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Kosaka H, Okamoto Y, Munesue T, Yamasue H, Inohara K, Fujioka T, Anme T, Orisaka M, Ishitobi M, Jung M, Fujisawa TX, Tanaka S, Arai S, Asano M, Saito DN, Sadato N, Tomoda A, Omori M, Sato M, Okazawa H, Higashida H, Wada Y. Oxytocin efficacy is modulated by dosage and oxytocin receptor genotype in young adults with high-functioning autism: a 24-week randomized clinical trial. Transl Psychiatry 2016; 6:e872. [PMID: 27552585 PMCID: PMC5022092 DOI: 10.1038/tp.2016.152] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/22/2016] [Accepted: 07/04/2016] [Indexed: 12/27/2022] Open
Abstract
Recent studies have suggested that long-term oxytocin administration can alleviate the symptoms of autism spectrum disorder (ASD); however, factors influencing its efficacy are still unclear. We conducted a single-center phase 2, pilot, randomized, double-blind, placebo-controlled, parallel-group, clinical trial in young adults with high-functioning ASD, to determine whether oxytocin dosage and genetic background of the oxytocin receptor affects oxytocin efficacy. This trial consisted of double-blind (12 weeks), open-label (12 weeks) and follow-up phases (8 weeks). To examine dose dependency, 60 participants were randomly assigned to high-dose (32 IU per day) or low-dose intranasal oxytocin (16 IU per day), or placebo groups during the double-blind phase. Next, we measured single-nucleotide polymorphisms (SNPs) in the oxytocin receptor gene (OXTR). In the intention-to-treat population, no outcomes were improved after oxytocin administration. However, in male participants, Clinical Global Impression-Improvement (CGI-I) scores in the high-dose group, but not the low-dose group, were significantly higher than in the placebo group. Furthermore, we examined whether oxytocin efficacy, reflected in the CGI-I scores, is influenced by estimated daily dosage and OXTR polymorphisms in male participants. We found that >21 IU per day oxytocin was more effective than ⩽21 IU per day, and that a SNP in OXTR (rs6791619) predicted CGI-I scores for ⩽21 IU per day oxytocin treatment. No severe adverse events occurred. These results suggest that efficacy of long-term oxytocin administration in young men with high-functioning ASD depends on the oxytocin dosage and genetic background of the oxytocin receptor, which contributes to the effectiveness of oxytocin treatment of ASD.
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Affiliation(s)
- H Kosaka
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan,Research Center for Child Mental Development, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji 910-1193, Fukui, Japan. E-mail:
| | - Y Okamoto
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
| | - T Munesue
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - H Yamasue
- Department of Neuropsychiatry, School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Inohara
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan,Department of Informatics, Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Japan
| | - T Fujioka
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan
| | - T Anme
- International Community Care and Lifespan Development, Empowerment Sciences, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - M Orisaka
- Department of Obstetrics and Gynecology, University of Fukui, Eiheiji, Japan
| | - M Ishitobi
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan,Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - M Jung
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
| | - T X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
| | - S Tanaka
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan
| | - S Arai
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
| | - M Asano
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
| | - D N Saito
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan,Biomedical Imaging Research Center, University of Fukui, Eiheiji, Japan
| | - N Sadato
- Department of Cerebral Research, National Institute for Physiological Sciences, Okazaki, Japan
| | - A Tomoda
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
| | - M Omori
- Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, Eiheiji, Japan
| | - M Sato
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan,Department of Anatomy and Neuroscience, Graduate School of Medicine, Osaka University, Suita, Japan,Division of Developmental Neuroscience, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - H Okazawa
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan,Biomedical Imaging Research Center, University of Fukui, Eiheiji, Japan
| | - H Higashida
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Y Wada
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Japan,Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan,Division of Developmental Higher Brain Functions, Department of Child Development United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Eiheiji, Japan
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3
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Munesue T, Nakamura H, Kikuchi M, Miura Y, Takeuchi N, Anme T, Nanba E, Adachi K, Tsubouchi K, Sai Y, Miyamoto KI, Horike SI, Yokoyama S, Nakatani H, Niida Y, Kosaka H, Minabe Y, Higashida H. Oxytocin for Male Subjects with Autism Spectrum Disorder and Comorbid Intellectual Disabilities: A Randomized Pilot Study. Front Psychiatry 2016; 7:2. [PMID: 26834651 PMCID: PMC4720778 DOI: 10.3389/fpsyt.2016.00002] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 01/05/2016] [Indexed: 12/27/2022] Open
