Many people with autism have trouble making eye contact, reading the emotions in other faces, and sharing affection. And no drugs are approved to treat such social impairments. Now, results from a small academic clinical trial suggest boosting levels of vasopressin—a hormone active in the brain that’s known to promote bonding in many animals—can improve social deficits in children with autism. But in a confusing twist, a larger, company-sponsored trial that took the reverse approach, tamping down vasopressin’s effects, also found some improvements in adults with autism.
“I’ve never seen this before,” Kevin Pelphrey, a neuroscientist who studies autism at the University of Virginia in Charlottesville, says of the conflicting results. He and others say the vasopressin-blocking approach doesn’t have much support from previous animal research. The new study showed some benefits but failed to meet the main endpoint set out by investigators. Still, he says, both studies suggest vasopressin’s signaling in the brain plays a key role in autism and “give me a lot of renewed excitement” for treating the condition.
Though vasopressin seems to stimulate social bonding in animals, the hormone’s activity in the brain isn’t fully understood, and its effects vary by species and context. Blocking its activity in the brains of some rodents prevents them from forming an attraction to a mate. But in a species of asocial hamster, injecting it into a male’s brain seems to stimulate aggression.
Another brain signaling molecule with a very similar structure, oxytocin, is already under investigation as an autism treatment. But vasopressin has gotten less attention. Recently, Karen Parker, a neuroscientist at Stanford University in Palo Alto, California, and her colleagues turned up evidence that monkeys that were less social—that tended to keep their distance from their peers, for example—also had lower levels of vasopressin in their cerebrospinal fluid. The group also found that children with autism who had the most social impairment also had the lowest vasopressin levels.
So the Stanford team gave a nasal spray containing vasopressin to 17 children with autism, aged 6 to 12 years. Another 13 children with autism served as a control group and got a placebo spray. Before and after the 4-week treatment, the research team asked parents to rate the children on a questionnaire called the Social Responsiveness Scale (SRS-2), which asks how often the children “would rather be alone than with others,” for example, and how often they “avoid eye contact.” This 65-question scale results in gender-adjusted scores of 37 to 90 in girls and 38 to 90 for boys.
Vasopressin-treated children showed significantly more improvement—a seven-point-greater reduction—on the SRS-2 than those in the placebo group, the team reported today in Science Translational Medicine (STM).
Those results “are very exciting,” especially because the team didn’t see major side effects, says Angela Sirigu, a neuroscientist at CNRS, the French national research agency, in Bron who is also investigating neurohormones for autism treatment.
Children with higher levels of vasopressin in their blood at the start of the Stanford study saw greater improvements. That’s counterintuitive, Sirigu says—you’d expect children who were most deficient in the hormone to benefit most from the boost. These children may have needed a higher dose or longer treatment course to see maximum benefits, Parker speculates. Or maybe blood vasopressin is a marker for some other, yet-unknown feature of the children that predicts how much they’ll improve with the treatment.
The only weakness Pelphrey found with the Stanford study was its sample size: “If it were double, I would be jumping up and down.” Still, he says, “I’m kind of rocking back and forth in my chair with excitement.”
The second trial, meanwhile, tested a very different hypothesis about vasopressin. Although many people with autism have trouble interpreting and reciprocating emotions, they also sometimes have overactive emotional responses, says neurologist Paulo Fontoura of Roche Pharmaceuticals in Basel, Switzerland. And vasopressin could drive those responses, he suggests. In a rat model of autism, blocking a vasopressin receptor appeared to reduce the animal’s abnormally heightened brain response to the presence of a juvenile rat. In the new trial, the Roche team recruited 223 men with autism to test a compound called Balovaptan that blocks a vasopressin receptor in the brain. The 148 men who took the drug improved according to an SRS-2 assessment, but those who got a placebo improved just as much, the team reports today in STM. Fontoura and his colleagues say the strong placebo effect in the study suggests the SRS-2 isn’t the best way to measure social improvements. Men receiving Balovaptan did show significant improvements over a placebo group on a different test of autism symptoms, called the Vineland-II.
The authors of both studies propose that there could be important differences in their participants. Maybe some people with autism could benefit from boosting vasopressin and others from blocking it.
The Stanford group is running another trial of vasopressin that aims to enroll 100 children. Roche has two trials of Balovaptan underway—an initial test in children, and a larger study in adults meant to demonstrate the drug’s effectiveness to regulators. “It’s early to make a head-to-head comparison,” Fontoura says. “It’s only when we do see more data that we’ll be able to draw conclusions about which way is the right way.”
A new study suggests that trigeminal nerve stimulation (TNS), a noninvasive electrical stimulation treatment, may reduce symptoms of attention-deficit/hyperactivity disorder (ADHD) in children.
“Many parents are hesitant to give strong medications like stimulants to young children, so there has been a lot of interest from families in non-pharmacological alternatives for ADHD,” said lead study author James McGough, M.D., a professor of clinical psychiatry at the University of California, Los Angeles (UCLA).
The trigeminal nerve, the largest of the cranial nerves, connects sensory cells on the head with several brain regions involved in attention.
For the study, researchers at the David Geffen School of Medicine at the UCLA randomly assigned 62 children ages 8 to 12 with ADHD to receive four weeks of nightly stimulation with either a TNS device or sham device.
The research was designed to specifically test the effects of TNS, so all the children were medication-free during the study and at least 30 days prior.
The TNS and sham device looked the same — a small box with wires for placement on the forehead via an adhesive patch. The only difference was the sham devices produced no electric current.
While both groups of children experienced symptom improvements after one week, the children who received the active TNS showed continued improvements over the next three weeks. In contrast, symptoms among children in the placebo stimulation group plateaued after the first week.
