The Effects of Transcranial Direct Current Stimulation and Selective Motor Training on Fine Motor Skills in Children with Autism Spectrum Disorders

Document Type : Original Articles

Authors

1 PhD Student, Department of Physical Education, School of Humanities and Social Sciences, Islamic Azad University, Science and Research Branch, Tehran, Iran

2 Professor, Department of Physical Education, School of Sport Sciences, University of Isfahan, Isfahan, Iran

3 Associate Professor, Department of Physical Education, College of Sport Sciences, University of Tehran, Tehran, Iran

4 Associate Professor, Department of Children with Special Needs, School of Psychology, University of Isfahan, Isfahan, Iran

10.22122/jrrs.v13i1.2845

Abstract

Introduction: Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates motor performance and learning. Previous studies have shown that tDCS over the primary motor cortex (M1) can facilitate consolidation of various motor skills in healthy subjects; but the effect of tDCS on motor skills improvement in autism spectrum disorders (ASD) remains unknown. The aim of the current study was to examine the effects of anodal tDCS and selective motor training on fine motor skills in 6-14-year-old children with ASD.Materials and Methods: This was an experimental research with a pretest–posttest design. A total of eighteen children with ASD (age range 6-14 years) were selected according to available sampling and inclusion criteria and then were randomly divided to experimental and control group. Nine subjects received 1.5 mA anodal tDCS over the left M1 for 20 min before the training session and practiced motor training after tDCS to improve fine motor skills. The remaining 9 subjects underwent identical training sessions, except that tDCS was artificially applied for them (sham group). Fine motor skills were assessed at baseline (pre-intervention) and after 10 sessions (post-intervention).Results: Anodal tDCS and fine motor skill training have significant effects on fine motor skills in children with ASD (P < 0.05).Conclusion: Our findings suggest that tDCS may be considered as a useful adjunct to fine motor skill training for children with ASD, although studies in a larger group of children with varying levels of autistic traits and different stimulation polarity are needed to evaluate the functional use of non-invasive brain stimulation.

