Autism & Developmental

Impact of chronic intranasal oxytocin administration on face expression processing in autistic children: a randomized controlled trial using fMRI.

Moerkerke et al. (2024) · Molecular Autism 2024
★ The Verdict

Four weeks of intranasal oxytocin did not change autistic children's brain response to faces.

✓ Read this if BCBAs asked about oxytocin or biomedical add-ons for social deficits.
✗ Skip if Clinicians focused only on behavioral interventions with no pharmacology questions.

01Research in Context

01

What this study did

Researchers gave autistic children a daily nose spray of oxytocin for four weeks.

They used brain scans to watch how the kids' brains reacted to faces.

Half the kids got real oxytocin, half got salt-water spray. No one knew who had which.

02

What they found

The scans showed no clear difference between the oxytocin group and the placebo group.

Some brain areas lit up a little less in the oxytocin kids, but the finding did not pass the math test for real change.

In short, four weeks of oxytocin did not move the brain's face-reading meter.

03

How this fits with other research

Hirosawa et al. (2017) ran a smaller, longer study. They gave oxytocin for eight to ten weeks and saw a rise in serotonin markers. Moerkerke's stricter four-week RCT found no brain change, showing that longer dosing may still be worth testing.

Bao et al. (2017) warned that oxytocin papers often have weak methods. The new RCT answered that call by adding random assignment and brain imaging, yet still came up empty.

Laposa et al. (2017) showed that parent ratings can improve even with no treatment. Moerkerke used objective fMRI instead of parent forms, avoiding that placebo trap.

04

Why it matters

For now, daily oxytocin is not a magic key for face skills in autistic kids. BCBAs should keep using proven social-skills training and watch for future trials that test longer dosing or pairing oxytocin with behavioral teaching.

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Stick to evidence-based social-skill programs; skip recommending oxytocin until stronger data arrive.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
58
Population
autism spectrum disorder
Finding
null

03Original abstract

Difficulties with (non-verbal) social communication, including facial expression processing, constitute a hallmark of autism. Intranasal administration of oxytocin has been considered a potential therapeutic option for improving social difficulties in autism, either by enhancing the salience of social cues or by reducing the social stress and anxiety experienced in social encounters. We recorded fMRI brain activity while presenting neutral, fearful and scrambled faces, to compare the neural face processing signature of autistic children (n = 58) with that of matched non-autistic controls (n = 38). Next, in the autistic children group, we implemented this fMRI face processing task in a double-blind, placebo-controlled, multiple-dose oxytocin clinical trial, to evaluate the impact of four-week repeated oxytocin administration (24 IU daily dose) on brain activity in face processing regions. No significant diagnostic-group differences were identified between autistic versus non-autistic children with regard to neural face processing. Furthermore, no significant treatment effects were found in the oxytocin clinical trial. However, exploratory analyses (uncorrected for multiple comparisons) demonstrated decreases in brain activity in the left superior temporal sulcus (STS) and inferior frontal region in the oxytocin compared to the placebo group, and change-from-baseline analyses in the oxytocin group revealed significantly reduced neural activity in the core face-processing network (STS, inferior occipital, and posterior fusiform), as well as in amygdala and inferior frontal region. These findings suggest an attenuating effect of multiple-dose oxytocin administration on neural face processing, potentially supporting the anxiolytic account of oxytocin. The online version contains supplementary material available at 10.1186/s13229-024-00635-z.

Molecular Autism, 2024 · doi:10.1186/s13229-024-00635-z