Oxytocin and social interaction improve autism symptoms

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The study covered in this summary has been published on medRxiv.org as a preprint and has not yet been peer-reviewed.

Key points to remember

  • A novel reduced-dose intranasal oxytocin followed by a period of positive social interaction improved symptoms in young children with autism spectrum disorder (ASD).

  • In the study, improvement was seen in both objective and subjective measures, and there was for the first time evidence of improved social functioning using two measures derived from eye tracking.

why it matters

  • There is no first-line therapy to treat the social symptoms of ASD.

  • Long-term use of intranasal oxytocin is associated with reduced response to emotional stimuli.

  • This is the first placebo-controlled study to demonstrate changes in Autism Diagnostic Observation Schedule-2 (ADOS-2) score with intranasal oxytocin.

study design

  • The study was a double-blind, randomized, crossover pilot trial with 41 children with ASD aged 3 to 8 years.

    • Participants with a genetic disease, chromosomal abnormalities, neurological disease, psychiatric disorder, or severe respiratory, hearing, or visual impairment were excluded.

  • Study participants received intranasal placebo over a period of 2 weeks, after which they were randomly assigned in a 1:1 ratio to receive 6 weeks of either intranasal oxytocin or intranasal placebo mornings followed by a positive social interaction 30 minute session.

  • The primary outcomes were ADOS-2 score and Social Reactivity Scale, Second Edition (SRS-2) total score.

  • Secondary measures included a general assessment of adaptive behavior (Adaptive Behavior Assessment Schedule), social communication (Social Communication Quotient), and repetitive behaviors (Repetitive Behavior Scale–Revised).

  • Caregivers completed questionnaire-based measures at a 6-month follow-up to assess the long-term impact of the intervention.

Principle results

  • Intranasal oxytocin was associated with significant improvements in primary outcomes (P

  • An increase in time spent viewing dynamic social stimuli was observed in the treatment group.

  • On the 6-month follow-up questionnaire, the SRS-2 score remained significantly improved in the intranasal oxytocin group compared to patients who received the placebo.

  • No adverse side effects have been reported.

Boundaries

  • Crossover designs do not reliably assess the duration of effects.

  • Longer treatment durations may have resulted in improved social and repetitive behavior symptoms.

  • The required period of positive social interaction after intranasal treatments was neither controlled nor structured.

Disclosures

  • The study was supported by grants from the Key Technology Projects of Guangdong Province for the Development of New Autism Diagnosis and Treatment Tools and the Development of High-End Expert Projects from UESTC.

  • The authors did not disclose any relevant financial relationship.

This is an abstract of a pre-print research study, “Infrequent intranasal oxytocin followed by positive social interaction improves symptoms in children with autism: a pilot randomized clinical trial”, by Jiao Le of the Hospital clinical study from the Chengdu Institute of Brain Sciences in China and colleagues, published on medRxiv.org, and brought to you by Medscape. The study has not yet been peer reviewed. The full text of the study is available at medRxiv.org.

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