Autism Spectrum Disorder
Conditions
Brief summary
Growing evidence demonstrates the critical contribution of the neuropeptide oxytocin in the development and maintenance of autism, due to its role in social behaviour and learning processes. While some preliminary findings in oxytocin administration trials have been promising, a complete understanding of the effects of long-term oxytocin administration in autism remains elusive, as participant numbers in oxytocin administration studies in autism have been small, most studies exclusively recruit males, and reproducibility has been inconsistent. To address this critical knowledge gap, this project will include a double-blind, placebo-controlled, randomized controlled crossover trial of a four-week intranasal oxytocin treatment (24 international units, twice-daily) in 128 male and female youth with ASD aged 12-20, with social and repetitive behaviors as primary outcome measures. The investigators predict that intranasal oxytocin treatments will increase performance on social behavior measures and reduce repetitive behaviors using caregiver-reported measures. Along with the investigation of oxytocin's long-term effects, the investigators will also assess the impact of oxytocin administration on computer-based laboratory tasks that can precisely measure how participants process social cues and disengage with repetitive behaviours. In addition, an electrocardiogram will be collected to evaluate the impact of oxytocin administration on parasympathetic nervous system activity.
Interventions
DRUGOxytocin nasal spray
24IU oxytocin liquid delivered with a pump-actuated nasal spray device, administered twice-daily
DRUGPlacebo
Placebo liquid nasal spray administered twice-daily
Sponsors
University of Oslo
Oslo University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
12 Years to 20 Years
Healthy volunteers
No
Inclusion criteria
1. Male and female participants between the ages of 12 and 20, both inclusive, with a confirmed diagnosis of autism spectrum disorder (ASD) diagnosis as per the ADOS/ADI. 2. Participants must be in good general physical health, as determined by the investigator. 3. Participant's pre-study physical examination and vital signs must not show any clinically significant abnormalities as determined by the investigator. 4. Participants and caregivers must be able to communicate well with the investigator, to understand and comply with the requirements of the study, and to understand the oral and written study information
Exclusion criteria
1. Previous nasal disease, surgery, and dependence on inhaled drugs. 2. Current significant nasal congestion due to common colds. 3. Clinically relevant history of significant hepatic, renal, endocrine, cardiac, nervous, pulmonary, haematological or metabolic disorder. 4. Systemic illness requiring treatment within 2 weeks prior to Study Day 1. 5. Full scale IQ \< 70 (due to the prerequisite ability to complete self-report measures). 6. Known allergic reactions or hypersensitivity to any component of the study medication in the nasal spray, such as propyl parahydroxybenzoate (E216), methyl parahydroxybenzoate (E218) and chlorobutanol hemihydrate. 7. Known allergic reactions or hypersensitivity/intolerance to latex 8. Currently breastfeeding 9. Pregnancy (self-reported or assessed by pregnancy test prior to the first administration at Experimental session 1 and 2 for all menstruating females) 10. Participation in any (other) clinical trial with an investigational medicinal product or medical device within 3 months prior to randomisation. 11. New concomitant medications or formal cognitive/behavioral therapies. If a participant has been taking any medications or receiving formal cognitive/behavioral therapies for at least 4 weeks, then this is not considered a new therapy. 12. Other unspecified reasons that, in the opinion of the investigator or the sponsor make the participants unsuitable for enrolment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Social behavior | Four weeks | Assessed by the total score of the Social Responsiveness Scale-Second Edition (SRS-2), as completed by caregivers of the participants. Lower scores represent better outcomes. |
| Repetitive behaviour | Four weeks | Assessed with the Repetitive Behavior Scale-Revised (RBS-R), as completed by caregivers of the participants. Lower scores represent better outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Social cognition | Four weeks | Assessed by a computerized Emotional body language task completed by the participants. Higher accuracy scores represent better outcomes. |
| Behavioral inflexibility | Four weeks | Assessed by the Behavioral inflexibility scale (BIS), completed by caregivers of the participants. Lower scores represent better outcomes. |
| Repetitive cognition | Four weeks | Assessed by a computerised probabilistic reversal learning task completed by participants. More regressive errors represent worse outcomes (i.e., after initially choosing the new correct response, participants regress back to choosing the previously rewarded response) |
| Vagally-mediated heart rate variability | Four weeks | Calculated using electrocardiogram (RMSSD and High Frequency HRV) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Caregiver quality of life | Four weeks | As measured by the Care-related Quality of Life instrument (CarerQol). Higher scores represent better outcomes |
| Participation in social activities | Four weeks | As measured by the Participation and Environment measure-Child and Youth scale. Higher scores on the participation frequency, level of involvement, and Percent total environmental supportiveness subscores represent better outcomes, and lower scores on the Percent never participates and Percent that parents desired change represent better outcomes |
| Executive function | Four weeks | As measured by the Behavior Rating Inventory of Executive Functions. Lower scores represent better outcomes |
Countries
Norway
Contacts
Primary ContactDaniel S Quintana, PhD
Outcome results
None listed