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Zerbit J, Bordenave J, Benoit G. Physicochemical and microbiological stability studies of a melatonin oral suspension in a commercially available vehicle for paediatric use. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2014-000485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Yeh AM, Golianu B. Integrative Treatment of Reflux and Functional Dyspepsia in Children. CHILDREN (BASEL, SWITZERLAND) 2014; 1:119-33. [PMID: 27417471 PMCID: PMC4928719 DOI: 10.3390/children1020119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/24/2014] [Accepted: 07/29/2014] [Indexed: 01/10/2023]
Abstract
Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are common problems in the pediatric population, with up to 7% of school-age children and up to 8% of adolescents suffering from epigastric pain, heartburn, and regurgitation. Reflux is defined as the passage of stomach contents into the esophagus, while GERD refers to reflux symptoms that are associated with symptoms or complications-such as pain, asthma, aspiration pneumonia, or chronic cough. FD, as defined by the Rome III classification, is a persistent upper abdominal pain or discomfort, not related to bowel movements, and without any organic cause, that is present for at least two months prior to diagnosis. Endoscopic examination is typically negative in FD, whereas patients with GERD may have evidence of esophagitis or gastritis either grossly or microscopically. Up to 70% of children with dyspepsia exhibit delayed gastric emptying. Treatment of GERD and FD requires an integrative approach that may include pharmacologic therapy, treating concurrent constipation, botanicals, mind body techniques, improving sleep hygiene, increasing physical activity, and traditional Chinese medicine and acupuncture.
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Affiliation(s)
- Ann Ming Yeh
- Department of Pediatrics, Stanford University, 750 Welch Road, Suite 116, Palo Alto, CA 94304, USA.
| | - Brenda Golianu
- Department of Anesthesiology, Stanford University, 300 Pasteur Dr. Stanford, CA 94304, USA.
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103
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Damiani JM, Sweet BV, Sohoni P. Melatonin: an option for managing sleep disorders in children with autism spectrum disorder. Am J Health Syst Pharm 2014; 71:95-101. [PMID: 24375600 DOI: 10.2146/ajhp130215] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Justina M Damiani
- University of Michigan Health System and College of PharmacyAnn Arbor
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104
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Gringras P, Green D, Wright B, Rush C, Sparrowhawk M, Pratt K, Allgar V, Hooke N, Moore D, Zaiwalla Z, Wiggs L. Weighted blankets and sleep in autistic children--a randomized controlled trial. Pediatrics 2014; 134:298-306. [PMID: 25022743 DOI: 10.1542/peds.2013-4285] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD). METHODS This phase III trial was a randomized, placebo-controlled crossover design. Participants were aged between 5 years and 16 years 10 months, with a confirmed ASD diagnosis and severe sleep problems, refractory to community-based interventions. The interventions were either a commercially available weighted blanket or otherwise identical usual weight blanket (control), introduced at bedtime; each was used for a 2-week period before crossover to the other blanket. Primary outcome was total sleep time (TST) recorded by actigraphy over each 2-week period. Secondary outcomes included actigraphically recorded sleep-onset latency, sleep efficiency, assessments of child behavior, family functioning, and adverse events. Sleep was also measured by using parent-report diaries. RESULTS Seventy-three children were randomized and analysis conducted on 67 children who completed the study. Using objective measures, the weighted blanket, compared with the control blanket, did not increase TST as measured by actigraphy and adjusted for baseline TST. There were no group differences in any other objective or subjective measure of sleep, including behavioral outcomes. On subjective preference measures, parents and children favored the weighted blanket. CONCLUSIONS The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period.
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Affiliation(s)
- Paul Gringras
- Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom;
| | | | - Barry Wright
- Lime Trees Child and Family Unit, York, England; and
| | - Carla Rush
- Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom
| | - Masako Sparrowhawk
- Department of Psychology, Oxford Brookes University, Oxford, United Kingdom
| | - Karen Pratt
- Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom
| | - Victoria Allgar
- Department of Psychology, Oxford Brookes University, Oxford, United Kingdom
| | - Naomi Hooke
- Lime Trees Child and Family Unit, York, England; and
| | | | - Zenobia Zaiwalla
- Department of Clinical Neurophysiology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Luci Wiggs
- Department of Psychology, Oxford Brookes University, Oxford, United Kingdom
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105
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Proietti S, Carlomagno G, Dinicola S, Bizzarri M. Soft gel capsules improve melatonin's bioavailability in humans. Expert Opin Drug Metab Toxicol 2014; 10:1193-8. [PMID: 25046730 DOI: 10.1517/17425255.2014.943183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Oral bioavailability is one of the most important properties in drug design and development. A poor oral bioavailability can result in low efficacy and unpredictable response to a drug. Several dosages of melatonin have been used for various investigations to clarify its bioavailability in humans. Aiming to search for a pharmaceutical form, which is better absorbed, the pharmacokinetic (PK) profile of the new manufactured melatonin soft gelatin (soft gel) capsule form has been evaluated and compared with the commercially available melatonin powder. RESEARCH DESIGN AND METHODS A total of 60 healthy volunteers received 1, 3 mg of melatonin powder and 1 mg of melatonin in soft gel capsules. PK profiles were obtained by analysis of melatonin plasma concentration, and the respective melatonin bioavailability was compared. RESULTS Melatonin soft gel capsule form showed similar PK parameters compared with the highest doses of melatonin in powder form, but its bioavailability was improved. CONCLUSIONS Soft gel capsules improved the bioavailability of melatonin in humans even when administered dose was reduced. Considering the number of conditions in which melatonin supplementation is recommended, this evidence could support a broader use of melatonin in clinical practice.
