451
|
Rice CE, Rosanoff M, Dawson G, Durkin MS, Croen LA, Singer A, Yeargin-Allsopp M. Evaluating Changes in the Prevalence of the Autism Spectrum Disorders (ASDs). Public Health Rev 2012; 34:1-22. [PMID: 26236074 DOI: 10.1007/bf03391685] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Autism spectrum disorders (ASDs) are estimated to occur among about one percent of children in the United States. This estimate is in line with estimates from other industrialized countries. However, the identified prevalence of ASDs has increased significantly in a short time period based on data from multiple studies including the U.S. Centers for Disease Control and Prevention's (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network. Whether increases in ASD prevalence are partly attributable to a true increase in the risk of developing ASD or solely to changes in community awareness and identification patterns is not known. It is clear that more children are identified with an ASD now than in the past and the impact on individuals, families, and communities is significant. However, disentangling the many potential reasons for ASD prevalence increases has been challenging. Understanding the relative contribution of multiple factors such as variation in study methods, changes in diagnostic and community identification, and potential changes in risk factors is an important priority for the ADDM Network and for CDC. This article summarizes the discussion from a workshop that was co-sponsored by CDC and Autism Speaks as a forum for sharing knowledge and opinions of a diverse range of stakeholders about changes in ASD prevalence. Panelists discussed recommendations for building on existing infrastructure and developing new initiatives to better understand ASD trends. The information, research, and opinions shared during this workshop add to the knowledge base about ASD prevalence in an effort to stimulate further work to understand the multiple reasons behind increasing ASD prevalence.
Collapse
Affiliation(s)
- Catherine E Rice
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, USA
| | | | - Geraldine Dawson
- Autism Speaks, USA ; University of North Carolina at Chapel Hill, USA
| | | | | | | | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, USA
| |
Collapse
|
452
|
A review of complementary and alternative treatments for autism spectrum disorders. AUTISM RESEARCH AND TREATMENT 2012; 2012:870391. [PMID: 23243505 PMCID: PMC3515887 DOI: 10.1155/2012/870391] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 08/08/2012] [Accepted: 09/07/2012] [Indexed: 12/30/2022]
Abstract
Given the severe and chronic problems associated with Autism Spectrum Disorders (ASD) and the limitations of available treatments, there exists a large public health need for additional interventions. As more parents are inquiring about complementary and alternative treatments (CATs), both parents and practitioners require up-to-date information about them and whether and how to integrate them into treatment. After presenting data on CAT usage patterns for ASD, we review 13 ingestible (i.e., orally administered) and 6 noningestible (i.e., externally administered) CATs for ASD. For each CAT we briefly describe its definition; rationale for use; current research support, limitations, and future directions; safety issues; and whether we currently recommend, not recommend, or find it acceptable for the treatment of ASD. We conclude this paper with recommendations for future research and ten clinical recommendations for practitioners.
Collapse
|
453
|
Empirical Data Confirm Autism Symptoms Related to Aluminum and Acetaminophen Exposure. ENTROPY 2012. [DOI: 10.3390/e14112227] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
454
|
Hamlyn J, Duhig M, McGrath J, Scott J. Modifiable risk factors for schizophrenia and autism--shared risk factors impacting on brain development. Neurobiol Dis 2012; 53:3-9. [PMID: 23123588 DOI: 10.1016/j.nbd.2012.10.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 10/03/2012] [Accepted: 10/20/2012] [Indexed: 10/27/2022] Open
Abstract
Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors.
Collapse
Affiliation(s)
- Jess Hamlyn
- Gold Coast Hospital, Southport, QLD 4215, Australia
| | | | | | | |
Collapse
|
455
|
Kumar B, Prakash A, Sewal RK, Medhi B, Modi M. Drug therapy in autism: a present and future perspective. Pharmacol Rep 2012; 64:1291-304. [DOI: 10.1016/s1734-1140(12)70927-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Revised: 08/03/2012] [Indexed: 10/25/2022]
|
456
|
Hoffman K, Kalkbrenner AE, Vieira VM, Daniels JL. The spatial distribution of known predictors of autism spectrum disorders impacts geographic variability in prevalence in central North Carolina. Environ Health 2012; 11:80. [PMID: 23113973 PMCID: PMC3499188 DOI: 10.1186/1476-069x-11-80] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 10/22/2012] [Indexed: 05/20/2023]
Abstract
BACKGROUND The causes of autism spectrum disorders (ASD) remain largely unknown and widely debated; however, evidence increasingly points to the importance of environmental exposures. A growing number of studies use geographic variability in ASD prevalence or exposure patterns to investigate the association between environmental factors and ASD. However, differences in the geographic distribution of established risk and predictive factors for ASD, such as maternal education or age, can interfere with investigations of ASD etiology. We evaluated geographic variability in the prevalence of ASD in central North Carolina and the impact of spatial confounding by known risk and predictive factors. METHODS Children meeting a standardized case definition for ASD at 8 years of age were identified through records-based surveillance for 8 counties biennially from 2002 to 2008 (n=532). Vital records were used to identify the underlying cohort (15% random sample of children born in the same years as children with an ASD, n=11,034), and to obtain birth addresses. We used generalized additive models (GAMs) to estimate the prevalence of ASD across the region by smoothing latitude and longitude. GAMs, unlike methods used in previous spatial analyses of ASD, allow for extensive adjustment of individual-level risk factors (e.g. maternal age and education) when evaluating spatial variability of disease prevalence. RESULTS Unadjusted maps revealed geographic variation in surveillance-recognized ASD. Children born in certain regions of the study area were up to 1.27 times as likely to be recognized as having ASD compared to children born in the study area as a whole (prevalence ratio (PR) range across the study area 0.57-1.27; global P=0.003). However, geographic gradients of ASD prevalence were attenuated after adjusting for spatial confounders (adjusted PR range 0.72-1.12 across the study area; global P=0.052). CONCLUSIONS In these data, spatial variation of ASD in central NC can be explained largely by factors impacting diagnosis, such as maternal education, emphasizing the importance of adjusting for differences in the geographic distribution of known individual-level predictors in spatial analyses of ASD. These results underscore the critical importance of accounting for such factors in studies of environmental exposures that vary across regions.
Collapse
Affiliation(s)
- Kate Hoffman
- University of North Carolina, Gillings School of Global Public Health, CB #7435, Chapel Hill, NC, 27599, USA
| | - Amy E Kalkbrenner
- University of North Carolina, Gillings School of Global Public Health, CB #7435, Chapel Hill, NC, 27599, USA
- University of Wisconsin at Milwaukee, Zilber School of Public Health, 3230 E. Kenwood Blvd, Milwaukee, WI, 53211, USA
| | - Veronica M Vieira
- Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
- School of Ecology, University of California, Irvine, CA, 92617, USA
| | - Julie L Daniels
- University of North Carolina, Gillings School of Global Public Health, CB #7435, Chapel Hill, NC, 27599, USA
| |
Collapse
|
457
|
Maenner MJ, Arneson CL, Levy SE, Kirby RS, Nicholas JS, Durkin MS. Brief report: Association between behavioral features and gastrointestinal problems among children with autism spectrum disorder. J Autism Dev Disord 2012; 42:1520-5. [PMID: 22012246 DOI: 10.1007/s10803-011-1379-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Recent reports suggest certain behaviors among children with autism spectrum disorders (ASD) may indicate underlying gastro-intestinal (GI) problems, and that the presence of these behaviors may help alert primary care providers to the need to evaluate a child with ASD for GI problems. The purpose of this population-based study of 487 children with ASD, including 35 (7.2%) with a medically documented history of GI problems, was to compare behavioral features of children with and without a history of GI problems. Unusual sleeping or eating habits and oppositional behavior were significantly associated with GI problems. These behaviors, however, were frequent in both children with and without GI problems, suggesting they may have limited utility in a screening capacity for GI problems.
Collapse
Affiliation(s)
- Matthew J Maenner
- Waisman Center and Department of Population Health Sciences, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI 53705, USA.
| | | | | | | | | | | |
Collapse
|
458
|
Spooren W, Lindemann L, Ghosh A, Santarelli L. Synapse dysfunction in autism: a molecular medicine approach to drug discovery in neurodevelopmental disorders. Trends Pharmacol Sci 2012; 33:669-84. [PMID: 23084458 DOI: 10.1016/j.tips.2012.09.004] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/04/2012] [Accepted: 09/14/2012] [Indexed: 11/24/2022]
Abstract
Autism and autism spectrum disorders (ASDs) affect millions of individuals worldwide. Despite increased autism diagnoses over the past 30 years, therapeutic intervention is often 'trial and error'. This approach has identified some beneficial agents, but complex heterogeneous disorders require a more personalized treatment regimen. Many ASD risk factors are genetic, implicating impaired synaptic development and function. Monogenetic disorders (e.g., fragile X syndrome, Rett syndrome, and neurofibromatosis) that have phenotypic overlap with autism provide insights into ASD pathology through the identification novel drug targets (e.g., glutamatergic receptors). Encouragingly, some of these novel drug targets provide symptomatic improvement, even in patients who have lived with ASDs for protracted periods of time. Consequently, a targeted drug discovery approach is expected to deliver improved agents for the treatment and management of ASDs. Here, we review the opportunities and challenges in drug development for autism and provide insight into the neurobiology of ASDs.