At the end of four weeks, symptom scores in children in the TNS group dropped an average of 9 points (using the doctor-administered ADHD-Rating Scale) compared with a reduction of scores by about 4.5 points in children in the placebo group.
Overall, this 9-point reduction is less than what stimulants such as methylphenidate have shown in clinical studies, but is on par to nonstimulant medications used to treat children with ADHD, such as the norepinephrine reuptake inhibitor atomoxetine.
According to McGough, the differences seen between the two groups after the first week point to the improvements of TNS being more than just a placebo effect. But stronger validation came after analyzing electroencephalography (EEG) tests given to all the children.
“EEG measures brain wave activity, and our tests showed emphatic differences between the kids receiving active versus sham stimulation,” McGough said.
In fact, the brainwave changes found in children whose symptoms improved resembled those seen in people performing well on executive function tests, said McGough. This similarity supports the idea that the EEG changes represent changes in attention and decision-making.
McGough added that TNS was very well-tolerated. There were a few instances of headache or increased appetite among TNS users, but there were no serious side effects and no children had to quit treatment due to side effects.
The Food and Drug Administration is currently reviewing TNS as a treatment for pediatric ADHD. McGough noted that if approved, there can be more detailed discussions about where this approach might fit in the spectrum of available treatments.
He noted that more research is needed, particularly studies testing the long-term effects of TNS and studies assessing how TNS works in conjunction with medication.
The findings are published in the Journal of the American Academy of Child and Adolescent Psychiatry.
Source: American Psychiatric Association
“On this International Day, let us reaffirm our commitment to work together for a better world that is inclusive, equitable and sustainable for everyone, where the rights of people with disabilities are fully realized.” — António Guterres, UN Secretary-General
Here at Options For College Success we believe that given the opportunity, persons with disabilities can flourish. We share this message from the UN Secretary-General for 2018
2018 Theme: Empowering persons with disabilities and ensuring inclusiveness and equality
This year’s theme focuses on empowering persons with disabilities for an inclusive, equitable and sustainable development as part of the 2030 Agenda for Sustainable Development. The 2030 Agenda pledges to “leave no one behind”. Persons with disabilities, as both beneficiaries and agents of change, can fast track the process towards inclusive and sustainable development and promote resilient society for all, including in the context of disaster risk reduction and humanitarian action, and urban development. Governments, persons with disabilities and their representative organisations, academic institutions and the private sector need to work as a “team” to achieve the Sustainable Development Goals (SDGs).
This year, the UN Secretary-General will launch on the Day a flagship report, entitled “UN Flagship Report on Disability and Development | 2018 – Realizing the SDGs by, for and with persons with disabilities”. Events at UNHQ on the International Day of Persons with Disabilities at UN Headquarters will bring together Member States, UN entities, Mayors, national and local policy makers, civil society organizations, academic institutes and organizations of persons with disabilities to discuss the way forward for inclusive, equitable and sustainable development. Read more about the events.
According to the mentalhelp.net website, there are four strategies that can be used with students who suffer from an intellectual disability, but it can also be used for students who suffer from anxiety, and autism as well. The four strategies are the following: the first strategy is to break down learning tasks into small steps. Second is to modify the teaching approach. Third, use visual aids. Lastly, provide direct and immediate feedback.
Here at Options for College Succes, we partner a student with one of our tutors to meet these four strategies. By meeting individually with our tutors, our students learn how to develop studying skills, build coping skills during midterms and finals, and learn his or her school work at a pace that works best for each student. Our tutors break down the school work in small steps so that our students are able to understand the material by modifying their teaching approach suited for each student. Each of our classrooms has a whiteboard on which both our students and tutors use as a visual aid to put into practice what the students are learning. In the end, our students create a relationship with our tutors which helps them get immediate feedback on how they are doing in their learning process as well as provide positive direct advice and opinions on how to improve their weaknesses or strengthen their strengths.
Take a moment to help us reach our goal of being able to help out a student with a scholarship so that he or she can benefit from our one on one tutoring sessions that are adequately fit for each individual. Thank you again for all of your support!
OCS Scholarship Project
Options for College Success is a not-for-profit organization located in Evanston, IL. We are committed to helping young adults with learning disabilities realize their full potential. We take an individualized approach to develop skills, courage, and confidence necessary to transition to independent living and work-life. Our program focuses on six areas of a student’s life: academic support, career advising, independent living skills, financial management, social skills, and social activities. We provide these customized services via a residential, day, or Skype program.
Over the past 10 years, we have successfully supported 225 students in achieving their vocational, academic, and personal goals. Although we have had great success, there are still a large number of post-secondary students who could benefit from our services. Unfortunately, their participation is restricted due to financial burdens. With this in mind, we greatly appreciate any gift amount to help us establish a scholarship fund!
The purpose of our scholarship fund is to provide students who are in need of our services with financial support. This scholarship applies to all local students who enroll in our programs. Our goal is to raise $5,000 for the scholarship fund which will allow us to help 21 students in total (5-$400, 7-$200, 9- $100).
Thank you for reading our story. We appreciate your time, monetary gifts, and commitment to helping the leaders of tomorrow realize their full potential.
Options for College Success
By Andrea Martinez Cabrera
Summer is around the corner! This is the time to focus on your mental health. School hours, homework, work and even volunteering at places can wear you out and leave you feeling mentally tired at the end of the day. I encourage you during the summer to take care of your mental health by creating a bucket list of things that you would like to do in the summer. It can be as simple as getting plenty of rest, going out to a movie with friends, drinking tea while reading, etc. to something spontaneous such as going on a road trip, going to the beach, attend a festival, etc. Give your mind some peace before starting another year of school and/or breaks from work and volunteering. Remember that your mental health is just as important as your physical health.