The influence of oxytocin nasal spray on children with autism

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Understanding and treating autism is a complex challenge. Autism affects how someone communicates, experiences social interaction, and processes information. Researchers are constantly searching for ways to improve daily functioning. One promising area of research? The hormone oxytocin, also known as the "cuddle hormone."

Recent studies by the Leuven Autism Research team (KU Leuven) show that oxytocin administered via a nasal spray to children with autism not only stimulates the body's own system, but can also reduce social stress.

What is oxytocin and why is it interesting in autism?

Oxytocin plays a key role in social behavior, attachment, and stress regulation. Previous studies have shown that children with autism have lower oxytocin levels than children without autism. This difference largely disappears in adolescents and adults. This provides an important basis for investigating whether administering oxytocin can help.

The research

In a clinical study, 80 children aged 8 to 12 years with autism were treated for four weeks with either oxytocin or placebo nasal spray.

Key findings:

• Stimulation of the body's own oxytocin system. The treatment increased salivary oxytocin levels and influenced the activity of the oxytocin receptor gene. This can lead to more receptors and thus improved hormone function in the body.

• Sense of Secure Attachment Higher oxytocin levels were associated with improvements in how children felt emotionally connected to their environment.

Less social stress

The oxytocin group showed biological improvements indicating better stress regulation:

• Positive effects on heart rate variability (a measure of relaxation).

• Decreased activity between brain areas that process fear (amygdala and OFC).

• Changes in brain activity measured by EEG that indicate resting.

Moreover, oxytocin appeared to dampen sensitivity to emotionally expressive faces, which may reduce social anxiety and promote closeness.

Behavioral changes: subtle, but hopeful when combined with therapy

After four weeks, no significant difference was found on the Social Responsiveness Scale compared to placebo. However, when oxytocin was combined with psychosocial therapy, the effects were stronger. This indicates that hormone treatment works best in a positive, socially stimulating context.

Future perspective

The researchers see particular potential in oxytocin and social stimulation as a combined approach. Future projects like MOX-AID and OXYSYNC should further demonstrate how this can be applied in practice. Oxytocin nasal spray appears to activate the body's own system and reduce social stress in children with autism. Although behavioral improvements alone are limited, the combination with therapy may be promising. Or, as the researchers summarize:

"It is not a miracle cure, but it is a valuable link in a broader treatment."

Theoretical Framework: Oxytocin and Autism

1. Autism and social functioning

Autism spectrum disorder (ASD) is a developmental disorder characterized by:

• Limitations in social interaction and communication

• Restricted, repetitive behavior patterns and interests

• Changes in sensory processing

Although the exact neurobiological causes are not yet fully understood, abnormalities in social-cognitive networks in the brain play a central role. Social stress and difficulties with social-emotional processing are important factors that affect daily functioning.

2. Oxytocin: the 'social' neuropeptide

Oxytocin is a neuropeptide hormone produced in the hypothalamus and active in both the blood and the brain. Key functions:

• Promoting social bonding and attachment

• Regulating stress and anxiety

• Modulating effect on social recognition and empathy

Several studies (including Moerkerke et al., 2020/2021) have found lower basal oxytocin levels in people with autism, especially in childhood. This suggests possible disruptions in the oxytocin system.

3. Mechanisms of intranasal oxytocin

Administering oxytocin via a nasal spray is a way to deliver the hormone directly to the brain—via the olfactory and trigeminal nerves. Possible mechanisms of action:

• Activation of oxytocin receptors → enhancement of social information processing

• Stress reduction through amygdala regulation → reduction of social anxiety

• Epigenetic changes → for example reduced methylation of the oxytocin receptor gene, leading to more receptors and a stronger signal

4. Biological and clinical relevance

The effects of oxytocin in autism are typically studied at three levels:

1. Biological level – hormone levels, gene expression, brain activity

2. Psychological level – experienced attachment, stress perception

3. Behavioral level – social responsiveness, interaction in practice

The Leuven research shows that significant changes occur mainly at the biological and psychological level, while behavioural improvements become particularly visible when oxytocin is combined with psychosocial therapy.

5. Integrative treatment model

The theoretical framework supports a biopsychosocial model in which:

• Biology (oxytocin administration) strengthens the physiological basis for social behavior

• Psychosocial stimulation (therapy, social training) utilizes this biological 'window of opportunity'

• Environmental factors