51
|
Assessing the Dim Light Melatonin Onset in Adults with Autism Spectrum Disorder and No Comorbid Intellectual Disability. J Autism Dev Disord 2018; 47:2120-2137. [PMID: 28444476 DOI: 10.1007/s10803-017-3122-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study assessed melatonin levels and the dim light melatonin onset (DLMO) in adults with Autism Spectrum Disorder (ASD) and also investigated the relationships between melatonin and objectively measured sleep parameters. Sixteen adults with ASD (ASD-Only), 12 adults with ASD medicated for comorbid diagnoses of anxiety and/or depression (ASD-Med) and 32 controls participated in the study. Although, the timing of the DLMO did not differ between the two groups, advances and delays of the melatonin rhythm were observed in individual profiles. Overall mean melatonin levels were lower in the ASD-Med group compared to the two other groups. Lastly, greater increases in melatonin in the hour prior to sleep were associated with greater sleep efficiency in the ASD groups.
Collapse
|
52
|
Verhoeff ME, Blanken LME, Kocevska D, Mileva-Seitz VR, Jaddoe VWV, White T, Verhulst F, Luijk MPCM, Tiemeier H. The bidirectional association between sleep problems and autism spectrum disorder: a population-based cohort study. Mol Autism 2018; 9:8. [PMID: 29423134 PMCID: PMC5791216 DOI: 10.1186/s13229-018-0194-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 01/16/2018] [Indexed: 01/02/2023] Open
Abstract
Background Sleep difficulties are prevalent in children with autism spectrum disorder (ASD). The temporal nature of the association between sleep problems and ASD is unclear because longitudinal studies are lacking. Our aim is to clarify whether sleep problems precede and worsen autistic traits and ASD or occur as a consequence of the disorder. Methods Repeated sleep measures were available at 1.5, 3, 6, and 9 years of age in 5151 children participating in the Generation R Study, a large prospective birth cohort in the Netherlands. Autistic traits were determined with the Pervasive Developmental Problems score (PDP) of the Child Behavior Checklist (CBCL) at 1.5 and 3 years and the Social Responsiveness Scale (SRS) at 6 years. This cohort included 81 children diagnosed with ASD. Results Sleep problems in early childhood were prospectively associated with a higher SRS score, but not when correcting for baseline PDP score. By contrast, a higher SRS score and an ASD diagnosis were associated with more sleep problems at later ages, even when adjusting for baseline sleep problems. Likewise, a trajectory of increasing sleep problems was associated with ASD. Conclusions Sleep problems and ASD are not bidirectionally associated. Sleep problems do not precede and worsen autistic behavior but rather co-occur with autistic traits in early childhood. Over time, children with ASD have an increase in sleep problems, whereas typically developing children have a decrease in sleep problems. Our findings suggest that sleep problems are part of the construct ASD.
Collapse
Affiliation(s)
- Maria E Verhoeff
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Laura M E Blanken
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Desana Kocevska
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Viara R Mileva-Seitz
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.,3Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.,4Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tonya White
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands.,5Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Frank Verhulst
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands
| | - Maartje P C M Luijk
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands.,6Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- 2Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, 2060, Rotterdam, 3000 CB the Netherlands.,4Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,7Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
53
|
Tye C, Runicles AK, Whitehouse AJO, Alvares GA. Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review. Front Psychiatry 2018; 9:751. [PMID: 30733689 PMCID: PMC6354568 DOI: 10.3389/fpsyt.2018.00751] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 12/19/2018] [Indexed: 12/18/2022] Open
Abstract
Co-occurring medical disorders and associated physiological abnormalities in individuals with autism spectrum disorder (ASD) may provide insight into causal pathways or underlying biological mechanisms. Here, we review medical conditions that have been repeatedly highlighted as sharing the strongest associations with ASD-epilepsy, sleep, as well as gastrointestinal and immune functioning. We describe within each condition their prevalence, associations with behavior, and evidence for successful treatment. We additionally discuss research aiming to uncover potential aetiological mechanisms. We then consider the potential interaction between each group of conditions and ASD and, based on the available evidence, propose a model that integrates these medical comorbidities in relation to potential shared aetiological mechanisms. Future research should aim to systematically examine the interactions between these physiological systems, rather than considering these in isolation, using robust and sensitive biomarkers across an individual's development. A consideration of the overlap between medical conditions and ASD may aid in defining biological subtypes within ASD and in the development of specific targeted interventions.
Collapse
Affiliation(s)
- Charlotte Tye
- Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Abigail K Runicles
- Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| |
Collapse
|
54
|
Goldman SE, Alder ML, Burgess HJ, Corbett BA, Hundley R, Wofford D, Fawkes DB, Wang L, Laudenslager ML, Malow BA. Characterizing Sleep in Adolescents and Adults with Autism Spectrum Disorders. J Autism Dev Disord 2017; 47:1682-1695. [PMID: 28286917 DOI: 10.1007/s10803-017-3089-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We studied 28 adolescents/young adults with autism spectrum disorders (ASD) and 13 age/sex matched individuals of typical development (TD). Structured sleep histories, validated questionnaires, actigraphy (4 weeks), and salivary cortisol and melatonin (4 days each) were collected. Compared to those with TD, adolescents/young adults with ASD had longer sleep latencies and more difficulty going to bed and falling asleep. Morning cortisol, evening cortisol, and the morning-evening difference in cortisol did not differ by diagnosis (ASD vs. TD). Dim light melatonin onsets (DLMOs) averaged across participants were not different for the ASD and TD participants. Average participant scores indicated aspects of poor sleep hygiene in both groups. Insomnia in ASD is multifactorial and not solely related to physiological factors.
Collapse
Affiliation(s)
- S E Goldman
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - M L Alder
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - H J Burgess
- Departments of Behavioral Sciences & Internal Medicine, Rush University Medical Center, Chicago, USA
| | - B A Corbett
- Department of Psychiatry and Kennedy Center, Vanderbilt University School of Medicine, Nashville, USA
| | - R Hundley
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA
| | - D Wofford
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - D B Fawkes
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - L Wang
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - M L Laudenslager
- Behavioral Immunology and Endocrinology Laboratory, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - B A Malow
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA.
| |
Collapse
|
55
|
Cohen S, Fulcher BD, Rajaratnam SMW, Conduit R, Sullivan JP, St Hilaire MA, Phillips AJK, Loddenkemper T, Kothare SV, McConnell K, Braga‐Kenyon P, Ahearn W, Shlesinger A, Potter J, Bird F, Cornish KM, Lockley SW. Sleep patterns predictive of daytime challenging behavior in individuals with low‐functioning autism. Autism Res 2017; 11:391-403. [DOI: 10.1002/aur.1899] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 11/05/2017] [Accepted: 11/06/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Simonne Cohen
- Monash Institute of Cognitive and Clinical NeurosciencesSchool of Psychological Sciences, Monash UniversityMelbourne Australia
| | - Ben D. Fulcher
- Monash Institute of Cognitive and Clinical NeurosciencesSchool of Psychological Sciences, Monash UniversityMelbourne Australia
- School of Physics, Sydney UniversityPhysics Road Camperdown, NSW, 2006 Australia
| | - Shantha M. W. Rajaratnam
- Monash Institute of Cognitive and Clinical NeurosciencesSchool of Psychological Sciences, Monash UniversityMelbourne Australia
- Division of Sleep and Circadian Disorders, Brigham and Women's HospitalBoston Massachusetts
- Division of Sleep MedicineHarvard Medical SchoolBoston Massachusetts
| | - Russell Conduit
- School of Health SciencesRoyal Melbourne Institute of TechnologyMelbourne Australia
| | - Jason P. Sullivan
- Division of Sleep and Circadian Disorders, Brigham and Women's HospitalBoston Massachusetts
| | - Melissa A. St Hilaire
- Division of Sleep and Circadian Disorders, Brigham and Women's HospitalBoston Massachusetts
- Division of Sleep MedicineHarvard Medical SchoolBoston Massachusetts
| | - Andrew J. K. Phillips
- Monash Institute of Cognitive and Clinical NeurosciencesSchool of Psychological Sciences, Monash UniversityMelbourne Australia
- Division of Sleep and Circadian Disorders, Brigham and Women's HospitalBoston Massachusetts
- Division of Sleep MedicineHarvard Medical SchoolBoston Massachusetts
| | - Tobias Loddenkemper
- Division of Sleep MedicineHarvard Medical SchoolBoston Massachusetts
- Boston Children's HospitalBoston Massachusetts
| | - Sanjeev V. Kothare
- Division of Sleep MedicineHarvard Medical SchoolBoston Massachusetts
- Boston Children's HospitalBoston Massachusetts
- New York University Langone Medical SchoolNew York New York
| | | | - Paula Braga‐Kenyon
- New England Center for ChildrenSouthborough Massachusetts
- North Eastern UniversityBoston Massachusetts
- Melmark New EnglandAndover Massachusetts
| | - William Ahearn
- New England Center for ChildrenSouthborough Massachusetts
| | | | | | | | - Kim M. Cornish
- Monash Institute of Cognitive and Clinical NeurosciencesSchool of Psychological Sciences, Monash UniversityMelbourne Australia
| | - Steven W. Lockley
- Monash Institute of Cognitive and Clinical NeurosciencesSchool of Psychological Sciences, Monash UniversityMelbourne Australia
- Division of Sleep and Circadian Disorders, Brigham and Women's HospitalBoston Massachusetts
- Division of Sleep MedicineHarvard Medical SchoolBoston Massachusetts
| |
Collapse
|
56
|
Thomas AM, Schwartz MD, Saxe MD, Kilduff TS. Cntnap2 Knockout Rats and Mice Exhibit Epileptiform Activity and Abnormal Sleep-Wake Physiology. Sleep 2017; 40:2661545. [PMID: 28364455 DOI: 10.1093/sleep/zsw026] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 11/12/2022] Open
Abstract
Study Objectives Although recent innovations have enabled modification of the rat genome, it is unclear whether enhanced utility of rodents as human disease models will result. We compared electroencephalogram (EEG) and behavioral phenotypes of rats and mice with homozygous deletion of Cntnap2, a gene associated with cortical dysplasia-focal epilepsy (CDFE) and autism spectrum disorders (ASD). Methods Male contactin-associated protein-like 2 (Cntnap2) knockout (KO) and wild-type (WT) rats and male Cntnap2 KO and WT mice were implanted with telemeters to record EEG, electromyogram, body temperature, and locomotor activity. Animals were subjected to a test battery for ASD-related behaviors, followed by 24-hr EEG recordings that were analyzed for sleep-wake parameters and subjected to spectral analysis. Results Cntnap2 KO rats exhibited severe motor seizures, hyperactivity, and increased consolidation of wakefulness and REM sleep. By contrast, Cntnap2 KO mice demonstrated absence seizure-like events, hypoactivity, and wake fragmentation. Although seizures observed in Cntnap2 KO rats were more similar to those in CDFE patients than in KO mice, neither model fully recapitulated the full spectrum of disease symptoms. However, KOs in both species had reduced spectral power in the alpha (9-12 Hz) range during wake, suggesting a conserved EEG biomarker. Conclusions Deletion of Cntnap2 impacts similar behaviors and EEG measures in rats and mice, but with profound differences in nature and phenotypic severity. These observations highlight the importance of cross-species comparisons to understand conserved gene functions and the limitations of single- species models to provide translational insights relevant to human diseases.