Collapse
Affiliation(s)
- Will Spooren
- CNS Research and Early Clinical Development, F. Hoffmann-La Roche Ltd., Basel, Switzerland.
| | | | | | | |
Collapse
|
459
|
Abdallah MW, Pearce BD, Larsen N, Greaves-Lord K, Nørgaard-Pedersen B, Hougaard DM, Mortensen EL, Grove J. Amniotic fluid MMP-9 and neurotrophins in autism spectrum disorders: an exploratory study. Autism Res 2012; 5:428-33. [PMID: 23008271 DOI: 10.1002/aur.1254] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 08/27/2012] [Indexed: 12/22/2022]
Abstract
Evidence suggests that some developmental disorders, such as autism spectrum disorders (ASDs), are caused by errors in brain plasticity. Given the important role of matrix metalloproteinases (MMPs) and neurotrophins (NTs) in neuroplasticity, amniotic fluid samples for 331 ASD cases and 698 frequency-matched controls were analyzed for levels of MMP-9, brain-derived neurotrophic factor, NT-4 and transforming growth factor-β utilizing a Danish historic birth cohort and Danish nationwide health registers. Laboratory measurements were performed using an in-house multiplex sandwich immunoassay Luminex xMAP method, and measurements were analyzed using tobit and logistic regression. Results showed elevated levels of MMP-9 in ASD cases compared with controls (crude and adjusted tobit regression P-values: 0.01 and 0.06). Our results highlight the importance of exploring the biologic impact of MMP-9 and potential therapeutic roles of its inhibitors in ASD and may indicate that neuroplastic impairments in ASD may present during pregnancy.
Collapse
Affiliation(s)
- Morsi W Abdallah
- Section for Epidemiology, Health, Aarhus University, Aarhus C, Denmark.
| | | | | | | | | | | | | | | |
Collapse
|
460
|
Chiri G, Warfield ME. Unmet need and problems accessing core health care services for children with autism spectrum disorder. Matern Child Health J 2012; 16:1081-91. [PMID: 21667201 DOI: 10.1007/s10995-011-0833-6] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To investigate the health care experiences of children with autism spectrum disorder, whether they have unmet needs, and if so, what types, and problems they encounter accessing needed care. We address these issues by identifying four core health care services and access problems related to provider and system characteristics. Using data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) we compared children with autism spectrum disorder with children with special health care needs with other emotional, developmental or behavioral problems (excluding autism spectrum disorder) and with other children with special health care needs. We used weighted logistic regression to examine differences in parent reports of unmet needs for the three different health condition groups. Overall unmet need for each service type among CSHCN ranged from 2.5% for routine preventive care to 15% for mental health services. After controlling for predisposing, enabling and need factors, some differences across health condition groups remained. Families of children with autism spectrum disorder were in fact significantly more at risk for having unmet specialty and therapy care needs. Additionally, families of children with autism spectrum disorder were more likely to report provider lack of skills to treat the child as a barrier in obtaining therapy and mental health services. Disparities in unmet needs for children with autism suggest that organizational features of managed care programs and provider characteristics pose barriers to accessing care.
Collapse
Affiliation(s)
- Giuseppina Chiri
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA 02453, USA.
| | | |
Collapse
|
461
|
Gutman SA, Raphael-Greenfield EI, Rao AK. Effect of a Motor-Based Role-Play Intervention on the Social Behaviors of Adolescents With High-Functioning Autism: Multiple-Baseline Single-Subject Design. Am J Occup Ther 2012; 66:529-37. [DOI: 10.5014/ajot.2012.003756] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We examined the effect of a motor-based role-play intervention on the social skills of adolescents with high-functioning autism.
METHOD. An ABA multiple-baseline design with three 3-mo phases occurring over 12 mo was used with 7 participants. Frequency of targeted verbal and nonverbal behaviors was tallied in each phase. Frequency data were analyzed using repeated-measures analyses of variance with post hoc comparisons to examine differences in targeted behaviors over the three phases.
RESULTS. Three participants completed all three study phases, 2 completed Phase 2, and 2 completed Phase 1. All participants (N = 7) demonstrated improved social skill use in Phase 1. Participants completing Phase 2 (n = 5) further improved social skill use. Additional improvements were observed among participants (n = 3) who completed Phase 3.
CONCLUSION. The intervention helped participants improve targeted social skill use. Further testing with larger samples and intervention modifications is warranted.
Collapse
Affiliation(s)
- Sharon A. Gutman
- Sharon A. Gutman, PhD, OTR, FAOTA, is Associate Professor, Programs in Occupational Therapy, Columbia University, 710 West 168th Street, NI-8, New York, NY 10032;
| | - Emily I. Raphael-Greenfield
- Emily I. Raphael-Greenfield, EdD, OTR, is Assistant Professor, Programs in Occupational Therapy, Columbia University, New York
| | - Ashwini K. Rao
- Ashwini K. Rao, EdD, OTR, is Associate Professor, Program in Physical Therapy, Huntington’s Disease Center of Excellence, Columbia University, New York
| |
Collapse
|
462
|
Connolly JJ, Glessner JT, Hakonarson H. A genome-wide association study of autism incorporating autism diagnostic interview-revised, autism diagnostic observation schedule, and social responsiveness scale. Child Dev 2012; 84:17-33. [PMID: 22935194 DOI: 10.1111/j.1467-8624.2012.01838.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Efforts to understand the causes of autism spectrum disorders (ASDs) have been hampered by genetic complexity and heterogeneity among individuals. One strategy for reducing complexity is to target endophenotypes, simpler biologically based measures that may involve fewer genes and constitute a more homogenous sample. A genome-wide association study of 2,165 participants (mean age = 8.95 years) examined associations between genomic loci and individual assessment items from the Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, and Social Responsiveness Scale. Significant associations with a number of loci were identified, including KCND2 (overly serious facial expressions), NOS2A (loss of motor skills), and NELL1 (faints, fits, or blackouts). These findings may help prioritize directions for future genomic efforts.
Collapse
|
463
|
Investigating the Measurement Properties of the Social Responsiveness Scale in Preschool Children with Autism Spectrum Disorders. J Autism Dev Disord 2012; 43:860-8. [DOI: 10.1007/s10803-012-1627-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
464
|
Neonatal levels of cytokines and risk of autism spectrum disorders: an exploratory register-based historic birth cohort study utilizing the Danish Newborn Screening Biobank. J Neuroimmunol 2012; 252:75-82. [PMID: 22917523 DOI: 10.1016/j.jneuroim.2012.07.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 07/21/2012] [Accepted: 07/23/2012] [Indexed: 01/07/2023]
Abstract
The aim of the study was to analyze cytokine profiles in neonatal dried blood samples (n-DBSS) retrieved from The Danish Newborn Screening Biobank of children developing Autism Spectrum Disorders (ASD) later in life and controls. Samples of 359 ASD cases and 741 controls were analyzed using Luminex xMAP technology and clinical data were retrieved from nationwide registers. Findings showed that children developing ASD were more likely to have decreased levels of both T helper-1(Th-1)-like cytokines (i.e. IFN-γ) and Th-2like cytokines (i.e. IL-4, IL-10) which may suggest a depressed or hypoactive immune cell activity during neonatal period in ASD.
Collapse
|
465
|
Meyza KZ, Defensor EB, Jensen AL, Corley MJ, Pearson BL, Pobbe RLH, Bolivar VJ, Blanchard DC, Blanchard RJ. The BTBR T+ tf/J mouse model for autism spectrum disorders-in search of biomarkers. Behav Brain Res 2012; 251:25-34. [PMID: 22958973 DOI: 10.1016/j.bbr.2012.07.021] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 07/11/2012] [Accepted: 07/12/2012] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorders (ASD) form a common group of neurodevelopmental disorders appearing to be under polygenic control, but also strongly influenced by multiple environmental factors. The brain mechanisms responsible for ASD are not understood and animal models paralleling related emotional and cognitive impairments may prove helpful in unraveling them. BTBR T+ tf/J (BTBR) mice display behaviors consistent with the three diagnostic categories for ASD. They show impaired social interaction and communication as well as increased repetitive behaviors. This review covers much of the data available to date on BTBR behavior, neuroanatomy and physiology in search for candidate biomarkers, which could both serve as diagnostic tools and help to design effective treatments for the behavioral symptoms of ASD.
