ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Autism
Unveiling Heterogeneous Gaze Patterns in Autistic Children Undergoing rTMS: Insights from Latent Profile Analysis
Provisionally accepted
- 1Tianjin Municipal Mental Health Center, Tianjin, China
- 2Tianjin Medical University, Tianjin, China
- 3Tianjin Huanhu Hospital, Tianjin, China
- 4Tianjin University, Tianjin, China
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Aim: Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising intervention for Autism Spectrum Disorder (ASD), but objective markers for rTMS tolerance remain lacking. This case-control study explored gaze behavior variability toward emotional faces in ASD children undergoing rTMS, focusing on identifying subgroups associated with rTMS intolerance. Method: Eye-tracking data (Tobii technology, preferential-looking paradigm) were collected from 104 ASD children (48 intolerant, 56 tolerant) receiving DLPFC-targeted rTMS (left high-frequency, right low-frequency). Latent Profile Analysis (LPA) identified fixation subgroups across eight conditions. Demographic (sex, age), clinical (CARS scores) differences, and profile-tolerance associations were analyzed. Results: LPA revealed three gaze profiles: moderate non-preferential fixation (80.76%), low diverse fixation (9.62%), and increased fixation with mild variability (9.62%). Sex and CARS scores differed across profiles (age did not). Intolerance rates were 38.1%, 60.0%, and 100%, with profiles predicting rTMS intolerance (OR=0.210, 95% CI: 0.079–0.557). Conclusion: ASD children exhibit heterogeneous emotional face gaze patterns. Findings highlight the need for personalized rTMS interventions, especially for those with higher CARS scores and increased emotional face fixation—at elevated intolerance risk.
Keywords: Autism spectrum disorder (ASD), Repetitive Transcranial Magnetic, Stimulation (rTMS), Latent profile analysis (LPA), Gaze Patterns, tolerance
Received: 13 Jul 2025; Accepted: 04 Dec 2025.
Copyright: © 2025 Yang, Xu, Xiao, Tian, Li, Zhang and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lei Gao
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