Cucinotta Francesca, Ricciardello Arianna, Turriziani Laura, Mancini Arianna, Keller Roberto, Sacco Roberto, Persico Antonio M
Interdepartmental Program "Autism 0-90", "G. Martino" University Hospital, Messina, Italy.
IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
Front Psychiatry. 2022 Mar 3;13:829516. doi: 10.3389/fpsyt.2022.829516. eCollection 2022.
Increased oxidative stress and defective mitochondrial functioning are shared features among many brain disorders. The aim of this study was to verify retrospectively the clinical efficacy and safety of a metabolic support therapy with Q10 ubiquinol, vitamin E and complex-B vitamins in various neurodevelopmental disorders. This retrospective chart review study included 59 patients (mean age 10.1 ± 1.2 y.o., range 2.5-39 years; M:F = 2.47:1), diagnosed with Autism Spectrum Disorder ( = 17), Autism Spectrum Disorder with co-morbid Intellectual Disability ( = 19), Intellectual Disability or Global Developmental Delay ( = 15), Attention-Deficit/Hyperactivity Disorder ( = 3) and Intellectual Disability in Phelan-McDermid syndrome due to chr. 22q13.33 deletion ( = 5). After a minimum of 3 months of therapy, a positive outcome was recorded in 45/59 (76.27%) patients, with Clinical Global Impression-Improvement scores ranging between 1 ("very much improved") and 3 ("minimally improved"). The most widespread improvements were recorded in cognition ( = 26, 44.1%), adaptative functioning ( = 26, 44.1%) and social motivation ( = 19, 32.2%). Improvement rates differed by diagnosis, being observed most consistently in Phelan-McDermid Syndrome (5/5, 100%), followed by Intellectual Disability/Global Developmental Delay (13/15, 86.7%), Autism Spectrum Disorder with co-morbid Intellectual Disability (15/19, 78.9%), Autism Spectrum Disorder (11/17, 64.7%) and ADHD (1/3, 33.3%). No significant adverse event or side effect leading to treatment discontinuation were recorded. Mild side effects were reported in 18 (30.5%) patients, with the most frequent being increased hyperactivity (9/59, 15.3%). This retrospective chart review suggests that metabolic support therapy with Q10 ubiquinol, vitamin E and complex-B vitamins is well tolerated and produces some improvement in the majority of patients with neurodevelopmental disorders, especially in the presence of intellectual disability. Randomized controlled trials for each single neurodevelopmental disorder are now warranted to conclusively demonstrate the efficacy of these mitochondrial bioenergetic and antioxidant agents and to estimate their therapeutic effect size.
氧化应激增加和线粒体功能缺陷是许多脑部疾病的共同特征。本研究的目的是回顾性验证泛醇Q10、维生素E和复合B族维生素代谢支持疗法在各种神经发育障碍中的临床疗效和安全性。这项回顾性病历审查研究纳入了59例患者(平均年龄10.1±1.2岁,范围2.5 - 39岁;男:女 = 2.47:1),诊断为自闭症谱系障碍(n = 17)、合并智力残疾的自闭症谱系障碍(n = 19)、智力残疾或全面发育迟缓(n = 15)、注意力缺陷/多动障碍(n = 3)以及因22q13.33染色体缺失导致的费兰 - 麦克德米德综合征智力残疾(n = 5)。经过至少3个月的治疗,45/59(76.27%)的患者记录到了积极的结果,临床总体印象改善评分在1(“显著改善”)至3(“轻微改善”)之间。最普遍的改善出现在认知(n = 26,44.1%)、适应功能(n = 26,44.1%)和社交动机(n = 19,32.2%)方面。改善率因诊断而异,在费兰 - 麦克德米德综合征中观察到的改善最为一致(5/5,100%),其次是智力残疾/全面发育迟缓(13/15,86.7%)、合并智力残疾的自闭症谱系障碍(15/19,78.9%)、自闭症谱系障碍(11/17,64.7%)和注意力缺陷多动障碍(1/3,33.3%)。未记录到导致治疗中断的显著不良事件或副作用。18例(30.5%)患者报告了轻微副作用,最常见的是多动增加(9/59,15.3%)。这项回顾性病历审查表明,泛醇Q10、维生素E和复合B族维生素的代谢支持疗法耐受性良好,并且在大多数神经发育障碍患者中产生了一些改善,尤其是在存在智力残疾的情况下。现在需要针对每种单一的神经发育障碍进行随机对照试验,以最终证明这些线粒体生物能量和抗氧化剂的疗效,并估计它们的治疗效应大小。