Modulation of striatal functional connectivity differences in adults with and without autism spectrum disorder in a single-dose randomized trial of cannabidivarin
Pretzsch, Floris, Voinescu, Elsahib, Mendez, Wichers, Ajram, Ivin, Heasman, Pretzsch, Williams, Murphy, Daly, McAlonan · Molecular Autism 2021;12(1):49 · PMID 34210360 · doi:10.1186/s13229-021-00454-6
What was actually tested: Resting-state functional MRI in 28 MEN — 15 neurotypical, 13 autistic — scanned twice in a repeated-measures, double-blind, placebo-controlled design, once after 600 mg CBDV and once after placebo, at least 13 days apart. ⚠ Men only: this is not a study of “adults”, and the authors name the restriction as a limit on generalisability. Registered as NCT03537950, retrospectively.
Compared with the neurotypical participants, the autistic participants had LOWER connectivity between the ventral striatum and frontal and pericentral regions, and HIGHER connectivity within the striatum and between the putamen and temporal regions. CBDV reduced the HYPERconnectivity toward the neurotypical range. It did not change the ventral-striatal HYPOconnectivity — that half of the difference was untouched, and reporting the reduction without it would overstate what the drug did. The authors describe the result as “preliminary proof of concept” from a “small pilot study”.
What it shows: That one dose of CBDV can shift one measurable brain-connectivity difference, in a small group of autistic men, in a scanner.
What it does NOT show: Any change in autism symptoms, behaviour or function. A connectivity measure is an imaging biomarker, not a clinical endpoint, and the authors say explicitly that whether modulating it changes symptoms is still an open question.
Read it with this: Registered retrospectively (May 2018), which weakens the guarantee that the analysis was pre-specified. Read alongside Pretzsch 2019 below — the same group, the same one-dose paradigm, and a set of partial nulls that must travel with the positives.
Imaging biomarker · pilot · not a clinical endpointOff-registry · carries no evidence grade