Collapse
Affiliation(s)
- Alexia M Thomas
- Biosciences Division, Center for Neuroscience, SRI International, Menlo Park, CA
| | - Michael D Schwartz
- Biosciences Division, Center for Neuroscience, SRI International, Menlo Park, CA
| | - Michael D Saxe
- Pharma Research and Early Development, Neuroscience, Ophthalmology and Rare Disease DTA, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Thomas S Kilduff
- Biosciences Division, Center for Neuroscience, SRI International, Menlo Park, CA
| |
Collapse
|
57
|
Roberts CA, Hunter J, Cheng AL. Resilience in Families of Children With Autism and Sleep Problems Using Mixed Methods. J Pediatr Nurs 2017; 37:e2-e9. [PMID: 28916433 DOI: 10.1016/j.pedn.2017.08.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 08/27/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE About 80% of children with autism spectrum disorder (ASD) have sleep problems that may disrupt optimal family functioning. We explored the impact of sleep problems on families' resilience. DESIGN AND METHODS An explanatory sequential mixed methods design was used to discern whether resilience differed between families whose children with ASD have or do not have sleep problems, to seek predictors for family hardiness/resilience, and to determine whether narrative findings support, expand, or conflict quantitative findings. RESULTS Seventy complete surveys were returned from parents of children with ASD to compare sleep and family functioning. Fifty-seven children had sleep problems and six interviews regarding eight of these children were conducted. Parents of children with ASD and sleep problems had lower levels of resilience than those who slept well. Predictors of hardiness were social support, coping-coherence (stress management), and lower strain scores. Qualitative content analysis revealed a journey analogy with themes: finding the trailhead, dual pathways, crossing paths and choosing travel companions, forging new paths, resting along the way, and seeing the vistas. CONCLUSIONS Qualitative findings supported quantitative findings regarding the impact of sleep problems but also expanded them by illustrating how families' resilience and children's socialization improved over time. Social support predicted family hardiness. Parents revealed that sleep issues contributed to family strains and described their progression to resilience and embracing their child. PRACTICE IMPLICATIONS Findings support the need for community and provider advocacy and implicates a need for development of sleep interventions on behalf of families and children with ASD.
Collapse
Affiliation(s)
| | | | - An-Lin Cheng
- University of Missouri-Kansas City, Kansas City, MO, USA.
| |
Collapse
|
58
|
Examining the Behavioural Sleep-Wake Rhythm in Adults with Autism Spectrum Disorder and No Comorbid Intellectual Disability. J Autism Dev Disord 2017; 47:1207-1222. [PMID: 28160224 DOI: 10.1007/s10803-017-3042-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study aimed to examine the behavioural sleep-wake rhythm in 36 adults with autism spectrum disorder (ASD) and to determine the prevalence of circadian sleep-wake rhythm disorders compared to age- and sex-matched controls. Participants completed an online questionnaire battery, a 14-day sleep-wake diary and 14-day actigraphy assessment. The results indicated that a higher proportion of adults with ASD met criteria for a circadian rhythm sleep-wake disorder compared to control adults. In particular, delayed sleep-wake phase disorder was particularly common in adults with ASD. Overall the findings suggest that individuals with ASD have sleep patterns that may be associated with circadian rhythm disturbance; however factors such as employment status and co-morbid anxiety and depression appear to influence their sleep patterns.
Collapse
|
59
|
Sayad A, Noroozi R, Omrani MD, Taheri M, Ghafouri-Fard S. Retinoic acid-related orphan receptor alpha (RORA) variants are associated with autism spectrum disorder. Metab Brain Dis 2017; 32:1595-1601. [PMID: 28608249 DOI: 10.1007/s11011-017-0049-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 06/05/2017] [Indexed: 12/20/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with various epidemiologic, genetic, epigenetic, and environmental factors being associated with it. The observed sex bias in ASD towards male has prompted investigators to propose sex-dependent mechanisms for ASD. Retinoic acid-related orphan receptor-alpha (RORA) is a new autism candidate gene that has been shown to be differentially regulated by male and female hormones. Previous studies have shown deregulation of its expression in the prefrontal cortex and the cerebellum of ASD patients. In the present study we aimed at identification of the possible associations between two functional polymorphisms in the RORA gene (rs11639084 and rs4774388) and the risk of ASD in 518 Iranian ASD patients and 472 age, gender, and ethnic-matched healthy controls by means of tetra primer-amplification refractory mutation system-PCR. The allele and genotype frequencies of rs11639084 were not significantly different between patients and controls. However, the allele frequencies of rs4774388 showed significant overrepresentation of T allele in patients compared with controls (P = 0.04, OR (95% CI) =1.21 (1.01-1.46)). The rs4774388-TT genotype was significantly higher in patients compared with controls and was associated with ASD risk in dominant inheritance model (P = 0.04, OR (95% CI) =0.77 (0.59-0.99)). Haplotype analysis showed significant association of two estimated blocks of rs11639084/ rs4774388 with ASD risk. Consequently, the present data provide further evidence for RORA participation in the pathogenesis of ASD.
Collapse
Affiliation(s)
- Arezou Sayad
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | - Rezvan Noroozi
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mir Davood Omrani
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, No 23, Shahid Labbafi Nejad Educational Hospital, Amir Ebrahimi St, Pasdaran Ave, Tehran, Iran
| | - Mohammad Taheri
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran.
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, No 23, Shahid Labbafi Nejad Educational Hospital, Amir Ebrahimi St, Pasdaran Ave, Tehran, Iran.
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran.
| |
Collapse
|
60
|
Moore M, Evans V, Hanvey G, Johnson C. Assessment of Sleep in Children with Autism Spectrum Disorder. CHILDREN-BASEL 2017; 4:children4080072. [PMID: 28786962 PMCID: PMC5575594 DOI: 10.3390/children4080072] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/23/2017] [Accepted: 08/02/2017] [Indexed: 01/30/2023]
Abstract
Sleep disturbances in children with autism spectrum disorder (ASD) are significantly more prevalent than found in typically developing (TD) children. Given the detrimental impact of poor sleep on cognitive, emotional, and behavioral functioning, it is imperative to screen and assess for sleep disturbances in this population. In this paper, we describe the screening and assessment process, as well as specific measures commonly used for assessing sleep in children with ASD. Advantages and limitations for use in children with ASD are discussed. While subjective measures, such as parent-report questionnaires and sleep diaries, are the most widely used, more objective measures such as actigraphy, polysomnography, and videosomnography provide additional valuable information for both diagnostic purposes and treatment planning. These objective measures, nonetheless, are limited by cost, availability, and feasibility of use with children with ASD. The current review provides an argument for the complementary uses of both subjective and objective measures of sleep specifically for use in children with ASD.
Collapse
Affiliation(s)
- Makeda Moore
- Department of Clinical & Health Psychology, University of Florida, 1225 Center Dr., Room 3130, P.O. Box 100165, Gainesville, FL 32610, USA.
| | - Victoria Evans
- Department of Clinical & Health Psychology, University of Florida, 1225 Center Dr., Room 3130, P.O. Box 100165, Gainesville, FL 32610, USA.
| | - Grace Hanvey
- Department of Clinical & Health Psychology, University of Florida, 1225 Center Dr., Room 3130, P.O. Box 100165, Gainesville, FL 32610, USA.
| | - Cynthia Johnson
- Department of Clinical & Health Psychology, University of Florida, 1225 Center Dr., Room 3130, P.O. Box 100165, Gainesville, FL 32610, USA.
| |
Collapse
|
61
|
Umemura M, Ogura T, Matsuzaki A, Nakano H, Takao K, Miyakawa T, Takahashi Y. Comprehensive Behavioral Analysis of Activating Transcription Factor 5-Deficient Mice. Front Behav Neurosci 2017; 11:125. [PMID: 28744205 PMCID: PMC5504141 DOI: 10.3389/fnbeh.2017.00125] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/15/2017] [Indexed: 12/27/2022] Open
Abstract
Activating transcription factor 5 (ATF5) is a member of the CREB/ATF family of basic leucine zipper transcription factors. We previously reported that ATF5-deficient (ATF5-/-) mice demonstrated abnormal olfactory bulb development due to impaired interneuron supply. Furthermore, ATF5-/- mice were less aggressive than ATF5+/+ mice. Although ATF5 is widely expressed in the brain, and involved in the regulation of proliferation and development of neurons, the physiological role of ATF5 in the higher brain remains unknown. Our objective was to investigate the physiological role of ATF5 in the higher brain. We performed a comprehensive behavioral analysis using ATF5-/- mice and wild type littermates. ATF5-/- mice exhibited abnormal locomotor activity in the open field test. They also exhibited abnormal anxiety-like behavior in the light/dark transition test and open field test. Furthermore, ATF5-/- mice displayed reduced social interaction in the Crawley’s social interaction test and increased pain sensitivity in the hot plate test compared with wild type. Finally, behavioral flexibility was reduced in the T-maze test in ATF5-/- mice compared with wild type. In addition, we demonstrated that ATF5-/- mice display disturbances of monoamine neurotransmitter levels in several brain regions. These results indicate that ATF5 deficiency elicits abnormal behaviors and the disturbance of monoamine neurotransmitter levels in the brain. The behavioral abnormalities of ATF5-/- mice may be due to the disturbance of monoamine levels. Taken together, these findings suggest that ATF5-/- mice may be a unique animal model of some psychiatric disorders.
Collapse
Affiliation(s)
- Mariko Umemura
- Laboratory of Environmental Molecular Physiology, School of Life Sciences, Tokyo University of Pharmacy and Life SciencesHachioji, Japan
| | - Tae Ogura
- Laboratory of Environmental Molecular Physiology, School of Life Sciences, Tokyo University of Pharmacy and Life SciencesHachioji, Japan
| | - Ayako Matsuzaki
- Laboratory of Environmental Molecular Physiology, School of Life Sciences, Tokyo University of Pharmacy and Life SciencesHachioji, Japan
| | - Haruo Nakano
- Laboratory of Environmental Molecular Physiology, School of Life Sciences, Tokyo University of Pharmacy and Life SciencesHachioji, Japan
| | - Keizo Takao
- Section of Behavior Patterns, Center for Genetic Analysis of Behavior, National Institute for Physiological SciencesOkazaki, Japan.,Life Science Research Center, University of ToyamaToyama, Japan
| | - Tsuyoshi Miyakawa
- Section of Behavior Patterns, Center for Genetic Analysis of Behavior, National Institute for Physiological SciencesOkazaki, Japan.,Division of Systems Medical Science, Institute for Comprehensive Medical Science, Fujita Health UniversityToyoake, Japan
| | - Yuji Takahashi
- Laboratory of Environmental Molecular Physiology, School of Life Sciences, Tokyo University of Pharmacy and Life SciencesHachioji, Japan
| |
Collapse
|
62
|
Role of a circadian-relevant gene NR1D1 in brain development: possible involvement in the pathophysiology of autism spectrum disorders. Sci Rep 2017; 7:43945. [PMID: 28262759 PMCID: PMC5338261 DOI: 10.1038/srep43945] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/31/2017] [Indexed: 02/07/2023] Open
Abstract
In our previous study, we screened autism spectrum disorder (ASD) patients with and without sleep disorders for mutations in the coding regions of circadian-relevant genes, and detected mutations in several clock genes including NR1D1. Here, we further screened ASD patients for NR1D1 mutations and identified three novel mutations including a de novo heterozygous one c.1499 G > A (p.R500H). We then analyzed the role of Nr1d1 in the development of the cerebral cortex in mice. Acute knockdown of mouse Nr1d1 with in utero electroporation caused abnormal positioning of cortical neurons during corticogenesis. This aberrant phenotype was rescued by wild type Nr1d1, but not by the c.1499 G > A mutant. Time-lapse imaging revealed characteristic abnormal migration phenotypes in Nr1d1-deficient cortical neurons. When Nr1d1 was knocked down, axon extension and dendritic arbor formation of cortical neurons were also suppressed while proliferation of neuronal progenitors and stem cells at the ventricular zone was not affected. Taken together, Nr1d1 was found to play a pivotal role in corticogenesis via regulation of excitatory neuron migration and synaptic network formation. These results suggest that functional defects in NR1D1 may be related to ASD etiology and pathophysiology.
