Autism Clinic for Translational Research, Brain & Mind Research Institute, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia.
Autism Clinic for Translational Research, Brain & Mind Research Institute, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia.
Biol Psychiatry. 2016 Feb 1;79(3):234-42. doi: 10.1016/j.biopsych.2015.06.028. Epub 2015 Jul 2.
Observed impairment in reciprocal social interaction is a diagnostic hallmark of autism spectrum disorders. There is no effective medical treatment for these problems. Psychological treatments remain costly, time intensive, and developmentally sensitive for efficacy. In this review, we explore the potential of oxytocin-based therapies for social impairments in autism. Evidence shows that acute oxytocin administration improves numerous markers critical to the social circuitry underlying social deficits in autism. Oxytocin may optimize these circuits and enhance reward, motivation, and learning to improve therapeutic outcomes. Despite this, the current evidence of therapeutic benefit from extended oxytocin treatment remains very limited. We highlight complexity in crossing from the laboratory to the autism clinical setting in evaluation of this therapeutic. We discuss a clinical trial approach that provides optimal opportunity for therapeutic response by using personalized methods that better target specific circuitry to define who will obtain benefit, at what stage of development, and the optimal delivery approach for circuitry manipulation. For the autism field, the therapeutic challenges will be resolved by a range of treatment strategies, including greater focus on specific interventions, such as oxytocin, that have a strong basis in the fundamental neurobiology of social behavior. More sophisticated and targeted clinical trials utilizing such approaches are now required, placing oxytocin into the autism context.
社交互动受损是自闭症谱系障碍的一个诊断标志。目前，这些问题还没有有效的医学治疗方法。心理治疗仍然昂贵、费时且对疗效的发展敏感。在这篇综述中，我们探讨了基于催产素的疗法治疗自闭症社交障碍的潜力。有证据表明，急性催产素给药可以改善许多对自闭症社交缺陷相关社交回路至关重要的标志物。催产素可以优化这些回路，增强奖励、动机和学习能力，从而改善治疗效果。尽管如此，目前关于延长催产素治疗的治疗益处的证据仍然非常有限。我们强调了在评估这种治疗方法时，从实验室到自闭症临床环境的复杂性。我们讨论了一种临床试验方法，该方法通过使用个性化方法提供了最佳的治疗反应机会，这些方法可以更好地针对特定回路，以确定谁将受益、在哪个发育阶段受益以及最佳的回路操作的传递方法。对于自闭症领域，治疗挑战将通过一系列治疗策略来解决，包括更加关注催产素等具有强大社交行为基础的神经生物学的特定干预措施。现在需要更复杂和有针对性的临床试验来利用这些方法，将催产素应用于自闭症领域。