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Affiliation(s)
- Sara Proietti
- Sapienza University of Rome, Department of Surgery P. Valdoni , via A. Scarpa 14, 00166 Rome , Italy
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106
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Wade AG, Farmer M, Harari G, Fund N, Laudon M, Nir T, Frydman-Marom A, Zisapel N. Add-on prolonged-release melatonin for cognitive function and sleep in mild to moderate Alzheimer's disease: a 6-month, randomized, placebo-controlled, multicenter trial. Clin Interv Aging 2014; 9:947-61. [PMID: 24971004 PMCID: PMC4069047 DOI: 10.2147/cia.s65625] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose A link between poor sleep quality and Alzheimer’s disease (AD) has recently been suggested. Since endogenous melatonin levels are already reduced at preclinical AD stages, it is important to ask whether replenishing the missing hormone would be beneficial in AD and whether any such effects would be related to the presence of sleep disorder in patients. Patients and methods The effects of add-on prolonged-release melatonin (PRM) (2 mg) to standard therapy on cognitive functioning and sleep were investigated in 80 patients (men [50.7%], women [49.3%], average age 75.3 years [range, 52–85 years]) diagnosed with mild to moderate AD, with and without insomnia comorbidity, and receiving standard therapy (acetylcholinesterase inhibitors with or without memantine). In this randomized, double-blind, parallel-group study, patients were treated for 2 weeks with placebo and then randomized (1:1) to receive 2 mg of PRM or placebo nightly for 24 weeks, followed by 2 weeks placebo. The AD Assessment Scale–Cognition (ADAS-Cog), Instrumental Activities of Daily Living (IADL), Mini–Mental State Examination (MMSE), sleep, as assessed by the Pittsburgh Sleep Quality Index (PSQI) and a daily sleep diary, and safety parameters were measured. Results Patients treated with PRM (24 weeks) had significantly better cognitive performance than those treated with placebo, as measured by the IADL (P=0.004) and MMSE (P=0.044). Mean ADAS-Cog did not differ between the groups. Sleep efficiency, as measured by the PSQI, component 4, was also better with PRM (P=0.017). In the comorbid insomnia (PSQI ≥6) subgroup, PRM treatment resulted in significant and clinically meaningful effects versus the placebo, in mean IADL (P=0.032), MMSE score (+1.5 versus −3 points) (P=0.0177), and sleep efficiency (P=0.04). Median ADAS-Cog values (−3.5 versus +3 points) (P=0.045) were significantly better with PRM. Differences were more significant at longer treatment duration. PRM was well tolerated, with an adverse event profile similar to that of placebo. Conclusion Add-on PRM has positive effects on cognitive functioning and sleep maintenance in AD patients compared with placebo, particularly in those with insomnia comorbidity. The results suggest a possible causal link between poor sleep and cognitive decline.
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Affiliation(s)
| | | | | | | | | | - Tali Nir
- Neurim Pharmaceuticals Ltd, Tel Aviv, Israel
| | | | - Nava Zisapel
- Neurim Pharmaceuticals Ltd, Tel Aviv, Israel ; Department of Neurobiology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
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107
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Williams K, Woolfenden S, Roberts J, Rodger S, Bartak L, Prior M. Autism in context 2: Assessment, intervention and services in Australia. J Paediatr Child Health 2014; 50:341-6. [PMID: 24422663 DOI: 10.1111/jpc.12456] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2013] [Indexed: 11/27/2022]
Abstract
Continuing from part 1, part 2 of the autism spectrum disorders review explores clinical practice and service delivery aspects of autism spectrum disorders including current assessment approaches in Australia, family-centred models of care, and key service structure and delivery issues. Treatments including behavioural interventions, established and emergent medication, and complementary and alternative therapies are discussed. The key role of paediatricians as both individual child and family care providers and advocates, as well as agents of service reform in Australia, is evident. Much still needs to be done.