Collapse
Affiliation(s)
- Ksenia Z Meyza
- Pacific Biosciences Research Center, University of Hawaii, 1993 East-west Road, Honolulu, HI 96822, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
466
|
Robinson SJ. Childhood epilepsy and autism spectrum disorders: psychiatric problems, phenotypic expression, and anticonvulsants. Neuropsychol Rev 2012; 22:271-9. [PMID: 22875726 DOI: 10.1007/s11065-012-9212-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 07/27/2012] [Indexed: 02/02/2023]
Abstract
Epilepsy and autism spectrum disorders (ASDs) frequently co-occur during childhood, however, the characteristics of psychiatric or behavioural problems in these children remains largely unknown. This article contributes to these discussions by reporting on the prevalence and presentation of psychiatric or behavioural problems in children with epilepsy and ASDs, as well as on the use of anticonvulsants in these children. The current evidence suggests that children with epilepsy and ASDs may present with a distinct clinical profile, with a greater number of developmental difficulties, and a more severe expression of the ASD phenotype that can not solely be accounted for by level of intellectual functioning. Positive effects of anticonvulsants on behavioural symptoms associated with ASDs were also reported, though pharmacoresistance and a lack of clear treatment guidelines may contribute to an elevated risk of adverse side effects. In relation to clinical presentation and management there is a need for careful consideration of potential interaction effects between disorder specific factors (e.g., age of seizure onset/ASD diagnosis), cognitive characteristics (e.g., intellectual functioning, memory), and psychosocial variables (e.g., coping strategies). Ultimately however, many conclusions are tentative and this review highlights the need for more empirically validated research on children with epilepsy and ASDs.
Collapse
Affiliation(s)
- Sally J Robinson
- Children's Neurosciences Centre, St Thomas' Hospital, London, SE1 7EH, UK.
| |
Collapse
|
467
|
Abstract
The autistic spectrum disorders have a significant male bias in incidence, which is unexplained. The Sertoli cells of the immature testes secrete supra-adult levels of Müllerian-inhibiting substance/anti-Müllerian hormone (AMH) and inhibin B (InhB), with both hormones being putative regulators of brain development. We report here, that 82 boys with an autism spectrum disorder have normal levels of InhB and AMH. However, the boys' level of InhB correlated with their autism diagnostic interview-revised (ADI-R) scores for the social interaction (R=0.29, P=0.009, N=82) and communication domains (R=0.29, P=0.022, N=63), and with the number of autistic traits the boys exhibited (R=0.34 and 0.27, respectively). The strengths of the abovementioned correlates were stronger in the boys with milder autism (R=0.42 and 0.50, respectively), with AMH exhibiting a significant negative correlation to the ADI-R score in these boys (R=-0.44 and R=-0.39, respectively). Neither hormone correlated to the incidence of stereotyped and repetitive behaviours. This suggests that the male bias in the autistic spectrum has multiple determinants, which modulate the effects of an otherwise non-dimorphic pathology. Furthermore, AMH and InhB have opposing effects on the SMAD1/5/8 pathway, and opposing correlates to autistic traits, implicating the SMAD pathways as a putative point of molecular convergence for the autistic spectrum.
Collapse
|
468
|
Abramowicz JS. Ultrasound and autism: association, link, or coincidence? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1261-1269. [PMID: 22837291 DOI: 10.7863/jum.2012.31.8.1261] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Autism spectrum disorders (ASDs) affect an estimated 1% of children in the United States. The etiology is probably multifactorial, including genetic components and exposure to infections, toxins, and other environmental factors, particularly unfavorable perinatal and neonatal conditions. There has been an increase in the frequency of diagnosis of ASDs over the last 20 years with a parallel increase in the use of obstetric diagnostic ultrasound, with prenatal ultrasound exposure mentioned as the possible main etiology for autism "epidemics." Central nervous system alterations have been described in ASDs, and certain similar changes have been described in animals after exposure to ultrasound. However, analysis of in utero exposure in humans has failed to show harmful effects in neonates or children, particularly in school performance, attention disorders, and behavioral changes. There is no independently confirmed peer-reviewed published evidence that a cause-effect relationship exists between in utero exposure to clinical ultrasound and development of ASDs in childhood. Ultrasound is a form of energy with effects in the tissues it traverses, and its use should be restricted to medical indications, by trained professionals, for as short a period and as low an intensity as compatible with accurate diagnosis.
Collapse
Affiliation(s)
- Jacques S Abramowicz
- Department of Obstetrics and Gynecology and Rush Fetal and Neonatal Medicine Center, Rush University, Chicago, Illinois 60612, USA.
| |
Collapse
|
469
|
Mazumdar S, Liu KY, Susser E, Bearman P. The disappearing seasonality of autism conceptions in California. PLoS One 2012; 7:e41265. [PMID: 22859972 PMCID: PMC3408493 DOI: 10.1371/journal.pone.0041265] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 06/22/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Autism incidence and prevalence have increased dramatically in the last two decades. The autism caseload in California increased 600% between 1992 and 2006, yet there is little consensus as to the cause. Studying the seasonality of conceptions of children later diagnosed with autism may yield clues to potential etiological drivers. OBJECTIVE To assess if the conceptions of children later diagnosed with autism cluster temporally in a systematic manner and whether any pattern of temporal clustering persists over time. METHOD We searched for seasonality in conceptions of children later diagnosed with autism by applying a one-dimensional scan statistic with adaptive temporal windows on case and control population data from California for 1992 through 2000. We tested for potential confounding effects from known risk factors using logistic regression models. RESULTS There is a consistent but decreasing seasonal pattern in the risk of conceiving a child later diagnosed with autism in November for the first half of the study period. Temporal clustering of autism conceptions is not an artifact of composition with respect to known risk factors for autism such as socio-economic status. CONCLUSION There is some evidence of seasonality in the risk of conceiving a child later diagnosed with autism. Searches for environmental factors related to autism should allow for the possibility of risk factors or etiological drivers that are seasonally patterned and that appear and remain salient for a discrete number of years.
Collapse
Affiliation(s)
- Soumya Mazumdar
- Paul F Lazarsfeld Center for the Social Sciences, Columbia University, New York, New York, United States of America.
| | | | | | | |
Collapse
|
470
|
Idring S, Rai D, Dal H, Dalman C, Sturm H, Zander E, Lee BK, Serlachius E, Magnusson C. Autism spectrum disorders in the Stockholm Youth Cohort: design, prevalence and validity. PLoS One 2012; 7:e41280. [PMID: 22911770 PMCID: PMC3401114 DOI: 10.1371/journal.pone.0041280] [Citation(s) in RCA: 193] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 06/19/2012] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Reports of rising prevalence of autism spectrum disorders (ASD), along with their profound personal and societal burden, emphasize the need of methodologically sound studies to explore their causes and consequences. We here present the design of a large intergenerational resource for ASD research, along with population-based prevalence estimates of ASD and their diagnostic validity. METHOD The Stockholm Youth Cohort is a record-linkage study comprising all individuals aged 0-17 years, ever resident in Stockholm County in 2001-2007 (N = 589,114). ASD cases (N = 5,100) were identified using a multisource approach, involving registers covering all pathways to ASD diagnosis and care, and categorized according to co-morbid intellectual disability. Prospectively recorded information on potential determinants and consequences of ASD were retrieved from national and regional health and administrative registers. Case ascertainment was validated through case-note review, and cross validation with co-existing cases in a national twin study. RESULTS The 2007 year prevalence of ASD in all children and young people was 11.5 per 1,000 (95% confidence interval 11.2-11.8), with a co-morbid intellectual disability recorded in 42.6% (41.0-44.2) of cases. We found 96.0% (92.0-98.4) of reviewed case-notes being consistent with a diagnosis of ASD, and confirmed ASD in 85.2% (66.2-95.8) of affected twins. CONCLUSIONS Findings from this contemporary study accords with recently reported prevalence estimates from Western countries at around 1%, based on valid case ascertainment. The Stockholm Youth Cohort, in light of the availability of extensive information from Sweden's registers, constitutes an important resource for ASD research. On-going work, including collection of biological samples, will enrich the study further.
Collapse
Affiliation(s)
- Selma Idring
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | |
Collapse
|
471
|
Paula CS, Ribeiro SH, Fombonne E, Mercadante MT. Brief report: prevalence of pervasive developmental disorder in Brazil: a pilot study. J Autism Dev Disord 2012; 41:1738-42. [PMID: 21337063 DOI: 10.1007/s10803-011-1200-6] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This pilot study presents preliminary results concerning the prevalence of Pervasive Developmental Disorder (PDD) in South America. It was a three-phase study conducted in a typical town in Southeast Brazil. Case definition was based in a combination of standardized instruments and clinical evaluations by experts. The prevalence of PDD was 27.2/10,000 (95% CI: 17.6-36.8) and some hypotheses were raised to explain this low frequency. Clinical findings of PDD cases were consistent with previous data, such as, male preponderance, more children diagnosed with PDD-NOS than with autistic disorder, and half of them born from older mothers. Moreover, the study raised concerns about treatment of cases, because identification of PDD had been late and access to services has been very limited.
