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[添加到大剂量二十二碳六烯酸中的花生四烯酸对自闭症谱系障碍个体社交障碍的治疗作用及其与多不饱和脂肪酸变化的关系]

[Therapeutic effects of larger doses of arachidonic acid added to DHA on social impairment and its relation to alterations of polyunsaturated fatty acids in individuals with autism spectrum disorders].

作者信息

Yui Kunio, Koshiba Mamiko, Nakamura Shun, Onishi Masako

机构信息

Research Institute of Pervasive Developmental Disorders, 13-22 Rokurokuso-machi, Ashiya 659 8511, Japan.

出版信息

Nihon Shinkei Seishin Yakurigaku Zasshi. 2011 Jun;31(3):117-24.

Abstract

The polyunsaturated fatty acids (PUFAs), arachidonic acid (ARA) and docosahexaenoic acid (DHA) may play key roles in brain network maturation. ARA plays an important role in signal transduction related to neuronal maturation. This study aims to evaluate the efficacy of supplementing with larger doses of ARA added to DHA in a double-blind, placebo-controlled 16-week trial. To confirm findings observed in the placebo-controlled trial, an additional 16-week open-label study was further conducted. To examine the relationship between the efficacy of the supplementation regimen and alterations in PUFAs levels, we examined plasma levels of PUFAs. We used the Social Responsiveness Scale (SRS) and the Aberrant Behavior Checklist-Community (ABC) to estimate psychotic symptoms. Repeated measures ANOVA revealed that this supplementation significantly improved SRS-measured communication as well as ABC-measured social withdrawal during the placebo-controlled trial. The treatment effect sizes were more favorable for the treatment group compared with the placebo group (communication: 0.87 vs. 0.44; social withdrawal: 0.88 vs. 0.54). At the end of the placebo-controlled trial, there was a significant difference in the change in plasma ARA levels from the baseline and a trend towards a significant difference in plasma ARA levels between the two groups. The open-label study was not powered to detect significant improvements in the outcome measures or significant differences in plasma ARA levels. The present clinical trials suggest that supplementation with larger ARA doses added to DHA improves social impairment in individuals with ASD via ARA-induced upregulation of neuronal functioning.

摘要

多不饱和脂肪酸(PUFAs)、花生四烯酸(ARA)和二十二碳六烯酸(DHA)可能在脑网络成熟过程中发挥关键作用。ARA在与神经元成熟相关的信号转导中起重要作用。本研究旨在通过一项为期16周的双盲、安慰剂对照试验,评估在DHA中添加较大剂量ARA进行补充的效果。为了证实安慰剂对照试验中观察到的结果,又进一步开展了一项为期16周的开放标签研究。为了研究补充方案的效果与PUFAs水平变化之间的关系,我们检测了血浆中PUFAs的水平。我们使用社会反应量表(SRS)和异常行为检查表-社区版(ABC)来评估精神症状。重复测量方差分析显示,在安慰剂对照试验期间,这种补充显著改善了SRS测量的沟通能力以及ABC测量的社交退缩情况。与安慰剂组相比,治疗组的治疗效应量更有利(沟通能力:0.87对0.44;社交退缩:0.88对0.54)。在安慰剂对照试验结束时,两组血浆ARA水平相对于基线的变化存在显著差异,且两组间血浆ARA水平有显著差异的趋势。开放标签研究没有足够的效力来检测结局指标的显著改善或血浆ARA水平的显著差异。目前的临床试验表明,在DHA中添加较大剂量的ARA进行补充,可通过ARA诱导的神经元功能上调来改善自闭症谱系障碍(ASD)个体的社交障碍。

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