Transcranial Direct Current Stimulation Combined with Computerized Cognitive Training Synergistically Enhances Efficacy in Autism Spectrum Disorder: A Randomized Controlled Trial Based on Behavioral and Neurophysiological Evidence

Shunbo YANG; Yanmei LAI; Qinghong LI; Jindi YANG; Zhihai LV

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Shunbo YANG, Yanmei LAI, Qinghong LI, Jindi YANG, Zhihai LV. Transcranial Direct Current Stimulation Combined with Computerized Cognitive Training Synergistically Enhances Efficacy in Autism Spectrum Disorder: A Randomized Controlled Trial Based on Behavioral and Neurophysiological Evidence[J]. Journal of Kunming Medical University.

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Transcranial Direct Current Stimulation Combined with Computerized Cognitive Training Synergistically Enhances Efficacy in Autism Spectrum Disorder: A Randomized Controlled Trial Based on Behavioral and Neurophysiological Evidence

Department of Children’s Rehabilitation，Longgang District Maternal and Child Health Care Hospital，Shenzhen Guangdong 518000，China

Received Date: 2026-03-06

Abstract

Abstract

Objective To investigate the efficacy of transcranial direct current stimulation （tDCS） combined with computerized cognitive training （CCT） in treating autism spectrum disorder （ASD）. Methods A total of 208 children with ASD admitted to Longgang District Maternal and Child Health Hospital, Shenzhen from January 2021 to August 2024 were selected, and randomly divided into four groups using a random number table: CCT group （n = 52）, tDCS group （n = 52）, combination group （n = 52）, and sham stimulation group （n = 52）. All four groups received standard rehabilitation treatment. Additionally, the CCT group received CCT, the tDCS group received tDCS, the combination group received tDCS combined with CCT, and the sham stimulation group received sham tDCS combined with CCT. Therapeutic efficacy, Childhood Autism Rating Scale （CARS）, Aberrant Behavior Checklist （ABC）, Chinese Version of Psychoeducational Profile-3 （C-PEP-3）, and Children’ s Neuropsychological Behavioral Scale （abbreviated as China Children Development Scale） scores, electroencephalographic parameters [latency and amplitude of mismatch negativity （MMN） at Fz and Cz leads, frontal lobe relative θ power, sleep discharge index] before and after treatment, and the incidence of adverse reactions were compared among the four groups. Results The overall therapeutic efficacy rate showed no significant difference among the four groups （χ² = 6.811, P = 0.078）. After 3 months of treatment, the combination group showed significantly lower scores on ABC scale dimensions （somatic motor, language, sensory, social interaction, self-care） and CARS total scores compared with the CCT, tDCS, and sham stimulation groups, and significantly higher C-PEP-3 total scores and Child Neuropsychological Behavior Examination Scale scores in language, social behavior, developmental quotient, mental age, adaptive ability, gross motor, and fine motor dimensions compared with the other three groups （F = 7.575, 14.741, 7.616, 6.817, 6.896, 21.804, 12.175, 13.034, 17.661, 11.925, 12.690, 9.691, 8.777, 13.485, P < 0.05）. No significant differences were found among the CCT, tDCS, and sham stimulation groups in ABC dimensions, CARS scores, C-PEP-3 scores, or Child Neuropsychological Behavior Examination Scale dimensions （P > 0.05）. After 3 months of treatment, the combination group showed significantly lower MMN latency in Fz and Cz leads, relative frontal theta power, and sleep discharge index, and significantly higher MMN amplitude in Fz and Cz leads compared with the other three groups （F = 15.593, 12.714, 12.072, 48.912, 6.901, 5.723, P < 0.05）. No significant differences were found among the CCT, tDCS, and sham stimulation groups in these EEG parameters （P > 0.05）. The overall incidence of adverse reactions showed no significant difference among the four groups （P = 0.123）. Conclusion tDCS combined with CCT demonstrates significant therapeutic efficacy in treating ASD, potentially improving cognitive and social functioning, reducing aberrant behaviors, and improving cerebral electrical activity in affected children.
- Transcranial direct current stimulation,
- Computer cognitive training,
- Autism spectrum disorder,
- Electroencephalogram,
- Mismatched negative waves

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References(25)

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