Collapse
Affiliation(s)
- Cristiane S Paula
- Developmental Disorder Post Graduation Program, Mackenzie Presbyterian University, Rua da Consolação, 930. Edifício 38 Secretaria de Pós-Graduação em Distúrbios do Desenvolvimento, São Paulo, SP, 01302-907, Brazil.
| | | | | | | |
Collapse
|
472
|
Yang Y, Wang C, Wang F, Zhu L, Liu H, He X. Novel chromosomal translocation t(11;9)(p15;p23) involving deletion and duplication of 9p in a girl associated with autism and mental retardation. Gene 2012; 502:154-8. [DOI: 10.1016/j.gene.2012.04.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/15/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
|
473
|
Kalkbrenner AE, Braun JM, Durkin MS, Maenner MJ, Cunniff C, Lee LC, Pettygrove S, Nicholas JS, Daniels JL. Maternal smoking during pregnancy and the prevalence of autism spectrum disorders, using data from the autism and developmental disabilities monitoring network. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1042-8. [PMID: 22534110 PMCID: PMC3404663 DOI: 10.1289/ehp.1104556] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 04/17/2012] [Indexed: 05/22/2023]
Abstract
BACKGROUND Reported associations between gestational tobacco exposure and autism spectrum disorders (ASDs) have been inconsistent. OBJECTIVE We estimated the association between maternal smoking during pregnancy and ASDs among children 8 years of age. METHODS This population-based case-cohort study included 633,989 children, identified using publicly available birth certificate data, born in 1992, 1994, 1996, and 1998 from parts of 11 U.S. states subsequently under ASD surveillance. Of these children, 3,315 were identified as having an ASD by the active, records-based surveillance of the Autism and Developmental Disabilities Monitoring Network. We estimated prevalence ratios (PRs) of maternal smoking from birth certificate report and ASDs using logistic regression, adjusting for maternal education, race/ethnicity, marital status, and maternal age; separately examining higher- and lower-functioning case subgroups; and correcting for assumed under-ascertainment of autism by level of maternal education. RESULTS About 13% of the source population and 11% of children with an ASD had a report of maternal smoking in pregnancy: adjusted PR (95% confidence interval) of 0.90 (0.80, 1.01). The association for the case subgroup autistic disorder (1,310 cases) was similar: 0.88 (0.72, 1.08), whereas that for ASD not otherwise specified (ASD-NOS) (375 cases) was positive, albeit including the null: 1.26 (0.91, 1.75). Unadjusted associations corrected for assumed under-ascertainment were 1.06 (0.98, 1.14) for all ASDs, 1.12 (0.97, 1.30) for autistic disorder, and 1.63 (1.30, 2.04) for ASD-NOS. CONCLUSIONS After accounting for the potential of under-ascertainment bias, we found a null association between maternal smoking in pregnancy and ASDs, generally. The possibility of an association with a higher-functioning ASD subgroup was suggested, and warrants further study.
Collapse
Affiliation(s)
- Amy E Kalkbrenner
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53201-0413, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
474
|
Hönekopp J. Digit ratio 2D:4D in relation to autism spectrum disorders, empathizing, and systemizing: a quantitative review. Autism Res 2012; 5:221-30. [PMID: 22674640 DOI: 10.1002/aur.1230] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 03/22/2012] [Indexed: 01/29/2023]
Abstract
Prenatal testosterone (PT) effects have been proposed to increase systemizing (the drive to understand lawful input-output relationships), to decrease empathizing (the drive to understand others), and to cause autism via hypermasculinization of the brain. Digit ratio 2D:4D is a putative marker of PT effects in humans. An online study (n = 1896) into the relationship between the Reading the Mind in the Eyes Test (a widely used measure of empathizing) and self-measured 2D:4D in a nonclinical sample is reported. No evidence for a link between empathizing and 2D:4D in either females or males emerged. Further, three meta-analyses are presented that look into the relationships of 2D:4D with autism spectrum disorder (ASD), systemizing, and empathizing. 2D:4D was substantially lower (more masculine) in ASD-affected individuals than in normal controls (d = -0.58, P < 0.001). However, 2D:4D was found to be virtually unrelated to systemizing and empathizing in normal adults. The results support the idea that high PT is a risk factor for autism, but they challenge the view that PT substantially contributes to sex differences in systemizing and empathizing. Possibly, this pattern reflects an interaction effect, whereby PT drives ASD characteristic changes only in brains with a specific damage.
Collapse
Affiliation(s)
- Johannes Hönekopp
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK.
| |
Collapse
|
475
|
Examination of the properties of the Modified Checklist for Autism in Toddlers (M-CHAT) in a population sample. J Autism Dev Disord 2012; 42:23-34. [PMID: 21373956 DOI: 10.1007/s10803-011-1211-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examines the following properties of the Modified Checklist for Autism in Toddlers (M-CHAT) in an unselected low-risk sample: (a) the maximum age for screen administration; (b) the positive screen rate in the absence of follow-up telephone interviews and; (c) the distributional properties of positive screens. Data came from a prospective cohort study (n = 1,604). Results suggest that the M-CHAT can appropriately be administered to children aged 20-48 months. Documented explanations provided by mothers during screening, appear to effectively identify potential screen misclassifications in the absence of the follow-up telephone interviews. This further emphasizes the importance of clinician expertise in verifying positive M-CHAT screens. Results have implications for the administration of the M-CHAT in clinical and research settings.
Collapse
|
476
|
Crosland K, Dunlap G. Effective Strategies for the Inclusion of Children With Autism in General Education Classrooms. Behav Modif 2012; 36:251-69. [DOI: 10.1177/0145445512442682] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Successful inclusion of students with autism spectrum disorder (ASD) in general education classrooms can be challenging and may require additional supports. This article provides information on recent trends in autism intervention research and a review of research that has addressed individualized and systemic interventions for promoting inclusion. Response to intervention and schoolwide positive behavior support are reviewed as organizational/ systems strategies relevant to preventing problems and improving social and academic outcomes for students with ASD. Additional individualized strategies that can be implemented within these models are described. A discussion of future research directions is provided.
Collapse
|
477
|
Parental socioeconomic status and risk of offspring autism spectrum disorders in a Swedish population-based study. J Am Acad Child Adolesc Psychiatry 2012; 51:467-476.e6. [PMID: 22525953 DOI: 10.1016/j.jaac.2012.02.012] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 01/23/2012] [Accepted: 02/08/2012] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Epidemiological studies in the United States consistently find autism spectrum disorders (ASD) to be overrepresented in high socioeconomic status (SES) families. These findings starkly contrast with SES gradients of many health conditions, and may result from SES inequalities in access to services. We hypothesized that prenatal measures of low, not high, parental SES would be associated with an increased risk of offspring ASD, once biases in case ascertainment are minimized. METHOD We tested this hypothesis in a population-based study in Sweden, a country that has free universal healthcare, routine screening for developmental problems, and thorough protocols for diagnoses of ASD. In a case-control study nested in a total population cohort of children aged 0 to 17 years living in Stockholm County between 2001 and 2007 (N = 589,114), we matched ASD cases (n = 4,709) by age and sex to 10 randomly selected controls. We retrieved parental SES measures collected at time of birth by record linkage. RESULTS Children of families with lower income, and of parents with manual occupations (OR = 1.4, 95% CI = 1.3-1.6) were at higher risk of ASD. No important relationships with parental education were observed. These associations were present after accounting for parental ages, migration status, parity, psychiatric service use, maternal smoking during pregnancy, and birth characteristics; and regardless of comorbid intellectual disability. CONCLUSIONS Lower, not higher, socioeconomic status was associated with an increased risk of ASD. Studies finding the opposite may be underestimating the burden of ASD in lower SES groups.
Collapse
|
478
|
Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, Hertz-Picciotto I. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics 2012; 129:e1121-8. [PMID: 22492772 PMCID: PMC3340592 DOI: 10.1542/peds.2011-2583] [Citation(s) in RCA: 449] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE We examined whether metabolic conditions (MCs) during pregnancy (diabetes, hypertension, and obesity) are associated with autism spectrum disorder (ASD), developmental delays (DD), or impairments in specific domains of development in the offspring. METHODS Children aged 2 to 5 years (517 ASD, 172 DD, and 315 controls) were enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) study, a population-based, case-control investigation between January 2003 and June 2010. Eligible children were born in California, had parents who spoke English or Spanish, and were living with a biological parent in selected regions of California. Children's diagnoses were confirmed by using standardized assessments. Information regarding maternal conditions was ascertained from medical records or structured interview with the mother. RESULTS All MCs were more prevalent among case mothers compared with controls. Collectively, these conditions were associated with a higher likelihood of ASD and DD relative to controls (odds ratio: 1.61 [95% confidence interval: 1.10-2.37; odds ratio: 2.35 [95% confidence interval: 1.43-3.88], respectively). Among ASD cases, children of women with diabetes had Mullen Scales of Early Learning (MSEL) expressive language scores 0.4 SD lower than children of mothers without MCs (P < .01). Among children without ASD, those exposed to any MC scored lower on all MSEL and Vineland Adaptive Behavior Scales (VABS) subscales and composites by at least 0.4 SD (P < .01 for each subscale/composite). CONCLUSIONS Maternal MCs may be broadly associated with neurodevelopmental problems in children. With obesity rising steadily, these results appear to raise serious public health concerns.
