April Flowers for redOrbit.com – Your Universe Online
Despite years of protests from children, scientists may just have found a good reason for eating broccoli, cauliflower and cabbage. These vegetables contain a molecule known as sulforaphane, and researchers from Massachusetts General Hospital for Children (MGHfC) and Johns Hopkins have found that a daily treatment of sulforaphane may improve some symptoms of autism spectrum disorders.
The findings, published in the Early Edition of the Proceedings of the National Academy of Sciences, demonstrate that patients with autism spectrum disorders show improvement in both behavioral and communication assessments in as little as four weeks of daily doses of the molecule.
“Over the years there have been several anecdotal reports that children with autism can have improvements in social interaction and sometimes language skills when they have a fever,” explained Andrew Zimmerman, MD, who also published a 2007 paper documenting the fever effect while he was at Johns Hopkins. “We investigated what might be behind that on a cellular level and postulated that it results from fever’s activation of the cellular stress response, in which protective cellular mechanisms that are usually held in reserve are turned on through activation of gene transcription.” Zimmerman is now based at UMass Memorial Medical Center as a professor of Pediatric Neurology and affiliated with the MGHfC Department of Neurology.
Currently a professor of Pharmacology and Molecular Sciences at Johns Hopkins, Paul Talalay, MD, isolated sulforaphane in the 1990s, finding that the molecule supports key aspects of the cell stress response. Zimmerman worked with Talalay’s team to investigate sulforaphane’s possible benefits for treating autism. Despite the fact that the underlying mechanism for autism and other disorders on the autism spectrum is unknown, researchers do know that several molecular abnormalities have been identified, including some related to the cellular stress response. The clinical trial began at the Lurie Center after Zimmerman moved to MGHfC in 2010.
The participant cohort consisted of 44 young men diagnosed with moderate to severe autism spectrum disorder. They were randomly assigned to receive a daily dose of either sulforaphane that was extracted from broccoli sprouts, or a placebo dose. Neither the participants, their caregivers or the investigators knew who was receiving the drug or not. Caregivers and staff used standardized measurements of behavior and social interaction at the onset of the study and again at 4, 10 and 18 weeks after treatment began. After 18 weeks, treatment was discontinued and additional assessments of 22 of the participants were performed after another four weeks.
Boys were chosen for this study because out of the 1 to 2 percent of the world’s population affected by autism spectrum disorder, the number of boys affected outweighs the number of girls by a factor of five, according to the CDC. Kanwaljit Singh, MD, MPH, from both MGHfC and the Lurie Center, reports that of the 40 participants who returned for at least one evaluation, the average scores for each assessment were noticeably different for the 26 who received the molecule when compared to the 14 who did not. By the 4 week visit, some caregivers had already started noticing a difference in behavior. By the end of the study, the identities of the majority of the patients receiving sulforaphane had been guessed by both caregivers and researchers. The caregivers of 17 of the 26 on sulforaphane judged their patients to have improvements in behavior, social interaction and calmness while on active treatment.
At the end of active treatment, the patients were assessed again using the Aberrant Behavior Checklist and the Social Responsiveness Scale. The scores of those on sulforaphane had decreased 34 and 17 percent, respectively. These decreases indicate improvement in irritability, lethargy, repetitive movements, hyperactivity, communication, motivation and mannerisms. The patients were also assessed using the Clinical Global Impression Scale, which indicated that 46 percent of the drug recipients exhibited noticeable behaviors in social interaction, 54 percent in aberrant behaviors and 42 percent in verbal communication.
“We believe that this may be preliminary evidence for the first treatment for autism that improves symptoms by apparently correcting some of the underlying cellular problems,” said Talalay, who has researched these vegetable compounds for the past 25 years.
“We are far from being able to declare a victory over autism, but this gives us important insights into what might help,” says Zimmerman.
By the time of the 4 week post treatment assessment, most, but not all, of the improvements had disappeared. This is a strong indication that the sulforaphane was the catalyst for the changes. “It seems like sulforaphane is temporarily helping cells to cope with their handicaps,” Talalay says.
“When we broke the code that revealed who was receiving sulforaphane and who got the placebo, the results weren’t surprising to us, since the improvements were so noticeable,” added Zimmerman. “The improvements seen on the Social Responsiveness Scale were particularly remarkable, and I’ve been told this is the first time that any statistically significant improvement on the SRS has been seen for a drug study in autism spectrum disorder.
“But it’s important to note that the improvements didn’t affect everyone – about one third had no improvement – and the study must be repeated in a larger group of adults and in children, something we’re hoping to organize soon,” he said. “Ultimately we need to get at the biology underlying the effects we have seen and study it at a cellular level. I think that will be done, and I hope it will teach us a lot about this still poorly understood disorder.”
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May we suggest – Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism
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