Document Type : Research Paper

Authors

1 Ph.D. Student of Motor Development, Department of Physical Education, Islamic Azad University, Science and Research Branch, Tehran

2 Professor of Motor Behavior, University of Isfahan

3 Associate Professor of Motor Behavior, University of Tehran

4 Associate Professor of Psychology and Education of Children with Special Needs, University of Isfahan

Abstract

The aim of the current study was to examine the effects of anodal transcranial direct current stimulation (tDCS) and selective motor training on gross motor skills in children with autism spectrum disorders (ASD). The method of research is experimental in which a pretest – posttest semi-experimental design with sham group was used. In so doing, a total of eighteen children with autism (age ranged from 6 to14 years) were selected according to available sampling and inclusion criteria and then were randomly divided to experimental and sham group. Participants of the exercise group practiced motor training after receiving tDCS over their primary motor cortex to improve gross motor skills. These participants received anodal tDCS over the left M1 for 20 min for ten sessions (three sessions per week) before the training session. The participants of the sham group underwent identical training sessions, except that tDCS was artificially applied for them. Gross motor skills (aiming and catching) were assessed at baseline (pre-intervention) and after 10 sessions (post- intervention). For analyzing data, two factor Mixed model ANOVA Paired t-test was used. Results showed that the combination of anodal tDCS and motor training have significant effects on improving gross motor skills in children with ASD while mere motor training failed to show improvement in gross motor skill of children with ASD. Our findings suggest that tDCS may be considered as a useful adjunct to gross motor skill training for autistic children.

