The almost cliché concept, “fight-or-flight,” is well-ingrained in our minds. Walking down a path, you suddenly realize that the stick you were headed toward is actually a snake. You are on Facebook at work and your boss appears out of thin air. Or, as a professor recently described, you are hiking in the woods and you come across a bear with a gun. Not just a bear. One with opposable thumbs and a firearm. Regardless of the event (no matter how implausible) the reaction is the same: your heart races, your palms sweat, and your breathing becomes rapid. Your body is preparing you either to roundhouse kick the gun from the bear’s mutant-hand or to run away faster than Michael Johnson.
What would it be like if this same reaction occurred when you tried to remember the list of grocery items you wanted to pick up? Or when an acquaintance starts a conversation with you?
According to several studies, these seemingly commonplace events are often quite stressful for people with autism, even stressful enough to bring on fight-or-flight symptoms. Behind these symptoms is a brain chemical called norepinephrine that runs the stress response system. Here’s where our lab comes into the picture. We are hypothesizing that blocking the function of norepinephrine in the brain will reduce stress in people with autism, thus improving their cognitive and social abilities. To block norepinephrine, we are using a drug called propranolol, which is typically prescribed for hypertension or test anxiety. Propranolol works by blocking receptors in the brain that normally respond to norepinephrine.
In a current study, we are comparing the effect of propranolol to that of placebo (or a sugar-pill) on a range of cognitive and social tasks completed by participants who have autism. These tasks involve things like remembering and repeating back lists of words or choosing between two topics and participating in a short conversation (sound familiar?). Our hypothesis is that propranolol, by blocking the stress response, will improve performance on these tasks. If this turns out to be true, we will have identified a drug (that is already on the market and is relatively cheap) as a potential treatment for some core features of autism.
Let’s be clear: propranolol is not and never will be a cure for autism. In fact it’s quite likely that there never will be a cure, or even just one drug that solves everything. What we are trying to do is to improve the daily life of someone with autism. To allow him to handle the stressors of the everyday things a little more easily. To help her engage the world a little bit more. For me, that’s an important enough goal as any.