Improving emotional face perception in autism with diuretic bumetanide: A proof-of-concept behavioral and functional brain imaging pilot study
Open accessAbstract
Clinical observations have shown that GABA-acting benzodiazepines exert paradoxical excitatory effects in autism, suggesting elevated intracellular chloride (Cl-)i and excitatory action of GABA. In a previous double-blind randomized study, we have shown that the diuretic NKCC1 chloride importer antagonist bumetanide, that decreases (Cl-)i and reinforces GABAergic inhibition, reduces the severity of autism symptoms. Here, we report results from an open-label trial pilot study in which we used functional magnetic resonance imaging and neuropsychological testing to determine the effects of 10 months bumetanide treatment in adolescents and young adults with autism. We show that bumetanide treatment improves emotion recognition and enhances the activation of brain regions involved in social and emotional perception during the perception of emotional faces. The improvement of emotion processing by bumetanide reinforces the usefulness of bumetanide as a promising treatment to improve social interactions in autism.
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A recent clinical trial with bumetanide has shown improved accuracy in facial emotional labeling and enhanced communication in a group of ASD children between the ages of 3 and 11 years.
“In that context, a recent clinical trial with bumetanide, a drug that inhibits NKCC1, has shown improved accuracy in facial emotional labeling and enhanced communication in a group of ASD children between the ages of 3 and 11 years 117,118 .”
From Developmental timing and critical windows for the treatment of psychiatric disorders (2016) · cites this paper as [118]
Functional-MRI-based evidence suggests that bumetanide reduces exaggerated amygdala activation to eye contact in individuals with ASD and contributes to increased eye-gaze time with biological stimuli and better emotional face perception.
“There is some functional-MRI-based evidence suggesting that bumetanide reduces the exaggerated amygdala activation to eye contact in individuals with ASD and contributes to increased eye-gaze time with biological stimuli and better emotional face perception [100, 101].”
From An Update on Psychopharmacological Treatment of Autism Spectrum Disorder (2022) · cites this paper as [101]
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References 68 · Cited by 129
- Authors
- Hadjikhani, N., Zürcher, N. R., Rogier, O., Ruest, T., Hippolyte, L., Ben-Ari, Y., & Lemonnier, E.
- Affiliations
- Athinoula A. Martinos Center for Biomedical Imaging (US)
- EPFL, Switzerland
- École Polytechnique Fédérale de Lausanne (CH)
- INMED, France
- Université de Brest, France
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2013-12-16
- Volume
- 19
- Issue
- 2
- Pages
- 149-157
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- OpenAlex
- W2124474476
- Cited by
- 129
- References
- 68
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 9 · 2023: 9 · 2022: 11 · 2021: 19 · 2020: 17 · 2019: 13 · 2018: 10 · 2017: 11 · 2016: 9 · 2015: 4 · 2014: 5
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- green
- infoscience.epfl.ch
- Locations
- Autism (publishedVersion)
- PubMed (publishedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Keywords
- bumetanide, facial expression perception, emotion recognition, intracellular chloride, GABAergic inhibition, social interaction, adolescents and young adults, functional neuroimaging
- MeSH terms
- Adolescent, Adult, Autistic Disorder, Brain, Bumetanide, Emotions, Facial Expression, Humans, Magnetic Resonance Imaging, Neuropsychological Tests, Pilot Projects, Visual Perception, Sodium Potassium Chloride Symporter Inhibitors, Young Adult
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