Appling Carrina, Nuraini Nanan, Holem Ryan, Hunter Samantha, Hirst Kathy, Takahashi Nicole, Mazurek Micah O, Kanne Stephen M, Ferguson Bradley, Beversdorf David Q
Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO 65212, USA.
Molecular Life Sciences Fellowship, University of Missouri, Columbia, MO 65212, USA.
J Pers Med. 2025 Jul 3;15(7):286. doi: 10.3390/jpm15070286.
Propranolol, a nonselective beta-adrenergic antagonist, has shown potential for improving anxiety in autistic individuals. Heart rate variability (HRV), a noninvasive cardiac marker of autonomic nervous system functioning, may help identify individuals most likely to benefit from propranolol. : Determine if baseline resting HRV and other cardiac measures predict the response to propranolol for anxiety and core autism symptomology in autistic children and young adults. Sixty-two autistic individuals (ages 7-24) participated in a two-phase (i.e., a 12-week randomized controlled trial and a 12-week open-label extension) trial of propranolol. Baseline (i.e., resting state, prior to treatment) HRV and other cardiac measures were obtained from an electrocardiogram. Clinical global impression for anxiety symptoms and overall behavioral treatment impact were assessed after the 12-week trial period. Group-level (i.e., all participants) and responder groups (i.e., strong, minimal, and non-responders to propranolol) were analyzed for treatment effects. HRV variables predicted group-level anxiety response to propranolol, particularly for strong responders. Also, lower baseline values of parasympathetic HRV indices were significantly correlated with greater behavioral improvement after treatment with propranolol. Last, several baseline cardiac variables were associated with improvement in multiple behavioral domains after treatment with propranolol. HRV may be a potential biomarker for predicting reduced anxiety and behavioral symptoms in response to propranolol in autistic children and young adults. Identifying autonomic profiles associated with positive treatment outcomes could guide future personalized interventions in autism. The results presented herein should be regarded as preliminary until the findings are replicated in future clinical trials.
普萘洛尔是一种非选择性β-肾上腺素能拮抗剂，已显示出改善自闭症个体焦虑症状的潜力。心率变异性（HRV）是自主神经系统功能的一种非侵入性心脏标志物，可能有助于识别最有可能从普萘洛尔治疗中获益的个体。目的：确定基线静息HRV和其他心脏指标是否能预测自闭症儿童和青少年对普萘洛尔治疗焦虑和核心自闭症症状的反应。62名自闭症个体（年龄7 - 24岁）参与了一项普萘洛尔的两阶段试验（即为期12周的随机对照试验和为期12周的开放标签扩展试验）。基线（即治疗前的静息状态）HRV和其他心脏指标通过心电图获得。在为期12周的试验期结束后，评估焦虑症状的临床总体印象和整体行为治疗效果。分析了组水平（即所有参与者）和反应者组（即对普萘洛尔反应强烈、反应轻微和无反应者）的治疗效果。HRV变量预测了组水平对普萘洛尔的焦虑反应，特别是对反应强烈者。此外，副交感神经HRV指数的较低基线值与普萘洛尔治疗后更大的行为改善显著相关。最后，几个基线心脏变量与普萘洛尔治疗后多个行为领域的改善相关。HRV可能是预测自闭症儿童和青少年对普萘洛尔治疗后焦虑和行为症状减轻的潜在生物标志物。识别与积极治疗结果相关的自主神经特征可以指导未来自闭症的个性化干预。在这些结果在未来临床试验中得到重复验证之前，本文所呈现的结果应被视为初步结果。
