SLPRCTJournal of autism and developmental disorders2024

Effects of Bumetanide on Neurocognitive Functioning in Children with Autism Spectrum Disorder: Secondary Analysis of a Randomized Placebo-Controlled Trial.

Dorinde M van Andel, Jan J Sprengers, Marsh Königs and 2 others

PMID 36626004

WHAT IT FOUND

Bumetanide showed no benefit on standard neurocognitive tests in children with autism.

However, experimental network analysis suggested subtle changes in how cognitive functions are organized. These findings are exploratory and not corrected for multiple testing, so they do not support changing clinical practice.

Key findings

01There was no significant difference between bumetanide and placebo on any of the eight standard neurocognitive domains identified by the study.

02Exploratory network analysis found that bumetanide increased the 'modularity' of the neurocognitive network, suggesting a shift toward more specialized organization.

03The study did not apply corrections for multiple testing, explicitly accepting a higher risk of false-positive results in these secondary analyses.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The neurocognitive analyses were secondary and exploratory, with no correction for multiple testing, increasing the risk of false positives. The treatment duration of 91 days may have been too short to detect subtle neurocognitive changes. Normative data for the neurocognitive tests were unavailable for participants older than 12, potentially biasing the baseline dysfunction analysis. The study found no correlation between the exploratory network changes and actual behavioral outcomes (ASD symptoms).

Declared interests

The paper does not explicitly state the funding source or specific conflicts of interest in the provided text, though it notes the trial was registered with the EudraCT registry.

The easy way to misread this

Do not interpret the significant network analysis results as evidence that bumetanide improves cognitive function. These were exploratory secondary analyses not corrected for multiple comparisons, and the standard clinical tests showed no benefit.

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