Keywords

Main Subjects

  1. 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. Morbidity and mortality weekly report surveillance summaries (Washington, DC: 2002). 2014; 63:1–21.
  2. 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.
  3. Hilton C, Wente L, LaVesser M, Reed Ito C, Herzberg G. Relationship between motor skill impairment and severity in children with Asperger syndrome. Res. Autism Spectr. Disord. 2007; 1(4):339–49.
  4. Manjiviona J, Prior M. Comparison of asperger syndrome and high-functioning autistic children on a test of motor impairment. JADD. 1995; 25:23–9.
  5. Miyahara M, Tisujii M, Hori M, Nakanishi K, Kageyama H, Sugiyama T. Brief report: Motor in-coordination in children with Asperger syndrome and learning disabilities. 1997; 27(5):595-603.
  6. DeMyer MK. Motor, perceptual-motor, intellectual disabilities of autistic children. Early Child. Aut. 1976; 2:169–96.
  7. Morin B, Reid G. A quantitative and qualitative assessment of autistic individuals on selected motor tasks. ADAPT PHYS ACT Q. 1985; 2:43–55.
  8. Wang Z, Magnon GC, White SP, Greene RK, Vaillancourt DE, Mosconi MW. Individuals with autism spectrum disorder show abnormalities during initial and subsequent phases of precision gripping. J Neurophysiol. 2014; 113:1989-2001.
  9. Whyatt CP, Craig CM. Interceptive skills in children aged 9–11 years, diagnosed with autism spectrum disorder. Res. Autism Spectr. Disord. 2013; 7:613–23.
  10. Gowen E, Hamilton A. Motor Abilities in autism: A review using a computational context. J Autism Dev Disord. 2012; 43(2):323-44.
  11. Liu T, Breslin CM. Fine and gross motor performance of the MABC-2 by children with autism spectrum disorder and typically developing children. Res. Autism Spectr. Disord. 2013; 7:1244–9.
  12. Sacrey LA, Germani T, Bryson SE, Zwaigenbaum L. Reaching and grasping in autism spectrum disorder: A review of recent literature. Front Neurol. 2013; 5(6):      1-33.
  13. Nutt JG, Marsden CD, Thompson PD. Human walking and higher-level gait disorders, particularly in the elderly. Neurology.1993; 43:268–79.
  14. Takarae Y, Luna B, Minshew NJ, Sweeney JA. Patterns of visual sensory and sensorimotor abnormalities in autism vary in relation to history of early language delay. J Int Neuropsychol Soc. 2008; 14:980–9.
  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; 160:262–73.
  16. 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.
  17. 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.
  18. Nitsche MA, Cohen LG, Wassermann EM, Priorit A, Lang N, Antal A, et al. Transcranial direct current stimulation: State of the art. Brain Stimul. 2008;1(3):    206–23.
  19. 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.
  20. Luna B, Doll SK, Hegedus SJ, Minshew NJ, Sweeney JA. Maturation of executive function in autism. Biol Psychiat. 2007; 61:474–81.
  21. Tortella G, Casati R, Aparicio LVM, Mantovani A, Senço N, D’Urso G, et al. Transcranial direct current stimulation in psychiatric disorders. World J Psychiatry. 2015; 5(1):88-102.
  22. Boggio PS, Asthana MK, Costa TL, Valasek CA, Osório AAC. Promoting social plasticity in developmental disorders with non-invasive brain stimulation techniques. Front Neurosci. 2015; 9:1-9.
  23. Floel A. tDCS-enhanced motor and cognitive function in neurological diseases. Neuroimage. 2014;85(3):934–47.
  24. Koyama S, Tanaka S, Tanabe Sh, 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.
  25. 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.
  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; 24:1215–8.
  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. Théoret H, Halligan E, Kobayashi M, Fregni F, Tager-Flusberg H, and Pascual-Leone A. Impaired motor facilitation during action observation in individuals with autism spectrum disorder. Curr Biol. 2005; 15:84–5.
  29. Enticott PG, Rinehart NJ, Tonge BJ, Bradshaw JL, Fitzgerald PB. Repetitive transcranial magnetic stimulation (rTMS) improves movement-related cortical potentials in autism spectrum disorders. Brain Stimul. 2012; 5:30–7.
  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):1–6.
  31. Schneider HD, Hopp JP. Theuse 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. Breslin CM, Liu T. Do You Know What Iʼm saying? strategies to assess motor skills for children with autism spectrum disorder. JOPERD. 2015; 86:10-5.
  33. Mccleery JP, Elliott NA, Sampanis DS, Stefanidou CA, Motor development and motor resonance difficulties in autism: Relevance to early intervention for language and communication skills. Front Integr Neurosci. 2013;7(30):1-20.
  34. Marchese R, Diverio M, Zucchi F, Lentino C, Abbruzzese G. The role of sensory cues in the rehabilitation of parkisonian patients: a comparison of two physical therapy protocols. Mov. Disord. 2000; 15:879–83.
  35. Wall AE, The developmental skill-learning gap hypothesis: Implications for children with movement difficulties. ADAPT PHYS ACT Q. 2004;21: 196–218.
  36. Raven J. The Raven’s progressive matrices: Change and stability over culture and time. Cogn. Psychol. 2002; 41:1-48.
  37. Corman L, Budoff M. Factor structures of retarded and nonretarded children on Raven's progressive matrices. ERIC. 1973; 3(54):1-11.
  38. Henderson SHE, Sugden DA, Barnett AL. Movement assessment battery for children-2. 2nd ed. London: Pearson Assessment; 2007.
  39. 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; 859–62.
  40. 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: 2-8.
  41. Miyaguchia 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.
  42. Lee DN, Georgopoulos AP, Clark MJO, Craig C, Port NL. Guiding contact by coupling taus of gaps. Exp. Brain Res. 2001; 139:151–9.
  43. Stoit AMB, Van Schie HT, Slaats-Willemse DIE, Buitelaar JK. Grasping motor impairments in autism: Not action planning but movement execution is deficient. J Autism Dev Dis. 2013:1825-8. Doi: 10.1007/s10803.
  44. David FJ, Baranek GT, Wiesen C, Miao AF, Thorpe DE. Coordination of precision grip in 2-6 years-old children with autism spectrum disorder compared to children developing typically and children with developmental disabilities. Front Integrat Neurosci. 2012; 6:1-13.
  45. 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; 27:13413–9.
  46. Kaski D, Quadir S, Patel M, Yousif N, Bronstein AM. Enhanced locomotor adaptation after effect in the ‘‘broken escalator’’ phenomenon using anodal tDCS. J. Neurophysiol. 2012; 107:2493–505.
  47. Classen J, Liepert J, Wise SP, Hallett M, Cohen LG. Rapid plasticity of human cortical movement representation induced by practice. Neurophysiol. 1998; 79:  1117–23.
  48. Orban de Xivry JJ, Marko MK, Pekny SE, Pastor D, Izawa J, Celnik P, et al. Stimulation of the human motor cortex alters generalization patterns of motor learning. Neuroscience. 2011;31(19):7102–10.
  49. Stagg ChJ, Best JG, Stephenson MC, O’Shea J, Wylezinska M, Kincses ZT, et al. Polarity-sensitive modulation of cortical neurotransmitters by transcranial stimulation. Neuroscience. 2009;29(16): 5202–6.
  50. Chao HT, Chen H, Samaco RC, Xue M, Chahrour M, Yoo J, et al. Dysfunction in GABA signalling mediates autism-like stereotypies and Rett syndrome phenotypes. Nature. 2010; 468:263-9.
  51. Kim S, Stephenson MC, Morris PG, Jackson SR. tDCS-induced alterations in GABA concentration within primary motor cortex predict motor learning and motor memory: A 7 T magnetic resonance spectroscopy study. NeuroImage. 2014; 99:237–43.
  52. Stagg ChJ, Bachtiar V, Johansen-Berg H. The Role of GABA in Human Motor Learning. Curr. Biol. 2011;21(6):480–4.
  53. Floyer-Lea A, Wylezinska M, Kincses T, Matthews PM. Rapid modulation of GABA concentration in human sensorimotor cortex during motor learning. J Neurophysiol. 2006; 95:1639 –44.