Identification and reduction of retained primitive reflexes by sensory stimulation in autism spectrum disorder: effects on qEEG networks and cognitive functions

Abstract

Several authors have reported finding retained primitive reflexes (RPRs) in individuals with autism spectrum disorders (ASD). This case report describes the reduction of RPRs and changes in cognitive function after transcutaneous electrical nerve stimulation (TENS) of muscle. Three individuals were examined in a study at the Institute for Neurology and Neurosurgery in Havana, Cuba. Two child neurologists, not involved in the study, conducted clinical examinations on each participant and diagnosed each with ASD based on DSM-V criteria and the Autism Diagnostic Interview-Revised (an autism evaluation tool). Each child with ASD possessed a triad of impairments in three domains: social interaction, communication, and repetitive behaviour. Individuals were evaluated by quantitative electroencephalographic measures and tested by standardised cognitive function tests before and after 12 weeks of intervention. These interventions were associated with reduced ASD symptoms in the three domains, significant changes in qEEG network connectivity and significantly improved performance on standardised cognitive tests.

Keywords: Child and adolescent psychiatry; Child and adolescent psychiatry (paediatrics); Clinical neurophysiology; Developmental paediatrocs.

Figure 1

Case 1: (A) Presents the EEG background activity both before and after treatment. After treatment, the background activity is better organised with the appearance of the alpha rhythm, with its typical wax and waning pattern. (B) The qEEG spectrum before and after treatment. Before treatment, the qEEG spectrum is poorly delineated; after treatment, the spectrum is clearly outlined with a dominant alpha pattern. (C) qEEG map. Before treatment, alpha absolute power is not significantly present in the left hemisphere, but after the treatment, the qEEG map demonstrates a dominant alpha pattern.

Figure 2

Case 2: (A) Background activity: Before treatment, the background activity is poorly organised, with focal paroxysmal activity. After treatment, the background activity is very well organised, demonstrating the absence of paroxysmal activity. (B) qEEG spectrum. The qEEG spectrum prior to treatment is middle-to-well delineated, but after treatment, a dominant alpha pattern. (C) qEEG map. qEEG map before treatment demonstrates low alpha absolute power values, and after treatment, a dominant alpha pattern is evidenced.

Figure 3

Case 3: (A) Background activity. Before treatment, the background activity is poorly organised but well outlined after treatment. (B) qEEG spectrum. Before treatment, the qEEG spectrum is poorly delineated but demonstrates a dominant alpha pattern after treatment. (C) qEEG map. Before treatment, the qEEG map demonstrates significantly low values of alpha absolute power, a dominant alpha pattern is evidenced after treatment.