Treatment of Severe Self-Injurious Behavior in Autism Spectrum Disorder by Neuromodulation

Douglas DʼAgati, Andrew D. Chang, Lee E. Wachtel, Irving M. Reti

Research output: Research - peer-reviewArticle

Abstract

ABSTRACT: An increasing number of case reports and series document the safe and effective use of electroconvulsive therapy (ECT) in children, adolescents, and young adults with autism spectrum disorder who engage in severe, intractable, repetitive self-injurious behavior (SIB) without environmental or operant function. Although the treatment is very effective for such patients, they typically remain highly dependent on frequent maintenance ECT (M-ECT) to maintain suppression of the SIB achieved during the acute course. Some patients receive M-ECT as frequently as once every 5 days. Such a regimen is quite burdensome for the patient and the patientʼs family, and the long-term effects of such regimens, starting as early as childhood, are unknown. In this review, we explore the expanding literature supporting the use of ECT for suppressing severe SIB associated with autism spectrum disorder. We also focus on the possible development of alternate nonconvulsive focal forms of brain stimulation, which might replace frequent M-ECT or reduce how frequently a patient needs to receive it. Although there are scarce clinical data currently available supporting these latter treatments, future studies are clearly indicated.

LanguageEnglish (US)
JournalJournal of ECT
DOIs
StateAccepted/In press - Jul 16 2016

Fingerprint

Self-Injurious Behavior
Therapeutics
Autism Spectrum Disorder
Electroconvulsive Therapy
Maintenance
Young Adult
Brain

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuroscience (miscellaneous)

Cite this

Treatment of Severe Self-Injurious Behavior in Autism Spectrum Disorder by Neuromodulation. / DʼAgati, Douglas; Chang, Andrew D.; Wachtel, Lee E.; Reti, Irving M.

In: Journal of ECT, 16.07.2016.

Research output: Research - peer-reviewArticle

@article{5d33f5c4370d496fa0db73288a37c780,
title = "Treatment of Severe Self-Injurious Behavior in Autism Spectrum Disorder by Neuromodulation",
abstract = "ABSTRACT: An increasing number of case reports and series document the safe and effective use of electroconvulsive therapy (ECT) in children, adolescents, and young adults with autism spectrum disorder who engage in severe, intractable, repetitive self-injurious behavior (SIB) without environmental or operant function. Although the treatment is very effective for such patients, they typically remain highly dependent on frequent maintenance ECT (M-ECT) to maintain suppression of the SIB achieved during the acute course. Some patients receive M-ECT as frequently as once every 5 days. Such a regimen is quite burdensome for the patient and the patientʼs family, and the long-term effects of such regimens, starting as early as childhood, are unknown. In this review, we explore the expanding literature supporting the use of ECT for suppressing severe SIB associated with autism spectrum disorder. We also focus on the possible development of alternate nonconvulsive focal forms of brain stimulation, which might replace frequent M-ECT or reduce how frequently a patient needs to receive it. Although there are scarce clinical data currently available supporting these latter treatments, future studies are clearly indicated.",
author = "Douglas DʼAgati and Chang, {Andrew D.} and Wachtel, {Lee E.} and Reti, {Irving M.}",
year = "2016",
month = "7",
doi = "10.1097/YCT.0000000000000346",
journal = "Journal of ECT",
issn = "1095-0680",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Treatment of Severe Self-Injurious Behavior in Autism Spectrum Disorder by Neuromodulation

AU - DʼAgati,Douglas

AU - Chang,Andrew D.

AU - Wachtel,Lee E.

AU - Reti,Irving M.

PY - 2016/7/16

Y1 - 2016/7/16

N2 - ABSTRACT: An increasing number of case reports and series document the safe and effective use of electroconvulsive therapy (ECT) in children, adolescents, and young adults with autism spectrum disorder who engage in severe, intractable, repetitive self-injurious behavior (SIB) without environmental or operant function. Although the treatment is very effective for such patients, they typically remain highly dependent on frequent maintenance ECT (M-ECT) to maintain suppression of the SIB achieved during the acute course. Some patients receive M-ECT as frequently as once every 5 days. Such a regimen is quite burdensome for the patient and the patientʼs family, and the long-term effects of such regimens, starting as early as childhood, are unknown. In this review, we explore the expanding literature supporting the use of ECT for suppressing severe SIB associated with autism spectrum disorder. We also focus on the possible development of alternate nonconvulsive focal forms of brain stimulation, which might replace frequent M-ECT or reduce how frequently a patient needs to receive it. Although there are scarce clinical data currently available supporting these latter treatments, future studies are clearly indicated.

AB - ABSTRACT: An increasing number of case reports and series document the safe and effective use of electroconvulsive therapy (ECT) in children, adolescents, and young adults with autism spectrum disorder who engage in severe, intractable, repetitive self-injurious behavior (SIB) without environmental or operant function. Although the treatment is very effective for such patients, they typically remain highly dependent on frequent maintenance ECT (M-ECT) to maintain suppression of the SIB achieved during the acute course. Some patients receive M-ECT as frequently as once every 5 days. Such a regimen is quite burdensome for the patient and the patientʼs family, and the long-term effects of such regimens, starting as early as childhood, are unknown. In this review, we explore the expanding literature supporting the use of ECT for suppressing severe SIB associated with autism spectrum disorder. We also focus on the possible development of alternate nonconvulsive focal forms of brain stimulation, which might replace frequent M-ECT or reduce how frequently a patient needs to receive it. Although there are scarce clinical data currently available supporting these latter treatments, future studies are clearly indicated.

UR - http://www.scopus.com/inward/record.url?scp=84978683006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978683006&partnerID=8YFLogxK

U2 - 10.1097/YCT.0000000000000346

DO - 10.1097/YCT.0000000000000346

M3 - Article

JO - Journal of ECT

T2 - Journal of ECT

JF - Journal of ECT

SN - 1095-0680

ER -