Transcranial Magnetic Stimulation Shows Promise for Autism in Children; Study Questions Value of Hospital Consultants

A new wave of medical research is offering hope for families affected by autism spectrum disorder (ASD), while also raising tough questions about how nonprofit hospitals spend millions of dollars. This week, we break down four major health stories, including a groundbreaking treatment for children with autism, a smarter way to prescribe weight-loss drugs, the potential for using those same drugs to treat alcohol addiction, and a surprising finding about expensive hospital consultants.

New Brain Stimulation Technique Helps Children with Autism Communicate

For parents of children with autism spectrum disorder (ASD), finding effective treatments can feel like an uphill battle. While cognitive behavioral therapy (CBT) remains the only evidence-based treatment for improving social communication and other ASD-related challenges, a new study published in The Lancet suggests a different approach may be on the horizon: transcranial magnetic stimulation (TMS).

TMS is not new. Doctors have used it for years in adults to treat conditions like depression and other neuropsychiatric disorders. The technique works by applying magnetic pulses to specific areas of the brain. However, using TMS in children has always been difficult. The procedure requires the patient to stay perfectly still while doctors precisely target a brain region. For kids with autism—many of whom also have intellectual disabilities—this can be nearly impossible.

Researchers in China developed a modified version of TMS to overcome this hurdle. Instead of relying on brain scans (neuroimaging) to find the right spot, they used a technique called evoked potentials to identify the part of the motor cortex (the M1 area) responsible for speech and language. This area of the brain has only recently been linked to communication.

In the study, 200 children aged 4 to 10 with well-documented ASD—some with IQs below 70—received 1,800 pulses of stimulation over just 120 seconds. They repeated this ten times a day, five days a week, for about a month. The results were encouraging. Compared to a placebo group, the children who received the real TMS showed significant improvement in social communication impairment. They also experienced secondary improvements in language skills.

What This Means for Families

This research is particularly exciting because it targets a developing brain. “TMS affects neuroplasticity, and these are kids in whom the neural system is developing,” explained Dr. Rick Lange, president of Texas Tech Health El Paso, during a recent podcast discussion. This means the therapy might help the brain form new, healthier connections during a critical growth period.

However, experts caution that this is early-stage research. One major unanswered question is durability. How long do the benefits last? Will children need repeated treatments? The study did not provide long-term follow-up data. Additionally, researchers don’t yet know the optimal duration of treatment for the best results.

Practical Takeaways for Parents:

– Know the current standard: Cognitive behavioral therapy remains the most proven treatment for ASD-related social and communication issues.

– TMS is experimental: This new approach is not yet widely available. It is still being studied, and more research is needed before it can be recommended as a standard therapy.

– Stay informed: Look for future studies that track these children over time to see if the improvements stick.

– Talk to your doctor: If you are interested in TMS, ask your child’s specialist about clinical trials or emerging research.

A Smarter Way to Prescribe Weight-Loss Drugs?

The explosion of GLP-1 receptor agonists—drugs like semaglutide (Ozempic, Wegovy)—has transformed the treatment of obesity. But these medications are expensive, and not everyone who is overweight will develop serious complications. A new study in Nature Medicine proposes a data-driven model to help doctors figure out who should get these drugs first.

Researchers analyzed data from the UK Biobank, looking at roughly 200,000 people with a body mass index (BMI) over 27. They created a model using the 20 most informative health features—things like age, hemoglobin A1c (blood sugar), cholesterol, gender, weight-to-height ratio, and kidney function—to predict the future risk of 18 different obesity-related complications. These complications include chronic kidney disease, gout, type 2 diabetes, heart disease, sleep apnea, and more.

The model successfully identified people most likely to develop these problems. Interestingly, the highest-risk group was not the most severely obese. Instead, it was people in the “medium” obesity range (BMI 27 to 30) who appeared disproportionately likely to develop comorbidities. For this group, factors like age and lab results mattered more than just the number on the scale.

