Objective. To assess the utility of the modulation of motor cortex (M1) excitability by continuous theta-burst stimulation (cTBS) as a physiologic biomarker for adults with autism spectrum disorder (ASD), and to evaluate the influences of brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) polymorphisms on cTBS aftereffects. Methods. 44 neurotypical individuals (NT; age 21-65, 34 males) and 19 age-matched adults with high-functioning ASD (age 21-58, 17 males) underwent M1 cTBS. Cortico-motor reactivity was assessed before cTBS and thereafter every 5-10 minutes for 60 minutes (T5-T60). Results. Logistic regressions found cTBS-induced change in amplitude of motor evoked potentials (ΔMEP) at T15 was a significant predictor of ASD diagnosis (p=0.04). ΔMEP at T15 remained a significant predictor of diagnosis among BDNF Met+ subjects and APOEε4- subjects (p-values < 0.05) but not BDNF Met- subjects. ΔMEP at T30 was the best predictor of diagnosis among APOEε4+ subjects (p = 0.08). Conclusions. We confirm previous findings on the utility of cTBS measures of plasticity for adults with ASD, and we find the diagnostic utility of cTBS is modulated by BDNF and APOE SNPs. Significance. It is important to control for BDNF and APOE polymorphisms when comparing TBS aftereffects in ASD and NT individuals.

中文翻译：

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成人自闭症谱系障碍患者持续不断的theta-burst刺激对运动皮层兴奋性的调节作用：BDNF和APOE多态性的作用

目的。评估通过持续θ-爆发刺激（cTBS）调节运动皮质（M1）兴奋性作为自闭症谱系障碍（ASD）成人的生理生物标志物的作用，并评估脑源性神经营养因子（BDNF）的影响）和载脂蛋白E（APOE）多态性对cTBS的后效应。方法。M1 cTBS患者为44例神经典型个体（NT； 21-65岁，男34例）和19位年龄相匹配的具有高功能ASD的成年人（21-58岁，男17例）。在进行cTBS之前，然后每5-10分钟进行60分钟（T5-T60），评估皮质运动反应性。结果。Logistic回归发现，cTBS诱导的T15时运动诱发电位幅度（ΔMEP）的变化是ASD诊断的重要预测指标（p = 0.04）。T15时的ΔMEP仍然是BDNF Met +受试者和APOEε4-受试者（p值<0.05）而非BDNF Met-受试者诊断的重要预测指标。T30时的ΔMEP是APOEε4+受试者中诊断的最佳预测因子（p = 0.08）。结论。我们证实了先前关于cTBS对成人ASD的可塑性测量的效用的发现，并且我们发现cTBS的诊断效用受到BDNF和APOE SNP的调节。意义。比较ASD和NT个体的TBS后效应时，控制BDNF和APOE多态性非常重要。并且我们发现cTBS的诊断功能受BDNF和APOE SNP的调节。意义。比较ASD和NT个体的TBS后效应时，控制BDNF和APOE多态性非常重要。并且我们发现cTBS的诊断功能受BDNF和APOE SNP的调节。意义。比较ASD和NT个体的TBS后效应时，控制BDNF和APOE多态性非常重要。