经皮尼古丁治疗自闭症谱系障碍成人攻击行为和易激惹的探索性试验
An Exploratory Trial of Transdermal Nicotine for Aggression and Irritability in Adults with Autism Spectrum Disorder.
机构信息
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Department of Psychiatry, Yale University School of Medicine, 184 Liberty Street, Room LV120, New Haven, CT, 06519, USA.
出版信息
J Autism Dev Disord. 2018 Aug;48(8):2748-2757. doi: 10.1007/s10803-018-3536-7.
Abstract
Nicotinic acetylcholine receptors (nAChRs), particularly the α7 nAChR, are implicated in the pathophysiology of both autism spectrum disorder (ASD) and aggressive behavior. We explored the feasibility, tolerability, and preliminary efficacy of targeting nAChRs using transdermal nicotine to reduce aggressive symptoms in adults with ASD. Eight subjects were randomized in a double-blind crossover trial of 7 mg transdermal nicotine or placebo, each for 1 week. All participants tolerated nicotine treatment well. Five subjects contributed data to the primary outcome, Aberrant Behavior Checklist-Irritability (ABC-I) subscale change from baseline, which was improved by nicotine compared to placebo. Sleep ratings were also improved by nicotine and correlated with ABC-I improvement. These findings support further investigation of nAChR agonists for aggression and sleep in ASD.
摘要
烟碱型乙酰胆碱受体（nAChRs），特别是α7 nAChR，与自闭症谱系障碍（ASD）和攻击性行为的病理生理学有关。我们探索了使用透皮尼古丁靶向 nAChRs 以减少 ASD 成人攻击症状的可行性、耐受性和初步疗效。8 名受试者在双盲交叉试验中随机分为 7mg 透皮尼古丁或安慰剂组，每组治疗 1 周。所有参与者均能很好地耐受尼古丁治疗。5 名受试者的主要结局数据（从基线开始的异常行为检查表-易怒（ABC-I）分量表变化）有所改善，与安慰剂相比，尼古丁治疗组的 ABC-I 改善更明显。尼古丁还改善了睡眠评分，并与 ABC-I 的改善相关。这些发现支持进一步研究 nAChR 激动剂在 ASD 中的攻击性和睡眠作用。
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