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Treatment of Children with ASD and Epileptiform EEG with Divalproex Sodium

Epilepsy or seizure disorders happen relatively frequently in individuals with autism spectrum disorders (ASD) and seizures are always treated with medication.  However, abnormalities on the electroencephalogram (EEG) can also be present in ASD even when there are no seizures. The need for treatment of these EEG abnormalities is unclear.  Dr. Spence’s research group believes that these EEG epileptiform discharges may represent an important biomarker in some individuals with ASD and wants to explore them as a target for treatment.  Studies suggest that epileptiform discharges contribute to problems in attention, language and behavior.  Dr. Spence tested whether there is a positive effect of treating children with ASD and epileptiform EEGs using an anti-seizure medication that is known to help normalize the EEG (Depakote).  Thirty subjects ages 4-8 were recruited from two large autism centers (Children’s Hospital Boston and Vanderbilt University).  Subjects were in the study for 26 weeks receiving active drug for 12 weeks and placebo (inactive substance) for 12 weeks.  EEGs and behavioral assessments were done at the beginning, middle, and the end.  The hope was to show that administration of Depakote would reduce the number of epileptiform EEG discharges.  Dr. Spence’s group also wanted to show that Depakote improves a wide range of behavioral measures including: language, mood, irritability, attention, motor, sensory, adaptive function and core ASD behaviors.  Because there is a known relationship between Depakote, EEG discharges and sleep, the researchers looked at changes in sleep and how these measures related as well.   Finally they tested a special EEG to see if brain connectivity measures change and are related to behavioral improvements.