阿尔茨海默病药物美金刚可能会改善自闭症儿童的社交功能

An approved pill for Alzheimer’s disease might help boost social functioning in some children and teens with autism spectrum disorder, a new small-scale clinical trial has found.

一项新的小规模临床试验发现，一种被批准用于治疗阿尔茨海默病的药片可能有助于提高一些自闭症谱系障碍儿童和青少年的社交功能。

Memantine improved these kids’ social behaviors 56%, compared to a 21% improvement among kids taking a placebo, researchers reported in JAMA Network Open.

研究人员在JAMA Network Open上报道，美金刚改善了这些孩子的社交行为56%，而服用安慰剂的孩子改善了21%。

“Participants who responded to memantine showed improvements in social competence and a reduction in autism symptom severity, although they continued to experience milder features of autism,” lead researcher Dr. Gagan Joshi said in a news release. He’s director of the Bressler Program for Autism Spectrum Disorder at Massachusetts General Hospital in Boston.“

对美金刚有反应的参与者在社交能力方面有所改善，自闭症症状严重程度也有所降低，尽管他们仍然会表现出较轻的自闭症特征，”首席研究员Gagan Joshi博士在新闻发布会上说。他是波士顿麻省总医院自闭症谱系障碍Bressler项目的负责人。

Memantine decreases abnormal activity in the brain caused by glutamate, an abundant neurotransmitter that plays a major role in learning and memory.

美金刚可减少谷氨酸引起的脑部异常活动，谷氨酸是一种丰富的神经递质，在学习和记忆中起主要作用。

It’s approved to treat people with moderate to severe Alzheimer’s, by blocking receptors that cause memory loss when persistently activated by glutamate, according to Drugs.com.

据Drugs.com报道，它被批准用于治疗中度至重度阿尔茨海默氏症患者，通过阻断受体，当谷氨酸持续激活时，这些受体会导致记忆丧失。

Some people with autism have abnormal levels of glutamate in their brains, which led researchers to think memantine might also help these patients.

一些自闭症患者大脑中的谷氨酸水平异常，这使得研究人员认为美金刚也可能帮助这些患者。

“If you have elevated blood glucose, we prescribe antidiabetic medications to decrease blood sugar levels,” Joshi said. “In the same way, we looked to see if glutamate modulators could improve social functioning in autism for individuals with abnormally high brain glutamate levels.”

“如果患者血糖偏高，我们会开降糖药来降低血糖水平，” Joshi，“同样地，我们也在研究谷氨酸调节剂是否可以改善大脑谷氨酸水平异常高的自闭症患者的社交功能。”

For the clinical trial, researchers recruited 42 kids ages 8 to 18 who had autism without intellectual disability. The kids were randomly assigned to take either memantine or a placebo for 12 weeks.

在临床试验中，研究人员招募了42名年龄在8岁到18岁的自闭症儿童，这些孩子没有智力障碍。孩子们被随机分配服用美金刚或安慰剂12周。

Of those kids, 33 completed the trial, including 16 on memantine and 17 on placebo, researchers said.

研究人员说，在这些孩子中，有33人完成了试验，其中包括16人服用美金刚，17人服用安慰剂。

“We saw that patients who responded to memantine became more socially engaged,” Joshi said.

“我们发现，对美金刚有反应的患者变得更加社会参与，”Joshi说。

Brain scans showed that all the kids had medium-to-high levels of glutamate activity in the pregenual anterior cingulate cortex (pgACC), a glutamate-rich brain region responsible for social processing and emotional awareness.

脑部扫描显示，所有孩子在前扣带回皮层（pgACC）都有中等至高水平的谷氨酸活性。前扣带回皮层是一个富含谷氨酸的大脑区域，负责社会处理和情绪意识。

About 54% had abnormally high levels of glutamate and the rest medium levels, compared to brain scans of 16 kids without autism.

与16名非自闭症儿童的大脑扫描结果相比，约54%的儿童谷氨酸水平异常高，其余为中等水平。

All of the kids who responded to memantine had high glutamate levels, and 80% of kids with abnormally high glutamate responded favorably to memantine, results showed.

结果显示，所有对美金刚有反应的孩子都有高水平的谷氨酸，而80%的谷氨酸异常高的孩子对美金刚有良好的反应。

The drug was generally well-tolerated, although some kids reported mild side effects like headaches, researchers said.

研究人员说，这种药物的耐受性一般很好，尽管一些孩子报告了轻微的副作用，如头痛。

More research is needed to better assess the drug’s potential usefulness in treating autism, Joshi said.

Joshi说，需要更多的研究来更好地评估药物在治疗自闭症方面的潜在用途。

“Larger clinical trials could help assess memantine responses in broader populations with ASD,” Joshi said.

“更大的临床试验可以帮助评估美金刚在更广泛自闭症人群中的反应，”Joshi说。