Oxytocin Nasal Spray, Brain Scans Can Improve Treatments for Children with Autism

A GW researcher published two papers about therapies that could help families save time and money in identifying effective treatments for children with autism.

Kevin Pelphrey, Carbonell Family Professor in Autism and Neurodevelopmental Disorders, director of the GW Autism and Neurodevelopmental Disorders Institute co-authored two papers published this month.
November 17, 2016

George Washington University researchers have identified two approaches with the potential to help a large number of children with autism through behavioral therapy, according to two scientific papers published this month.

The first paper, “Brain Responses to Biological Motion Predict Treatment Outcome in Young Children with Autism,” found that functional MRIs (fMRI) could predict with near-perfect accuracy which children would benefit from therapies known as Pivotal Response Treatment that target several critical areas of child development like motivation, responding to cues, self-management and social intuition. PRT is one of the few evidence-based interventions for autism. The paper was published in Translational Psychiatry.

Researchers from GW and the Children’s National Medical Center look at brain activity imaging to determine the functionality of three clusters in the brain that are involved in processing emotional information, social information and social reward. According to the study, children with higher functionality in those brain clusters benefitted more from PRT.

PRT is costly and typically involves a 25-hour weekly commitment, according to Autism Speaks. The therapy, which produces improvements in sociability, communication behavior and academic skill building, is currently effective in approximately 60 percent of children. By using fMRI to identify the children most likely to respond to the treatment, the technique could save time and money for those who would not immediately benefit.

Parents want their children to receive the best treatment, but it is not always clear how much a given treatment plan would benefit them, said Daniel Yang, researcher at the GW Autism and Neurodevelopmental Disorders Institute, assistant research professor of pediatrics at the GW School of Medicine and Health Sciences and Children’s National, and one of the lead authors of the paper.

“Although more research is needed, the current research provides an important first step toward establishing objective biomarkers that can accurately predict treatment outcome in young children with autism,” he said.

The second paper, “Intranasal Oxytocin Enhances Connectivity in the Neural Circuitry Supporting Social Motivation and Social Perception in Children with Autism,” examined the effect of the hormone oxytocin on the social perception and reward brain circuits in children with autism. The paper was published in Scientific Reports and is the first known paper to consider using the hormone as a primer to a treatment.

After giving children an oxytocin nasal spray before social experiences, researchers found they had stronger responses to social information. Using this treatment prior to behavioral therapy could help reinforce the brain’s reward system that motivates social behaviors.

Researchers stress the treatment must be developed in conjunction with therapies designed to positively reward social behaviors, as it can also heighten responses to negative emotions.

While oxytocin is often referred to as the love hormone, its effects depend on a child’s social surroundings, said Allison Jack, assistant research professor of pharmacology and physiology at the GW School of Medicine and Health Sciences and a co-author of the paper.

“Our study demonstrates that administering oxytocin to children with autism spectrum disorders has different effects on their brains depending on what type of environment they are exposed to,” Dr. Jack said. “Only when children were experiencing positive social cues (like happy voices) did we see oxytocin having the effect that we would need it to have for therapeutic use, by increasing brain activity in the reward system."

While researchers said the results are promising, using intranasal oxytocin should not be considered a core treatment for autism spectrum disorder. It is instead a way to enhance behavioral methods specifically tailored to provide children positive social experiences and rewards.

The research moves the field closer to developing precision treatments for people with autism, and getting the right treatments to the right person at the best time, said Kevin Pelphrey, Carbonell Family Professor in Autism and Neurodevelopmental Disorders, director of the GW Autism and Neurodevelopmental Disorders Institute and a co-author of both papers.

“As we move forward from here, we will launch a new era—brain imaging will become a routine part of a translational research chain,” he said. “Brain imaging biological markers could be used, at the outset, to make treatment decisions related to dose, duration, intensity and specific behavioral treatment approaches, as well as decisions about which drugs to use to improve treatment response.”

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