Collapse
|
63
|
Sharpley CF, Bitsika V, Andronicos NM, Agnew LL. Further evidence of HPA-axis dysregulation and its correlation with depression in Autism Spectrum Disorders: Data from girls. Physiol Behav 2016; 167:110-117. [DOI: 10.1016/j.physbeh.2016.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 12/28/2022]
|
64
|
Angelakos CC, Watson AJ, O'Brien WT, Krainock KS, Nickl-Jockschat T, Abel T. Hyperactivity and male-specific sleep deficits in the 16p11.2 deletion mouse model of autism. Autism Res 2016; 10:572-584. [PMID: 27739237 DOI: 10.1002/aur.1707] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 07/20/2016] [Accepted: 08/18/2016] [Indexed: 12/11/2022]
Abstract
Sleep disturbances and hyperactivity are prevalent in several neurodevelopmental disorders, including autism spectrum disorders (ASDs) and attention deficit-hyperactivity disorder (ADHD). Evidence from genome-wide association studies indicates that chromosomal copy number variations (CNVs) are associated with increased prevalence of these neurodevelopmental disorders. In particular, CNVs in chromosomal region 16p11.2 profoundly increase the risk for ASD and ADHD, disorders that are more common in males than females. We hypothesized that mice hemizygous for the 16p11.2 deletion (16p11.2 del/+) would exhibit sex-specific sleep and activity alterations. To test this hypothesis, we recorded activity patterns using infrared beam breaks in the home-cage of adult male and female 16p11.2 del/+ and wildtype (WT) littermates. In comparison to controls, we found that both male and female 16p11.2 del/+ mice exhibited robust home-cage hyperactivity. In additional experiments, sleep was assessed by polysomnography over a 24-hr period. 16p11.2 del/+ male, but not female mice, exhibited significantly more time awake and significantly less time in non-rapid-eye-movement (NREM) sleep during the 24-hr period than wildtype littermates. Analysis of bouts of sleep and wakefulness revealed that 16p11.2 del/+ males, but not females, spent a significantly greater proportion of wake time in long bouts of consolidated wakefulness (greater than 42 min in duration) compared to controls. These changes in hyperactivity, wake time, and wake time distribution in the males resemble sleep disturbances observed in human ASD and ADHD patients, suggesting that the 16p11.2 del/+ mouse model may be a useful genetic model for studying sleep and activity problems in human neurodevelopmental disorders. Autism Res 2016. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 572-584. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Christopher C Angelakos
- Department of Neuroscience, Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA, 19104
| | - Adam J Watson
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104
| | - W Timothy O'Brien
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, 19104
| | - Kyle S Krainock
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104
| | - Thomas Nickl-Jockschat
- Department of Psychiatry Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.,Jülich Aachen Research Alliance - Translational Brain Medicine, Jülich, Germany Germany and Aachen
| | - Ted Abel
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104
| |
Collapse
|
65
|
McLay LLK, France K. Empirical research evaluating non-traditional approaches to managing sleep problems in children with autism. Dev Neurorehabil 2016; 19:123-34. [PMID: 24724691 DOI: 10.3109/17518423.2014.904452] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This paper examines the efficacy of non-behavioural and non-pharmacological approaches to the treatment of sleep disturbance in individuals with autism spectrum disorder. METHODS A systematic search of electronic databases and reference lists identified eight studies that met inclusion criteria. Studies were evaluated according to (a) treatment used, (b) participants, (c) experimental design, (d) baseline measures, (e) dependent variables, (f) follow-up measures, (g) reliability and treatment integrity, (h) results and certainty of evidence and (i) implications for treatment. RESULTS Positive outcomes were reported for the use of massage therapy and vitamin supplements. Aromatherapy was reported to have no effect on sleep. No studies were found that examined other non-traditional treatment approaches, nor did any of the studies provide conclusive evidence. CONCLUSIONS The limited corpus of evidence and the methodological limitations suggests that the efficacy of non-traditional approaches to treatment of sleep problems in individuals with autism is yet to be demonstrated.
Collapse
Affiliation(s)
| | - Karyn France
- a School of Health Sciences, University of Canterbury , Christchurch , New Zealand
| |
Collapse
|
66
|
Rhoades SD, Sengupta A, Weljie AM. Time is ripe: maturation of metabolomics in chronobiology. Curr Opin Biotechnol 2016; 43:70-76. [PMID: 27701007 DOI: 10.1016/j.copbio.2016.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 09/15/2016] [Accepted: 09/18/2016] [Indexed: 12/14/2022]
Abstract
Sleep and circadian rhythms studies have recently benefited from metabolomics analyses, uncovering new connections between chronobiology and metabolism. From untargeted mass spectrometry to quantitative nuclear magnetic resonance spectroscopy, a diversity of analytical approaches has been applied for biomarker discovery in the field. In this review we consider advances in the application of metabolomics technologies which have uncovered significant effects of sleep and circadian cycles on several metabolites, namely phosphatidylcholine species, medium-chain carnitines, and aromatic amino acids. Study design and data processing measures essential for detecting rhythmicity in metabolomics data are also discussed. Future developments in these technologies are anticipated vis-à-vis validating early findings, given metabolomics has only recently entered the ring with other systems biology assessments in chronometabolism studies.
Collapse
Affiliation(s)
- Seth D Rhoades
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, United States; Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Arjun Sengupta
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, United States; Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Aalim M Weljie
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, United States; Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
| |
Collapse
|
67
|
Sharpley CF, Bitsika V, Andronicos NM, Agnew LL. Is afternoon cortisol more reliable than waking cortisol in association studies of children with an ASD? Physiol Behav 2016; 155:218-23. [PMID: 26717863 DOI: 10.1016/j.physbeh.2015.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/16/2015] [Accepted: 12/20/2015] [Indexed: 12/28/2022]
Abstract
Salivary cortisol may be used as a biomarker of stress and anxiety in children with an Autism Spectrum Disorder (ASD) and is particularly valuable in studies of the association between stress-related cortisol concentrations and other factors such as comorbid disorders or aspects of the ASD phenotype. Although protocols for the collection of cortisol shortly after waking are often based on the assumption of the presence of a diurnal rhythm in cortisol, that rhythm may not be as reliable in children with an ASD as in non-ASD children. Alternatively, collecting cortisol during the afternoon may represent a more reliable procedure with less inter-participant variability.
Collapse
Affiliation(s)
- Christopher F Sharpley
- Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia; Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - Vicki Bitsika
- Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia
| | - Nicholas M Andronicos
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| |
Collapse
|
68
|
Circadian-relevant genes are highly polymorphic in autism spectrum disorder patients. Brain Dev 2016; 38:91-9. [PMID: 25957987 DOI: 10.1016/j.braindev.2015.04.006] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/27/2015] [Accepted: 04/10/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND The genetic background of autism spectrum disorder (ASD) is considered a multi-genetic disorder with high heritability. Autistic children present with a higher prevalence of sleep disorders than has been observed in children with normal development. Some circadian-relevant genes have been associated with ASD (e.g., PER1, PER2, NPAS2, MTNR1A, and MTNR1B). METHODS We analyzed 28 ASD patients (14 with sleep disorders and 14 without) and 23 control subjects of Japanese descent. The coding regions of 18 canonical clock genes and clock-controlled genes were sequenced. Detected mutations were verified by direct sequencing analysis, and additional control individuals were screened. RESULTS Thirty-six base changes with amino acid changes were detected in 11 genes. Six missense changes were detected only in individuals with ASD with sleep disturbance: p.F498S in TIMELESS, p.S20R in NR1D1, p.R493C in PER3, p.H542R in CLOCK, p.L473S in ARNTL2, and p.A325V in MTNR1B. Six missense changes were detected only in individuals with ASD without sleep disturbance: p.S1241N in PER1, p.A325T in TIMELESS, p.S13T in ARNTL, p.G24E in MTNR1B, p.G24E in PER2, and p.T1177A in PER3. The p.R493C mutation in PER3 was detected in both groups. One missense change, p.P932L in PER2, was detected only in the control group. Mutations in NR1D1, CLOCK, and ARNTL2 were detected only in individuals with ASD with sleep disorder. The prevalence of the mutations detected only single time differed significantly among all ASD patients and controls (p=0.003). Two kinds of mutations detected only in individuals with ASD with sleep disorder, p.F498S in TIMELESS and p.R366Q in PER3, were considered to affect gene function by three different methods: PolyPhen-2, scale-invariant feature transform (SIFT) prediction, and Mutation Taster (www.mutationtaster.org). The mutations p.S20R in NR1D1, p.H542R in CLOCK, p.L473S in ARNTL2, p.A325T in TIMELESS, p.S13T in ARNTL, and p.G24E in PER2 were diagnosed to negatively affect gene function by more than one of these methods. CONCLUSION Mutations in circadian-relevant genes affecting gene function are more frequent in patients with ASD than in controls. Circadian-relevant genes may be involved in the psychopathology of ASD.
Collapse
|
69
|
Esbensen AJ, Schwichtenberg AJ. Sleep in Neurodevelopmental Disorders. INTERNATIONAL REVIEW OF RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51:153-191. [PMID: 28503406 PMCID: PMC5424624 DOI: 10.1016/bs.irrdd.2016.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Individuals with intellectual and developmental disabilities (IDD) experience sleep problems at higher rates than the general population. Although individuals with IDD are a heterogeneous group, several sleep problems cluster within genetic syndromes or disorders. This review summarizes the prevalence of sleep problems experienced by individuals with Angelman syndrome, Cornelia de Lange syndrome, Cri du Chat syndrome, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Smith-Magenis syndrome, Williams syndrome, autism spectrum disorder, and idiopathic IDD. Factors associated with sleep problems and the evidence for sleep treatments are reviewed for each neurodevelopmental disorder. Sleep research advancements in neurodevelopmental disorders are reviewed, including the need for consistency in defining and measuring sleep problems, considerations for research design and reporting of results, and considerations when evaluating sleep treatments.
Collapse
|
70
|
Abstract
Autism spectrum disorder (ASD) is a complex behavioral condition with onset during early childhood and a lifelong course in the vast majority of cases. To date, no behavioral, genetic, brain imaging, or electrophysiological test can specifically validate a clinical diagnosis of ASD. However, these medical procedures are often implemented in order to screen for syndromic forms of the disorder (i.e., autism comorbid with known medical conditions). In the last 25 years a good deal of information has been accumulated on the main components of the "endocannabinoid (eCB) system", a rather complex ensemble of lipid signals ("endocannabinoids"), their target receptors, purported transporters, and metabolic enzymes. It has been clearly documented that eCB signaling plays a key role in many human health and disease conditions of the central nervous system, thus opening the avenue to the therapeutic exploitation of eCB-oriented drugs for the treatment of psychiatric, neurodegenerative, and neuroinflammatory disorders. Here we present a modern view of the eCB system, and alterations of its main components in human patients and animal models relevant to ASD. This review will thus provide a critical perspective necessary to explore the potential exploitation of distinct elements of eCB system as targets of innovative therapeutics against ASD.
Collapse
Affiliation(s)
- Bhismadev Chakrabarti
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Antonio Persico
- Center of Integrated Research and School of Medicine, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy
- Mafalda Luce Center for Pervasive Developmental Disorders, Milan, Italy
| | - Natalia Battista
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Mauro Maccarrone
- Center of Integrated Research and School of Medicine, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy.