Collapse
Affiliation(s)
- Paula Krakowiak
- Division of Epidemiology, Department of Public Health Sciences, University of California, Davis, California, USA.
| | | | | | | | | | | | | |
Collapse
|
479
|
Sandin S, Hultman CM, Kolevzon A, Gross R, MacCabe JH, Reichenberg A. Advancing maternal age is associated with increasing risk for autism: a review and meta-analysis. J Am Acad Child Adolesc Psychiatry 2012; 51:477-486.e1. [PMID: 22525954 DOI: 10.1016/j.jaac.2012.02.018] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 02/14/2012] [Accepted: 02/24/2012] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We conducted a meta-analysis of epidemiological studies investigating the association between maternal age and autism. METHOD Using recommended guidelines for performing meta-analyses, we systematically selected, and extracted results from, epidemiological scientific studies reported before January 2012. We calculated pooled risk estimates comparing categories of advancing maternal age with and without adjusting for possible confounding factors. We investigated the influence of gender ratio among cases, ratio of infantile autism to autism spectrum disorder (ASD), and median year of diagnosis as effect moderators in mixed-effect meta-regression. RESULTS We found 16 epidemiological papers fulfilling the a priori search criteria. The meta-analysis included 25,687 ASD cases and 8,655,576 control subjects. Comparing mothers ≥ 35 years with mothers 25 to 29 years old, the crude relative risk (RR) for autism in the offspring was 1.52 (95% confidence interval [CI] = 1.12-1.92). Comparing mothers ≥ 35 with mothers 25-29, [corrected] the adjusted relative risk (RR) for autism in the offspring was 1.31 (95% CI = 1.19-1.45). [corrected] For mothers <20 compared with mothers 25 to 29 years old, there was a statistically significant decrease in risk (RR = 0.76; 95% confidence interval = 0.60-0.97). Almost all studies showed a dose-response effect of maternal age on risk of autism. The meta-regression suggested a stronger maternal age effect in the studies with more male offspring and for children diagnosed in later years. CONCLUSIONS The results of this meta-analysis support an association between advancing maternal age and risk of autism. The RR increased monotonically with increasing maternal age. The association persisted after the effects of paternal age and other potential confounders had been considered, supporting an independent relation between higher maternal age and autism.
Collapse
Affiliation(s)
- Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77 Stockholm, Sweden.
| | | | | | | | | | | |
Collapse
|
480
|
Main PAE, Angley MT, O'Doherty CE, Thomas P, Fenech M. The potential role of the antioxidant and detoxification properties of glutathione in autism spectrum disorders: a systematic review and meta-analysis. Nutr Metab (Lond) 2012; 9:35. [PMID: 22524510 PMCID: PMC3373368 DOI: 10.1186/1743-7075-9-35] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 04/24/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Glutathione has a wide range of functions; it is an endogenous anti-oxidant and plays a key role in the maintenance of intracellular redox balance and detoxification of xenobiotics. Several studies have indicated that children with autism spectrum disorders may have altered glutathione metabolism which could play a key role in the condition. METHODS A systematic literature review and meta-analysis was conducted of studies examining metabolites, interventions and/or genes of the glutathione metabolism pathways i.e. the γ-glutamyl cycle and trans-sulphuration pathway in autism spectrum disorders. RESULTS Thirty nine studies were included in the review comprising an in vitro study, thirty two metabolite and/or co-factor studies, six intervention studies and six studies with genetic data as well as eight studies examining enzyme activity. CONCLUSIONS The review found evidence for the involvement of the γ-glutamyl cycle and trans-sulphuration pathway in autistic disorder is sufficiently consistent, particularly with respect to the glutathione redox ratio, to warrant further investigation to determine the significance in relation to clinical outcomes. Large, well designed intervention studies that link metabolites, cofactors and genes of the γ-glutamyl cycle and trans-sulphuration pathway with objective behavioural outcomes in children with autism spectrum disorders are required. Future risk factor analysis should include consideration of multiple nutritional status and metabolite biomarkers of pathways linked with the γ-glutamyl cycle and the interaction of genotype in relation to these factors.
Collapse
Affiliation(s)
- Penelope AE Main
- Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide, SA 5000, Australia
- Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Kintore Ave, Adelaide, SA 5000, Australia
| | - Manya T Angley
- Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide, SA 5000, Australia
| | - Catherine E O'Doherty
- Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide, SA 5000, Australia
| | - Philip Thomas
- Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Kintore Ave, Adelaide, SA 5000, Australia
| | - Michael Fenech
- Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Kintore Ave, Adelaide, SA 5000, Australia
| |
Collapse
|
481
|
Jawaid A, Riby DM, Owens J, White SW, Tarar T, Schulz PE. 'Too withdrawn' or 'too friendly': considering social vulnerability in two neuro-developmental disorders. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2012; 56:335-350. [PMID: 21801261 DOI: 10.1111/j.1365-2788.2011.01452.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In some neuro-developmental disorders, the combined effect of intellectual disability and atypicalities of social cognition may put individuals at increased vulnerability in their social environment. The neuro-developmental disorders Williams syndrome, characterised by 'hypersociability', and autism spectrum disorders, characterised by 'social withdrawal', are at two extremes of atypical social functioning in humans. In this article, we use Williams syndrome and autism spectrum disorders as exemplars to demonstrate how atypicalities of social cognition may contribute to social vulnerability in these populations. The lives of individuals with both these disorders are marred by an increased risk of social isolation, bullying, unsteady relationships, employment difficulties and abuse. While different behavioural interventions have been tried to improve social functioning in these populations, there has been great variability in their success. Finally, we discuss different issues regarding social independence of these individuals; including employment, safety and decision making.
Collapse
Affiliation(s)
- A Jawaid
- Institute of Neuropathology, University Hospital Zurich, Zurich, Switzerland.
| | | | | | | | | | | |
Collapse
|
482
|
Lubecka EA, Ciarkowski J, Prahl A, Sikorska E. Highly Potent Antidiuretic Antagonists: Conformational Studies of Vasopressin Analogues Modified with 1-Naphthylalanine Enantiomers at Position 2. Chem Biol Drug Des 2012; 79:1033-42. [DOI: 10.1111/j.1747-0285.2012.01358.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
483
|
Berg AT, Plioplys S. Epilepsy and autism: is there a special relationship? Epilepsy Behav 2012; 23:193-8. [PMID: 22381386 PMCID: PMC3307824 DOI: 10.1016/j.yebeh.2012.01.015] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 01/24/2012] [Indexed: 01/31/2023]
Abstract
Increasingly, there has been an interest in the association between epilepsy and autism. The high frequency of autism in some of the early-onset developmental encephalopathic epilepsies is frequently cited as evidence of the relationship between autism and epilepsy. While these specific forms of epilepsy carry a higher-than-expected risk of autism, most, if not all, of the association may be due to intellectual disability (ID). The high prevalence of interictal EEG discharges in children with autism is also cited as further evidence although errors in the diagnosis of epilepsy seem to account for at least part of those findings. The prevalence of ID is substantially elevated in children with either epilepsy or autism. In the absence of ID, there is little evidence of a substantial, if any, increased risk of autism in children with epilepsy. Further, although the reported prevalence of autism has increased over the last several years, much of this increase may be attributable to changes in diagnostic practices, conceptualization of autism in the presence of ID, and laws requiring provision of services for children with autism. In the context of these temporal trends, any further efforts to tease apart the relationships between epilepsy, ID, and autism will have to address head-on the accuracy of diagnosis of all three conditions before we can determine whether there is, indeed, a special relationship between autism and epilepsy.
Collapse
Affiliation(s)
- Anne T. Berg
- Epilepsy Center, Children’s Memorial Hospital, Chicago, IL
| | - Sigita Plioplys
- Department of Child and Adolescent Psychiatry, Children’s Memorial Hospital, Chicago, IL
| |
Collapse
|
484
|
Decreased reelin expression and organophosphate pesticide exposure alters mouse behaviour and brain morphology. ASN Neuro 2012; 5:e00106. [PMID: 23298182 PMCID: PMC3575035 DOI: 10.1042/an20120060] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Genetic and environmental factors are both likely to contribute to neurodevelopmental disorders, including ASDs (autism spectrum disorders). In this study, we examined the combinatorial effect of two factors thought to be involved in autism – reduction in the expression of the extracellular matrix protein reelin and prenatal exposure to an organophosphate pesticide, CPO (chlorpyrifos oxon). Mice with reduced reelin expression or prenatal exposure to CPO exhibited subtle changes in ultrasound vocalization, open field behaviour, social interaction and repetitive behaviour. Paradoxically, mice exposed to both variables often exhibited a mitigation of abnormal behaviours, rather than increased behavioural abnormalities as expected. We identified specific differences in males and females in response to both of these variables. In addition to behavioural abnormalities, we identified anatomical alterations in the olfactory bulb, piriform cortex, hippocampus and cerebellum. As with our behavioural studies, anatomical alterations appeared to be ameliorated in the presence of both variables. While these observations support an interaction between loss of reelin expression and CPO exposure, our results suggest a complexity to this interaction beyond an additive effect of individual phenotypes.
