Efficacy and Safety of Propofol as a Sole Sedative for fMRI Sedation in Autism Spectrum Disorder Individuals with Low IQ

Autism spectrum disorder (ASD) is a group of complicated neurodevelopmental disorders. Functional magnetic resonance imaging (fMRI) can help to analyze the aberrant neurological functioning in ASD. However, due to their limited cognitive abilities, ASD individuals with low IQ may face challenges in cooperating during fMRI scanning. Consequently, sedation becomes necessary for them. To analyze and evaluate the sedative efficacy and safety of a single intravenous propofol sedation regimen for ASD individuals with low IQ undergoing fMRI examination. Seventy-seven ASD individuals with low IQ, aged 4 to 23 years, who underwent fMRI examination under propofol sedation, were included. Details of the sedation protocol, evaluation indices for effectiveness such as framewise displacement (FD) and temporal signal-to-noise ratio (tSNR), as well as safety assessment measures including pulse oxygen saturation (SPO2) and blood pressure were collected. Adverse events were also recorded. Data analysis was conducted upon completion of the study. Body movement was observed in 12 patients. The median and quartiles (25th percentile, 75th percentile) of FD was 0.065 (0.057, 0.086) mm, while the tSNR averaged at 89.6 ± 11.4. The image data from sixty-two cases (80.5%) were classified as high quality based on their tSNR surpassing 80. No serious adverse events, such as oxygen desaturation, hypotension, nausea, or vomiting, occurred that necessitated hospitalization. The exclusive propofol intravenous sedation protocol employed in this study demonstrates efficacy and safety for administering fMRI examinations to ASD individuals with low IQ, thereby warranting further investigation and validation towards its adoption in clinical practice.