Abstract
Autism spectrum conditions (autism) affect ~1% of the population and are characterized by deficits in social communication. Oxytocin has been widely reported to affect social-communicative function and its neural underpinnings. Here we report the first evidence that intranasal oxytocin administration improves a core problem that individuals with autism have in using eye contact appropriately in real-world social settings. A randomized double-blind, placebo-controlled, within-subjects design is used to examine how intranasal administration of 24 IU of oxytocin affects gaze behavior for 32 adult males with autism and 34 controls in a real-time interaction with a researcher. This interactive paradigm bypasses many of the limitations encountered with conventional static or computer-based stimuli. Eye movements are recorded using eye tracking, providing an objective measurement of looking patterns. The measure is shown to be sensitive to the reduced eye contact commonly reported in autism, with the autism group spending less time looking to the eye region of the face than controls. Oxytocin administration selectively enhanced gaze to the eyes in both the autism and control groups (transformed mean eye-fixation difference per second=0.082; 95% CI:0.025–0.14, P=0.006). Within the autism group, oxytocin has the most effect on fixation duration in individuals with impaired levels of eye contact at baseline (Cohen's d=0.86). These findings demonstrate that the potential benefits of oxytocin in autism extend to a real-time interaction, providing evidence of a therapeutic effect in a key aspect of social communication.
Highlights
Autism spectrum conditions are characterized by deficits in social communication alongside unusually narrow interests and repetitive behaviors
The present study aims to address these issues by evaluating the effect of oxytocin on gaze behavior during a naturalistic live, real-life social interaction with another person
Participants received an active intranasal oxytocin spray (24 IU, 40.32 μg, Syntocinonspray; Novartis, Switzerland), three actuations administered to each nostril, (4I U, 6.72 μg each) or a placebo containing the same ingredients with the exception of the active oxytocin, on two visits separated by 1 week
Summary
Autism spectrum conditions ( autism) are characterized by deficits in social communication alongside unusually narrow interests and repetitive behaviors. There are currently few effective behavioral or pharmacological treatments that can ameliorate core social difficulties associated with autism. Despite the mounting evidence for the importance of oxytocin as a potential pharmacological target for further development in terms of how it might affect aspects of social behavior in autism, all of the work until now has been based on studies done in constrained laboratory settings. These studies are obviously necessary and critical. We examined how oxytocin might be more or less effective in subgroups of individuals with autism who exhibited either below average eye contact (relative to the control group), intact, or above average eye contact under baseline placebo conditions
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