A small pilot study has shown that deep brain stimulation (DBS), a surgical treatment that delivers electrical signals to specific areas of the brain, may help reduce severe self-injurious behavior in children with autism spectrum disorder (ASD).
The results, published in the journal Biological Psychiatry, suggest that this approach is relatively safe and may improve quality of life for children who haven’t responded to other treatments.
Children with ASD who engage in frequent, severe self-injury—such as head banging, biting, or scratching—face serious risks, including permanent physical harm.
Unfortunately, not all children benefit from behavioral therapies or medications, leaving families and doctors with very limited options.
In this new study, a team of researchers led by Dr. George M. Ibrahim at The Hospital for Sick Children in Toronto tested the use of DBS on a region of the brain called the nucleus accumbens (NAc), which is involved in processing rewards and motivation.
The NAc is a key part of the brain’s reward system, and it helps regulate behavior through dopamine signals. In some mental health disorders, including obsessive-compulsive disorder (OCD), it has been used as a DBS target to help reduce compulsive or repetitive behaviors.
This was the first clinical trial to test DBS in children for a neurodevelopmental condition like autism. The phase I study included six children between the ages of 7 and 14 who showed extremely severe and treatment-resistant self-injurious behavior.
The trial was closely monitored and approved by Health Canada, and a full team of doctors, surgeons, and mental health professionals supported the children and their families throughout the process.
The children underwent surgery to implant electrodes in their brains, targeting the nucleus accumbens. After the surgery, researchers used wearable devices to track movements and self-injurious actions. They also conducted brain scans (PET scans) to observe changes in brain activity.
Over time, the team noticed significant reductions in self-harming behaviors, along with improvements in overall quality of life. Changes in the brain’s activity patterns also supported the observed behavioral improvements.
Dr. Ibrahim explained that existing medications for this type of behavior are often used off-label, meaning they haven’t been formally approved for this purpose.
These drugs tend to be only modestly effective and may cause serious side effects. “There is a critical and unmet need to develop effective treatments for children with severe, refractory self-injurious behavior,” he said.
Dr. John Krystal, Editor of Biological Psychiatry, emphasized the seriousness of the condition: “Repetitive self-injurious behavior is a terribly dangerous and potentially life-threatening condition for which there are limited treatment options.
While the findings are extremely preliminary, they suggest that stimulation of this reward-related region of the brain may reduce self-injurious behavior, justifying further study.”
Though DBS has been more commonly used in adults to treat conditions like Parkinson’s disease, epilepsy, and OCD, its use in children is still rare. That’s why this study is so important—it opens the door to developing safer and more targeted treatments for some of the most vulnerable young patients.
Review and Analysis
This pilot study is a groundbreaking step toward addressing one of the most difficult-to-treat symptoms in autism—severe self-injury. For children whose behaviors put their health and safety at risk, and for whom standard therapies have failed, DBS offers a potential new path forward.
The key finding is that targeting the brain’s reward system (the nucleus accumbens) may help reduce harmful behavior. While only six children were included in this first trial, the improvements in both self-harming behaviors and quality of life are encouraging.
However, this is early-stage research. More studies involving larger numbers of children are needed to better understand how well this works, how long the benefits last, and what risks may come with the procedure.
DBS is a surgical intervention and involves complex brain circuitry, so it won’t be appropriate for every child. But for those with the most severe and life-threatening self-injury, it may offer hope where there previously was none.
In summary, this study is the first of its kind and marks a major step forward in exploring how advanced brain-based treatments can support children with autism and severe behavioral challenges. It encourages continued research into the safety, effectiveness, and long-term outcomes of DBS for neurodevelopmental disorders in children.
If you care about autism, please read studies about a new cause of autism, and cats may help decrease anxiety for kids with autism.
For more information about health, please see recent studies about vitamin D that may hold the clue to more autism, and results showing strange eating habits may signal autism.
The research findings can be found in Biological Psychiatry.
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