Brain connectivity in ASD: a biomarker to predict treatment response
Research type
Research Study
Full title
Can Brain Connectivity Predict Treatment Response to two Serotonergic Medications (Citalopram and Tianeptine) in subjects with Autism Spectrum Disorders (ASD) and Comorbid Depression and/or Anxiety ?
IRAS ID
124827
Contact name
Declan Murphy
Contact email
Sponsor organisation
Institute of Psychiatry, King's College London
Research summary
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting 1% of the population. ASD is characterised by behavioural, social and communication impairments. ASD is considered a clinical and neurological heterogeneous disorder. Comorbid conditions such as depression and anxiety are common in ASD (31% and 43% respectively), which is significantly higher than the general population. These comorbid conditions can cause greater functional impairment and increase the burden of care.
There are no treatments available for the core symptoms of ASD, but treatments do exist for co-occurring mental health problems. However, not all ASD individuals respond to current drug treatments (mainly aimed at the serotonergic system) for depression and anxiety. It is possible that this variance in treatment response is due to disruptions in the serotonergic system that are observed in some but not all ASD individuals. Hence this neurological heterogeneity could explain heterogeneity in treatment response. Also, since approximately 30% of individuals with ASD have hyperserotonemia, they may benefit from a selective serotonin reuptake enhancer (SSRE; e.g. tianeptine). These have the opposite mechanism of action to SSRIs in that SSREs aim to decrease levels of extracellular 5-HT. Thus we wish to develop tools that predict treatment response to an SSRI and SSRE.
We will recruit 60 adults recently diagnosed with ASD with full capacity to consent who just started taking their treatment (30 on Citalopram, 30 on Tianeptine), 20 adults with ASD with full capacity to consent who do not wish to receive treatment and 20 healthy controls and test the main hypothesis that the degree of symptom improvement during treatment will be correlated with the measures of ‘serotonergic sensitivity’. Furthermore, we hypothesize that ASD individuals that do not respond to treatment have specific differences in the ‘connectivity’ of cortico-limbic-striatal pathways compared to ASD individuals who do respond positively to treatment.
REC name
London - Stanmore Research Ethics Committee
REC reference
14/LO/0663
Date of REC Opinion
15 May 2014
REC opinion
Favourable Opinion