Collapse
|
485
|
Radulescu E, Ganeshan B, Minati L, Beacher FDCC, Gray MA, Chatwin C, Young RCD, Harrison NA, Critchley HD. Gray matter textural heterogeneity as a potential in-vivo biomarker of fine structural abnormalities in Asperger syndrome. THE PHARMACOGENOMICS JOURNAL 2012; 13:70-9. [DOI: 10.1038/tpj.2012.3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
486
|
Philip RC, Dauvermann MR, Whalley HC, Baynham K, Lawrie SM, Stanfield AC. A systematic review and meta-analysis of the fMRI investigation of autism spectrum disorders. Neurosci Biobehav Rev 2012; 36:901-42. [PMID: 22101112 DOI: 10.1016/j.neubiorev.2011.10.008] [Citation(s) in RCA: 235] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 10/24/2011] [Accepted: 10/26/2011] [Indexed: 10/15/2022]
|
487
|
Brown HK, Ouellette-Kuntz H, Hunter D, Kelley E, Cobigo V, Lam M. Beyond an autism diagnosis: children's functional independence and parents' unmet needs. J Autism Dev Disord 2012; 41:1291-302. [PMID: 21153875 DOI: 10.1007/s10803-010-1148-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
High demand has resulted in gaps in autism service provision. Our objective was to explore the association between children's functioning and parents' perceived unmet needs. We conducted a cross-sectional study of 97 families of school-aged children with an autism spectrum disorder. Log binomial regression was used to examine the relative risk for unmet need. Families of children with high functional independence had lower unmet need than families of children with moderate functional independence (RR = 0.81, 95% CI = 0.67-0.99). Those who experienced greater impact of the child's disability had greater unmet need (RR = 1.22, 95% CI = 1.03-1.45). The child's functioning and its impact on the family provide insight into unmet need which may inform service planning.
Collapse
Affiliation(s)
- Hilary K Brown
- Department of Community Health and Epidemiology, Queen's University, 191 Portsmouth Avenue, Kingston, Ontario, Canada.
| | | | | | | | | | | |
Collapse
|
488
|
Windham GC, Anderson MC, Croen LA, Smith KS, Collins J, Grether JK. Birth prevalence of autism spectrum disorders in the San Francisco Bay area by demographic and ascertainment source characteristics. J Autism Dev Disord 2012; 41:1362-72. [PMID: 21264681 DOI: 10.1007/s10803-010-1160-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Using standardized methods for multi-source surveillance, we calculated the prevalence of autism spectrum disorders (ASD) among children born in a racially diverse region in 1994 or 1996 as 4.7/1000 live births. Children with ASD before age 9 were identified through chart abstraction at health-related sources; three-quarters were being served by the state-wide Department of Developmental Services. In adjusted models, we found a male:female ratio of 6:1, a doubling of ASD prevalence among children of older mothers (40+), and lower prevalence with lower paternal education. Children of Black or Hispanic mothers had lower prevalence than those of White, non-Hispanic mothers, but these differences were attenuated after adjustment. Prevalence in children of Asian mothers was similar to Whites. Potential under-counting is discussed.
Collapse
Affiliation(s)
- Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA.
| | | | | | | | | | | |
Collapse
|
489
|
Burton A, Kizhner O, Brown MB, Peltier MR. Effect of experimental genital mycoplasmosis on gene expression in the fetal brain. J Reprod Immunol 2012; 93:9-16. [PMID: 22244476 DOI: 10.1016/j.jri.2011.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 11/29/2011] [Accepted: 11/30/2011] [Indexed: 01/17/2023]
Abstract
Neurodevelopmental disorders may have their origins during intrauterine development. We used a well-defined animal model to test whether hematogenous infection with genital mycoplasma would alter the expression of genes associated with autism spectrum disorders (ASD). In a preliminary experiment, rats were exposed at 14 days gestation (GD14) to Mycoplasma pulmonis or sterile broth and sacrificed at GD18. Infection and inflammation status of the pups was ascertained by culture and cytokine ELISA. Intra-cardiac injection of 10(6)CFU M. pulmonis resulted in amniotic infection of 100% of the pups and was accompanied by higher levels of IL-1β in amniotic fluids. In a second experiment, animals were infected in a similar manner but dams and their litters were sacrificed at GD18, GD21 or postpartum day 3 (PPD3). Expression of proinflammatory cytokines and neurodevelopmental genes in the fetal brains was evaluated. M. pulmonis infection significantly increased the expression of IL-1β, TNF-α and COX-2 in fetal and neonatal brains. Expression of GFAP and CD11b, markers for activation on astrocytes and microglial cells, respectively, was also increased for infected animals. M. pulmonis significantly increased SHANK-3 gene expression at GD21 and PPD3 and PCP-2 expression at GD21. No effect of M. pulmonis infection on Reelin, PTEN, BDNF or HGF was detected. These data suggest that M. pulmonis infection at GD14 increases the expression of proinflammatory genes in the perinatal brain. Further studies with earlier time-points of infection and ones that use behavioral outcomes are needed to better understand the potential role of genital mycoplasmosis on pychopathology.
Collapse
Affiliation(s)
- Aiyanna Burton
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA
| | | | | | | |
Collapse
|
490
|
Abdallah MW, Larsen N, Grove J, Nørgaard-Pedersen B, Thorsen P, Mortensen EL, Hougaard DM. Amniotic fluid chemokines and autism spectrum disorders: an exploratory study utilizing a Danish Historic Birth Cohort. Brain Behav Immun 2012; 26:170-6. [PMID: 21933705 DOI: 10.1016/j.bbi.2011.09.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/17/2011] [Accepted: 09/02/2011] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Elevated levels of chemokines have been reported in plasma and brain tissue of individuals with Autism Spectrum Disorders (ASD). The aim of this study was to examine chemokine levels in amniotic fluid (AF) samples of individuals diagnosed with ASD and their controls. MATERIAL AND METHODS A Danish Historic Birth Cohort (HBC) kept at Statens Serum Institute, Copenhagen was utilized. Using data from Danish nation-wide health registers, a case-control study design of 414 cases and 820 controls was adopted. Levels of MCP-1, MIP-1α and RANTES were analyzed using Luminex xMAP technology. Case-control differences were assessed as dichotomized at below the 10th percentile or above the 90th percentile cut-off points derived from the control biomarker distributions (logistic regression) or continuous measures (tobit regression). RESULTS AND CONCLUSION AF volume for 331 cases and 698 controls was sufficient for Luminex analysis. Including all individuals in the cohort yielded no significant differences in chemokine levels in cases versus controls. Logistic regression analyses, performed on individuals diagnosed using ICD-10 only, showed increased risk for ASD with elevated MCP-1 (elevated 90th percentile adjusted OR: 2.32 [95% CI: 1.17-4.61]) compared to controls. An increased risk for infantile autism with elevated MCP-1 was also found (adjusted OR: 2.28 [95% CI: 1.16-4.48]). Elevated levels of MCP-1 may decipher an etiologic immunologic dysfunction or play rather an indirect role in the pathophysiology of ASD. Further studies to confirm its role and to identify the potential pathways through which MCP-1 may contribute to the development of ASD are necessary.
Collapse
Affiliation(s)
- Morsi W Abdallah
- Department of Epidemiology, Aarhus University School of Public Health, Aarhus, Denmark.
| | | | | | | | | | | | | |
Collapse
|
491
|
Tachibana Y, Green J, Hwang Y, Emsley R. A systematic review with meta-analysis of comprehensive interventions for preschool children with autism spectrum disorder (ASD): study protocol. BMJ Open 2012; 2:e000679. [PMID: 22396224 PMCID: PMC3298837 DOI: 10.1136/bmjopen-2011-000679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The aims of this study are to (1) conduct a systematic review of the intervention literature in preschool children with autism spectrum disorder (ASD), including types of interventions that are tested and the classification of outcome measures used and (2) to undertake a meta-analysis of the studies, allowing for the first time the comparison of different approaches to intervention using comparative outcomes. There are a number of alternative modalities of intervention for preschool children with ASD in use with different theoretical background and orientation, each of which tend to use different trial designs and outcome measures. There is at this time an urgent need for comprehensive systematic review and meta-analyses of intervention studies for preschool children with ASD, covering studies of adequate quality across different intervention types and measurement methods, with a view to identifying the best current evidence for preschool interventions in the disorder. METHODS AND ANALYSIS The authors will perform a systematic review of randomised controlled trials for preschool children with ASD aged 0-6 years, along with a meta-analysis of qualifying studies across intervention modality. The authors will classify the interventions for preschool children with ASD under three models: behaviour, multimodal developmental and communication focused. First, the authors will perform a systematic review. Then, the authors will conduct a meta-analysis by comparing the three models with various outcomes using an inverse variance method in a random effect model. The authors will synthesise each outcome of the studies for the three models using standardised mean differences. DISSEMINATION AND ETHICS This study will identify each intervention's strengths and weaknesses. This study may also suggest what kinds of elements future intervention programmes for children with ASD should have. The authors strongly believe those findings will be able to translated into the clinical practices and patients and their family benefits. Review registration: PROSPERO CRD42011001349.