- European Center for Brain Research (CERC)/Santa Lucia Foundation, Rome, Italy.
| |
Collapse
|
71
|
Mumford RA, Mahon LV, Jones S, Bigger B, Canal M, Hare DJ. Actigraphic investigation of circadian rhythm functioning and activity levels in children with mucopolysaccharidosis type III (Sanfilippo syndrome). J Neurodev Disord 2015; 7:31. [PMID: 26388955 PMCID: PMC4574189 DOI: 10.1186/s11689-015-9126-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 08/24/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Sleep disturbance is part of the behavioural phenotype of the rare genetic condition mucopolysaccharidosis (MPS) type III. A growing body of evidence suggests that underlying disturbance in circadian rhythm functioning may explain sleep problems within the MPS III population. METHODS Actigraphic data were recorded in eight children with MPS III over 7-10 days and compared to age-matched typically developing controls. Parameters of circadian rhythmicity and activity levels across a 24-h period were analysed. RESULTS Statistically and clinically significant differences between the two groups were noted. Analysis indicated that children with MPS III showed significantly increased fragmentation of circadian rhythm and reduced stability with external cues (zeitgebers), compared to controls. Average times of activity onset and offset were indicative of a phase delayed sleep-wake cycle for some children in the MPS III group. Children with MPS III had significantly higher activity levels during the early morning hours (midnight-6 am) compared to controls. CONCLUSIONS Results are consistent with previous research into MPS III and suggest that there is an impairment in circadian rhythm functioning in children with this condition. Implications for clinical practice and the management of sleep difficulties are discussed.
Collapse
Affiliation(s)
- Rachel A. Mumford
- />Psychological Services, Alder Hey Children’s Hospital, Liverpool, UK
| | - Louise V. Mahon
- />Manchester Mental Health & Social Care NHS Trust, Manchester, UK
| | - Simon Jones
- />Genetic Medicine Unit, St Mary’s Hospital, Manchester, UK
| | - Brian Bigger
- />Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
| | - Maria Canal
- />Faculty of Life Sciences, University of Manchester, Manchester, UK
| | | |
Collapse
|
72
|
|
73
|
Melatonin in children with autism spectrum disorders: endogenous and pharmacokinetic profiles in relation to sleep. J Autism Dev Disord 2015; 44:2525-35. [PMID: 24752680 DOI: 10.1007/s10803-014-2123-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Supplemental melatonin has been used to treat sleep onset insomnia in children with autism spectrum disorders (ASD), although the mechanism of action is uncertain. We assessed endogenous and supplemental melatonin profiles in relation to sleep in nine children with ASD. In endogenous samples, maximal melatonin concentration (C(max)) and time to peak concentration (T(max)) were comparable to those previously published in the literature for typically developing children, and dim light melatonin onsets were captured in the majority of children. In treatment samples (supplemental melatonin), melatonin parameters were also comparable to those previously published for typically developing children. Our findings support that children with ASD and insomnia responsive to low dose melatonin treatment have relatively normal profiles of endogenous and supplemental melatonin.
Collapse
|
74
|
Accardo JA, Malow BA. Sleep, epilepsy, and autism. Epilepsy Behav 2015; 47:202-6. [PMID: 25496798 DOI: 10.1016/j.yebeh.2014.09.081] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/26/2014] [Accepted: 09/29/2014] [Indexed: 01/11/2023]
Abstract
The purpose of this review article is to explore the links between sleep and epilepsy and the treatment of sleep problems in children with autism spectrum disorder (ASD). Epilepsy and sleep have bidirectional relationships, and problems with both are highly prevalent in children with ASD. Literature is reviewed to support the view that sleep is particularly important to address in the context of ASD. Identification and management of sleep disorders may improve seizure control and challenging behaviors. In closing, special considerations for evaluating and treating sleep disorders in children with ASD and epilepsy are reviewed. This article is part of a Special Issue entitled "Autism and Epilepsy".
Collapse
Affiliation(s)
- Jennifer A Accardo
- Kennedy Krieger Institute, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD, USA.
| | - Beth A Malow
- Vanderbilt University Medical Center, Department of Neurology, Nashville, TN, USA; Vanderbilt University Medical Center, Department of Pediatrics, Nashville, TN, USA; Kennedy Center, Nashville, TN, USA
| |
Collapse
|
75
|
Abstract
Autism spectrum disorders (ASD) are common neurodevelopmental conditions, affecting 1 in 68 children. Sleep disturbance, particularly insomnia, is very common in children diagnosed with ASD, with evidence supporting overlapping neurobiological and genetic underpinnings. Disturbed sleep exacerbates core and related ASD symptoms and has a substantial negative impact on the entire family. Treatment of sleep disturbance holds promise for ameliorating many of the challenging behavioral symptoms that children with ASD and their families face. Behavioral and pharmacological studies indicate promising approaches to treating sleep disturbances in this population. Awareness of treatment options is particularly important as parents and clinicians may believe that sleep disturbance is part of autism and refractory to therapy. In addition, autism symptoms refractory to treatment with conventional psychiatric medications may improve when sleep is addressed. Additional evidence-based studies are needed, including those that address the underlying biology of this condition.
Collapse
Affiliation(s)
- Olivia J Veatch
- Sleep Disorders Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela C Maxwell-Horn
- Department of Developmental Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Beth A Malow
- Sleep Disorders Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
76
|
Grice SJ, Liu JL, Webber C. Synergistic interactions between Drosophila orthologues of genes spanned by de novo human CNVs support multiple-hit models of autism. PLoS Genet 2015; 11:e1004998. [PMID: 25816101 PMCID: PMC4376901 DOI: 10.1371/journal.pgen.1004998] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/12/2015] [Indexed: 01/30/2023] Open
Abstract
Autism spectrum disorders (ASDs) are highly heritable and characterised by deficits in social interaction and communication, as well as restricted and repetitive behaviours. Although a number of highly penetrant ASD gene variants have been identified, there is growing evidence to support a causal role for combinatorial effects arising from the contributions of multiple loci. By examining synaptic and circadian neurological phenotypes resulting from the dosage variants of unique human:fly orthologues in Drosophila, we observe numerous synergistic interactions between pairs of informatically-identified candidate genes whose orthologues are jointly affected by large de novo copy number variants (CNVs). These CNVs were found in the genomes of individuals with autism, including a patient carrying a 22q11.2 deletion. We first demonstrate that dosage alterations of the unique Drosophila orthologues of candidate genes from de novo CNVs that harbour only a single candidate gene display neurological defects similar to those previously reported in Drosophila models of ASD-associated variants. We then considered pairwise dosage changes within the set of orthologues of candidate genes that were affected by the same single human de novo CNV. For three of four CNVs with complete orthologous relationships, we observed significant synergistic effects following the simultaneous dosage change of gene pairs drawn from a single CNV. The phenotypic variation observed at the Drosophila synapse that results from these interacting genetic variants supports a concordant phenotypic outcome across all interacting gene pairs following the direction of human gene copy number change. We observe both specificity and transitivity between interactors, both within and between CNV candidate gene sets, supporting shared and distinct genetic aetiologies. We then show that different interactions affect divergent synaptic processes, demonstrating distinct molecular aetiologies. Our study illustrates mechanisms through which synergistic effects resulting from large structural variation can contribute to human disease.
Collapse
Affiliation(s)
- Stuart J. Grice
- Medical Research Council Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Ji-Long Liu
- Medical Research Council Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Caleb Webber
- Medical Research Council Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
- * E-mail:
| |
Collapse
|
77
|
Nota JA, Sharkey KM, Coles ME. Sleep, arousal, and circadian rhythms in adults with obsessive-compulsive disorder: a meta-analysis. Neurosci Biobehav Rev 2015; 51:100-7. [PMID: 25603315 DOI: 10.1016/j.neubiorev.2015.01.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/18/2014] [Accepted: 01/05/2015] [Indexed: 11/19/2022]
Abstract
Findings of this meta-analysis show that obsessive-compulsive disorder (OCD) is related to disruptions in both the duration and timing of sleep. PsycINFO and Google Scholar database searches identified 12 relevant studies that compared measures of sleep in individuals with OCD to those of either a healthy control group or published norms. Sleep measures included sleep onset latency, sleep duration, awakening after sleep onset, percentage of rapid eye movement (REM) sleep, percentage of slow wave sleep, and prevalence of delayed sleep phase disorder (DSPD). Individual effect sizes were pooled using a random effects model. Sleep duration was found to be shorter, and the prevalence of DSPD higher, in individuals with OCD compared to controls. Further, excluding samples with comorbid depression did not meaningfully reduce the magnitude of these effects (although the results were no longer statistically significant) and medication use by participants is unlikely to have systematically altered sleep timing. Overall, available data suggest that sleep disruption is associated with OCD but further research on both sleep duration and sleep timing in individuals with OCD is needed.
Collapse
Affiliation(s)
- Jacob A Nota
- Department of Psychology, Binghamton University, PO Box 6000, Binghamton, NY 13902-6000, United States.
| | - Katherine M Sharkey
- Departments of Medicine and Psychiatry & Human Behavior, Rhode Island Hospital/Brown University, 300 Duncan Drive, Providence, RI 02906, United States
| | - Meredith E Coles
- Department of Psychology, Binghamton University, PO Box 6000, Binghamton, NY 13902-6000, United States
| |
Collapse
|
78
|
Bitsika V, Sharpley CF, Andronicos NM, Agnew LL. Hypothalamus–pituitary–adrenal axis daily fluctuation, anxiety and age interact to predict cortisol concentrations in boys with an autism spectrum disorder. Physiol Behav 2015; 138:200-7. [DOI: 10.1016/j.physbeh.2014.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 12/20/2022]
|
79
|
Tordjman S, Davlantis KS, Georgieff N, Geoffray MM, Speranza M, Anderson GM, Xavier J, Botbol M, Oriol C, Bellissant E, Vernay-Leconte J, Fougerou C, Hespel A, Tavenard A, Cohen D, Kermarrec S, Coulon N, Bonnot O, Dawson G. Autism as a disorder of biological and behavioral rhythms: toward new therapeutic perspectives. Front Pediatr 2015; 3:1. [PMID: 25756039 PMCID: PMC4337381 DOI: 10.3389/fped.2015.00001] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/05/2015] [Indexed: 12/13/2022] Open
Abstract
There is a growing interest in the role of biological and behavioral rhythms in typical and atypical development. Recent studies in cognitive and developmental psychology have highlighted the importance of rhythmicity and synchrony of motor, emotional, and interpersonal rhythms in early development of social communication. The synchronization of rhythms allows tuning and adaptation to the external environment. The role of melatonin in the ontogenetic establishment of circadian rhythms and the synchronization of the circadian clocks network suggests that this hormone might be also involved in the synchrony of motor, emotional, and interpersonal rhythms. Autism provides a challenging model of physiological and behavioral rhythm disturbances and their possible effects on the development of social communication impairments and repetitive behaviors and interests. This article situates autism as a disorder of biological and behavioral rhythms and reviews the recent literature on the role of rhythmicity and synchrony of rhythms in child development. Finally, the hypothesis is developed that an integrated approach focusing on biological, motor, emotional, and interpersonal rhythms may open interesting therapeutic perspectives for children with autism. More specifically, promising avenues are discussed for potential therapeutic benefits in autism spectrum disorder of melatonin combined with developmental behavioral interventions that emphasize synchrony, such as the Early Start Denver Model.
