Background Quantitative electroencephalogram (qEEG) studies exploring alpha rhythm-guided transcranial magnetic stimulation (α-rTMS) effect on the individual alpha frequency (IAF) of children with autism spectrum disorder (ASD) are sparse.

Method This qEEG study explored the IAF of twenty children (6-12 years old; 16 males) with ASD who were randomly assigned (1:1) to a treatment group (TG) or a waitlist control group (WLCG). The TG received ten α-rTMS sessions over two weeks, while the WLCG acted as control for that period. Next, the WLCG received ten α-rTMS over two weeks. All study participants were followed for one and four months post-study.

Results Following α-rTMS, the TG showed a significant increase in mean frontal region IAF (M =9.093 to 9.351Hz) compared to the WLCG (F (1,18) = 6.440, p = 0.021, ES = 0.263). When the WLCG received α-rTMS, the mean frontal region IAF increased (M = 8.33 to 8.78Hz) but was insignificant (F (2,18) = 2.720, p = 0.120, ES = 0.232). The increased regional IAF persisted at one and four months post-α-rTMS follow-up across groups. Additionally, the mean difference between the posterior and frontal region IAF consistently decreased, suggesting improved long-range functional connectivities.

Conclusion This qEEG study presents provisional evidence demonstrating α-rTMS increases IAF within the frontal region of children with ASD and potentially persists for one to four months. Future robust studies using larger sample sizes and more dimensions of electroencephalographic analysis are warranted.

Uchenna Ezedinma and Gary Campbell are employees of Brain Treatment Centre Australia (an affiliated entity of TMS IP Pty). Dr Evan Jones is a director of TMS IP Pty. Alexander Ring is an employee of Wave Neuroscience Inc., which is affiliated with Brain Treatment Centre Australia. Other authors declare they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

ANZCTR12623000757617

The study received funding from TMS IP Pty, Queensland's Children Sleep Specialist Clinic Australia and the University of Sunshine Coast Australia with grant number 1.043.08529

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study received ethics approval from the Ethics Committee of the University of the Sunshine Coast Australia, in February 2023 with ethics number S221766.

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Statement and Declarations: Uchenna Ezedinma and Gary Campbell are employees of Brain Treatment Centre Australia (an affiliated entity of TMS IP Pty). Dr Evan Jones is a director of TMS IP Pty. Alexander Ring is an employee of Wave Neuroscience Inc., which is affiliated with Brain Treatment Centre Australia. Other authors declare they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Data availability: Mediated access to non-identifiable study data is available from the corresponding author on written approval from funders to further protect the privacy and sensitivity of the health information of children participants.

Funding statement: The study received funding from TMS IP Pty, Queensland’s Children Sleep Specialist Clinic Australia and the University of Sunshine Coast Australia with grant number 1.043.08529

Mediated access to non-identifiable study data is available from the corresponding author on written approval from funders to further protect the privacy and sensitivity of the health information of children participants.