting motor threshold, 10 Hz, 3,000 pulses per session) applied to the left dorsolateral prefrontal cortex. Thirteen participants enrolled in the study, with two withdrawing due to tolerability, and one excluded from analysis. Overall, side effects were mild and rTMS was well tolerated. The Hamilton rating scale for depression (HAM‐D₁₇) improved 13.5 points (IQR 5–15), and 40% of participants achieved remission (HAM‐D₁₇ ≤ 7) after rTMS treatment. Informant clinical scales of core symptoms of autism also suggested improvement with rTMS, though no change was observed by the participants themselves. Thus, this open‐label trial suggests that high‐frequency rTMS is well tolerated by adults with autism and MDD, with improvement in depressive symptoms and possible effects on core autism symptoms. Autism Res 2020, 13: 346–351. © 2020 International Society for Autism Research,Wiley Periodicals, Inc.

中文翻译：

---

使用经颅磁刺激治疗患有自闭症和重度抑郁症的成年人：一项开放标签试点研究。

自闭症谱系障碍 (ASD) 患者患重度抑郁症 (MDD) 的风险很高，这会严重损害功能和生活质量。重复经颅磁刺激 (rTMS) 是一种非侵入性脑刺激技术，食品和药物管理局 (FDA) 已批准用于治疗成人 MDD。尽管已证明在治疗抑郁症方面有效，但关于在 ASD 和共病 MDD 患者中使用 rTMS 的数据有限。我们假设针对 MDD 的标准 rTMS 协议会减少患有 ASD 和 MDD 的成年人的抑郁症状。其次，我们调查了这种治疗是否也会减少核心 ASD 症状。18-65 岁患有 ASD 和 MDD，在上个月没有任何药物改变的参与者有资格参加这项开放标签试验。参与者接受了 25 次应用于左侧背外侧前额叶皮层的 rTMS（8 字形线圈，100-120% 静息运动阈值，10 Hz，每次 3,000 次脉冲）。13 名参与者参加了这项研究，其中两名因耐受性退出，一名被排除在分析之外。总的来说，副作用轻微且 rTMS 耐受性良好。汉密尔顿抑郁量表（HAM-D₁₇ ) 改善了 13.5 分 (IQR 5-15)，40% 的参与者 在 rTMS 治疗后达到缓解 (HAM-D _{17 ≤ 7)。}自闭症核心症状的临床量表也表明 rTMS 有所改善，但参与者自己没有观察到任何变化。因此，这项开放标签试验表明，患有自闭症和重度抑郁症的成年人对高频 rTMS 的耐受性良好，可以改善抑郁症状，并可能对核心自闭症症状产生影响。自闭症研究2020，13：346–351。© 2020 国际自闭症研究协会，Wiley Periodicals, Inc.