RCTMolecular autism2021

Modulation of striatal functional connectivity differences in adults with and without autism spectrum disorder in a single-dose randomized trial of cannabidivarin.

Charlotte M Pretzsch, Dorothea L Floris, Bogdan Voinescu and 11 others

PMID 34210360

WHAT IT FOUND

A single 600 mg dose of cannabidivarin shifted atypical brain connectivity in adults with autism toward neurotypical patterns on an MRI scan.

This was a small pilot study that measured brain activity only. It did not test whether the drug improved symptoms or behaviour.

Key findings

01Adults with autism showed both hyperconnectivity and hypoconnectivity in the striatum compared to neurotypical controls at baseline.

02A single dose of cannabidivarin significantly reduced atypical hyperconnectivity in the autism group, shifting these patterns toward those seen in neurotypical controls.

03The study was not designed to determine the impact of cannabidivarin on cognition or behaviour in autism, so clinical effects remain unknown.

STILL TO COME

How it was doneWhat they found

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What it does not show

The sample size was very small (28 participants), limiting the generalizability of the findings. The study included only adult men, excluding women and children who also have autism. Participants had higher than average IQs (mean 113 in autism group), so findings may not apply to those with intellectual disability. The study measured brain connectivity changes only; it did not assess whether these changes corresponded to improvements in symptoms, behaviour, or daily functioning. The drug was given as a single acute dose, so it is unknown if long-term use would have similar or different effects. Multiple comparisons were not corrected for in the baseline group differences due to the exploratory nature of the pilot, increasing the risk of false positives.

Declared interests

The study was funded by GW Research Ltd, which provided the CBDV and placebo. Other funders included the NIHR Mental Health Biomedical Research Centre, the Innovative Medicines Initiative 2 Joint Undertaking, the Sackler Institute for Translational Neurodevelopment, Autistica, and the Medical Research Council UK.

The easy way to misread this

Do not interpret the normalization of brain connectivity patterns as evidence that cannabidivarin treats autism symptoms. The study did not measure clinical outcomes, social communication, or behaviour, and the participants were a small, highly selected group of adult men with high IQs.

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The study

Participants
28 (13 adults with autism spectrum disorder, 15 neurotypical controls)
Certainty of evidence
Moderate

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    Charlotte M Pretzsch, Dorothea L Floris, Bogdan Voinescu, et al. Modulation of striatal functional connectivity differences in adults with and without autism spectrum disorder in a single-dose randomized trial of cannabidivarin. Molecular autism. 2021.

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