How This Affects You

If you are considering a GLP-1 medication, this model could change the conversation with your doctor. Instead of prescribing the drug based solely on BMI, your physician might use a risk assessment—similar to how they calculate heart disease risk—to determine if the medication is a good fit.

“Hopefully, it will allow us to target our more intensive therapies to those individuals that are more likely to have one of these comorbidities,” Dr. Lange said. For patients, seeing a clear, personalized risk score could also be highly motivating. Knowing that your specific profile puts you at high risk for developing diabetes or heart disease might encourage you to stick with the treatment, which is important because many people stop taking these drugs over time.

Can Weight-Loss Drugs Curb Alcohol Cravings?

In a separate study also published in The Lancet, researchers explored an unexpected side effect of GLP-1 drugs. Doctors have noticed that patients taking semaglutide for weight loss often report a reduced desire for alcohol. This observation led to a formal study on whether the drug could treat alcohol use disorder (AUD), a chronic brain condition characterized by a loss of control over drinking.

The 26-week, single-center trial enrolled people with both moderate-to-severe alcohol use disorder and obesity. Participants were randomly assigned to receive either a weekly injection of semaglutide or a placebo. Everyone in the study also received cognitive behavioral therapy.

The results were striking. Those who received semaglutide not only lost weight but also significantly reduced their heavy drinking days. They reported lower alcohol cravings, fewer drinks per drinking day, and a drop in total alcohol consumption.

What Experts Think

The exact mechanism is still unclear. Researchers believe the drug may work in two ways. First, it acts centrally in the brain (specifically in the hypothalamus) to reduce cravings—similar to how it reduces food cravings. Second, it may have peripheral effects in the body.

“It’s possible there are two [mechanisms],” Dr. Lange noted. “The central mechanism…and also peripheral mechanisms.” But he also raised important questions. Do the cravings return when the medication stops? Why didn’t some participants benefit at all? And most importantly, could this drug be used in people who are not obese but struggle with alcohol addiction? Future studies will need to examine side effects in non-obese users and whether reducing alcohol intake actually lowers the long-term risks of heart disease, liver disease, and neurological problems.

Do Expensive Hospital Consultants Actually Help?

Finally, a study in JAMA looked at a topic that affects every patient who walks through a hospital door: the use of management consultants. Nonprofit hospitals in the U.S. spend billions of dollars hiring outside experts for advice on strategy, cost-cutting, and technology. In fact, the healthcare industry now uses management consultants more than most other sectors of the economy.

Researchers analyzed 306 U.S. nonprofit hospitals that hired a management consultant for the first time between 2010 and 2022. They matched them with 513 similar hospitals that did not use consultants. The goal was to see if the consultants led to improvements in financial performance, operations, or patient care (measured by 30-day mortality and readmission rates for heart attack, pneumonia, and stroke).

The findings were sobering. More than 20% of all nonprofit hospitals used a consultant during the study period. The average payment to a consultant was nearly $16 million per hospital. Collectively, hospitals spent almost $8 billion on these services. Yet, researchers found no substantial, statistically significant, or systemic improvements linked to hiring the consultants.

Why This Matters to Patients

“Despite spending $8 billion from 2009 to 2023, no improvement in financial performance, operational measures, or quality-of-care measures,” Dr. Lange summarized. While the study could not determine why each hospital hired a consultant (some may be trying to fix problems, others may be preparing for a merger), the lack of any measurable benefit is striking.

Dr. Elizabeth Tracey, a medical journalist, pointed out that the public has a vested interest in how nonprofit hospitals spend their money. “It brings very clearly into question…the idea that they ought to be engaging management consultants at all,” she said. For patients, this raises a simple but powerful question: Could the billions spent on consultants be better used to improve patient care, lower costs, or support frontline staff? The study suggests it might be time for hospital boards to take a harder look at the value—or lack thereof—that these expensive advisors bring.

Source: MedPage Today