Predicting Treatment Response to Memantine in Autism Using Magnetic Resonance Spectroscopy
Status:
Completed
Trial end date:
2021-04-01
Target enrollment:
Participant gender:
Summary
Memantine, an N-methyl-D-aspartate receptor antagonist, has been explored as a possible
therapeutic agent that reduces the excitatory (glutamate) - inhibitory (gamma amino-butyric
acid, GABA) imbalance in autism pathology and improves social and communication deficits.
While some studies have shown positive results, a large clinical trial failed to show benefit
possibly because different subsets of autism responded differently to the treatment.
The investigator proposes a pilot, exploratory, clinical follow-on study using proton
magnetic resonance spectroscopy (1H-MRS) to determine whether baseline glutamate/GABA levels
in certain regions of the brain may help predict treatment response to Memantine in autistic
subjects. At study onset, subjects will be assessed on the behavioral scales such as the
Aberrant Behavior Checklist and Clinical Global Impressions scale, followed by MRS imaging.
Memantine treatment will be started post imaging. Assessment measures will be repeated at
week 12 during treatment. Glutamate and GABA levels in brain regions will be correlated to
improvements on assessment measures. Expected results include higher glutamate and/or lower
GABA levels in the anterior cingulate cortex at baseline in responders to memantine. If the
hypotheses are confirmed, it will provide evidence of a relevant neural biomarker to predict
treatment response to memantine with important implications for clinical care including
improving individualization of treatments.