Autism spectrum disorder (ASD) is associated with deficits in executive functioning (EF), and these have been suggested to contribute to core as well as co-occurring psychiatric symptoms. The biological basis of these deficits is unknown but may include the serotonergic system, which is involved both in regulating EF in neurotypical populations and in the pathophysiology of ASD. We previously demonstrated that reducing serotonin by acute tryptophan depletion (ATD) shifts differences in brain function during performance of EF tasks towards control levels. However, ATD cannot be easily used in the clinic, and we therefore need to adopt alternative approaches to challenge the serotonin system. Hence, we investigated the role of the serotonergic modulator tianeptine on EF networks in ASD. We conducted a pharmacological magnetic resonance imaging study, using a randomized double-blind crossover design, to compare the effect of an acute dosage of 12.5 mg tianeptine and placebo on brain activation during two EF tasks (of response inhibition and sustained attention) in 38 adult males: 19 with ASD and 19 matched controls. Under placebo, compared to controls, individuals with ASD had atypical brain activation in response inhibition regions including the inferior frontal cortex, premotor regions and cerebellum. During sustained attention, individuals with ASD had decreased brain activation in the right middle temporal cortex, right cuneus and left precuneus. Most of the case–control differences in brain function observed under placebo conditions were abolished by tianeptine administration. Also, within ASD individuals, brain functional differences were shifted significantly towards control levels during response inhibition in the inferior frontal and premotor cortices. We conducted a pilot study using a single dose of tianeptine, and therefore, we cannot comment on long-term outcome. Our findings provide the first evidence that tianeptine can shift atypical brain activation during EF in adults with ASD towards control levels. Future studies should investigate whether this shift in the biology of ASD is maintained after prolonged treatment with tianeptine and whether it improves clinical symptoms.

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自闭症执行功能期间非典型脑激活的调节：噻奈普汀的药理学 MRI 研究

自闭症谱系障碍 (ASD) 与执行功能 (EF) 的缺陷有关，并且这些缺陷被认为是导致核心以及同时发生的精神症状的原因。这些缺陷的生物学基础尚不清楚，但可能包括 5-羟色胺能系统，该系统参与调节神经典型人群的 EF 和 ASD 的病理生理学。我们之前证明，通过急性色氨酸耗竭 (ATD) 减少血清素可将执行 EF 任务期间脑功能的差异转移到控制水平。然而，ATD 在临床上并不容易使用，因此我们需要采用替代方法来挑战血清素系统。因此，我们研究了血清素调节剂噻奈普汀对 ASD EF 网络的作用。我们进行了一项药理学磁共振成像研究，使用随机双盲交叉设计，比较急性剂量 12.5 mg 噻奈普汀和安慰剂对 38 名成年男性的两项 EF 任务（反应抑制和持续注意力）期间大脑激活的影响：19 名患有 ASD 和 19 名匹配的对照. 在安慰剂下，与对照组相比，患有 ASD 的个体在包括下额叶皮层、前运动区和小脑在内的反应抑制区域具有非典型的大脑激活。在持续关注期间，ASD 患者右侧中颞叶皮层、右侧楔叶和左侧楔前叶的大脑激活减少。在安慰剂条件下观察到的大多数病例对照脑功能差异被噻奈普汀消除。此外，在 ASD 个体中，在下额叶和前运动皮层的反应抑制期间，大脑功能差异显着转向控制水平。我们使用单剂量的噻奈普汀进行了一项初步研究，因此，我们无法评论长期结果。我们的研究结果提供了第一个证据，证明噻奈普汀可以将 ASD 成人 EF 期间的非典型脑激活转变为控制水平。未来的研究应该调查在长期使用噻奈普汀治疗后是否能维持 ASD 生物学的这种转变，以及它是否能改善临床症状。我们的研究结果提供了第一个证据，证明噻奈普汀可以将 ASD 成人 EF 期间的非典型脑激活转变为控制水平。未来的研究应该调查在长期使用噻奈普汀治疗后是否能维持 ASD 生物学的这种转变，以及它是否能改善临床症状。我们的研究结果提供了第一个证据，证明噻奈普汀可以将 ASD 成人 EF 期间的非典型脑激活转变为控制水平。未来的研究应该调查在长期使用噻奈普汀治疗后是否能维持 ASD 生物学的这种转变，以及它是否能改善临床症状。