OBJECTIVE: To study the clinical effect of vitamin D (VitD) combined with the Early Start Denver Model (ESDM) in the treatment of autism spectrum disorder (ASD) in toddlers. METHODS: A total of 102 toddlers with ASD, aged 1 to 3 years, were enrolled. According to the wishes of their parents, they were divided into conventional rehabilitation, ESDM and ESDM+VitD groups. Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS) were used evaluate behavior problems before treatment and after 3 months of treatment. RESULTS: The conventional rehabilitation group had significant reductions in the total score and the scores on somatic movement and self-care subscales of the ABC scale after 3 months of treatment (P<0.05). After 3 months of treatment, the ESDM group had significant reductions in the total score and the scores on somatic movement, self-care, social interaction and language subscales of the ABC scale (P<0.05), as well as a significant reduction in the total score of the CARS (P<0.05). After 3 months of treatment, the ESDM+VitD group had a significant increase in the level of 25(OH)D and significant reductions in the total score and the scores on self-care, sensation, social interaction and language subscales of the ABC scale (P<0.05), as well as a significant reduction in the total score of the CARS (P<0.05). The ESDM group had a significantly greater reduction in the score on social interaction subscale than the conventional rehabilitation group (P<0.05). The ESDM+VitD group had a significantly greater reduction in the score on social interaction subscale than the other two groups (P<0.05). CONCLUSIONS ESDM can effectively improve the clinical symptoms of toddlers with ASD, with a significantly better clinical effect in improving social interaction and somatic movement than conventional rehabilitation. ESDM combined with VitD has a significantly better clinical effect in improving social communication skills and may be one of the best strategies for improving the clinical symptoms of toddlers with ASD.
Autism Spectrum Disorder ; drug therapy ; Autistic Disorder ; Child, Preschool ; Cholecalciferol ; therapeutic use ; Humans ; Infant ; Parents

Autism spectrum disorder (ASD) is characterized by impairment in two behavioral domains: social interaction/communication together with the presence of stereotyped behaviors and restricted interests. The heterogeneity in the phenotype among patients and the complex etiology of the disorder have long impeded the advancement of the development of successful pharmacotherapies. However, in the recent years, the integration of findings of multiple levels of research, from human genetics to mouse models, have made considerable progress towards the understanding of ASD pathophysiology, allowing the development of more effective targeted drug therapies. The present review discusses the current state of pharmacological research in ASD based on the emerging common pathophysiology signature.
Animals ; Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Drug Therapy ; Genetics, Medical ; Humans ; Mice ; Phenotype ; Population Characteristics ; Social Behavior ; Stereotyped Behavior

OBJECTIVETo study the effect of risperidone treatment on behavioral disorders in children with autism.

METHODSForty children with behavioral disorders (aged from 5 to 12 years) were treated with risperidone for 8 weeks. The behavioral symptoms were evaluated by the Clinical Global Impression (CGI) and the Autism Treatment Evaluation Checklist (ATEC) before and after the treatment. The adverse events related to risperidone treatment were observed.

RESULTSThe score of severity of illness and the ATEC total scores were significantly reduced 8 weeks after risperidone treatment. Besides the social intercourse ability, great improvements have been shown on the verbal communication, apperception and behavioural symptoms by the ATEC. No severe adverse events related to risperidone treatment were observed.

CONCLUSIONSRisperidone can significantly improve the behavioral disorders in children with autism and is well-tolerated.

Antipsychotic Agents ; therapeutic use ; Autistic Disorder ; drug therapy ; psychology ; Child ; Child Behavior Disorders ; drug therapy ; Child, Preschool ; Female ; Humans ; Male ; Risperidone ; adverse effects ; therapeutic use

OBJECTIVE: Anxiety is one of the most common symptoms associated with autistic spectrum disorder. The essential oil of Cananga odorata (Lam.) Hook. f. & Thomson, usually known as ylang-ylang oil (YYO), is often used in aromatherapy as a mood-regulating agent, sedative, or hypotensive agent. In the present study, the effects and mechanisms of YYO in alleviating anxiety, social and cognitive behaviors in autism-like rats were investigated. METHODS: The prenatal valproic acid (VPA) model was used to induce autism-like behaviors in offspring rats. The effectiveness of prenatal sodium valproate treatment (600 mg/kg) on offspring was shown by postnatal growth observation, and negative geotaxis, olfactory discrimination and Morris water maze (MWM) tests. Then three treatment groups were formed with varying exposure to atomized YYO to explore the effects of YYO on the anxiety, social and cognitive behaviors of the autistic-like offspring through the elevated plus-maze test, three-chamber social test, and MWM test. Finally, the monoamine neurotransmitters, including serotonin, dopamine and their metabolites, in the hippocampus and prefrontal cortex (PFC) of the rats were measured using a high-performance liquid chromatography. RESULTS: Offspring of VPA exposure rats showed autism-like behaviors. In the VPA offspring, medium-dose YYO exposure significantly elevated the time and entries into the open arms in the elevated plus-maze test, while low-dose YYO exposure significantly enhanced the social interaction time with the stranger rat in session 1 of the three-chamber social test. VPA offspring treated with YYO exposure used less time to reach the platform in the navigation test of the MWM test. YYO exposure significantly elevated the metabolism of serotonin and dopamine in the PFC of VPA offspring. CONCLUSION YYO exposure showed the effects in alleviating anxiety and improving cognitive and social abilities in the offspring of VPA exposure rats. The role of YYO was related to the regulation of the metabolism of serotonin and dopamine. Please cite this article as: Zhang N, Wang ST, Yao L. Inhalation of Cananga odorata essential oil relieves anxiety behaviors in autism-like rats via regulation of serotonin and dopamine metabolism. J Integr Med. 2023; 21(2): 205-214.
Pregnancy ; Female ; Rats ; Animals ; Autistic Disorder/drug therapy* ; Oils, Volatile/therapeutic use* ; Serotonin/metabolism* ; Cananga/metabolism* ; Dopamine ; Anxiety/drug therapy* ; Valproic Acid/pharmacology* ; Plant Oils ; Disease Models, Animal

