Application of Concomitant Transcranial Direct Current Stimulation (tDCS) and Cognitive Behavioral-Oriented Training (CBT) for Pragmatic Skills Improvement in Young Adults with Autism Spectrum Disorder (ASD): Preliminary Data from a Pilot Study

Objectives: Individuals with Autism Spectrum Disorder (ASD) exhibit difficulties in the social use of language, regardless of age, cognitive abilities, and symptom severity. The left Broca's area and adjacent cortex are crucial for socio-pragmatic language, particularly in retrieving and integrating context-dependent words. Neuroimaging studies in ASD have shown hypoactivation of the Broca's area and an aberrant pattern of functional connectivity between language-related regions, suggesting their potential involvement in socio-communicative deficits. Given the potential of tDCS to modulate brain activity, its application targeting Broca's areas in addition to psychological intervention may represent a promising approach for enhancing socio-communicative skills in ASD. Thus, this study aims to investigate the effect of concomitant anodal tDCS and cognitive behavioral-oriented training (CBT) on pragmatic and communicative skills in young adults with ASD. Methods: A sample of 10 ASD individuals (18-25 years) underwent treatment with both active and sham tDCS targeting the left Broca's area during concomitant CBT. Each condition was delivered for five consecutive days, and the order of the conditions was blindly randomized. Results: Active tDCS significantly improved global communicative and pragmatic abilities compared to sham. A negative correlation was observed between communicative skills improvement and Intelligence Quotient (IQ); no significant association was found between IQ and ASD symptoms' severity. Conclusions: Multisession tDCS targeting the left Broca's area, combined with CBT, may enhance social language in terms of both production and comprehension of non-literal meanings, supporting Broca's area as a central neural hub for social language.