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CompletedNCT05927792Updated May 19, 2026

Efficacy and Mechanism of Repetitive Transcranial Magnetic Stimulation in Children With Autism Spectrum Disorders

A Phase 2/3 interventional study of repeated transcranial magnetic stimulation (continuous theta-burst stimulation) and sham repeated transcranial magnetic stimulation in Autism Spectrum Disorder, sponsored by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Completed at 3 sites in China. Open to participants aged 4 Years to 10 Years. Per ClinicalTrials.gov, last updated 2026-05-19.

Sponsored by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
4 Years to 10 Years
Sex
All
01

Study summary

This study is a prospective, multicenter, randomized, single-blind controlled trial to enroll 200 children with autism spectrum disorders (ASD). The investigators hope to further explore the effectiveness of accelerated continuous theta-burst stimulation (a-cTBS) over the left primary motor cortex (M1) to improve core symptoms in ASD children based on a previous open-label clinical trial.

Read the detailed description

This study is a prospective, multicenter, randomized, single-blind controlled trial. Shanghai Xinhua hospital, Qilu hospital and Zhengzhou Children's hospital expect to enroll a total of 200 children with autism spectrum disorders (ASD) to participate in this trial.

The children seen at Department of Developmental Behavioral Child Health, who meet the The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5) ASD diagnostic criteria and strict inclusion/exclusion criteria, can be enrolled for the intervention after informed consent.

At each study center, participants will be randomized into intervention group and sham group stratified by IQ level. The participants, their legal guardians, and the assessors were unaware of the grouping except for the intervention operator (single-blind).

During the trial, participants in intervention group will receive accelerated continuous theta-burst stimulation (a-cTBS) on the left primary motor cortex (M1) for 5 consecutive days. The sham group will be stimulated with a pseudo-stimulation coil, which emitted sounds with the same intensity, rhythm and vibratory sensation as the real stimulation, and the intervention target, duration and frequency are the same as the real intervention group.

All participants need to complete clinical assessments within 2 weeks before the cTBS intervention (pre-cTBS), repeated within 3 days after the completion of the cTBS course (post-cTBS) and 1 month following the last cTBS session (one month follow-up), respectively.

The investigators hope to further explore the effectiveness of accelerated continuous theta-burst stimulation (a-cTBS) over the left primary motor cortex (M1) to improve core symptoms in ASD children based on a previous open-label clinical trial and investigate the appropriate intervention model, effective adaptation population and underlying neurological mechanisms.

02

Conditions studied

  • Autism Spectrum Disorder

Keywords

  • Repetitive Transcranial Magnetic Stimulation(rTMS)
  • Autism Spectrum Disorder
  • Intervention
  • Social Deficits
  • Language Function
  • Children
03

In context

Autism Spectrum Disorder

1,724 studies on the registry are indexed under Autism Spectrum Disorder; 500 are open to participants now.

This study's enrollment of 200 is above the median of 52 across 1,368 interventional studies indexed under Autism Spectrum Disorder.

Browse Autism Spectrum Disorder studies →

Lead sponsor

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine is the lead sponsor of 225 studies on the registry; 55 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
4 Years to 10 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Children aged 4-10 years old
  • Meet the diagnostic criteria for ASD of the , Fifth Edition (DSM-5)
  • ASD Diagnosis confirmed by the Autism Diagnostic Observation Schedule (ADOS) or Autism Diagnostic Interview, Revised (ADI-R)
  • IQ of 50 or above
  • Provide written informed consents

Exclusion criteria

Exclusion Criteria:

  • With metal implants in the body
  • History of epilepsy or other neurological disease
  • Require surgical treatment due to structural abnormalities indicated by brain MRI
  • Diagnosed with genetic and chromosomal abnormalities
  • With psychiatric/mental disorder (e.g., very early-onset schizophrenia) other than ASD
  • Suffer from serious heart disease and/or severe hearing impairment
  • Intracranial hypertension
  • Participating in other clinical trials
  • Participants who received other interventions within 4 weeks prior to enrollment.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
200 participants (actual)

Study arms

  • Experimental
    Intervention Group

    participants in intervention group will receive accelerated continuous theta-burst stimulation (a-cTBS) on the left primary motor cortex (M1) for 5 consecutive days.

    Device: repeated transcranial magnetic stimulation (continuous theta-burst stimulation)

  • Sham comparator
    Sham Group

    The sham group will be stimulated with a pseudo-stimulation coil, which emitted sounds with the same intensity, rhythm and vibratory sensation as the real stimulation, and the intervention target, duration and frequency are the same as the real intervention group.

    Device: sham repeated transcranial magnetic stimulation

Interventions

  • Devicerepeated transcranial magnetic stimulation (continuous theta-burst stimulation)

    Participants in intervention group will receive cTBS over the left M1for 5 consecutive days. The detailed parameters as follows: 80% of resting motor threshold (RMT), 60 cycles of 10 bursts of three pulses at 50 Hz were delivered in 2-second trains (5 Hz) with no intertrain interval (i.e. triplet standard cTBS, 1800 pulses, 120s). Stimulation sessions were delivered hourly, 10 sessions were applied per day (18,000 pulses/day).

  • Devicesham repeated transcranial magnetic stimulation

    The sham group will be stimulated with a pseudo-stimulation coil, which emitted sounds with the same intensity, rhythm and vibratory sensation as the real stimulation, and the intervention target, duration and frequency are the same as the real intervention group.

