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Modulation of the Activity of the Cerebellum in Autism (MACA)

Not Applicable
Recruiting
Conditions
Autism Spectrum Disorder
Interventions
Device: tDCS
Registration Number
NCT05781412
Lead Sponsor
Beatriz Catoira
Brief Summary

Research on the involvement of the cerebellum in social understanding behavior and the mentalizing brain system has just begun. Knowledge about the neurobiology of social understanding is important for understanding the ways to manipulate these processes. Like cerebral tDCS, cerebellar tDCS could then be used to enhance more complex processes, such as mentalizing, in healthy individuals. It can eventually also be examined as a therapeutic tool for patients with mentalizing difficulties such as patients with ASD. In this study, it is examined whether anodal tDCS at the right posterior cerebellum influences social understanding and which cerebro-cerebellar networks play a role in this process.

Detailed Description

Autism Spectrum Disorders (ASD) are a group of lifelong neurodevelopmental disorders characterized by social and communicative difficulties and repetitive and stereotyped behaviors. Research has shown that cerebellar abnormalities are among the most important etiological factors for ASD. The cerebellum is found to be most frequently involved in tasks where participants must remember or imagine past or future autobiographical events, judge persons or situations based on behavioral sentences, make trait inferences of others using stories, words or faces, and describe persons or objects based on behavioral or object pictures. Recent research has also provided evidence on the involvement of the posterior areas of the cerebellum in social cognition.

Specifically, the areas crus I and crus II, located at the lateral hemispheres of the posterior cerebellum, are associated with more complex cognitive and social processes, such as mentalizing. Mentalizing is the cognitive ability to attribute mental states, such as desires, intentions, and beliefs, to other people. This ability is needed to understand and predict other people's behavior and is the main component of social cognition. Problems with mentalizing, including the attribution of false beliefs to others, are characteristic for autism spectrum disorder (ASD). A sequencing task (that included social and non social conditions) showing that cerebellar patients performed worse than healthy participants.

Facial emotion recognition refers to the ability to derive emotional meaning from facial expressions and has been shown to underlie social competency. Recent literature reviews have reported significant facial emotion recognition impairments in individuals with ASD. These impairments take various forms, such as a reduced accuracy in labeling facial emotions or reduced specificity in rating facial emotions of varying intensity . Thus, there is evidence suggesting that ASD is associated with a selective impairment in facial emotion recognition.

Transcranial direct current stimulation (tDCS) is a noninvasive technique that can produce long-lasting changes in the excitability and spontaneous activity of the stimulated brain areas. Therefore, tDCS is investigated as a possible treatment for different psychiatric diseases. Cerebellar tDCS have shown to also produce prolonged changes successfully at the neural and behavioral level. However, due to the high density of neurons in the cerebellum and diffuse connections to the cerebrum, it is more difficult to understand the working mechanisms of cerebellar as compared to cerebral tDCS. In addition, the electrical current will spread across more neurons in the cerebellum by cerebellar tDCS and will functionally affect the cerebral regions to which these cerebellar neurons are connected as well. Therefore, the type of behavioral effect, such as an improvement of performance after anodal tDCS or an impairment of performance after cathodal tDCS, is harder to predict for cerebellar than cerebral tDCS.

Modulation of social understanding with tDCS has been studied by stimulating the key mentalizing regions mPFC and TPJ. In healthy participants, an improvement on tasks was found that required the enhancement or inhibition of representation of the self or of others, which is important for mentalizing, after anodal tDCS at the TPJ compared to sham tDCS or cathodal tDCS. The effect of cerebellar tDCS on social understanding using action sequences has not yet been examined.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
H-AQ_anodalstimulationtDCSnon diagnosed autistic participant,anodal stimulation on the first session, sham stimulation on the second sesion
ASD_anodalstimulationtDCSASD participant, anodal stimulation on the first session, sham stimulation on the second sesion
H-AQ_shamstimulationtDCSnon diagnosed autistic participant, sham stimulation on the first session, anodal stimulation on the second sesion
NT_anodalstimulationtDCSNeurotypical participant, anodal stimulation on the first session, sham stimulation on the second sesion
ASD_shamstimulationtDCSASD participant, sham stimulation on the first session, anodal stimulation on the second sesion
NT_shamstimulationtDCSNeurotypical participant, sham stimulation on the first session, anodal stimulation on the second sesion
Primary Outcome Measures
NameTimeMethod
PS_RTassessment will begin 10 minutes after stimulation and last up to 15 minutes

Reaction Time in the pictorial sequencing time

PS_accuracyassessment will begin 10 minutes after stimulation and last up to 15 minutes

Accuracy in the pictorial sequencing task

ER_accuracyassessment will begin 20 minutes after stimulation and last up to 5 minutes

Accuracy in the emotion recognition task

Brain activity at the emotion recognition taskassessment will begin 20 minutes after stimulation and last up to 5 minutes

Brain activity (fMRI) in regions of interest/whole brain analysis. Differences between stimulation and sham, between task conditions and between sessions as well as possible interactions in between those factors and covariates (AQ scores, age, gender...)

ER_RTassessment will begin 20 minutes after stimulation and last up to 5 minutes

Reaction Times in the emotion recognition task

Brain activity at resting stateassesment will begin concurrent with stimulation and last up to 20 minutes

Brain activity (fMRI) in regions of interest/whole brain analysis. Differences between stimulation and sham, between task conditions and between sessions as well as possible interactions in between those factors and covariates (AQ scores, age, gender...)

Brain activity at the pictorial sequencing taskassessment will begin 10 minutes after stimulation and last up to 15 minutes

Brain activity (fMRI) in regions of interest/whole brain analysis. Differences between stimulation and sham, between task conditions and between sessions as well as possible interactions in between those factors and covariates (AQ scores, age, gender...)

White matter integrity in the cerebellumassessment will begin immediately after stimulation and last up to 10 minutes

White matter integrity matrix (FA, MD, RD) in the cerebellum using tract-based spatial statistics in the cerebellum \& differences between groups

Secondary Outcome Measures
NameTimeMethod
Connectivity_ERtaskassessment will begin 20 minutes after stimulation and last up to 5 minutes

Brain connectivity (fMRI) analysis on the emotion recognition task

Connectivity_stimulationassesment will begin concurrent with stimulation and last up to 20 minutes

Brain connectivity (fMRI) analysis during stimulation

Connectivity_PStaskassessment will begin 10 minutes after stimulation and last up to 15 minutes

Brain connectivity (fMRI) analysis on the pictorial sequencing task

Fiber tractography between the cerebellum and the default mode/ mentalizing networkassessment will begin immediately after stimulation and last up to 10 minutes

Fiber tractography (Diffusion weighted imaging) between the cerebellum and the default mode / mentalizing network, by extraction of white matter integrity parameters on each fiber tract

ROI-based structural connectivityassessment will begin immediately after stimulation and last up to 10 minutes

Structural connectivity (DWI) between ROIs from the default mode/mentalizing network

Whole brain structural network constructionassessment will begin immediately after stimulation and last up to 10 minutes

Structural connectivity (DWI) within the whole brain using graph theory

Trial Locations

Locations (1)

UZ Brussel

🇧🇪

Jette, Brussels, Belgium

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