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Paired-pulse transcranial magnetic stimulation (TMS) measures, including intracortical facilitation (ICF), short interval cortical inhibition (SICI), and cortical silent period (CSP) were measured in an age matched cohort of youth with ASD- (<jats:italic>n<\/jats:italic>\u2009=\u200920), ASD\u2009+\u2009(<jats:italic>n<\/jats:italic>\u2009=\u200929), and controls (TDC) (<jats:italic>n<\/jats:italic>\u2009=\u200924). ASD\u2212 and ASD+ groups did not differ by IQ or social functioning; however, ASD+ had significantly higher inattention and hyperactivity ratings. ICF (higher ratio indicates greater facilitation) in ASD+ (Mean 1.0, SD 0.19) was less than ASD\u2212 (Mean 1.3, SD 0.36) or TDC (Mean 1.2, SD 0.24) (F2,68\u2009=\u20096.5,<jats:italic>p<\/jats:italic>\u2009=\u20090.003; post-hoc tests, ASD+ vs either TDC or ASD\u2212,<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.05). No differences were found between groups for SICI or age corrected active\/resting motor threshold (AMT\/RMT). Across all ASD youth (ASD\u2212 and ASD+), ICF was inversely correlated with worse inattention (Conners-3 Inattention (r\u2009=\u2009\u22120.41;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and ADHDRS-IV Inattention percentile (r\u2009=\u2009\u22120.422,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) scores. ICF remains intact in ASD\u2212 but is impaired in ASD+. Lack of ICF is associated with inattention and executive function across ASD. Taken with the present findings, ADHD may have a distinct electrophysiological \u201csignature\u201d in ASD youth. ICF may constitute an emerging biomarker to study the physiology of ADHD in ASD, which may align with disease prognosis or treatment response.<\/jats:p>","DOI":"10.1038\/s41398-019-0614-3","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T10:03:17Z","timestamp":1573639397000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Motor cortex facilitation: a marker of attention deficit hyperactivity disorder co-occurrence in autism spectrum disorder"],"prefix":"10.1038","volume":"9","author":[{"given":"Ernest V.","family":"Pedapati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey N.","family":"Mooney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve W.","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig A.","family":"Erickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Sweeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca C.","family":"Shaffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4990-5754","authenticated-orcid":false,"given":"Paul S.","family":"Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan K.","family":"Wink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald L.","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"614_CR1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.rasd.2016.07.003","volume":"31","author":"T Stevens","year":"2016","unstructured":"Stevens, T., Peng, L. & Barnard-Brak, L. 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E.V.P. receives current and\/or past research support by the NIH, American Academy of Child and Adolescent Psychiatry, and Cincinnati Children\u2019s Hospital Research Foundation. He is a clinical trial site investigator for the Marcus Autism Center and Statking. He receives compensation for consulting for Proctor & Gamble, Eccrine Systems, and Autism Speaks. He receives textbook royalties from Springer. C.A.E. has received funding from Confluence Pharmaceuticals, Novartis, F. Hoffmann-La Roche Ltd., Seaside Therapeutics, Riovant Sciences, Inc., Fulcrum Therapeutics, Neuren Pharmaceuticals Ltd., Alcobra Pharmaceuticals, Neurotrope, Zynerba Pharmaceuticals, Inc., and Ovid Therapeutics Inc. to consult on trial design or development strategies and\/or conduct clinical trials in neurodevelopmental disorders. C.A.E. is additionally the inventor or co-inventor on several patents held by Cincinnati Children\u2019s Hospital Medical Center or Indiana University School of Medicine describing methods of treatment of neurodevelopmental disorders. L.K.W. has received consulting fees from Ovid Therapeutics, research funding from Cures within Reach, Roivant Sciences, Ovid Therapeutics, Autism Speaks, NIH\/NICHD\/NIMH. She has no conflicts of interest directly relating to this research. S.W.W. receives research support from NIH and Tourette Association of America. He is the site principal investigator for an ataxia-telangiectasia clinical trial sponsored by EryDel S.p.A. S.W.W. is also a consultant for Medtronic. D.L.G. has received honoraria and\/or travel support from the Tourette Association of America\/ Centers for Disease Control and Prevention, the American Academy of Pediatrics, the Child Neurology Society, the Texas Neurological Society. He has received compensation for expert testimony for the U.S. National Vaccine Injury Compensation Program, through the Department of Health and Human Services, and for the US Armed Services\/US Attorney\u2019s Office of VA. D.L.G. has received research support from the NIH (NIMH, NINDS). He has received funding for work as a clinical trial site investigator from Ecopipam Pharmaceuticals (clinical trial, Tourette Syndrome) and EryDel (clinical trial, Ataxia Telangiectasia). He has received book royalties from Elsevier and Wolters Kluwer. L.N.M., P.S.H., R.C.S., and J.A.S. have no conflicts of interest to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"298"}}