Keywords

  1. Lord C. The development of peer relations in children with autism. In: Morrison FJ, Lord C, Keating DP. Applied developmental psychology. New York, NY: Academic Press; 1984. p. 165-229.
  2. Wing L, Gould J. Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. J Autism Dev Disord 1979; 9(1): 11-29.
  3. Berkeley SL, Zittel LL, Pitney LV, Nichols SE. Locomotor and object control skills of children diagnosed with autism. Adapt Phys Activ Q 2001; 18(4): 405-16.
  4. Breslin CM, Rudisill ME. The effect of visual supports on performance of the TGMD-2 for children with autism spectrum disorder. Adapt Phys Activ Q 2011; 28(4): 342-53.
  5. Dziuk MA, Gidley Larson JC, Apostu A, Mahone EM, Denckla MB, Mostofsky SH. Dyspraxia in autism: Association with motor, social, and communicative deficits. Dev Med Child Neurol 2007; 49(10): 734-9.
  6. Liu T, Breslin CM. The effect of a picture activity schedule on performance of the MABC-2 for children with autism spectrum disorder. Res Q Exerc Sport 2013; 84(2): 206-12.
  7. Pan CY, Tsai CL, Chu CH. Fundamental movement skills in children diagnosed with autism spectrum disorders and attention deficit hyperactivity disorder. J Autism Dev Disord 2009; 39(12): 1694-705.
  8. Provost B, Heimerl S, Lopez BR. Levels of gross and fine motor development in young children with autism spectrum disorder. Phys Occup Ther Pediatr 2007; 27(3): 21-36.
  9. Staples KL, Reid G. Fundamental movement skills and autism spectrum disorders. J Autism Dev Disord 2010; 40(2): 209-17.
  10. Green D, Baird G, Barnett AL, Henderson L, Huber J, Henderson SE. The severity and nature of motor impairment in Asperger's syndrome: a comparison with specific developmental disorder of motor function. J Child Psychol Psychiatry 2002; 43(5): 655-68.
  11. Manjiviona J, Prior M. Comparison of Asperger syndrome and high-functioning autistic children on a test of motor impairment. J Autism Dev Disord 1995; 25(1): 23-39.
  12. Miyahara M, Tsujii M, Hori M, Nakanishi K, Kageyama H, Sugiyama T. Brief report: motor incoordination in children with Asperger syndrome and learning disabilities. J Autism Dev Disord 1997; 27(5): 595-603.
  13. Gowen E, Hamilton A. Motor abilities in autism: A review using a computational context. J Autism Dev Disord 2013; 43(2): 323-44.
  14. Mahajan R, Dirlikov B, Crocetti D, Mostofsky SH. Motor Circuit Anatomy in Children with Autism Spectrum Disorder With or Without Attention Deficit Hyperactivity Disorder. Autism Res 2016; 9(1): 67-81.
  15. Allen G, Courchesne E. Differential effects of developmental cerebellar abnormality on cognitive and motor functions in the cerebellum: an fMRI study of autism. Am J Psychiatry 2003; 160(2): 262-73.
  16. Theoret H, Halligan E, Kobayashi M, Fregni F, Tager-Flusberg H, Pascual-Leone A. Impaired motor facilitation during action observation in individuals with autism spectrum disorder. Curr Biol 2005; 15(3): R84-R85.
  17. Cornish KM, McManus IC. Hand preference and hand skill in children with autism. J Autism Dev Disord 1996; 26(6): 597-609.
  18. Fritsch B, Reis J, Martinowich K, Schambra HM, Ji Y, Cohen LG, et al. Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning. Neuron 2010; 66(2): 198-204.
  19. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 2000; 527 Pt 3: 633-9.
  20. Nitsche MA, Cohen LG, Wassermann EM, Priori A, Lang N, Antal A, et al. Transcranial direct current stimulation: State of the art 2008. Brain Stimul 2008; 1(3): 206-23.
  21. Antal A, Nitsche MA, Kincses TZ, Kruse W, Hoffmann KP, Paulus W. Facilitation of visuo-motor learning by transcranial direct current stimulation of the motor and extrastriate visual areas in humans. Eur J Neurosci 2004; 19(10): 2888-92.
  22. Kaski D, Dominguez RO, Allum JH, Bronstein AM. Improving gait and balance in patients with leukoaraiosis using transcranial direct current stimulation and physical training: an exploratory study. Neurorehabil Neural Repair 2013; 27(9): 864-71.
  23. Koyama S, Tanaka S, Tanabe S, Sadato N. Dual-hemisphere transcranial direct current stimulation over primary motor cortex enhances consolidation of a ballistic thumb movement. Neurosci Lett 2015; 588: 49-53.
  24. Kwon YH, Cho JS. Effect of transcranial direct current stimulation on movement variability in repetitive - simple tapping task. J Kor Phys Ther 2015; 27(1): 38-42.
  25. Lapenta OM, Minati L, Fregni F, Boggio PS. Je pense donc je fais: Transcranial direct current stimulation modulates brain oscillations associated with motor imagery and movement observation. Front Hum Neurosci 2013; 7: 256.
  26. Lee YS, Yang HS, Jeong CJ, Yoo YD, Jeong SH, Jeon OK, et al. The effects of transcranial direct current stimulation on functional movement performance and balance of the lower extremities. J Phys Ther Sci 2012; 24(12): 1215-8.
  27. Matsuo A, Maeoka H, Hiyamizu M, Shomoto K, Morioka S, Seki K. Enhancement of precise hand movement by transcranial direct current stimulation. Neuroreport 2011; 22(2): 78-82.
  28. Scocchia L, Bolognini N, Convento S, Stucchi N. Cathodal transcranial direct current stimulation can stabilize perception of movement: Evidence from the two-thirds power law illusion. Neurosci Lett 2015; 609: 87-91.
  29. Vines BW, Nair DG, Schlaug G. Contralateral and ipsilateral motor effects after transcranial direct current stimulation. Neuroreport 2006; 17(6): 671-4.
  30. D'Urso G, Bruzzese D, Ferrucci R, Priori A, Pascotto A, Galderisi S, et al. Transcranial direct current stimulation for hyperactivity and noncompliance in autistic disorder. World J Biol Psychiatry 2015; 16(5): 361-6.
  31. Schneider HD, Hopp JP. The use of the Bilingual Aphasia Test for assessment and transcranial direct current stimulation to modulate language acquisition in minimally verbal children with autism. Clin Linguist Phon 2011; 25(6-7): 640-54.
  32. Marchese R, Diverio M, Zucchi F, Lentino C, Abbruzzese G. The role of sensory cues in the rehabilitation of parkinsonian patients: a comparison of two physical therapy protocols. Mov Disord 2000; 15(5): 879-83.
  33. Duarte NA, Grecco LA, Galli M, Fregni F, Oliveira CS. Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PLoS One 2014; 9(8): e105777.
  34. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): Challenges and future directions. Brain Stimul 2012; 5(3): 175-95.
  35. Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators; Centers for Disease Control and Prevention (CDC).Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ 2014; 63(2): 1-21.
  36. Raven J. The Raven's progressive matrices: change and stability over culture and time. Cogn Psychol 2000; 41(1): 1-48.
  37. Henderson SE, Sugden DA, Barnett A. Movement assessment battery for children. London, UK: Pearson; 2007.
  38. Minhas P, Bikson M, Woods AJ, Rosen AR, Kessler SK. Transcranial direct current stimulation in pediatric brain: A computational modeling study. Conf Proc IEEE Eng Med Biol Soc 2012; 2012: 859-62.
  39. Horvath JC, Carter O, Forte JD. Transcranial direct current stimulation: five important issues we aren't discussing (but probably should be). Front Syst Neurosci 2014; 8: 2.
  40. Miyaguchi S, Onishi H, Kojima S, Sugawara K, Tsubaki A, Kirimoto H, et al. Corticomotor excitability induced by anodal transcranial direct current stimulation with and without non-exhaustive movement. Brain Res 2013; 1529: 83-91.
  41. Hadipour-Niktarash A, Lee CK, Desmond JE, Shadmehr R. Impairment of retention but not acquisition of a visuomotor skill through time-dependent disruption of primary motor cortex. J Neurosci 2007; 27(49): 13413-9.
  42. Hunter T, Sacco P, Nitsche MA, Turner DL. Modulation of internal model formation during force field-induced motor learning by anodal transcranial direct current stimulation of primary motor cortex. J Physiol 2009; 587(Pt 12): 2949-61.
  43. Stoit AM, van Schie HT, Slaats-Willemse DI, Buitelaar JK. Grasping motor impairments in autism: not action planning but movement execution is deficient. J Autism Dev Disord 2013; 43(12): 2793-806.
  44. Forti S, Valli A, Perego P, Nobile M, Crippa A, Molteni M. Motor planning and control in autism. A kinematic analysis of preschool children. Research in Autism Spectrum Disorders 2011; 5(2): 834-42.
  45. Constantinescu AO, Ilie A., Moldovan M., Stagg CJ. Trans-cranial direct current stimulation (tDCS): A promising new tool to facilitate rehabilitation of manual dexterity after stroke. Romanian Journal of Neurology/ Revista Romana de Neurologie 2010; 9(3): 118-23.
  46. Classen J, Liepert J, Wise SP, Hallett M, Cohen LG. Rapid plasticity of human cortical movement representation induced by practice. J Neurophysiol 1998; 79(2): 1117-23.