OBJECTIVETo study the effect and safety of aripiprazole in the treatment of childhood autism.

METHODSThirty-five children (aged from 4 to 16 years) with autism presenting as behavioral disorders were treated with aripiprazole for 8 weeks. They were evaluated according to the Clinical Global Impression (CGI) and the Autism Treatment Evaluation Checklist (ATEC) before treatment and at the end of the 2nd, 4th and 8th weeks of treatment. Adverse reactions were observed.

RESULTSThe CGI showed illness severity decreased from the second week of aripiprazole treatment (P<0.05) and more significantly decreased illness severity was observed at the end of the 8th week (P<0.01). The curative effect score significantly increased at the end of the 8th week (P<0.05). The ATEC total scores were significantly reduced at the end of the 8th week after aripiprazole treatment. Besides the social intercourse ability, great improvements were shown in verbal communication, apperception and behavioural symptoms after aripiprazole treatment (P<0.01). Self-harm, sleep disorders and psychiatric symptoms were greatly improved after treatment and attention deficit, excessive activities, impulse to attack behavior, stereotyped behaviors and irritability were also improved to some extent. No severe adverse effects were found.

CONCLUSIONSAripiprazole is safe and effective for the treatment of childhood autism.

Adolescent ; Antipsychotic Agents ; therapeutic use ; Aripiprazole ; Autistic Disorder ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Piperazines ; adverse effects ; therapeutic use ; Quinolones ; adverse effects ; therapeutic use

Children with autism are often medicated to manage emotional and behavioral symptoms; yet, data on such pharmacotherapy is insufficient. In this study, we investigated the Korean National Health Insurance Claims Database (NHICD) information related to autism incidence and psychotropic medication use. From the 2010–2012 NHICD, we selected a total of 31,919,732 subjects under 19 years old. To examine the diagnostic incidence, we selected patients who had at least one medical claim containing an 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for pervasive developmental disorder, F84, not diagnosed in the previous 360 days. Psychotropics were categorized into seven classes. Then, we analyzed the data to determine the mean annual diagnostic incidence and psychotropic prescription trends. Diagnostic incidence was 17,606 for the 3 years, with a mean annual incidence per 10,000 population of 5.52. Among them, 5,348 patients were prescribed psychotropics. Atypical antipsychotics were the most commonly used, followed by antidepressants. An older age, male sex, and the availability of medical aid were associated with a higher rate of prescription than observed for a younger age, female sex, and the availability of health insurance. Psychotropic drugs were used for less than one-third of patients newly diagnosed with autism, and prescription differed by sex and age. Increased diagnostic incidence is associated with an increased prescription of psychotropic drugs. Therefore, medication-related safety data and policies for psychotropic drugs in autism should be prepared.
Adolescent* ; Antidepressive Agents ; Antipsychotic Agents ; Autistic Disorder* ; Behavioral Symptoms ; Central Nervous System Stimulants ; Child* ; Drug Therapy ; Drug Utilization ; Female ; Humans ; Incidence ; Insurance, Health* ; International Classification of Diseases ; Male ; National Health Programs ; Prescriptions* ; Psychotropic Drugs

OBJECTIVETo test the effect of sulindac on autistic behaviors in a rat model and explore the possible mechanisms.

METHODSAutistic rat models were established by a single intraperitoneal injection of sodium valproate (VPA) at 12.5 days of pregnancy. The pregnant rats were treated with oral sulindac at a daily dose of 80 mg/kg until weaning of the newborn rats (23 days after being born), which were divided into control, VPA treatment, sulindac treatment, and VPA+ sulindac treatment groups. The social interaction and neuroethology of the newborn rats were evaluated at 35 days, and the levels of β-catenin and phosphorylated Gsk3β in the brain tissues were investigated by Western blotting.

RESULTSCompared with the control rats, the rats treated with VPA showed lower social interaction, longer moving time in central area, and reduced standing times. Treatment with sulindac alone resulted in no obvious changes in the social interaction or neuroethology of the newborn rats, but sulindac treatment corrected VPA-induced autistic-like behaviors. Sulindac also attenuated VPA-triggered p-Gsk3β downregulation and β-catenin upregulation in the prefrontal lobe, seahorse and cerebellum.

CONCLUSIONSulindac can improve the behaviors of autistic rats possibly by suppressing Wnt signaling pathway.

Animals ; Autistic Disorder ; drug therapy ; Disease Models, Animal ; Down-Regulation ; Female ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Prefrontal Cortex ; Pregnancy ; Rats ; Sulindac ; pharmacology ; Up-Regulation ; Valproic Acid ; Wnt Signaling Pathway ; beta Catenin ; metabolism