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一项评估早期行为干预与普萘洛尔联合对自闭症谱系障碍(ASD)影响的试点可行性研究。

A Pilot Feasibility Study Assessing the Combined Effects of Early Behavioral Intervention and Propranolol on Autism Spectrum Disorder (ASD).

作者信息

Hirst Kathy, Zamzow Rachel M, Stichter Janine P, Beversdorf David Q

机构信息

Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO 65211, USA.

Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO 65211, USA.

出版信息

Children (Basel). 2023 Sep 30;10(10):1639. doi: 10.3390/children10101639.

Abstract

Autism spectrum disorder (ASD), a neurodevelopmental disorder typified by differences in social communication as well as restricted and repetitive behaviors, is often responsive to early behavioral intervention. However, there is limited information on whether such intervention can be augmented with pharmacological approaches. We conducted a double-blinded, placebo-controlled feasibility trial to examine the effects of the β-adrenergic antagonist propranolol combined with early intensive behavioral intervention (EIBI) for children with ASD. Nine participants with ASD, ages three to ten, undergoing EIBI were enrolled and randomized to a 12-week course of propranolol or placebo. Blinded assessments were conducted at baseline, 6 weeks, and 12 weeks. The primary outcome measures focusing on social interaction were the General Social Outcome Measure-2 (GSOM-2) and Social Responsiveness Scale-Second Edition (SRS-2). Five participants completed the 12-week visit. The sample size was insufficient to evaluate the treatment efficacy. However, side effects were infrequent, and participants were largely able to fully participate in the procedures. Conducting a larger clinical trial to investigate propranolol's effects on core ASD features within the context of behavioral therapy will be beneficial, as this will advance and individualize combined therapeutic approaches to ASD intervention. This initial study helps to understand feasibility constraints on performing such a study.

摘要

自闭症谱系障碍(ASD)是一种神经发育障碍,其特征为社交沟通方面的差异以及受限的重复行为,通常对早期行为干预有反应。然而,关于这种干预是否可以通过药物治疗方法得到增强的信息有限。我们进行了一项双盲、安慰剂对照的可行性试验,以研究β-肾上腺素能拮抗剂普萘洛尔联合早期强化行为干预(EIBI)对患有ASD的儿童的影响。九名年龄在三至十岁、正在接受EIBI的ASD参与者被纳入研究,并随机分为接受12周普萘洛尔治疗或安慰剂治疗的组。在基线、6周和12周时进行盲法评估。侧重于社交互动的主要结局指标是一般社会结局测量-2(GSOM-2)和社交反应量表第二版(SRS-2)。五名参与者完成了12周的访视。样本量不足以评估治疗效果。然而,副作用很少见,并且参与者基本上能够充分参与研究程序。进行一项更大规模的临床试验,以研究普萘洛尔在行为治疗背景下对ASD核心特征的影响将是有益的,因为这将推进并使ASD干预的联合治疗方法个性化。这项初步研究有助于了解进行此类研究的可行性限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b628/10605265/1f7ee37fcac5/children-10-01639-g001.jpg

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