Treatment of Adults with Autism and Major Depressive Disorder Using Transcranial Magnetic Stimulation: An Open Label Pilot Study.
Daily magnetic pulses over the left forehead eased depression in autistic adults without harsh side effects.
01Research in Context
What this study did
Ten adults with autism and major depression got 25 sessions of high-frequency magnetic brain pulses. The coil sat over the left side of their forehead each weekday for five weeks. Doctors tracked mood and autism signs before and after the full course. No control group, just the same people compared to themselves.
What they found
Depression scores dropped enough that most people felt real relief. Parents and staff also saw small gains in social and repetitive behaviors. No one quit because of side effects; headaches were mild and faded fast. The team called it safe, doable, and worth a bigger test.
How this fits with other research
Hsing-Liu et al. (2025) moved the same kind of brain buzz down to younger kids who speak little or not at all. They proved it was safe, yet saw no mood or skill gains—showing age and diagnosis may decide who benefits.
Panerai et al. (2014) tried a short burst of the same pulses over a motor spot in low-talking children. Eye-hand play got better for an hour, hinting that where you aim the coil changes what improves.
Zemestani et al. (2022) used a gentler zap called tDCS on both sides of the forehead in 7- to 12-year-olds. Communication and emotion control rose, backing the idea that waking up the front of the brain helps autistic people—just in different ways at different ages.
Why it matters
If you serve verbal adults who carry both autism and depression, rTMS is now a low-risk option to discuss with their doctor. You can keep measuring mood each week while they attend sessions. Until larger trials appear, pair this tool with your usual behavior plans and watch for the small social gains parents noticed.
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02At a glance
03Original abstract
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. LAY SUMMARY: This study evaluated the safety and effects of repetitive transcranial magnetic stimulation (rTMS) on depression and autism symptoms in individuals with both major depressive disorder and autism spectrum disorder. rTMS was well tolerated by the participants, depression improved with treatment, and family members' assessment of autism symptoms improved as well. This study supports the need for further work to evaluate rTMS in individuals who have both autism and depression.
Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2266