Wink Logan K, Minshawi Noha F, Shaffer Rebecca C, Plawecki Martin H, Posey David J, Horn Paul S, Adams Ryan, Pedapati Ernest V, Schaefer Tori L, McDougle Christopher J, Swiezy Naomi B, Erickson Craig A
Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
Christian Sarkine Autism Treatment Center, Riley Hospital for Children at Indiana University Health and the Indiana University School of Medicine Department of Psychiatry, Indianapolis, IN USA.
Mol Autism. 2017 Jan 25;8:2. doi: 10.1186/s13229-017-0116-1. eCollection 2017.
d-Cycloserine (DCS) enhances extinction learning across species, but it has proven challenging to identify consistent benefit of DCS when added to therapeutic interventions. We conducted a placebo-controlled trial of DCS to potentiate social skills training in autism spectrum disorder (ASD) but found substantial improvement in both the DCS and placebo groups at the conclusion of active treatment. Here, we assess the impact of DCS 11 weeks following active treatment to evaluate the impact of DCS on treatment response durability.
Study participants included 60 outpatient youth with ASD, ages 5-11 years, all with IQ above 70, and significantly impaired social functioning who completed a 10-week active treatment phase during which they received weekly single doses of 50 mg of DCS or placebo administered 30 min prior to group social skills training. Following the 10-week active treatment phase, blinded follow-up assessments occurred at week 11 and week 22. The primary outcome measure for our durability of treatment evaluation was the parent-rated social responsiveness scale (SRS) total raw score at week 22.
Analysis of the SRS total raw score demonstrated significant decrease for the DCS group compared to the placebo group ( = 0.042) indicating greater maintenance of treatment effect in the DCS group. DCS was well tolerated, with irritability being the most frequently reported adverse effect in both groups.
The findings of this study suggest that DCS may help youth with ASD to maintain skills gained during sort-term social skills training. Larger-scale studies with longer follow-up will be necessary to further understand the long-term impact of DCS paired with structured social skills training.
ClinicalTrials.gov, NCT01086475.
d-环丝氨酸（DCS）可增强跨物种的消退学习，但事实证明，在治疗干预中添加DCS时，要确定其一致的益处具有挑战性。我们进行了一项DCS的安慰剂对照试验，以增强自闭症谱系障碍（ASD）的社交技能训练，但在积极治疗结束时发现DCS组和安慰剂组均有显著改善。在此，我们评估积极治疗11周后DCS的影响，以评估DCS对治疗反应持久性的影响。
研究参与者包括60名年龄在5至11岁之间的ASD门诊青少年，他们的智商均高于70，社交功能严重受损，他们完成了一个为期10周的积极治疗阶段，在此期间，他们在每周一次的小组社交技能训练前30分钟接受50毫克DCS或安慰剂的单剂量治疗。在为期10周的积极治疗阶段之后，在第11周和第22周进行了盲法随访评估。我们评估治疗持久性的主要结局指标是第22周时家长评定的社交反应量表（SRS）总原始得分。
与安慰剂组相比，DCS组的SRS总原始得分分析显示显著降低（P = 0.042），表明DCS组的治疗效果维持得更好。DCS耐受性良好，易怒是两组中最常报告的不良反应。
本研究结果表明，DCS可能有助于患有ASD的青少年维持在短期社交技能训练中获得的技能。需要进行更大规模、更长随访时间的研究，以进一步了解DCS与结构化社交技能训练相结合的长期影响。
ClinicalTrials.gov，NCT01086475。