06

What researchers measure

Primary outcomes

  1. Changes of Social Responsiveness Scale, Second Edition (SRS-2) scores from pre-intervention to post-intervention

    SRS provides the multi-dimensional measure of social interaction allowing the rating of social impairment in ASD. SRS generates a total score and five theoretical subscale scores (labeled social awareness, social cognition, social communication, social motivation, restricted interests and repetitive behavior), and higher scores are indicative of greater social impairment.

    Time frame: within 2 weeks before the intervention (pre-intervention), within 3 days after the completion of the intervention course (post-intervention)

  2. Changes of Social Responsiveness Scale, Second Edition (SRS-2) scores from pre-intervention to 1 month follow-up

    SRS provides the multi-dimensional measure of social interaction allowing the rating of social impairment in ASD. SRS generates a total score and five theoretical subscale scores (labeled social awareness, social cognition, social communication, social motivation, restricted interests and repetitive behavior), and higher scores are indicative of greater social impairment.

    Time frame: within 2 weeks before the intervention (pre-intervention), 1 month following the last intervention session (one month follow-up)

Secondary outcomes

  1. Chinese Communicative Development Inventory (CCDI)

    a parent questionnaire serves as a powerful tool to evaluate the early vocabulary development and language skills of older children with developmental disorders and the effectiveness of their interventions. CCDI yields two subscale scores, including words produced score and sentence complexity score.Higher scores suggest better language level.

    Time frame: within 2 weeks before the intervention (pre-intervention), 1 month following the last intervention session (one month follow-up)

  2. Language Comprehension Test

    Peabody Picture Vocabulary Test (PPVT) is a standard assessment tool for measuring single-word comprehension, to objectively evaluate the language ability of the children involved in our study. Higher scores suggest better language level. Meanwhile, a sentence-picture matching test will be administered to test children's language comprehension abilities in the syntactic domain.

    Time frame: within 2 weeks before the intervention (pre-intervention), 1 month following the last intervention session (one month follow-up)

  3. Multilingual Assessment Instrument for Narratives (MAIN)

    assess narrative comprehension and production skills of children who exhibited a certain level of expressive ability (at least can use flexible phrases).In this test, children tell or retell the stories and answer some questions, with assessors evaluating performance across four dimensions: story structure, structural complexity, internal state terms, and comprehension questions. Higher scores suggest better language level.

    Time frame: within 2 weeks before the intervention (pre-intervention), 1 month following the last intervention session (one month follow-up)

  4. Clinical Global Impression Scale (CGI)

    we used CGI-I to rate how much the patient's illness has improved or worsened relative to a baseline measurement (a seven-point scale: 1 = "very much improved" to 7 = "very much worse")

    Time frame: within 3 days after the completion of the intervention course (post-intervention), 1 month following the last intervention session (one month follow-up)

  5. Vineland Adaptive Behavior Scales, Third Edition (Vineland-3)

    The Vineland Adaptive Behavior Scales were designed to address adaptive behavior, or the personal and social skills necessary for everyday independent living. For individuals with ASDs, the Vineland can be used for tracking and reporting progress of intervention or treatment. Domains of adaptive functioning assessed with the Vineland include: Communication, Daily Living Skills, Socialization, Motor Skills. The higher scores suggest better adaptive level.

    Time frame: within 2 weeks before the intervention (pre-intervention), 1 month following the last intervention session (one month follow-up)

  6. Electroencephalography (EEG)

    Electroencephalography (EEG): We plan to collect resting-state and task-related EEG data from children with ASD at baseline, after 5 days of intervention after intervention to evaluate changes in power spectrum and inter-trial phase coherence (ITPC) in the alpha and theta frequency bands at different time points. The EEG data will be collected using a 128-channel EEG system with a sampling rate of 1000 Hz and a reference electrode at Cz (central zero). Prior to data collection, we will ensure that the resistance of each channel is below 100 kΩ.

    Time frame: within 2 weeks before the intervention (pre-intervention), within 2 days after the completion of the intervention course (post-intervention)

07

Study locations

3 sites
  • Henan Children's Hospital
    Zhengzhou, Henan 450000, China
  • Qilu Hospital of Shandong University
    Qilu, Shandong 250000, China
  • Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
    Shanghai, Shanghai Municipality 200092, China
08

References and documents

Publications

  • Tan H, Ren T, Cao A, Fang S, Deng L, Hu B, Wang M, Cheng Y, Zhang X, Li Y, Zhang Y, Zhang L, Chen L, Zhou W, Zhang Q, Li J, Zhou X, Langley C, Luo Q, Zhang J, Sahakian BJ, Yuan TF, Li F. Accelerated continuous theta burst stimulation targeting left primary motor cortex for children with autism spectrum disorder: multicentre randomised sham controlled trial. BMJ. 2026 Apr 29;393:e086295. doi: 10.1136/bmj-2025-086295. PubMed 42055586 ↗

Individual participant data

Plan to share: No — Study Protocol, Statistical Analysis Plan, Informed Consent Form (ICF), etc are available through contacting researchers if required.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05927792
Collaborators
Shanghai Mental Health Center, Zhengzhou Children's Hospital, China, Qilu Hospital of Shandong University
Responsible party
Fei Li (Chief Physician ,Doctoral Supervisor, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine) — Principal investigator
First posted
Jul 3, 2023
Start date
Jul 4, 2023
Primary completion
Oct 25, 2024
Completion
Oct 31, 2024
Last update
May 19, 2026

Study contacts

Fei Li, MD, PhD
principal investigator · Shanghai Jiaotong University School of Medicine Xinhua Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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