Collapse
Affiliation(s)
- Sylvie Tordjman
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, UMR 8158 , Paris , France ; Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, Université de Rennes 1 , Rennes , France
| | - Katherine S Davlantis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham, NC , USA
| | - Nicolas Georgieff
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Le Vinatier , Lyon , France
| | - Marie-Maude Geoffray
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Le Vinatier , Lyon , France
| | - Mario Speranza
- Department of Child and Adolescent Psychiatry, Centre Hospitalier de Versailles, Université de Versailles Saint-Quentin-en-Yvelines , Le Chensay , France
| | - George M Anderson
- Child Study Center, Yale University School of Medicine , New Haven, CT , USA
| | - Jean Xavier
- Department of Child and Adolescent Psychiatry, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, CNRS FRE 2987, University Pierre and Marie Curie , Paris , France
| | - Michel Botbol
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, UMR 8158 , Paris , France ; Service Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Brest, Université de Bretagne Occidentale , Brest , France
| | - Cécile Oriol
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, Université de Rennes 1 , Rennes , France
| | - Eric Bellissant
- Clinical Investigation Center, INSERM CIC 0203, University Hospital, Rennes 1 University , Rennes , France ; Department of Clinical Pharmacology, University Hospital, Rennes 1 University , Rennes , France
| | - Julie Vernay-Leconte
- Pôle Hospitalo-Universitaire de Psychiatrie Adulte (PHUPA), Centre Hospitalier Guillaume Régnier, Université de Rennes 1 , Rennes , France
| | - Claire Fougerou
- Clinical Investigation Center, INSERM CIC 0203, University Hospital, Rennes 1 University , Rennes , France ; Department of Clinical Pharmacology, University Hospital, Rennes 1 University , Rennes , France
| | - Anne Hespel
- Clinical Investigation Center, INSERM CIC 0203, University Hospital, Rennes 1 University , Rennes , France ; Department of Clinical Pharmacology, University Hospital, Rennes 1 University , Rennes , France
| | - Aude Tavenard
- Clinical Investigation Center, INSERM CIC 0203, University Hospital, Rennes 1 University , Rennes , France ; Department of Clinical Pharmacology, University Hospital, Rennes 1 University , Rennes , France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, CNRS FRE 2987, University Pierre and Marie Curie , Paris , France
| | - Solenn Kermarrec
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, UMR 8158 , Paris , France ; Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, Université de Rennes 1 , Rennes , France
| | - Nathalie Coulon
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, UMR 8158 , Paris , France
| | - Olivier Bonnot
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, UMR 8158 , Paris , France
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham, NC , USA
| |
Collapse
|
80
|
Cohen S, Conduit R, Lockley SW, Rajaratnam SMW, Cornish KM. The relationship between sleep and behavior in autism spectrum disorder (ASD): a review. J Neurodev Disord 2014; 6:44. [PMID: 25530819 PMCID: PMC4271434 DOI: 10.1186/1866-1955-6-44] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/26/2014] [Indexed: 01/27/2024] Open
Abstract
Although there is evidence that significant sleep problems are common in children with autism spectrum disorder (ASD) and that poor sleep exacerbates problematic daytime behavior, such relationships have received very little attention in both research and clinical practice. Treatment guidelines to help manage challenging behaviors in ASD fail to mention sleep at all, or they present a very limited account. Moreover, limited attention is given to children with low-functioning autism, those individuals who often experience the most severe sleep disruption and behavioral problems. This paper describes the nature of sleep difficulties in ASD and highlights the complexities of sleep disruption in individuals with low-functioning autism. It is proposed that profiling ASD children based on the nature of their sleep disruption might help to understand symptom and behavioral profiles (or vice versa) and therefore lead to better-targeted interventions. This paper concludes with a discussion of the limitations of current knowledge and proposes areas that are important for future research. Treating disordered sleep in ASD has great potential to improve daytime behavior and family functioning in this vulnerable population.
Collapse
Affiliation(s)
- Simonne Cohen
- />School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Melbourne, Australia
| | - Russell Conduit
- />School of Health Sciences, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Steven W Lockley
- />School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Melbourne, Australia
- />Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, USA
- />Division of Sleep Medicine, Harvard Medical School, Boston, USA
| | - Shantha MW Rajaratnam
- />School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Melbourne, Australia
- />Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, USA
- />Division of Sleep Medicine, Harvard Medical School, Boston, USA
| | - Kim M Cornish
- />School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Melbourne, Australia
| |
Collapse
|
81
|
Tordjman S, Anderson GM, Kermarrec S, Bonnot O, Geoffray MM, Brailly-Tabard S, Chaouch A, Colliot I, Trabado S, Bronsard G, Coulon N, Botbol M, Charbuy H, Camus F, Touitou Y. Altered circadian patterns of salivary cortisol in low-functioning children and adolescents with autism. Psychoneuroendocrinology 2014; 50:227-45. [PMID: 25244637 DOI: 10.1016/j.psyneuen.2014.08.010] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 08/14/2014] [Accepted: 08/18/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Reports of higher stress responsivity, altered sleep-wake cycle and a melatonin deficit in autism have stimulated interest in the cortisol circadian rhythm in individuals with autism. METHODS The study was conducted on 55 low-functioning children and adolescents with autism (11.3 ± 4.1 years-old) and 32 typically developing controls (11.7 ± 4.9 years-old) matched for age, sex and puberty. Behavioral assessment was performed using the Autism Diagnostic Observation Schedule (ADOS). Salivary samples for measurement of cortisol were collected during a 24-h period (at least 0800 h-Day 1, 1600 h, 0800 h-Day 2 for 46 individuals with autism and 27 controls, and 0800 h-Day 1, 1100 h, 1600 h, 2400 h, 0800 h-Day 2 for 13 individuals with autism and 20 controls). Overnight (2000 h-0800 h) urinary cortisol excretion was also measured. RESULTS The autism group displayed significantly higher levels of salivary cortisol at all time-points, flatter daytime and nighttime slopes, higher 0800 h cortisol levels on Day 2 compared to Day 1, and greater variances of salivary and urinary cortisol. There was a significant relationship between salivary cortisol levels and impairments in social interaction and verbal language. Overnight urinary cortisol excretion was similar in the autism and control groups. CONCLUSION Anticipation of the stressful collection procedure appears to contribute to the higher 0800 h-Day 2 versus 0800 h-Day 1 salivary cortisol levels in autism. This sensitization to stressors might be as, or even more, important clinically than exposure to novelty in autism. The similar group means for overnight urinary cortisol excretion indicate that basal HPA axis functioning is unaltered in low-functioning autism. The elevated salivary cortisol levels observed in autism over the 24-h period in a repeated stressful condition, flattened diurnal cortisol patterns and the apparent effect of anticipation are consistent with prior findings in high trait anxiety.
Collapse
Affiliation(s)
- Sylvie Tordjman
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (PHUPEA), CHGR et Université de Rennes 1, Rennes, France; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France.
| | - George M Anderson
- Child Study Center, Yale University School of Medicine, New-Haven, CT, USA
| | - Solenn Kermarrec
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (PHUPEA), CHGR et Université de Rennes 1, Rennes, France; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France
| | - Olivier Bonnot
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Nantes, Nantes, France
| | - Marie-Maude Geoffray
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital le Vinatier, Bron, France
| | - Sylvie Brailly-Tabard
- INSERM U 693, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Amel Chaouch
- AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Isabelle Colliot
- AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Severine Trabado
- INSERM U 693, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Guillaume Bronsard
- Maison Départementale de l'Adolescent et Centre Médico-Psycho-Pédagogique, Conseil Général des Bouches-du-Rhône, France; Laboratoire de Santé Publique EA3279, Faculté de Médecine de Marseille, France
| | - Nathalie Coulon
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France
| | - Michel Botbol
- Service Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Brest, EA4686, UBO, Brest, France
| | - Henriette Charbuy
- Medical Biochemistry and Molecular Biology, Paris 6 School of Medicine, Paris, France
| | | | - Yvan Touitou
- Chronobiology Unit, Rothschild Foundation, Paris, France
| |
Collapse
|
82
|
Mullegama SV, Pugliesi L, Burns B, Shah Z, Tahir R, Gu Y, Nelson DL, Elsea SH. MBD5 haploinsufficiency is associated with sleep disturbance and disrupts circadian pathways common to Smith-Magenis and fragile X syndromes. Eur J Hum Genet 2014; 23:781-9. [PMID: 25271084 DOI: 10.1038/ejhg.2014.200] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/23/2014] [Accepted: 08/26/2014] [Indexed: 11/09/2022] Open
Abstract
Individuals with autism spectrum disorders (ASD) who have an identifiable single-gene neurodevelopmental disorder (NDD), such as fragile X syndrome (FXS, FMR1), Smith-Magenis syndrome (SMS, RAI1), or 2q23.1 deletion syndrome (del 2q23.1, MBD5) share phenotypic features, including a high prevalence of sleep disturbance. We describe the circadian deficits in del 2q23.1 through caregiver surveys in which we identify several frequent sleep anomalies, including night/early awakenings, coughing/snoring loudly, and difficulty falling asleep. We couple these findings with studies on the molecular analysis of the circadian deficits associated with haploinsufficiency of MBD5 in which circadian gene mRNA levels of NR1D2, PER1, PER2, and PER3 were altered in del 2q23.1 lymphoblastoid cell lines (LCLs), signifying that haploinsufficiency of MBD5 can result in dysregulation of circadian rhythm gene expression. These findings were further supported by expression microarrays of MBD5 siRNA knockdown cells that showed significantly altered expression of additional circadian rhythm signaling pathway genes. Based on the common sleep phenotypes observed in del 2q23.1, SMS, and FXS patients, we explored the possibility that MBD5, RAI1, and FMR1 function in overlapping circadian rhythm pathways. Bioinformatic analysis identified conserved putative E boxes in MBD5 and RAI1, and expression levels of NR1D2 and CRY2 were significantly reduced in patient LCLs. Circadian and mTOR signaling pathways, both associated with sleep disturbance, were altered in both MBD5 and RAI1 knockdown microarray data, overlapping with findings associated with FMR1. These data support phenotypic and molecular overlaps across these syndromes that may be exploited to provide therapeutic intervention for multiple disorders.
Collapse
Affiliation(s)
- Sureni V Mullegama
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Loren Pugliesi
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Brooke Burns
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Zalak Shah
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Raiha Tahir
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Yanghong Gu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - David L Nelson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Sarah H Elsea
- 1] Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA [2] Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| |
Collapse
|
83
|
Cusmano DM, Mong JA. In utero exposure to valproic acid changes sleep in juvenile rats: a model for sleep disturbances in autism. Sleep 2014; 37:1489-99. [PMID: 25142574 DOI: 10.5665/sleep.3998] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
STUDY OBJECTIVES To determine whether sleep disturbances are found in the valproic acid model of autism spectrum disorders (ASD). DESIGN Comparative study for sleep behavior, sleep architecture, electroencephalogram (EEG) spectral analysis, and glutamic acid decarboxylase (GAD) 65/67 protein expression in juvenile rats exposed to valproic acid (VPA), sodium salt, or saline in utero. SETTING N/A. PARTICIPANTS Juvenile (postnatal day 32) male and female Sprague-Dawley rats. INTERVENTIONS In utero exposure to either saline or 400 mg/kg VPA administered intraperitoneally to the dams on gestational day 12.5. On postnatal days 22-24, all rats were implanted with transmitters to record EEG and electromyogram (EMG) activity. MEASUREMENTS AND RESULTS During the light phase, when nocturnal animals are typically quiescent, the VPA-exposed animals spent significantly more time in wake (∼35 min) and significantly less time in non-rapid eye movement (NREM) sleep (∼26 min) compared to the saline controls. Furthermore, spectral analysis of the EEG revelled that VPA-exposed animals exhibited increased high-frequency activity during wake and rapid eye movement (REM) sleep and reduced theta power across all vigilance states. Interestingly, the gamma-aminobutyric acid (GABA)-ergic system, which modulates the induction and maintenance of sleep states, was also disrupted, with reduced levels of both GAD 65 and GAD67 in the cortical tissue of VPA-exposed animals compared to saline controls. CONCLUSIONS To date, the current animal models of ASD have been underutilized in the investigation of associated sleep disturbances. The VPA animal model recapitulates aspects of sleep disruptions reported clinically, providing a tool to investigate cellular and molecular dysregulation contributing to sleep disruptions in ASD.
