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Drug improves stimulus processing in children with autism

6 october 2021


By the editors

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The drug bumetanide for high blood pressure can help children with autism to better process stimuli, according to a study by Amsterdam UMC. The researchers also developed an algorithm that helps predict which children this drug works for.

The researchers looked at 92 children with a developmental disorder using brain videos (EEG) to see whether they would benefit from this drug. That turned out to be the case with some of them. According to lead researcher Hilgo Bruining, this method provides a first tailor-made treatment in child and adolescent psychiatry.

Influencing stimulus balance
Bumetanide is normally prescribed in people with high blood pressure. It now appears that it also has an effect in the brains of children who have difficulty processing information. Their stimulus balance is then not optimal, the brain is over- or under-stimulated.

The researchers showed that bumetanide can influence the stimulus balance by reducing the chlorine concentration in the brain cells. “The big question was whether the drug has an effect on stimulus processing and whether and for whom this leads to an improvement in symptoms,” says child psychiatrist Hilgo Bruining. “By analyzing the brain activity with a brain video before and after the treatment with bumetanide, it appears that this drug can influence the stimulus balance.”

Model predicts who it works for
Using an EEG, the brain video, the researchers developed a model that can predict which children will benefit from the drug and which will not. “It has to be done with just prescribing something for these children with autism symptoms,” says Bruining.

“We have found a method that allows us to see quite precisely for which child this drug will work. We do this by looking at the stimulus balance in the brain with a new EEG analysis. By combining this data with clinical data, we get an algorithm with which we can predict who the drug will work for. This drug has no serious side effects like antipsychotics or ritalin.”

Release labels
Bruining advocates precision psychiatry. By focusing on stimulus processing and thus on the cause of the symptoms, he wants to give each child a unique treatment.

Bruining has previously shown that children on the autism spectrum can have both overstimulated and understimulated brains. This is the core of the approach in the new N=You Knowledge Center for Developmental Disorders of Emma Children’s Hospital in Amsterdam UMC.

Study design
This study, which was set up in collaboration with the Vrije Universiteit Amsterdam and UMC Utrecht, tested a placebo and bumetanide (twice daily up to 1.0 mg) in 92 drug-free children aged 7-15 years with a diagnosis of autism spectrum disorder. Children with an IQ below 55 and taking psychoactive medications were excluded from the study. The children received 91 days of treatment with either the drug or placebo. The brain activity before and after treatment was examined by means of an EEG. |

Read more about the research published in Biological Psychiatry CNII on the website of Amsterdam UMC.

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