As the flagship center for MeRT®, our Newport Beach clinic relies on extensive EEG analysis to guide this individualized form of rTMS. Over many years and tens of thousands of EEGs reviewed, the scientific literature has continued to expand. Below is a summary of key peer-reviewed studies on rTMS for autism that underpin this treatment, along with essential findings from each.
Published May 31, 2024
A recent review examined all published studies using TMS to treat ASD between 2018 and 2023. Researchers systematically analyzed each study’s design, treatment parameters, stimulation targets, localization methods, behavioral outcomes, and neuroimaging findings. The review was extensive.
After TMS intervention, discernible enhancements across a spectrum of scales are evident in stereotyped behavior, repetitive behavior, and verbal social domains. A comprehensive review of literature spanning the last five years demonstrates the potential of TMS treatment for ASD in ameliorating the clinical core symptoms.”
“Recent findings generally indicate that TMS has positive effects on stereotypical behavior, repetitive behavior, verbal and social aspects of ASD, leading to overall improvement across all scale scores post-intervention.”
Published Sept 9, 2015
Repetitive TMS affords researchers to design specific stimulation protocols that can modulate neuroplasticity, and such neuroplasticity-based brain stimulation interventions look promising.”
“Existing evidence still indicates that aberrant neuroplasticity could play a critical role in the pathogenesis of ASD. Therefore, it can be postulated that it may be possible to attain optimal social and cognitive performance in ASD by stabilizing aberrant neuroplasticity. In this context, we discussed a novel mechanism-driven approach toward achieving such goal using rTMS. If successful, this information will not only help us better understand the brain mechanisms involved in ASD but also stimulate trials testing mechanism-driven novel brain stimulation treatment paradigms for ASD.”
Published July 7, 2021
“Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts a range of domains, including social communication, behaviour, cognition, emotion regulation and sensorimotor function. Core symptoms of ASD include social interaction and communication problems, and restricted and repetitive behaviours.”
“Non-invasive brain stimulation (NIBS) has emerged as a novel, safe and efficacious intervention for a range of brain-based disorders. These techniques allow non-invasive modulation of specific brain regions via electromagnetic or electrical stimulation. The most common of these is repetitive transcranial magnetic stimulation (rTMS), which is now widely used as an intervention for treatment-resistant major depressive disorder. It has also been established as an intervention for other neurological disorders, including migraine and obsessive-compulsive disorder.”
“rTMS is considered a very safe and tolerable technique. It is typically administered by an experienced clinician (nurse or physician), and patients are monitored throughout and at the completion of rTMS administration. Clinical researchers have established a detailed set of safety guidelines, and when rTMS is administered within guideline parameters, serious adverse effects are exceedingly rare. NIBS (including rTMS) is also considered very safe for paediatric populations, with a recent study showing no adverse effects across 382 children aged 0–18 years.”
Published Sept 26, 2022
The results of our systematic review and meta-analysis data indicate that TMS may offer a promising and safe treatment option for pediatric and young adult patients with IC-ASD.”
Published April 2015
Several rTMS trials in ASD have shown marked improvements in motor symptomatology, attention and perceptual binding.
“Conclusion: rTMS is the first therapeutic attempt at ASD aimed at correcting some of its core pathology.”
Published in Autism Parenting Magazine, May 13, 2025
In a study by Krishnan et al. (2014) noninvasive brain stimulation techniques such as TMS were examined to assess the treatment’s safety when administered to children and adolescents.
“The study found repetitive TMS to be safe in children and adolescents when safety guidelines were followed. When side effects were present, it seemed similar to side effects experienced by adults. Out of 513 of the children (or adolescents) involved in the study, 11.5% experienced headaches, 2.5% experienced scalp discomfort, 1.2% experienced twitching, and a very small percentage experienced mood changes, fatigue and tinnitus (Krishnan et al., 2014).
“When looking at anecdotal evidence of pain and discomfort experienced, when undergoing TMS treatment, the verdict seems positive. The treatment is generally well tolerated and some feel the lack of serious side effects make it a great alternative for those sensitive to medication.”
“There may be further good news, as a new treatment combines TMS with Quantitative Electroencephalogram (qEEG) and Electrocardiogram (ECG/EKG) to deliver a tailored treatment to the patient’s unique brain pattern. The fact that this personalized protocol, known as Magnetic e-Resonance Therapy (MeRT), ascertains the individual’s brain patterns, means greater success may be achieved in restoring chemical imbalances.
“For parents who would like to find out more about MeRT, specifically for a child with ASD, the following story of Frankie (who stopped toe-walking and learned to talk after his family discovered MeRT) will be an inspiring read.”
Published June 24, 2020
TMS improves executive function skills related to self-monitoring behaviors and the ability to apply corrective actions. These improvements manifest themselves as a reduction of stimulus bound behaviors and diminished sympathetic arousal. Results become more significant with increasing number of sessions and bear synergism when used along with neurofeedback. When applied at low frequencies in individuals with ASD, TMS appears to be safe and to improve multiple patient-oriented outcomes.”
“TMS is a non-invasive therapeutic intervention capable of modulating evoked and induced gamma oscillations and altering maladaptive behaviors. Recent reviews of the literature suggest that TMS is safe and effective when used in ASD.”