Collapse
|
84
|
Gannon RL. Non-peptide oxytocin receptor ligands and hamster circadian wheel running rhythms. Brain Res 2014; 1585:184-90. [PMID: 25148710 DOI: 10.1016/j.brainres.2014.08.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/01/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
Abstract
The synchronization of circadian rhythms in sleep, endocrine and metabolic functions with the environmental light cycle is essential for health, and dysfunction of this synchrony is thought to play a part in the development of many neurological disorders. There is a demonstrable need to develop new therapeutics for the treatment of neurological disorders such as depression and schizophrenia, and oxytocin is currently being investigated for this purpose. There are no published reports describing activity of oxytocin receptor ligands on mammalian circadian rhythms and that, then, is the purpose of this study. Non-peptide oxytocin receptor ligands that cross the blood brain barrier were systemically injected in hamsters to determine their ability to modulate light-induced phase advances and delays of circadian wheel running rhythms. The oxytocin receptor agonist WAY267464 (10 mg/kg) inhibited light induced phase advances of wheel running rhythms by 55%, but had no effect on light-induced phase delays. In contrast, the oxytocin receptor antagonist WAY162720 (10 mg/kg) inhibited light-induced phase delays by nearly 75%, but had no effect on light-induced phase advances. Additionally, WAY162720 was able to antagonize the inhibitory effects of WAY267464 on light-induced phase advances. These results are consistent for a role of oxytocin in the phase-delaying effects of light on circadian activity rhythms early in the night. Therefore, oxytocin may prove to be useful in developing therapeutics for the treatment of mood disorders with a concomitant dysfunction in circadian rhythms. Investigators should also be cognizant that oxytocin ligands may negatively affect circadian rhythms during clinical trials for other conditions.
Collapse
Affiliation(s)
- Robert L Gannon
- Department of Biology, Valdosta State University, Valdosta, GA 31698, USA.
| |
Collapse
|
85
|
Pet-1 deficiency alters the circadian clock and its temporal organization of behavior. PLoS One 2014; 9:e97412. [PMID: 24831114 PMCID: PMC4022518 DOI: 10.1371/journal.pone.0097412] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/18/2014] [Indexed: 11/20/2022] Open
Abstract
The serotonin and circadian systems are two important interactive regulatory networks in the mammalian brain that regulate behavior and physiology in ways that are known to impact human mental health. Previous work on the interaction between these two systems suggests that serotonin modulates photic input to the central circadian clock (the suprachiasmatic nuclei; SCN) from the retina and serves as a signal for locomotor activity, novelty, and arousal to shift the SCN clock, but effects of disruption of serotonergic signaling from the raphe nuclei on circadian behavior and on SCN function are not fully characterized. In this study, we examined the effects on diurnal and circadian behavior, and on ex vivo molecular rhythms of the SCN, of genetic deficiency in Pet-1, an ETS transcription factor that is necessary to establish and maintain the serotonergic phenotype of raphe neurons. Pet-1−/− mice exhibit loss of rhythmic behavioral coherence and an extended daily activity duration, as well as changes in the molecular rhythms expressed by the clock, such that ex vivo SCN from Pet-1−/− mice exhibit period lengthening and sex-dependent changes in rhythmic amplitude. Together, our results indicate that Pet-1 regulation of raphe neuron serotonin phenotype contributes to the period, precision and light/dark partitioning of locomotor behavioral rhythms by the circadian clock through direct actions on the SCN clock itself, as well as through non-clock effects.
Collapse
|
86
|
Michetti C, Romano E, Altabella L, Caruso A, Castelluccio P, Bedse G, Gaetani S, Canese R, Laviola G, Scattoni ML. Mapping pathological phenotypes in reelin mutant mice. Front Pediatr 2014; 2:95. [PMID: 25237666 PMCID: PMC4154529 DOI: 10.3389/fped.2014.00095] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 08/21/2014] [Indexed: 11/20/2022] Open
Abstract
Autism Spectrum Disorders (ASD) are neurodevelopmental disorders with multifactorial origin characterized by social communication deficits and the presence of repetitive behaviors/interests. Several studies showed an association between the reelin gene mutation and increased risk of ASD and a reduced reelin expression in some brain regions of ASD subjects, suggesting a role for reelin deficiency in ASD etiology. Reelin is a large extracellular matrix glycoprotein playing important roles during development of the central nervous system. To deeply investigate the role of reelin dysfunction as vulnerability factor in ASD, we assessed the behavioral, neurochemical, and brain morphological features of reeler male mice. We recently reported a genotype-dependent deviation in the ultrasonic vocal repertoire and a general delay in motor development of reeler pups. We now report that adult male heterozygous (Het) reeler mice did not show social behavior and communication deficits during male-female social interactions. Wildtype and Het mice showed a typical light/dark locomotor activity profile, with a peak during the central interval of the dark phase. However, when faced with a mild stressful stimulus (a saline injection) only Het mice showed an over response to stress. In addition to the behavioral studies, we conducted high performance liquid chromatography and magnetic resonance imaging and spectroscopy to investigate whether reelin mutation influences brain monoamine and metabolites levels in regions involved in ASD. Low levels of dopamine in cortex and high levels of glutamate and taurine in hippocampus were detected in Het mice, in line with clinical data collected on ASD children. Altogether, our data detected subtle but relevant neurochemical abnormalities in reeler mice supporting this mutant line, particularly male subjects, as a valid experimental model to estimate the contribution played by reelin deficiency in the global ASD neurobehavioral phenotype.
Collapse
Affiliation(s)
- Caterina Michetti
- Neurotoxicology and Neuroendocrinology Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy ; Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome , Rome , Italy
| | - Emilia Romano
- Behavioural Neuroscience Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy ; Bambino Gesù Children's Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico , Rome , Italy
| | - Luisa Altabella
- Molecular and Cellular Imaging Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy
| | - Angela Caruso
- Neurotoxicology and Neuroendocrinology Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy ; Department of Psychology, School of Behavioural Neuroscience, Sapienza University of Rome , Rome , Italy
| | - Paolo Castelluccio
- Neurotoxicology and Neuroendocrinology Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy
| | - Gaurav Bedse
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome , Rome , Italy
| | - Silvana Gaetani
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome , Rome , Italy
| | - Rossella Canese
- Molecular and Cellular Imaging Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy
| | - Giovanni Laviola
- Behavioural Neuroscience Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy
| | - Maria Luisa Scattoni
- Neurotoxicology and Neuroendocrinology Section, Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità , Rome , Italy
| |
Collapse
|
87
|
Paemka L, Mahajan VB, Skeie JM, Sowers LP, Ehaideb SN, Gonzalez-Alegre P, Sasaoka T, Tao H, Miyagi A, Ueno N, Takao K, Miyakawa T, Wu S, Darbro BW, Ferguson PJ, Pieper AA, Britt JK, Wemmie JA, Rudd DS, Wassink T, El-Shanti H, Mefford HC, Carvill GL, Manak JR, Bassuk AG. PRICKLE1 interaction with SYNAPSIN I reveals a role in autism spectrum disorders. PLoS One 2013; 8:e80737. [PMID: 24312498 PMCID: PMC3849077 DOI: 10.1371/journal.pone.0080737] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 10/04/2013] [Indexed: 11/18/2022] Open
Abstract
The frequent comorbidity of Autism Spectrum Disorders (ASDs) with epilepsy suggests a shared underlying genetic susceptibility; several genes, when mutated, can contribute to both disorders. Recently, PRICKLE1 missense mutations were found to segregate with ASD. However, the mechanism by which mutations in this gene might contribute to ASD is unknown. To elucidate the role of PRICKLE1 in ASDs, we carried out studies in Prickle1(+/-) mice and Drosophila, yeast, and neuronal cell lines. We show that mice with Prickle1 mutations exhibit ASD-like behaviors. To find proteins that interact with PRICKLE1 in the central nervous system, we performed a yeast two-hybrid screen with a human brain cDNA library and isolated a peptide with homology to SYNAPSIN I (SYN1), a protein involved in synaptogenesis, synaptic vesicle formation, and regulation of neurotransmitter release. Endogenous Prickle1 and Syn1 co-localize in neurons and physically interact via the SYN1 region mutated in ASD and epilepsy. Finally, a mutation in PRICKLE1 disrupts its ability to increase the size of dense-core vesicles in PC12 cells. Taken together, these findings suggest PRICKLE1 mutations contribute to ASD by disrupting the interaction with SYN1 and regulation of synaptic vesicles.
Collapse
Affiliation(s)
- Lily Paemka
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Program in Genetics, The University of Iowa, Iowa City, Iowa, United States of America
| | - Vinit B. Mahajan
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
| | - Jessica M. Skeie
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa, United States of America
| | - Levi P. Sowers
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
| | - Salleh N. Ehaideb
- The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Program in Genetics, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Biology, The University of Iowa, Iowa City, Iowa, United States of America
| | - Pedro Gonzalez-Alegre
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Graduate Program of Neuroscience, The University of Iowa, Iowa City, Iowa, United States of America
| | - Toshikuni Sasaoka
- Center for Bioresources, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hirotaka Tao
- Hospital for Sick Kids, University of Toronto, Toronto, Canada
| | - Asuka Miyagi
- Developmental Biology Department, National Institute for Basic Biology, Okazaki City, Japan
| | - Naoto Ueno
- Developmental Biology Department, National Institute for Basic Biology, Okazaki City, Japan
| | - Keizo Takao
- Section of Behavior Patterns, Center for Genetic Analysis of Behavior National Institute for Physiological Sciences, Okazaki, Japan
- Japan Science and Technology Agency, Kawaguchi-shi, Japan
| | - Tsuyoshi Miyakawa
- Section of Behavior Patterns, Center for Genetic Analysis of Behavior National Institute for Physiological Sciences, Okazaki, Japan
- Japan Science and Technology Agency, Kawaguchi-shi, Japan
- Division of Systems Medical Science, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan
| | - Shu Wu
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
| | - Benjamin W. Darbro
- The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pathology, The University of Iowa, Iowa City, Iowa, United States of America
| | - Polly J. Ferguson
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
| | - Andrew A. Pieper
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Jeremiah K. Britt
- The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - John A. Wemmie
- The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Graduate Program of Neuroscience, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Danielle S. Rudd
- The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Program in Genetics, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Thomas Wassink
- The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Hatem El-Shanti
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Shafallah Medical Genetics Center, Doha, Qatar
| | - Heather C. Mefford
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - Gemma L. Carvill
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - J. Robert Manak
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Program in Genetics, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Biology, The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Graduate Program in Molecular and Cellular Biology, The University of Iowa, Iowa City, Iowa, United States of America
| | - Alexander G. Bassuk
- The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Program in Genetics, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
- Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States of America
- Interdisciplinary Graduate Program in Molecular and Cellular Biology, The University of Iowa, Iowa City, Iowa, United States of America
| |
Collapse
|
88
|
Dennis M, Spiegler BJ, Juranek JJ, Bigler ED, Snead OC, Fletcher JM. Age, plasticity, and homeostasis in childhood brain disorders. Neurosci Biobehav Rev 2013; 37:2760-73. [PMID: 24096190 PMCID: PMC3859812 DOI: 10.1016/j.neubiorev.2013.09.010] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 07/29/2013] [Accepted: 09/19/2013] [Indexed: 12/26/2022]
Abstract
It has been widely accepted that the younger the age and/or immaturity of the organism, the greater the brain plasticity, the young age plasticity privilege. This paper examines the relation of a young age to plasticity, reviewing human pediatric brain disorders, as well as selected animal models, human developmental and adult brain disorder studies. As well, we review developmental and childhood acquired disorders that involve a failure of regulatory homeostasis. Our core arguments are as follows:
Collapse
Affiliation(s)
- Maureen Dennis
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1X8, Canada.