Abstract
UNLABELLED Approximately half of autism spectrum disorder (ASD) individuals suffer from comorbid intellectual disabilities (IDs). Oxytocin (OXT) receptors are highly expressed in temporal lobe structures and are likely to play a modulatory role in excitatory/inhibitory balance, at least based on animal model findings. Thus, it is feasible that in the highly representative group of Kanner-type ASD subjects, OXT could have a beneficial effect on social communication and social interaction. The aim of this pilot study is to investigate the feasibility and adverse events, such as epilepsy, of the long-term administration of intranasal OXT for adolescent and adult ASD subjects with ID because such patients frequently have seizures. We also addressed the question on how to scale the OXT effects to the core symptoms of social deficits because of the relative difficulty in obtaining objective measurements. Twenty-nine males (aged 15-40 years old) participated in a randomized, double-blind, and placebo-controlled crossover study (each for 8 weeks) with OXT (16 IU/day). Except for seizures experienced by one participant, other serious adverse events did not occur. The primary and secondary outcomes measured using the Childhood Autism Rating Scale and several standard scales, respectively, revealed no difference between the OXT and placebo groups. Instead, in an exploratory analysis, the social interactions observed in the play sessions or in daily life were significantly more frequent in the initial half period in the OXT-first arm of the crossover trial. There were also significant correlations between the plasma OXT concentration and subscale scores for irritability on the Aberrant Behavior Checklist. In conclusion, this pilot study demonstrates that long-term administration of intranasal OXT is tolerable in a representative cohort of ASD individuals with ID and suggests that future multicenter trials of OXT are warranted and should include measurements of reciprocal social interactions based on daily life under closer surveillance for epilepsy. TRIAL REGISTRATION UMIN000007250.
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Affiliation(s)
- Toshio Munesue
- Research Center for Child Mental Development, Kanazawa University , Kanazawa , Japan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University , Kanazawa , Japan
| | - Mitsuru Kikuchi
- Research Center for Child Mental Development, Kanazawa University , Kanazawa , Japan
| | - Yui Miura
- Research Center for Child Mental Development, Kanazawa University , Kanazawa , Japan
| | - Noriyuki Takeuchi
- Research Center for Child Mental Development, Kanazawa University , Kanazawa , Japan
| | - Tokie Anme
- International Community Care and Lifespan Development, Empowerment Sciences, Faculty of Medicine, University of Tsukuba , Tsukuba , Japan
| | - Eiji Nanba
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University , Yonago , Japan
| | - Kaori Adachi
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University , Yonago , Japan
| | | | - Yoshimichi Sai
- Department of Pharmacy, Kanazawa University Hospital , Kanazawa , Japan
| | - Ken-Ichi Miyamoto
- Department of Pharmacy, Kanazawa University Hospital , Kanazawa , Japan
| | - Shin-Ichi Horike
- Advanced Science Research Center, Kanazawa University , Kanazawa , Japan
| | - Shigeru Yokoyama
- Research Center for Child Mental Development, Kanazawa University , Kanazawa , Japan
| | - Hideo Nakatani
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan; Department of Psychiatry and Neurobiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yo Niida
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan; Division of Genomic Medicine, Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Uchinada, Japan
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui , Fukui , Japan
| | - Yoshio Minabe
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan; Department of Psychiatry and Neurobiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Haruhiro Higashida
- Research Center for Child Mental Development, Kanazawa University , Kanazawa , Japan
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Cordier R, Speyer R, Chen YW, Wilkes-Gillan S, Brown T, Bourke-Taylor H, Doma K, Leicht A. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review. PLoS One 2015; 10:e0132299. [PMID: 26151362 PMCID: PMC4494713 DOI: 10.1371/journal.pone.0132299] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/11/2015] [Indexed: 11/23/2022] Open
Abstract
Introduction Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.
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Affiliation(s)
- Reinie Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
- * E-mail:
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Yu-Wei Chen
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Wilkes-Gillan
- School of Allied Health, Australian Catholic University, North Sydney, NSW, Australia
| | - Ted Brown
- Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University–Peninsula Campus, Frankston, VIC, Australia
| | - Helen Bourke-Taylor
- School of Allied Health, Australian Catholic University, St Patricks Campus, Fitzroy, VIC, Australia
| | - Kenji Doma
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Anthony Leicht
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
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