This month's blog is regarding ‘treatment under evaluation’ and autism spectrum disorder (ASD). The following, recently published, studies represent some of the numerous ways and means that various interventions are being investigated for different aspects of ASD. Each study adds to the huge scientific knowledge base that informs us about ASD and guides clinical decisions and guidance about ASD.
Science is evidence!
Probiotic + oxytocin for ASD = more study required?
Combining the probiotic Lactobacillus plantarum PS128 with the hormone oxytocin may improve some aspects of ASD according to a new study from Harvard Medical School. Utilizing a gold-standard double blind, placebo-controlled trial design, researchers examined whether a dual intervention targeting both the gut microbiome and a biological part of the system that contributes to human sociability may have some usefulness in ASD. Their results, while not overwhelmingly significant, suggested positive changes in blinded clinical impression scores of autism after intervention.
Kong XJ, Liu J, Liu K, Koh M, Sherman H, Liu S, Tian R, Sukijthamapan P, Wang J, Fong M, Xu L, Clairmont C, Jeong MS, Li A, Lopes M, Hagan V, Dutton T, Chan SP, Lee H, Kendall A, Kwong K, Song Y. Probiotic and Oxytocin Combination Therapy in Patients with Autism Spectrum Disorder: A Randomized, Double-Blinded, Placebo- Controlled Pilot Trial. Nutrients. 2021 May 5;13(5):1552. doi: 10.3390/nu13051552.
Treating immune related problems in ASD has behavioral benefits
Analysis of data obtained from over 25 clinical studies of the immune system medicine intravenous immunoglobulin (IVIG) for ASD revealed that IVIG treatment use is associated with some behavioral improvements in ASD. The application of the meta-analysis, the pinnacle of scientific inquiry, to IVIG showed various improvements to social communication and other behaviors following therapeutic use. This was accompanied by positive changes in important markers of inflammation and immune activation. Further, more scientifically rigorous studies are required to ascertain which groups of people with ASD may benefit most from IVIG and why.
Rossignol DA, Frye RE. A Systematic Review and Meta-Analysis of Immunoglobulin G Abnormalities and the Therapeutic Use of Intravenous Immunoglobulins (IVIG) in Autism Spectrum Disorder. J Pers Med. 2021 May 30;11(6):488. doi: 10.3390/jpm11060488.
One more time: melatonin is good for sleep in ASD
Melatonin, the premier medicine for treating a range of sleep problems, once again proves its usefulness for sleep issues in ASD according to new research from Japan. Including nearly 200 children with ASD, researchers administered various doses of melatonin and compared a measure of sleep latency onset (time taken to get to sleep) with a placebo or dummy medicine. Those taking melatonin fell asleep much quicker than those taking the placebo. Sleep is a big issue for many people with ASD. Given also the intricate connection between sleep and behaviour in ASD, the usefulness of melatonin may far extend beyond just improved sleeping patterns.
Hayashi M, Mishima K, Fukumizu M, Takahashi H, Ishikawa Y, Hamada I, Sugioka H, Yotsuya O, Yamashita Y. Melatonin Treatment and Adequate Sleep Hygiene Interventions in Children with Autism Spectrum Disorder: A Randomized Controlled Trial. J Autism Dev Disord. 2021 Jun 28. doi: 10.1007/s10803-021 05139-w. Epub ahead of print.
Abstract: https://pubmed.ncbi.nlm.nih.gov/34181143
Transcranial direct current stimulation for autism: an emerging intervention
A non-invasive way of stimulating areas of the brain may show promise as an intervention for ASD according to a review of existing research. Already used therapeutically across many different conditions, transcranial direct current stimulation (tDCS) applied to ASD produced improvements in social communication and cognitive abilities when targeting various areas of the brain. Additional studies are required to provide further information on mechanisms and the duration of any effects from tDCS.
Luckhardt C, Boxhoorn S, Schütz M, Fann N, Freitag CM. Brain stimulation by tDCS as treatment option in Autism Spectrum Disorder-A systematic literature review. Prog Brain Res. 2021;264:233-257. doi: 10.1016/bs.pbr.2021.03.002. Epub 2021 Apr 16.
Abstract: https://pubmed.ncbi.nlm.nih.gov/34167658
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