| | | | | | | | | | | |
Collapse
|
89
|
Tordjman S, Najjar I, Bellissant E, Anderson GM, Barburoth M, Cohen D, Jaafari N, Schischmanoff O, Fagard R, Lagdas E, Kermarrec S, Ribardiere S, Botbol M, Fougerou C, Bronsard G, Vernay-Leconte J. Advances in the research of melatonin in autism spectrum disorders: literature review and new perspectives. Int J Mol Sci 2013; 14:20508-42. [PMID: 24129182 PMCID: PMC3821628 DOI: 10.3390/ijms141020508] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 09/03/2013] [Accepted: 09/13/2013] [Indexed: 12/31/2022] Open
Abstract
Abnormalities in melatonin physiology may be involved or closely linked to the pathophysiology and behavioral expression of autistic disorder, given its role in neurodevelopment and reports of sleep-wake rhythm disturbances, decreased nocturnal melatonin production, and beneficial therapeutic effects of melatonin in individuals with autism. In addition, melatonin, as a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. More specifically, the role of melatonin in the ontogenetic establishment of circadian rhythms and the synchronization of peripheral oscillators opens interesting perspectives to ascertain better the mechanisms underlying the significant relationship found between lower nocturnal melatonin excretion and increased severity of autistic social communication impairments, especially for verbal communication and social imitative play. In this article, first we review the studies on melatonin levels and the treatment studies of melatonin in autistic disorder. Then, we discuss the relationships between melatonin and autistic behavioral impairments with regard to social communication (verbal and non-verbal communication, social interaction), and repetitive behaviors or interests with difficulties adapting to change. In conclusion, we emphasize that randomized clinical trials in autism spectrum disorders are warranted to establish potential therapeutic efficacy of melatonin for social communication impairments and stereotyped behaviors or interests.
Collapse
Affiliation(s)
- Sylvie Tordjman
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France; E-Mails: (I.N.); (E.L.); (S.K.); (S.R.); (J.V.-L.)
- Laboratory of Psychology of Perception, CNRS UMR 8158, Paris 75270, France; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +33-6-15-38-07-48; Fax: +33-2-99-64-18-07
| | - Imen Najjar
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France; E-Mails: (I.N.); (E.L.); (S.K.); (S.R.); (J.V.-L.)
| | - Eric Bellissant
- Inserm CIC 0203 Clinical Investigation Centre, University Hospital, Rennes 1 University, Rennes 35033, France; E-Mails: (E.B.); (C.F.)
- Department of Clinical Pharmacology, University Hospital, Rennes 1 University, Rennes 35033, France
| | - George M. Anderson
- Laboratory of Developmental Neurochemistry, Yale Child Study Center, New Haven, CT 06519, USA; E-Mail:
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Marianne Barburoth
- Laboratory of Psychology of Perception, CNRS UMR 8158, Paris 75270, France; E-Mail:
| | - David Cohen
- Hospital-University Department of Child and Adolescent Psychiatry, Pitié-SalpétrièreHospital, Paris 6 University, Paris 75013, France; E-Mail:
| | - Nemat Jaafari
- CIC INSERM U 802, CHU de Poitiers, Unité de recherche clinique intersectorielle en psychiatrie du Centre Hospitalier Henri Laborit, Poitiers 86022, France; E-Mail:
| | - Olivier Schischmanoff
- INSERM UMR U978, University of Paris 13, Bobigny 93009, France; E-Mails: (O.S.); (R.F.)
- Laboratoire de Biochimie et Biologie Moléculaire, Hôpital Avicenne, APHP, Bobigny 93009, France
| | - Rémi Fagard
- INSERM UMR U978, University of Paris 13, Bobigny 93009, France; E-Mails: (O.S.); (R.F.)
- Laboratoire de Biochimie et Biologie Moléculaire, Hôpital Avicenne, APHP, Bobigny 93009, France
| | - Enas Lagdas
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France; E-Mails: (I.N.); (E.L.); (S.K.); (S.R.); (J.V.-L.)
| | - Solenn Kermarrec
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France; E-Mails: (I.N.); (E.L.); (S.K.); (S.R.); (J.V.-L.)
| | - Sophie Ribardiere
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France; E-Mails: (I.N.); (E.L.); (S.K.); (S.R.); (J.V.-L.)
| | - Michel Botbol
- Service Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent de Brest, UBO, Brest 29238, France; E-Mail:
| | - Claire Fougerou
- Inserm CIC 0203 Clinical Investigation Centre, University Hospital, Rennes 1 University, Rennes 35033, France; E-Mails: (E.B.); (C.F.)
- Department of Clinical Pharmacology, University Hospital, Rennes 1 University, Rennes 35033, France
| | - Guillaume Bronsard
- Maison Départementale de l’Adolescent et Centre Médico-Psycho-Pédagogique, Conseil Général des Bouches-du-Rhône; Laboratoire de Santé Publique EA3279, Faculté de Médecine de la Timone, Marseille 13256, France; E-Mail:
| | - Julie Vernay-Leconte
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes 35000, France; E-Mails: (I.N.); (E.L.); (S.K.); (S.R.); (J.V.-L.)
| |
Collapse
|
90
|
Sarachana T, Hu VW. Differential recruitment of coregulators to the RORA promoter adds another layer of complexity to gene (dys) regulation by sex hormones in autism. Mol Autism 2013; 4:39. [PMID: 24119295 PMCID: PMC4016566 DOI: 10.1186/2040-2392-4-39] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 09/19/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Our independent cohort studies have consistently shown the reduction of the nuclear receptor RORA (retinoic acid-related orphan receptor-alpha) in lymphoblasts as well as in brain tissues from individuals with autism spectrum disorder (ASD). Moreover, we have found that RORA regulates the gene for aromatase, which converts androgen to estrogen, and that male and female hormones regulate RORA in opposite directions, with androgen suppressing RORA, suggesting that the sexually dimorphic regulation of RORA may contribute to the male bias in ASD. However, the molecular mechanisms through which androgen and estrogen differentially regulate RORA are still unknown. METHODS Here we use functional knockdown of hormone receptors and coregulators with small interfering RNA (siRNA) to investigate their involvement in sex hormone regulation of RORA in human neuronal cells. Luciferase assays using a vector containing various RORA promoter constructs were first performed to identify the promoter regions required for inverse regulation of RORA by male and female hormones. Sequential chromatin immunoprecipitation methods followed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) analyses of RORA expression in hormone-treated SH-SY5Y cells were then utilized to identify coregulators that associate with hormone receptors on the RORA promoter. siRNA-mediated knockdown of interacting coregulators was performed followed by qRT-PCR analyses to confirm the functional requirement of each coregulator in hormone-regulated RORA expression. RESULTS Our studies demonstrate the direct involvement of androgen receptor (AR) and estrogen receptor (ER) in the regulation of RORA by male and female hormones, respectively, and that the promoter region between -10055 bp and -2344 bp from the transcription start site of RORA is required for the inverse hormonal regulation. We further show that AR interacts with SUMO1, a reported suppressor of AR transcriptional activity, whereas ERα interacts with the coactivator NCOA5 on the RORA promoter. siRNA-mediated knockdown of SUMO1 and NCOA5 attenuate the sex hormone effects on RORA expression. CONCLUSIONS AR and SUMO1 are involved in the suppression RORA expression by androgen, while ERα and NCOA5 collaborate in the up-regulation of RORA by estrogen. While this study offers a better understanding of molecular mechanisms involved in sex hormone regulation of RORA, it also reveals another layer of complexity with regard to gene regulation in ASD. Inasmuch as coregulators are capable of interacting with a multitude of transcription factors, aberrant expression of coregulator proteins, as we have seen previously in lymphoblasts from individuals with ASD, may contribute to the polygenic nature of gene dysregulation in ASD.
Collapse
Affiliation(s)
- Tewarit Sarachana
- Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20037, USA.
| | | |
Collapse
|
91
|
Torres EB, Brincker M, Isenhower RW, Yanovich P, Stigler KA, Nurnberger JI, Metaxas DN, José JV. Autism: the micro-movement perspective. Front Integr Neurosci 2013; 7:32. [PMID: 23898241 PMCID: PMC3721360 DOI: 10.3389/fnint.2013.00032] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 04/21/2013] [Indexed: 11/13/2022] Open
Abstract
The current assessment of behaviors in the inventories to diagnose autism spectrum disorders (ASD) focus on observation and discrete categorizations. Behaviors require movements, yet measurements of physical movements are seldom included. Their inclusion however, could provide an objective characterization of behavior to help unveil interactions between the peripheral and the central nervous systems (CNSs). Such interactions are critical for the development and maintenance of spontaneous autonomy, self-regulation, and voluntary control. At present, current approaches cannot deal with the heterogeneous, dynamic and stochastic nature of development. Accordingly, they leave no avenues for real time or longitudinal assessments of change in a coping system continuously adapting and developing compensatory mechanisms. We offer a new unifying statistical framework to reveal re-afferent kinesthetic features of the individual with ASD. The new methodology is based on the non-stationary stochastic patterns of minute fluctuations (micro-movements) inherent to our natural actions. Such patterns of behavioral variability provide re-entrant sensory feedback contributing to the autonomous regulation and coordination of the motor output. From an early age, this feedback supports centrally driven volitional control and fluid, flexible transitions between intentional and spontaneous behaviors. We show that in ASD there is a disruption in the maturation of this form of proprioception. Despite this disturbance, each individual has unique adaptive compensatory capabilities that we can unveil and exploit to evoke faster and more accurate decisions. Measuring the kinesthetic re-afference in tandem with stimuli variations we can detect changes in their micro-movements indicative of a more predictive and reliable kinesthetic percept. Our methods address the heterogeneity of ASD with a personalized approach grounded in the inherent sensory-motor abilities that the individual has already developed.
Collapse
Affiliation(s)
- Elizabeth B Torres
- Psychology Department, Rutgers Center for Cognitive Science, Center for Computational Biomedicine Imaging and Modeling (Computer Science), Movement Disorders, Neurology, Rutgers University School of Medicine, Rutgers University New Brunswick, NJ, USA ; Movement Disorders, Neurology Department, Indiana University School of Medicine Indianapolis, IN, USA
| | | | | | | | | | | | | | | |
Collapse
|
92
|
Torres EB, Isenhower RW, Yanovich P, Rehrig G, Stigler K, Nurnberger J, José JV. Strategies to develop putative biomarkers to characterize the female phenotype with autism spectrum disorders. J Neurophysiol 2013; 110:1646-62. [PMID: 23864377 DOI: 10.1152/jn.00059.2013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Current observational inventories used to diagnose autism spectrum disorders (ASD) apply similar criteria to females and males alike, despite developmental differences between the sexes. Recent work investigating the chronology of diagnosis in ASD has raised the concern that females run the risk of receiving a delayed diagnosis, potentially missing a window of opportunity for early intervention. Here, we retake this issue in the context of the objective measurements of natural behaviors that involve decision-making processes. Within this context, we quantified movement variability in typically developing (TD) individuals and those diagnosed with ASD across different ages. We extracted the latencies of the decision movements and velocity-dependent parameters as the hand movements unfolded for two movement segments within the reach: movements intended toward the target and withdrawing movements that spontaneously, without instruction, occurred incidentally. The stochastic signatures of the movement decision latencies and the percent of time to maximum speed differed between males and females with ASD. This feature was also observed in the empirically estimated probability distributions of the maximum speed values, independent of limb size. Females with ASD showed different dispersion than males with ASD. The distinctions found for females with ASD were better appreciated compared with those of TD females. In light of these results, behavioral assessment of autistic traits in females should be performed relative to TD females to increase the chance of detection.
