Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (10): 2550-2559.doi: 10.12307/2026.649

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Efficacy of non-invasive neuromodulation techniques on autism spectrum disorder: a network meta-analysis

Gao Shiai1, Yu Zifu2, Chen Jinhui1, Cao Xinyan1, Leng Xiaoxuan1, Liu Xihua3   

  1. 1School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China; 2Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong Province, China; 3Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • Received:2025-04-09 Accepted:2025-06-26 Online:2026-04-08 Published:2025-08-30
  • Contact: Liu Xihua, PhD, Associate chief physician, Master’s supervisor, Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • About author:Gao Shiai, MS candidate, School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
  • Supported by:
    National Natural Science Foundation of China for the Youth, No. 81802239 (to LXH); Shandong Provincial Traditional Chinese Medicine Science and Technology Project, No. M-2023142 (to LXH); Shandong Provincial Medical Staff Science and Technology Innovation Program, No. SDYWZGKCJH2022024 (to LXH)

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Abstract: OBJECTIVE: To systematically evaluate the rehabilitation efficacy of different non-invasive neuromodulation techniques in children with autism spectrum disorder by network meta-analysis. 
METHODS: A literature search was conducted in CNKI, VIP, WanFang, China Biomedical Literature Database, PubMed, Web of Science, Cochrane Library, and Embase for randomized controlled trials of different non-invasive neuromodulation techniques to improve autism spectrum disorders. The search time was from database inception to January 2025, and two reviewers independently screened the literature, extracted the data, and evaluated the quality of the included studies, and used Stata 18.0 to perform a network meta-analysis of the data. 
RESULTS: A total of 32 randomized controlled trials involving 8 intervention modalities were included. The results of network meta-analysis showed that based on the application of conventional rehabilitation training, virtual reality technology had the best effect in improving the score of the Autism Behavior Scale [standardized mean difference (SMD)=-12.55, 95% confidence interval (CI) (-20.85, -4.25), P < 0.05], followed by Theta burst magnetic stimulation [SMD=-11.34, 95% CI (-20.94, -1.74), P < 0.05], repetitive transcranial magnetic stimulation [SMD=-9.28, 95% CI (-12.80, -5.77), P < 0.05], and neurofeedback technology [SMD=-8.75, 95% CI (-15.26, -2.23), P < 0.05]. In terms of the Childhood Autism Rating Scale score, virtual reality technology had the most significant improvement effect [SMD=-6.36, 95% CI (-9.61, -3.11), P < 0.05], followed by repetitive transcranial magnetic stimulation [SMD=-5.98, 95% CI (-9.46, -2.51), P < 0.05], neurofeedback technology [SMD=-4.63, 95% CI (-9.14, -0.13), P < 0.05], and transcutaneous electrical nerve stimulation [SMD=-4.14, 95% CI (-5.73, -2.55), P < 0.05]. In terms of Autism Treatment Assessment Scale score, neurofeedback technology had the most significant improvement effect [SMD=-16.44, 95% CI (-24.10, -8.78), P < 0.05], followed by virtual reality technology [SMD=-14.09, 95% CI (-22.45, -5.73), P < 0.05], repetitive transcranial magnetic stimulation [SMD=-12.06, 95% CI (-16.45, -7.68), P < 0.05], transcutaneous electrical nerve stimulation [SMD=-10.58, 95% CI (-20.44, -0.72), P < 0.05], and transcranial direct current stimulation [SMD=-9.75, 95% CI (-18.62, -0.88), P < 0.05].
CONCLUSION: The current evidence suggests that different non-invasive neuromodulation techniques have different effects on the improvement of autism spectrum disorder on the basis of conventional rehabilitation training. Virtual reality shows the best effect in improving Autism Behavior Scale and Child Autism Rating Scale scores, while neurofeedback technology shows the most significant improvement in Autism Treatment Assessment Scale scores. Due to the limitations of the number and quality of included studies, these conclusions need to be validated by more high-quality studies.


Key words: autism spectrum disorder, non-invasive neuromodulation techniques, virtual reality technology, network meta-analysis, randomized controlled trials

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