Published May 9, 2019
Our findings suggest that HF [high frequency] rTMS over the left parietal cortex might improve core deficits in low-functioning children with ASD.”
Published December 2022
rTMS provides changes in connectivity and behavior, suggesting its potential use as a viable treatment option for ASD individuals.”
Published May 28, 2018
Our results suggest that rTMS, particularly after 18 sessions, facilitates cognitive control, attention and target stimuli recognition by improving discrimination between task-relevant and task-irrelevant illusory figures in an oddball test. The noted improvement in executive functions of behavioral performance monitoring further suggests that TMS has the potential to target core features of ASD.”
Published June 2021
There was a statistically significant clinical improvement in patients receiving active TMS comparing baseline Childhood Autism Rating Scale (CARS) assessment and after treatment.
“There was significant difference in improvement between the two groups according to eye contact. There was significant improvement in response to examiner. There was significant difference in improvement between the two groups according to active expressive language.
“Conclusion: Repetitive transcranial magnetic stimulation (rTMS) over left inferior frontal gyrus may be a safe and effective way of improving language of ASD. The joint application of rTMS and standard language therapy may lead to more rapid improvement in the language progress of children with ASD.”
Published Nov 2019
These findings supported our hypothesis by demonstration of positive effects of combined rTMS neurotherapy in active treatment group as compared to the waitlist group, as the rTMS group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group.”
Published in Austin Publishing Group, August 2016
Given our understanding of the EEG and the consistent abnormalities in the electrophysiology of children with ASD, we would suggest that MRT [MeRT] is an appropriate therapeutic option to further pursue. The existing literature in depression and posttraumatic stress disorder in addition to preliminary studies in children with ASD all support its potential impact as a therapeutic option.”
Published in Society for Brain Mapping and Therapeutics
Following 5 weeks of EEG-EKG guided trans-magnetic stimulation, significant changes in symptom severity and EEG measures are reported for 28 children with autism spectrum disorder. … This suggests that EKG-EEG guided TMS may be effective at mitigating averse sensory misperceptions common in ASD.”
Published June 6, 2025, in Nature Neuroscience, by Takamitsu Watanabe & Hidenori Yamasue
Autistic behaviors correlate with reductions in specific brain-state transitions in global neural dynamics, implying that the mitigation of such rigid brain dynamics may alter autistic traits. To examine this possibility, we investigated longitudinal behavioral effects of state-dependent transcranial magnetic stimulation (TMS) in autistic adults. We found that excitatory TMS over the right parietal lobule decreased neural rigidity, which commensurately reduced social and nonsocial autistic behaviors…. These results indicate that alteration of neural rigidity could change multiple autistic traits.
“Here, we have shown that mitigating neural rigidity seen in autism can alter different ASD-associated behaviors in different neural processes, which demonstrated the direct/indirect brain–behavior causal relationships between neural rigidity and diverse atypical behaviors in autism. These findings imply that brain-state-driven neural stimulation could be a foundation for a new noninvasive approach to influence some behaviours associated with ASD.”
Published in 2021 by the Autism Research Institute (includes a video presentation & summary)
Manuel Casanova, MD, served on the founding board of the National Alliance for Autism Research (now Autism Speaks) and the Autism Tissue Board. He has served on the Board of Directors or Scientific Advisory Board of numerous organizations including the Autism Research Institute. His research has been recognized by a EUREKA award from the NIMH for the introduction of repetitive Transcranial Magnetic Stimulation (rTMS) in the therapy of autism spectrum disorders.
“Casanova outlines his research group studies that found direct relationships between TMS sessions and increased coherence of function across brain regions, improved error-rate and post-error response time, normalized autonomic nervous system parameters, and minimized abhorrent and repetitive behaviors. He posits that this type of therapy must be investigated as an alternative to neuroleptics as TMS has no known side effects.”
Published February 2016
Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study and potential treatment of ASD. Recent studies suggest that TMS measures provide rapid and noninvasive pathophysiological ASD biomarkers. Furthermore, repetitive TMS (rTMS) may represent a novel treatment strategy for reducing some of the core and associated ASD symptoms.
“While its true potential in ASD has yet to be delineated, TMS represents an innovative research tool and a novel, possibly transformative approach to the treatment of neurodevelopmental disorders.”
This is a large-scale research study currently underway in Australia.
TMS is a safe and non-invasive means of stimulating nerve cells in a particular part of the brain via the administration of brief magnetic pulses. TMS has been developed for a range of conditions, including depression.”
By Grant Hilary Brenner, MD. Updated June 17, 2025
This 12-session protocol reduced neural rigidity as shown by EEG findings and improved all three test measures. Neural rigidity and cognitive flexibility improved earliest (by week 1), perceptual overstability by week 7, and nonverbal information processing by week 9.”
“This pioneering approach using TMS timed to EEG measurements can be implemented in clinical settings with additional development and advances our understanding of ASD pathophysiology.”
Published May-June 2020
Conclusions: Standard non-invasive brain stimulation paradigms are safe and well-tolerated in children and should be considered minimal risk.”