Collapse
|
93
|
Impairment of cortical GABAergic synaptic transmission in an environmental rat model of autism. Int J Neuropsychopharmacol 2013; 16:1309-18. [PMID: 23228615 PMCID: PMC3674140 DOI: 10.1017/s1461145712001216] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The biological mechanisms of autism spectrum disorders (ASDs) are largely unknown in spite of extensive research. ASD is characterized by altered function of multiple brain areas including the temporal cortex and by an increased synaptic excitation:inhibition ratio. While numerous studies searched for evidence of increased excitation in ASD, fewer have investigated the possibility of reduced inhibition. We characterized the cortical γ-amino butyric acid (GABA)ergic system in the rat temporal cortex of an ASD model [offspring of mothers prenatally injected with valproic acid (VPA)], by monitoring inhibitory post-synaptic currents (IPSCs) with patch-clamp. We found that numerous features of inhibition were severely altered in VPA animals compared to controls. Among them were the frequency of miniature IPSCs, the rise time and decay time of electrically-evoked IPSCs, the slope and saturation of their input/output curves, as well as their modulation by adrenergic and muscarinic agonists and by the synaptic GABAA receptor allosteric modulator zolpidem (but not by the extra-synaptic modulator gaboxadol). Our data suggest that both pre- and post-synaptic, but not extra-synaptic, inhibitory transmission is impaired in the offspring of VPA-injected mothers. We speculate that impairment in the GABAergic system critically contributes to an increase in the ratio between synaptic excitation and inhibition, which in genetically predisposed individuals may alter cortical circuits responsible for emotional, communication and social impairments at the core of ASD.
Collapse
|
94
|
Amos P. Rhythm and timing in autism: learning to dance. Front Integr Neurosci 2013; 7:27. [PMID: 23626527 PMCID: PMC3630367 DOI: 10.3389/fnint.2013.00027] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 04/02/2013] [Indexed: 01/30/2023] Open
Abstract
In recent years, a significant body of research has focused on challenges to neural connectivity as a key to understanding autism. In contrast to attempts to identify a single static, primarily brain-based deficit, children and adults diagnosed with autism are increasingly perceived as out of sync with their internal and external environments in dynamic ways that must also involve operations of the peripheral nervous systems. The noisiness that seems to occur in both directions of neural flow may help explain challenges to movement and sensing, and ultimately to entrainment with circadian rhythms and social interactions across the autism spectrum, profound differences in the rhythm and timing of movement have been tracked to infancy. Difficulties with self-synchrony inhibit praxis, and can disrupt the “dance of relationship” through which caregiver and child build meaning. Different sensory aspects of a situation may fail to match up; ultimately, intentions and actions themselves may be uncoupled. This uncoupling may help explain the expressions of alienation from the actions of one's body which recur in the autobiographical autism literature. Multi-modal/cross-modal coordination of different types of sensory information into coherent events may be difficult to achieve because amodal properties (e.g., rhythm and tempo) that help unite perceptions are unreliable. One question posed to the connectivity research concerns the role of rhythm and timing in this operation, and whether these can be mobilized to reduce overload and enhance performance. A case is made for developmental research addressing how people with autism actively explore and make sense of their environments. The parent/author recommends investigating approaches such as scaffolding interactions via rhythm, following the person's lead, slowing the pace, discriminating between intentional communication and “stray” motor patterns, and organizing information through one sensory mode at a time.
Collapse
Affiliation(s)
- Pat Amos
- Training and Private Consultation Ardmore, PA, USA
| |
Collapse
|
95
|
Chiu CN, Prober DA. Regulation of zebrafish sleep and arousal states: current and prospective approaches. Front Neural Circuits 2013; 7:58. [PMID: 23576957 PMCID: PMC3620505 DOI: 10.3389/fncir.2013.00058] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 03/14/2013] [Indexed: 01/20/2023] Open
Abstract
Every day, we shift among various states of sleep and arousal to meet the many demands of our bodies and environment. A central puzzle in neurobiology is how the brain controls these behavioral states, which are essential to an animal's well-being and survival. Mammalian models have predominated sleep and arousal research, although in the past decade, invertebrate models have made significant contributions to our understanding of the genetic underpinnings of behavioral states. More recently, the zebrafish has emerged as a promising model system for sleep and arousal research. Here we review experimental evidence that the zebrafish, a diurnal vertebrate, exhibits fundamental behavioral and neurochemical characteristics of mammalian sleep and arousal. We also propose how specific advantages of the zebrafish can be harnessed to advance the field. These include tractable genetics to identify and manipulate molecular and cellular regulators of behavioral states, optical transparency to facilitate in vivo observation of neural structure and function, and amenability to high-throughput drug screens to discover novel therapies for neurological disorders.
Collapse
Affiliation(s)
| | - David A. Prober
- Division of Biology, California Institute of TechnologyPasadena, CA, USA
| |
Collapse
|
96
|
Roullet FI, Lai JKY, Foster JA. In utero exposure to valproic acid and autism--a current review of clinical and animal studies. Neurotoxicol Teratol 2013; 36:47-56. [PMID: 23395807 DOI: 10.1016/j.ntt.2013.01.004] [Citation(s) in RCA: 298] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 01/16/2023]
Abstract
Valproic acid (VPA) is both an anti-convulsant and a mood stabilizer. Clinical studies over the past 40 years have shown that exposure to VPA in utero is associated with birth defects, cognitive deficits, and increased risk of autism. Two recent FDA warnings related to use of VPA in pregnancy emphasize the need to reevaluate its use clinically during child-bearing years. The emerging clinical evidence showing a link between VPA exposure and both cognitive function and risk of autism brings to the forefront the importance of understanding how VPA exposure influences neurodevelopment. In the past 10 years, animal studies have investigated anatomical, behavioral, molecular, and physiological outcomes related to in utero VPA exposure. Behavioral studies show that VPA exposure in both rats and mice leads to autistic-like behaviors in the offspring, including social behavior deficits, increased repetitive behaviors, and deficits in communication. Based on this work VPA maternal challenge in rodents has been proposed as an animal model to study autism. This model has both face and construct validity; however, like all animal models there are limitations to its translation to the clinical setting. Here we provide a review of clinical studies that examined pregnancy outcomes of VPA use as well as the related animal studies.
Collapse
Affiliation(s)
- Florence I Roullet
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.
| | | | | |
Collapse
|
97
|
Tumiran MA, Mohamad SP, Saat RM, Mohd Yusoff MYZ, Abdul Rahman NN, Hasan Adli DS. Addressing sleep disorder of autistic children with Qur’anic sound therapy. Health (London) 2013. [DOI: 10.4236/health.2013.58a2011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
98
|
Millan MJ. An epigenetic framework for neurodevelopmental disorders: from pathogenesis to potential therapy. Neuropharmacology 2012; 68:2-82. [PMID: 23246909 DOI: 10.1016/j.neuropharm.2012.11.015] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 11/11/2012] [Accepted: 11/22/2012] [Indexed: 12/12/2022]
Abstract
Neurodevelopmental disorders (NDDs) are characterized by aberrant and delayed early-life development of the brain, leading to deficits in language, cognition, motor behaviour and other functional domains, often accompanied by somatic symptoms. Environmental factors like perinatal infection, malnutrition and trauma can increase the risk of the heterogeneous, multifactorial and polygenic disorders, autism and schizophrenia. Conversely, discrete genetic anomalies are involved in Down, Rett and Fragile X syndromes, tuberous sclerosis and neurofibromatosis, the less familiar Phelan-McDermid, Sotos, Kleefstra, Coffin-Lowry and "ATRX" syndromes, and the disorders of imprinting, Angelman and Prader-Willi syndromes. NDDs have been termed "synaptopathies" in reference to structural and functional disturbance of synaptic plasticity, several involve abnormal Ras-Kinase signalling ("rasopathies"), and many are characterized by disrupted cerebral connectivity and an imbalance between excitatory and inhibitory transmission. However, at a different level of integration, NDDs are accompanied by aberrant "epigenetic" regulation of processes critical for normal and orderly development of the brain. Epigenetics refers to potentially-heritable (by mitosis and/or meiosis) mechanisms controlling gene expression without changes in DNA sequence. In certain NDDs, prototypical epigenetic processes of DNA methylation and covalent histone marking are impacted. Conversely, others involve anomalies in chromatin-modelling, mRNA splicing/editing, mRNA translation, ribosome biogenesis and/or the regulatory actions of small nucleolar RNAs and micro-RNAs. Since epigenetic mechanisms are modifiable, this raises the hope of novel therapy, though questions remain concerning efficacy and safety. The above issues are critically surveyed in this review, which advocates a broad-based epigenetic framework for understanding and ultimately treating a diverse assemblage of NDDs ("epigenopathies") lying at the interface of genetic, developmental and environmental processes. This article is part of the Special Issue entitled 'Neurodevelopmental Disorders'.
Collapse
Affiliation(s)
- Mark J Millan
- Unit for Research and Discovery in Neuroscience, IDR Servier, 125 chemin de ronde, 78290 Croissy sur Seine, Paris, France.
| |
Collapse
|
99
|
Tordjman S, Anderson GM, Bellissant E, Botbol M, Charbuy H, Camus F, Graignic R, Kermarrec S, Fougerou C, Cohen D, Touitou Y. Day and nighttime excretion of 6-sulphatoxymelatonin in adolescents and young adults with autistic disorder. Psychoneuroendocrinology 2012; 37:1990-7. [PMID: 22613035 DOI: 10.1016/j.psyneuen.2012.04.013] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 04/25/2012] [Accepted: 04/26/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Several reports indicate that nocturnal production of melatonin is reduced in autism. Our objective was to examine whether melatonin production is decreased during the whole 24-h cycle, whether the melatonin circadian rhythm is inverted, and whether the reduction in melatonin production is related to the severity of autistic behavioral impairments. METHOD Day and nighttime urinary excretion of 6-sulphatoxymelatonin (6-SM) was examined during a 24-h period in post-pubertal individuals with autism (N=43) and typically developing controls (N=26) matched for age, sex and pubertal stage. RESULTS Low 6-SM excretion (mean ± SEM) was observed in autism, both at daytime (0.16 ± 0.03 vs. 0.36 ± 0.05 μg/h, p<0.01), nighttime (0.52 ± 0.07 vs. 1.14 ± 0.23 μg/h, p<0.05), and during 24h (8.26 ± 1.27 vs. 18.00 ± 3.43 μg/24-h collection, p<0.001). Intra-individual nighttime-daytime differences (delta values) in 6-SM excretion were smaller in individuals with autism than in controls (0.36 ± 0.07 vs. 0.79 ± 0.23 μg/h, p<0.05). Nocturnal excretion of 6-SM was negatively correlated with autism severity in the overall level of verbal language (Spearman ρ=-0.30, p<0.05), imitative social play (Spearman ρ=-0.42, p<0.05), and repetitive use of objects (Spearman ρ=-0.36, p<0.05). CONCLUSION A deficit in melatonin production is present both at daytime and at nighttime in individuals with autism, particularly in the most severely affected individuals. These results highlight interest in potential therapeutic uses of melatonin in autistic disorder, especially in individuals with severe autistic impairment and/or low urinary 6-SM excretion.
Collapse
Affiliation(s)
- Sylvie Tordjman
- Hospital-University Department of Child and Adolescent Psychiatry, Guillaume Régnier Hospital, Rennes 1 University, Rennes, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
100
|
Potential opposite roles of the extracellular signal-regulated kinase (ERK) pathway in autism spectrum and bipolar disorders. Neurosci Biobehav Rev 2012; 36:2206-13. [DOI: 10.1016/j.neubiorev.2012.07.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/20/2012] [Accepted: 07/28/2012] [Indexed: 11/22/2022]
|