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J Med Genet 2009;46:217-222 doi:10.1136/jmg.2008.062141
  • Original article

Intranasal insulin to improve developmental delay in children with 22q13 deletion syndrome: an exploratory clinical trial

  1. H Schmidt1,
  2. W Kern2,
  3. R Giese3,
  4. M Hallschmid4,
  5. A Enders3
  1. 1
    Department of Paediatric Endocrinology and Medical Genetics, Dr. von Hauner Children’s Hospital, University of Munich, Lindwurmstr. 4, 80337 Munich/Germany
  2. 2
    Departments of Internal Medicine I, University of Lübeck, Ratzeburger Alle 160, Lübeck/Germany
  3. 3
    Department of Paediatric Neurology, Dr. von Hauner Children’s Hospital, University of Munich, Lindwurmstr. 4, 80337 Munich, Germany
  4. 4
    Departments of Neuroendocrinology, University of Lübeck, Ratzeburger Alle 160, Lübeck/Germany
  1. Professor H Schmidt, Dr von Hauner Children’s Hospital, University of Munich, Lindwurmstr. 4, 80337 Munich, Germany; heinrich.schmidt{at}med.uni-muenchen.de
  • Received 31 July 2008
  • Revised 29 September 2008
  • Accepted 2 October 2008
  • Published Online First 23 October 2008

Abstract

Background: The 22q13 deletion syndrome (Phelan–McDermid syndrome) is characterised by a global developmental delay, absent or delayed speech, generalised hypotonia, autistic behaviour and characteristic phenotypic features. Intranasal insulin has been shown to improve declarative memory in healthy adult subjects and in patients with Alzheimer disease.

Aims: To assess if intranasal insulin is also able to improve the developmental delay in children with 22q13 deletion syndrome.

Methods: We performed exploratory clinical trials in six children with 22q13 deletion syndrome who received intranasal insulin over a period of 1 year. Short-term (during the first 6 weeks) and long-term effects (after 12 months of treatment) on motor skills, cognitive functions, or autonomous functions, speech and communication, emotional state, social behaviour, behavioural disorders, independence in daily living and education were assessed.

Results: The children showed marked short-term improvements in gross and fine motor activities, cognitive functions and educational level. Positive long-term effects were found for fine and gross motor activities, nonverbal communication, cognitive functions and autonomy. Possible side effects were found in one patient who displayed changes in balance, extreme sensitivity to touch and general loss of interest. One patient complained of intermittent nose bleeding.

Conclusions: We conclude that long-term administration of intranasal insulin may benefit motor development, cognitive functions and spontaneous activity in children with 22q13 deletion syndrome.

Footnotes

  • Competing interests: None.

  • Patient consent: Obtained.

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