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Improved symptoms following bumetanide treatment in children aged 3−6 years with autism spectrum disorder: A randomized, double-blind, placebo-controlled trial (Open Access)

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收录情况： ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ SSCI ◇ EI ◇ 卓越：领军期刊

作者：
Dai, Y[a] * ; Zhang, L[a] * ; Yu, J[a,b] * ; Zhou, X[c] ; He, H[a] ; Ji, Y[a] ; Wang, K[a] ; Du, X[a] ; Liu, X[a] ; Tang, Y[a,d] ; Deng, S[a] ; Langley, C[e] ; Li, W.-G[f] ; Zhang, J[a] ; Feng, J[g] ; Sahakian, B.J[a,e,g] ; Luo, Q[g,h,*b] ; Li, F[a,*a] ;
机构： [a]Department of Developmental and Behavioural Pediatric & Child Primary Care, Brain and Behavioural Research Unit of Shanghai Institute for Pediatric Research andMOE-Shanghai Key Laboratory for Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China [b]Centre for Experimental Studies and Research, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China [c]Clinical Research Unit, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China [d]The School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China [e]Department of Psychiatry and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB21TN, UK [f]Collaborative Innovation Center for Brain Science, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China [g]Institute of Science and Technology for Brain-Inspired Intelligence, Ministry of Education-Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence andResearch and Research Institute of Intelligent Complex Systems, Fudan University, Shanghai 200433, China [h]State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science and National Clinical Research Center forAging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
出处：
DOI： 10.1016/j.scib.2021.01.008
ISSN：

关键词： Autism spectrum disorder Bumetanide Children GABA RCT

摘要：
With the current limited drug therapy for the core symptoms of autism spectrum disorder (ASD), we herein report a randomized, double-blind, placebo-controlled trial to investigate the efficacy, safety, and potential neural mechanism of bumetanide in children with ASD aged 3−6 years old. A total of 120 children were enrolled into the study and randomly assigned to either 0.5 mg bumetanide or placebo. In the final sample, 119 children received at least one dose of bumetanide (59 children) or placebo (60 children) were included in the final analysis. The primary outcome was a reduction in the Childhood Autism Rating Scale (CARS) score, and the secondary outcomes were the Clinical Global Impressions Scale (CGI) -Global Improvement (CGI-I) score at 3 months and the change from baseline to 3-month in the Autism Diagnostic Observation Schedule (ADOS). Magnetic resonance spectroscopy (MRS) was used to measure γ-aminobutyric acid (GABA) and glutamate neurotransmitter concentrations in the insular cortex (IC) before and after the treatment. As compared with the placebo, bumetanide treatment was significantly better in reducing the severity. No patient withdrew from the trial due to adverse events. The superiority of bumetanide to placebo in reducing insular GABA, measured using MRS, was demonstrated. The clinical improvement was associated with a decrease in insular GABA in the bumetanide group. In conclusion, this trial in a large group of young children with predominantly moderate and severe ASD demonstrated that bumetanide is safe and effective in improving the core symptoms of ASD. However, the clinical significance remains uncertain, and future multi-center clinical trials are required to replicate these findings and confirm the clinical significance using a variety of outcome measures. © 2021 Science China Press

基金：
This work was supported by the Shanghai Municipal Commission of Health and Family Planning (2018BR33, 2017EKHWYX-02, and GWV-10.1-XK07), the Shanghai Shenkang Hospital Development Center (16CR2025B), the Shanghai Clinical Key?Subject?Construction?Project (shslczdzk02902), the National Natural Science Foundation of China (81761128035, 81930095, 81873909, 82001771, and 31860306), the Shanghai Committee of Science and Technology (17XD1403200, 20ZR1404900, and 19410713500), Xinhua Hospital of Shanghai Jiao Tong University School of Medicine (2018YJRC03), the National Human Genetic Resources Sharing Service Platform (2005DKA21300), the National Key Research and Development Program of China (2018YFC0910503), 111 Project (B18015), the Shanghai Municipal Science and Technology Major Project (2018SHZDZX01), Guangdong Key Project in ?Development of New Tools for Diagnosis and Treatment of Autism? (2018B030335001), and the Science and Technology Department of Yunnan Province (202001AV070010). We acknowledge Prof. Y?h?zkel Ben-Ari and his team for pioneering the researches on bumetanide in autism. We also thank the children and families for their participation and support in this study. Fei Li and Qiang Luo designed the study. Yuan Dai, Lingli Zhang, Yiting Ji, Kai Wang, Xujian Du, Yun Tang, Xin Liu, Hua He, and Shining Deng collected the data. Yuan Dai, Lingli Zhang, Juehua Yu, Wei-Guang Li, and Christelle Langley interpreted the data and wrote the report. Barbara J. Sahakian contributed to the data analysis and interpretation and manuscript preparation. Xin Zhou, Jun Zhang, and Jianfeng Feng provided methodology support. Fei Li and Qiang Luo were the principal investigators. All authors approved the final version of the manuscript.
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外文
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出版当年[2022]版：
大类 | 1 区 综合性期刊
小类 | 1 区 综合性期刊
最新[2023]版：
大类 | 1 区 综合性期刊
小类 | 1 区 综合性期刊
JCR分区：
出版当年[2021]版：
Q1 MULTIDISCIPLINARY SCIENCES
最新[2023]版：
Q1 MULTIDISCIPLINARY SCIENCES

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者机构： [a]Department of Developmental and Behavioural Pediatric & Child Primary Care, Brain and Behavioural Research Unit of Shanghai Institute for Pediatric Research andMOE-Shanghai Key Laboratory for Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
共同第一作者：
通讯作者：
通讯机构： [a]Department of Developmental and Behavioural Pediatric & Child Primary Care, Brain and Behavioural Research Unit of Shanghai Institute for Pediatric Research andMOE-Shanghai Key Laboratory for Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China [g]Institute of Science and Technology for Brain-Inspired Intelligence, Ministry of Education-Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence andResearch and Research Institute of Intelligent Complex Systems, Fudan University, Shanghai 200433, China [h]State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science and National Clinical Research Center forAging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China [*a]Department of Developmental and Behavioural Pediatric & Child Primary Care, Brain and Behavioural Research Unit of Shanghai Institute for Pediatric Research and MOE-Shanghai Key Laboratory for Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China [*b]Institute of Science and Technology for Brain-Inspired Intelligence, Ministry of Education-Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence and Research and Research Institute of Intelligent Complex Systems, Fudan University, Shanghai 200433, China
推荐引用方式(GB/T 7714)：
Dai Y,Zhang L,Yu J,et al.Improved symptoms following bumetanide treatment in children aged 3−6 years with autism spectrum disorder: A randomized, double-blind, placebo-controlled trial (Open Access)[J].SCIENCE BULLETIN.2021,66(15):1591-1598.doi:10.1016/j.scib.2021.01.008.
APA：
Dai, Y,Zhang, L,Yu, J,Zhou, X,He, H...&Li, F.(2021).Improved symptoms following bumetanide treatment in children aged 3−6 years with autism spectrum disorder: A randomized, double-blind, placebo-controlled trial (Open Access).SCIENCE BULLETIN,66,(15)
MLA：
Dai, Y,et al."Improved symptoms following bumetanide treatment in children aged 3−6 years with autism spectrum disorder: A randomized, double-blind, placebo-controlled trial (Open Access)".SCIENCE BULLETIN 66..15(2021):1591-1598

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