A Preliminary Study of Methylcobalamin Therapy in Autism

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  • preliminary study of methylcobalamin therapy in autism
  • 自閉症におけるメチルコバラミン療法の予備的検討

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我々は13例の自閉症患者でビタミンB_<12>(メチルコバラミン:Me-B_<12>)の治療効果をオープン試験で試みた.Me-B_<12>の治療開始時期は2歳3ヵ月から18歳で,Me-B_<12>を25～30μg/kg/day,6～25ヵ月間投与した.IQ/DQによる評価では,治療前は45±5.3(平均±標準誤差)であったが,治療後は52±6.0と有意な上昇が認められた(p=0.0199).CARS検査(小児自閉症評定尺度)では,治療前は35.9±1.6であったが,治療後は33.0±1.7(p=0.0008)と改善した.自然経過による改善とMe-B_<12>効果を鑑別するため,患者を年齢,知能でそれぞれ2群に分類し検討したところ,思春期群と低IQ群のCARSスコアーが,幼児・早期学童期群,高IQ群と同様に改善した.自閉症児において思春期は一般に症状改善に乏しく,症状の自然改善は高機能自閉症児に見られることから,この結果は, Me-B_<12>効果は自然経過とは異なると考えられた.検討はまだ予備的段階であるが,自閉症においてMe-B_<12>は治療薬として試みる価値があると考えられた.

We conducted an open trial on the effect of methylcobalamin (Me-B_<12>) in 13 patients with autism. The patients' ages at the start of treatment ranged from 2 years and 3 months to 18 years. Me-B_<12> was administered at a dosage of 25-30 g/kg/day for 6-25 months. The intelligence and developmental quotient (IQ/DQ) after Me-B_<12>treatment was 52±6.0 (mean ± SE), which was significantly higher than before treatment (45±5.3) (p<0.05). The childhood autism rating scale (CARS) score improved significantly, from 35.9±1.6 before to 33.0±1.7 after treatment (p<0.001). To distinguish the effects of Me-B_<12> from natural developmental factors, the patients were divided into two subgroups, both according to age and according to intelligence. The CARS scores of the teenage and the low-IQ groups improved as much as those of the pre-early school age and the high-IQ groups. As adolescent autism patients usually show a decline in their condition, while some high function autism patients exhibit positive development, the improvement of CARS scores with Me-B_<12> treatment in the teenage and the low-IQ groups suggests that the Me-B_<12> effect is distinct from developmental factors. Although these data are very preliminary, Me-B_<12> is potentially beneficial in autism as an additional or alternative treatment.

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