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Efficacy of Adding Large Doses of Arachidonic Acid to Docosahexaenoic Acid against Restricted Repetitive Behaviors in Individuals with AutismSpectrum Disorders: A Placebo-Controlled Trial

Kunio Yui, Mamiko Koshiba, Shun Nakamura, Yuji Kobayashim and Masaki Ohnishi

Objectives: It has been documented that behavioral addictions resemble substance addiction in many domains, including the repetitive patterns of interests and behavior displayed by addicts and their failure to resist impulses to perform an act that are harmful to themselves or others. Restricted and repetitive patterns of interests and behavior resembling the characteristics of behavioral addictions are also a core feature of autism spectrum disorders (ASD). Impaired delivery of afferent signals has been proposed to be a factor in pathophysiology of ASD. The polyunsaturated fatty acids, arachidonicacid (ARA) and docosahexaenoic acid (DHA) play key roles in the maturation of the brain network. Supplementation of larger doses of ARA added to DHA may therefore improve repetitive and addictive behavior.

Methods: To estimate the effi cacy of this supplementation in individuals with ASD, we conducted a 16-week double-blind, randomized placebo-controlled trial in 13 individuals with ASD. The outcomes were measured using the Aberrant Behavior Checklist (ABC), and the repetitive behavior subdomains of the Autism Diagnostic Interview-Revised (ADI-R). To study the mechanisms underlying the effects of this supplementation regimen, we examined the plasma levels of main polyunsaturated fatty acids (i.e., eicosapentaenoic acid, DHA and ARA).

Results: Our supplementation regimen signifi cantly improved ABC-measured social withdrawal and ADI-R C3 subdomain (stereotyped and repetitive motor mannerisms). Their scores of the ADI-R C3 subdomain were signifi cantly correlated with ABC-measured inappropriate speech (r=0.397, P<0.01).The changes in the plasma ARA levels at the end of the placebo-controlled trial was signifi cantly increased in the treatment group.

Conclusion: The observed improvement in repetitive and addictive behavior might have been related to reduction in the scores of the ABC-measured social withdrawal and ABC-measured inappropriate speech. These fi ndings suggest that improvements in impaired social interactions may contribute to improvements in repetitive and addictive behavior.