Abstract

Approximately half of all autism spectrum disorder (ASD) individuals suffer from comorbid intellectual disabilities. Furthermore, the prevalence of epilepsy has been estimated to be 46% of patients with low intelligence quotient. It is important to investigate the therapeutic benefits and adverse effects of any recently developed drugs for this proportion of individuals with the so-called Kanner type of ASD. Therefore, we investigated the therapeutic and/or adverse effects of intranasal oxytocin (OT) administration, especially in adolescents and adults with ASD and comorbid intellectual disability and epilepsy, with regard to core symptoms of social deficits. We have already reported three randomized placebo-controlled trials (RCTs). However, we revisit results in our pilot studies from the view of comorbidity. Most of the intellectually disabled participants were found to be feasible participants of the RCT. We observed significantly more events regarded as reciprocal social interaction in the OT group compared with the placebo group. In the trial, no or little differences in adverse events were found between the OT and placebo arms, as found in some other reports. However, seizures were induced in three participants with medical history of epilepsy during or after OT treatment. In conclusion, we stress that behavioral changes in ASD patients with intellectual disabilities could be recognized not by the conventional measurements of ASD symptoms but by detailed evaluation of social interactions arising in daily-life situations.

Highlights

  • Autism spectrum disorder (ASD) is a neurodevelopmental condition with lifelong various phenotypes and a high prevalence, estimated at 0.62–2% [1,2,3]

  • A large number of studies investigating the theory of mind (ToM), which refers to the ability to attribute one’s own mind to others and oneself [7], have been conducted in individuals with ASD

  • Considering that social deficits appear by 12 months of age in infants later diagnosed with ASD [11], these infants are not likely to be endowed with ToM, which

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Summary

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental condition with lifelong various phenotypes and a high prevalence, estimated at 0.62–2% [1,2,3]. Impairment of ToM has been proven to be among the influential theories explaining social deficits in ASD [8,9,10]. Many studies have focused on social cognition and prosociality promoted by OT in interpersonal relationships in typically developing individuals [26,27,28,29]. The results of these studies have suggested that OT could benefit individuals with ASD due to its favorable effects associated with sociality [30,31,32,33]. We reviewed and compared recent randomized controlled clinical trials (RCTs) of OT, and whether or not the primary, secondary and exploratory outcome measures were favourable, especially for improvement of social behavioral impairments

Chronic Treatment with OT in Randomized Controlled Trials
ASD with Comorbidities
RCT for Male ASD Subjects with Low IQ
Outcomes
Real-Life Assessments of Social Interactions
Verbal Communication
Flexibility in Behavior
Self-Harm
Assessment of Harm
Further Consideration
Findings
Conclusions
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