Collapse
Affiliation(s)
- Yoshiyuki Tachibana
- Department of Child and Adolescent Psychiatry, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
- Smart Aging International Research Centre, IDAC, Tohoku University, Sendai, Japan
| | - Jonathan Green
- Department of Child and Adolescent Psychiatry, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Yeonhee Hwang
- Special Support Education Research Centre, Tohoku Fukushi University, Sendai, Japan
| | - Richard Emsley
- Health Methodology Research Group, Department of Biostatistics, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| |
Collapse
|
492
|
Durand CM, Perroy J, Loll F, Perrais D, Fagni L, Bourgeron T, Montcouquiol M, Sans N. SHANK3 mutations identified in autism lead to modification of dendritic spine morphology via an actin-dependent mechanism. Mol Psychiatry 2012; 17:71-84. [PMID: 21606927 PMCID: PMC3252613 DOI: 10.1038/mp.2011.57] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Genetic mutations of SHANK3 have been reported in patients with intellectual disability, autism spectrum disorder (ASD) and schizophrenia. At the synapse, Shank3/ProSAP2 is a scaffolding protein that connects glutamate receptors to the actin cytoskeleton via a chain of intermediary elements. Although genetic studies have repeatedly confirmed the association of SHANK3 mutations with susceptibility to psychiatric disorders, very little is known about the neuronal consequences of these mutations. Here, we report the functional effects of two de novo mutations (STOP and Q321R) and two inherited variations (R12C and R300C) identified in patients with ASD. We show that Shank3 is located at the tip of actin filaments and enhances its polymerization. Shank3 also participates in growth cone motility in developing neurons. The truncating mutation (STOP) strongly affects the development and morphology of dendritic spines, reduces synaptic transmission in mature neurons and also inhibits the effect of Shank3 on growth cone motility. The de novo mutation in the ankyrin domain (Q321R) modifies the roles of Shank3 in spine induction and morphology, and actin accumulation in spines and affects growth cone motility. Finally, the two inherited mutations (R12C and R300C) have intermediate effects on spine density and synaptic transmission. Therefore, although inherited by healthy parents, the functional effects of these mutations strongly suggest that they could represent risk factors for ASD. Altogether, these data provide new insights into the synaptic alterations caused by SHANK3 mutations in humans and provide a robust cellular readout for the development of knowledge-based therapies.
Collapse
Affiliation(s)
- C M Durand
- Planar Polarity and Plasticity Group, Neurocentre Magendie, Laboratory of ‘Pathophysiology of Neural Plasticity,' INSERM U862, Bordeaux, France,University of Bordeaux, Bordeaux, France
| | - J Perroy
- Institute of Functional Genomics, CNRS UMR5203, INSERM U661, University of Montpellier I and II, Montpellier, France
| | - F Loll
- Planar Polarity and Plasticity Group, Neurocentre Magendie, Laboratory of ‘Pathophysiology of Neural Plasticity,' INSERM U862, Bordeaux, France,University of Bordeaux, Bordeaux, France
| | - D Perrais
- University of Bordeaux, Bordeaux, France,CNRS, Interdisciplinary Institute for Neuroscience, UMR 5297, Bordeaux, France
| | - L Fagni
- Institute of Functional Genomics, CNRS UMR5203, INSERM U661, University of Montpellier I and II, Montpellier, France
| | - T Bourgeron
- Human Genetics and Cognitive Functions, Pasteur Institute, Paris, France,University Denis Diderot Paris 7, Paris, France
| | - M Montcouquiol
- Planar Polarity and Plasticity Group, Neurocentre Magendie, Laboratory of ‘Pathophysiology of Neural Plasticity,' INSERM U862, Bordeaux, France,University of Bordeaux, Bordeaux, France
| | - N Sans
- Planar Polarity and Plasticity Group, Neurocentre Magendie, Laboratory of ‘Pathophysiology of Neural Plasticity,' INSERM U862, Bordeaux, France,University of Bordeaux, Bordeaux, France,Planar Polarity and Plasticity Group, INSERM, Neurocentre Magendie, Laboratory of Pathophysiology of Neural Plasticity, U862, 33077 Bordeaux, France. E-mail:
| |
Collapse
|
493
|
Antai D. Gender inequities, relationship power, and childhood immunization uptake in Nigeria: a population-based cross-sectional study. Int J Infect Dis 2011; 16:e136-45. [PMID: 22197748 DOI: 10.1016/j.ijid.2011.11.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 11/03/2011] [Accepted: 11/10/2011] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND This study aimed to simultaneously examine the association between multiple dimensions of gender inequities and full childhood immunization. METHODS A multilevel logistic regression analysis was performed on nationally representative sample data from the 2008 Nigeria Demographic and Health Survey, which included 33,385 women aged 15-49 years who had a total of 28,647 live-born children; 24,910 of these children were included in this study. RESULTS A total of 4283 (17%) children had received full immunization. Children of women whose spouse did not contribute to household earnings had a higher likelihood of receiving full childhood immunization (odds ratio (OR) 1.96, 95% confidence interval (95% CI) 1.02-3.77), and children of women who lacked decision-making autonomy had a lower likelihood of receiving full childhood immunization (OR 0.74, 95% CI 0.60-0.91). The likelihood of receiving full childhood immunization was higher among female children (OR 1.28, 95% CI 1.06-1.54), Yoruba children (OR 2.45, 95% CI 1.19-4.26), and children resident in communities with low illiteracy (OR 1.82, 95% CI 1.06-3.12), but lower for children of birth order 5 or above (OR 0.64, 95% CI 0.45-0.96), children of women aged ≤ 24 years (OR 0.66, 95% CI 0.50-0.87) and 25-34 years (OR 0.79, 95% CI 0.63-0.99), children of women with no education (OR 0.33, 95% CI 0.21-0.54) and primary education (OR 0.66, 95% CI 0.45-0.97), as well as children of women resident in communities with high unemployment (OR 0.34, 95% CI 0.20-0.57). CONCLUSIONS The woman being the sole provider for her family (i.e., having a spouse who did not contribute to household earnings) was associated with a higher likelihood of fully immunizing the child, and the woman lacking decision-making autonomy was associated with a lower likelihood of fully immunizing the child. These findings draw attention to the need for interventions aimed at promoting women's employment and earning possibilities, whilst changing gender-discriminatory attitudes within relationships, communities, and society in general.
Collapse
Affiliation(s)
- Diddy Antai
- Department of Public Health, Division of Social Medicine, Karolinska Institutet, 171 76 Stockholm, Sweden.
| |
Collapse
|
494
|
Li N, Chen G, Song X, Du W, Zheng X. Prevalence of autism-caused disability among Chinese children: a national population-based survey. Epilepsy Behav 2011; 22:786-9. [PMID: 22079437 DOI: 10.1016/j.yebeh.2011.10.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 09/28/2011] [Accepted: 10/01/2011] [Indexed: 01/21/2023]
Abstract
Few articles in English have discussed the prevalence of autism in China. The work described here was aimed at estimating the prevalence rate of autism-caused disability among Chinese children and exploring family environmental factors associated with autism based on a national population sample. Data for this study were derived from the Second China National Sample Survey on Disability. A weighted number of 77,301 disabled children affected by autism were identified, yielding a prevalence rate of 2.38/10,000. A history of mental disorders in adults was strongly associated with autism. The prevalence of autism in Chinese children was underestimated, and the lack of qualified professionals able to identify and diagnose autism was the main reason. Countermeasures are warranted to obtain a more precise overview of autism in China.
Collapse
Affiliation(s)
- Ning Li
- Institute of Population Research, Peking University, Beijing, China
| | | | | | | | | |
Collapse
|
495
|
Abdallah MW, Grove J, Hougaard DM, Nørgaard-Pedersen B, Ibrahimov F, Mortensen EL. Autism spectrum disorders and maternal serum α-fetoprotein levels during pregnancy. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:727-34. [PMID: 22152641 DOI: 10.1177/070674371105601204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Numerous studies have been trying to disentangle the complex pathophysiology of autism spectrum disorders (ASD). In our study, we explored the potential role of maternal serum (MS) alpha-fetoprotein (AFP) in the prediction and the pathophysiology of ASD. METHODS A total of 112 patients with ASD and 243 control subjects were included in a case-control study, using a historic birth cohort maintained at Statens Serum Institute. Measurements of MS-AFP were obtained from a multicentre screening program, whereas clinical data were obtained from nationwide registers. Association between MS-AFP and ASD status was analyzed using logistic regression models and nonparametric tests. RESULTS Crude, but not adjusted, estimates showed that MS-AFP levels were slightly, but significantly, higher in mothers of children with ASD, compared with their control subject counterparts. People with ASD had an odds ratio of 2.33, with 95% confidence intervals of 1.00 to 5.39, to have MS-AFP above 2.5 multiple of median. Excluding subjects with congenital malformation comorbidities did not alter the direction of our estimates (OR 2.60; 95% CI 1.04 to 6.51, P = 0.04). CONCLUSION Biologic plausibility of its role in the pathophysiology of ASD makes AFP a good candidate for further larger-scale studies to confirm such an association and to determine whether this pattern is unique to ASD or related to other psychiatric disorders as well.
