Gabapentin may promote language development in a pediatric patient with autism spectrum disorder: a case report

TL;DR

A child with autism spectrum disorder showed improved language skills after taking gabapentin, possibly due to reduced neuropathic pain and better neural function.

Contribution

This case report suggests gabapentin may promote language development in ASD by reducing neuropathic pain and modulating neural activity.

Findings

A child with ASD showed a significant increase in expressive vocabulary after starting gabapentin.

Speech therapy had failed to improve the child's language skills prior to gabapentin treatment.

Gabapentin may reduce atypical neural oscillations in ASD, improving cognitive processing and language acquisition.

Abstract

At this time, there is no report of how gabapentin may promote language development in children with autism spectrum disorder (ASD) experiencing neuropathic pain. A clinically significant increase in expressed vocabulary, around 10 words when gabapentin was prescribed to around 150 words at the 6-month follow-up, was observed in a child with ASD. This was likely due to improved symptoms of neuropathic pain, which could have allowed the patient to more effectively focus on language acquisition. Given that speech therapy had failed for years at that time to improve the patient's vocabulary and had been discontinued prior to and during the observed increase in expressive vocabulary, it was hypothesized a more direct neural effects of gabapentin could have contributed to the increase in verbal fluency. For instance, one could hypothesize that an increase in tonic, inhibitory conductance in neurons and increased stabilization of the neuronal membrane potential could negate atypical oscillatory activity observed in patients with ASD, thereby allowing for more effective learning processing. Neurodevelopmental outcomes following this reduction of atypical oscillatory activity may be mediated by thought differentiation, or cognitive defusion. Rather than cognitive defusion being an instructed state of mind as it is in psychotherapy research, it may be increased resolution to perception that is interoceptive awareness with large language models (LLMs) in neurodevelopment of the psychophysics of the neural effect, with clinical implications for the treatment of ASD.