Collapse
Affiliation(s)
- Morsi W Abdallah
- Department of Epidemiology, Aarhus University School of Public Health, Denmark.
| | | | | | | | | | | |
Collapse
|
496
|
Owens SE, Summar ML, Ryckman KK, Haines JL, Reiss S, Summar SR, Aschner M. Lack of association between autism and four heavy metal regulatory genes. Neurotoxicology 2011; 32:769-75. [PMID: 21798283 PMCID: PMC3206176 DOI: 10.1016/j.neuro.2011.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 07/07/2011] [Accepted: 07/08/2011] [Indexed: 11/29/2022]
Abstract
Autism is a common neurodevelopmental disorder with genetic and environmental components. Though unproven, genetic susceptibility to high mercury (Hg) body burden has been suggested as an autism risk factor in a subset of children. We hypothesized that exposure to "safe" Hg levels could be implicated in the etiology of autism if genetic susceptibility altered Hg's metabolism or intracellular compartmentalization. Genetic sequences of four genes implicated in the transport and response to Hg were screened for variation and association with autism. LAT1 and DMT1 function in Hg transport, and Hg exposure induces MTF1 and MT1a. We identified and characterized 74 variants in MT1a, DMT1, LAT1 and MTF1. Polymorphisms identified through screening 48 unrelated individuals from the general and autistic populations were evaluated for differences in allele frequencies using Fisher's exact test. Three variants with suggestive p-values <0.1 and four variants with significant p-values <0.05 were followed-up with TaqMan genotyping in a larger cohort of 204 patients and 323 control samples. The pedigree disequilibrium test was used to examine linkage and association. Analysis failed to show association with autism for any variant evaluated in both the initial screening set and the expanded cohort, suggesting that variations in the ability of the four genes studied to process and transport Hg may not play a significant role in the etiology of autism.
Collapse
Affiliation(s)
- Sarah E. Owens
- Department of Pediatric Toxicology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Marshall L. Summar
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kelli K. Ryckman
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jonathan L. Haines
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Sara Reiss
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Samantha R. Summar
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Michael Aschner
- Department of Pediatric Toxicology, Vanderbilt University School of Medicine, Nashville, TN, USA
| |
Collapse
|
497
|
Abstract
The role of the immune system in neuropsychiatric diseases, including autism spectrum disorder (ASD), has long been hypothesized. This hypothesis has mainly been supported by family cohort studies and the immunological abnormalities found in ASD patients, but had limited findings in genetic association testing. Two cross-disorder genetic association tests were performed on the genome-wide data sets of ASD and six autoimmune disorders. In the polygenic score test, we examined whether ASD risk alleles with low effect sizes work collectively in specific autoimmune disorders and show significant association statistics. In the genetic variation score test, we tested whether allele-specific associations between ASD and autoimmune disorders can be found using nominally significant single-nucleotide polymorphisms. In both tests, we found that ASD is probabilistically linked to ankylosing spondylitis (AS) and multiple sclerosis (MS). Association coefficients showed that ASD and AS were positively associated, meaning that autism susceptibility alleles may have a similar collective effect in AS. The association coefficients were negative between ASD and MS. Significant associations between ASD and two autoimmune disorders were identified. This genetic association supports the idea that specific immunological abnormalities may underlie the etiology of autism, at least in a number of cases.
Collapse
Affiliation(s)
- J-Y Jung
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - I S Kohane
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA,Informatics Program, Children's Hospital, Boston, MA, USA,i2b2 National Center for Biomedical Computing, Boston, MA, USA
| | - D P Wall
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA,Division of Genomic Medicine, Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Center for Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA. E-mail:
| |
Collapse
|
498
|
Obrenovich ME, Shamberger RJ, Lonsdale D. Altered heavy metals and transketolase found in autistic spectrum disorder. Biol Trace Elem Res 2011; 144:475-86. [PMID: 21755304 DOI: 10.1007/s12011-011-9146-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 06/06/2011] [Indexed: 11/26/2022]
Abstract
Autism and autism spectrum disorder (ASD) are developmental brain disorders with complex, obscure, and multifactorial etiology. Our recent clinical survey of patient records from ASD children under the age of 6 years and their age-matched controls revealed evidence of abnormal markers of thiol metabolism, as well as a significant alteration in deposition of several heavy metal species, particularly arsenic, mercury, copper, and iron in hair samples between the groups. Altered thiol metabolism from heavy metal toxicity may be responsible for the biochemical alterations in transketolase, and are mechanisms for oxidative stress production, dysautonomia, and abnormal thiamine homeostasis. It is unknown why the particular metals accumulate, but we suspect that children with ASD may have particular trouble excreting thiol-toxic heavy metal species, many of which exist as divalent cations. Accumulation or altered mercury clearance, as well as concomitant oxidative stress, arising from redox-active metal and arsenic toxicity, offers an intriguing component or possible mechanism for oxidative stress-mediated neurodegeneration in ASD patients. Taken together, these factors may be more important to the etiology of this symptomatically diverse disease spectrum and may offer insights into new treatment approaches and avenues of exploration for this devastating and growing disease.
Collapse
Affiliation(s)
- Mark E Obrenovich
- Department of Chemistry, Cleveland State University, Cleveland, OH, USA
| | | | | |
Collapse
|
499
|
Mutations causing syndromic autism define an axis of synaptic pathophysiology. Nature 2011; 480:63-8. [PMID: 22113615 PMCID: PMC3228874 DOI: 10.1038/nature10658] [Citation(s) in RCA: 464] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 10/21/2011] [Indexed: 02/06/2023]
Abstract
Tuberous sclerosis complex and fragile X syndrome are genetic diseases characterized by intellectual disability and autism. Because both syndromes are caused by mutations in genes that regulate protein synthesis in neurons, it has been hypothesized that excessive protein synthesis is one core pathophysiological mechanism of intellectual disability and autism. Using electrophysiological and biochemical assays of neuronal protein synthesis in the hippocampus of Tsc2+/− and Fmr1−/y mice, we show that synaptic dysfunction caused by these mutations actually falls at opposite ends of a physiological spectrum. Synaptic, biochemical and cognitive defects in these mutants are corrected by treatments that modulate metabotropic glutamate receptor 5 in opposite directions, and deficits in the mutants disappear when the mice are bred to carry both mutations. Thus, normal synaptic plasticity and cognition occur within an optimal range of metabotropic glutamate receptor-mediated protein synthesis, and deviations in either direction can lead to shared behavioral impairments.
Collapse
|
500
|
Jaber MA. Dental caries experience, oral health status and treatment needs of dental patients with autism. J Appl Oral Sci 2011; 19:212-7. [PMID: 21625735 PMCID: PMC4234331 DOI: 10.1590/s1678-77572011000300006] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Accepted: 02/16/2010] [Indexed: 12/24/2022] Open
Abstract
Objectives Autism is a lifelong neurodevelopmental disorder. The aims of this study were to
investigate whether children with autism have higher caries prevalence, higher
periodontal problems, or more treatment needs than children of a control group of
non-autistic patients, and to provide baseline data to enable comparison and
future planning of dental services to autistic children. Material and Methods 61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai
and Sharjah Autism Centers were selected for the study. The control group
consisted of 61 non-autistic patients chosen from relatives or friends of autistic
patients in an attempt to have matched age, sex and socioeconomic status. Each
patient received a complete oral and periodontal examination, assessment of caries
prevalence, and caries severity. Other conditions assessed were dental plaque,
gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test
of significance were used to compare groups. Results The autism group had a male-tofemale ratio of 2.8:1. Compared to controls,
children with autism had significantly higher decayed, missing or filled teeth
than unaffected patients and significantly needed more restorative dental
treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic
children were 0.02 and 0.3, respectively. The majority of the autistic children
either having poor 59.0% (36/61) or fair 37.8% (23/61) oral hygiene compared with
healthy control subjects. Likewise, 97.0% (59/61) of the autistic children had
gingivitis. Conclusions Children with autism exhibited a higher caries prevalence, poor oral hygiene and
extensive unmet needs for dental treatment than non-autistic healthy control
group. Thus oral health program that emphasizes prevention should be considered of
particular importance for children and young people with autism.
Collapse
Affiliation(s)
- Mohamed Abdullah Jaber
- Dental School, Ajman University of Science & Technology, Al Jurf campus, Ajman, United Arab Emirates.
| |
Collapse
|