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Affiliation(s)
- Katrina Williams
- Developmental Medicine, Royal Children's Hospital, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Victoria, Australia
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Albertini B, Di Sabatino M, Melegari C, Passerini N. Formulating SLMs as oral pulsatile system for potential delivery of melatonin to pediatric population. Int J Pharm 2014; 469:67-79. [PMID: 24768728 DOI: 10.1016/j.ijpharm.2014.04.055] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 04/19/2014] [Accepted: 04/22/2014] [Indexed: 12/21/2022]
Abstract
The formulation development of melatonin (MLT) for infants and children with neurodevelopmental difficulties was fully investigated. This population have a higher prevalence of sleep disorders and present special challenges for drug administration and swallowing. To solve these issues, solid lipid microparticles (SLMs) were designed to obtain an oral flexible dosage form constituted by GRAS excipients and a free flow pulsatile delivery system for MLT, able to maintain its release through 8h. Three groups of SLMs were produced by spray congealing and characterized as regards particle size, morphology, flowability, solid state, drug content and release behavior. The SLMs manipulation with milk and yogurt and the MLT stability in these foods were also investigated. Microparticles with different excipient composition were selected to obtain a pulsatile release pattern over 8h. The final delivery platform displayed a prompt release from group I SLMs together with a lag phase of groups II and III SLMs, followed by a repeated MLT release from group II and a prolonged MLT release related to the last group. Finally, MLT was compatible and stable in milk and yogurt suggesting that microparticles sprinkled into food is acceptable for MLT administration to children unable to swallow capsules or tablets.
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Affiliation(s)
- Beatrice Albertini
- Department of Pharmacy and Biotechnology, University of Bologna, Via San Donato 19/2, Bologna 40127, Italy.
| | - Marcello Di Sabatino
- Department of Pharmacy and Biotechnology, University of Bologna, Via San Donato 19/2, Bologna 40127, Italy
| | - Cecilia Melegari
- Department of Pharmacy and Biotechnology, University of Bologna, Via San Donato 19/2, Bologna 40127, Italy
| | - Nadia Passerini
- Department of Pharmacy and Biotechnology, University of Bologna, Via San Donato 19/2, Bologna 40127, Italy
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109
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Sleep in Individuals with an Intellectual or Developmental Disability: Recent Research Reports. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2014. [DOI: 10.1007/s40474-014-0010-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Hsia Y, Wong AYS, Murphy DGM, Simonoff E, Buitelaar JK, Wong ICK. Psychopharmacological prescriptions for people with autism spectrum disorder (ASD): a multinational study. Psychopharmacology (Berl) 2014; 231:999-1009. [PMID: 24005531 DOI: 10.1007/s00213-013-3263-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 08/22/2013] [Indexed: 11/29/2022]
Abstract
RATIONALE Previous studies on psychotropic drugs prescribing in autism spectrum disorder (ASD) were from the USA or the UK. However, these studies may not be generalizable to other countries. There is a need to understand the extent of psychopharmacological prescribing for ASD treatment at a multinational level to identify areas of prescribing which lack evidence. METHODS We used the IMS Prescribing Insights database to investigate psychotropic drugs prescribing patterns for ASD treatment in children and adults in 2010-2012. Data were obtained from Europe (France, Germany, Italy, Spain and UK), South America (Mexico and Brazil), North America (Canada and USA) and Asia (Japan). RESULTS North American countries have the highest prescription rates, followed by the European and South American countries. Prescribing rates were higher in children compared to adults in individual countries. The most commonly prescribed drug for ASD was risperidone in young people (except in UK and Japan). In the UK, methylphenidate (34 %) was the most commonly prescribed for young people and haloperidol (44.1 %) in Japan. In adults, the most commonly prescribed drug class was antipsychotics and particularly risperidone (thioridazine and ziprasidone were the most prescribed antipsychotics in Brazil and USA, respectively). CONCLUSION There is variation in medication prescription for people with ASD among countries, which may be attributable to diagnostic criteria, clinical guidelines or health care systems. However, there is a lack of evidence of efficacy and safety for many psychotropic drugs prescribed for people with ASD. Research is needed to bridge the evidence gaps in prescribing.
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Affiliation(s)
- Yingfen Hsia
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
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Humphreys JS, Gringras P, Blair PS, Scott N, Henderson J, Fleming PJ, Emond AM. Sleep patterns in children with autistic spectrum disorders: a prospective cohort study. Arch Dis Child 2014; 99:114-8. [PMID: 24061777 PMCID: PMC3913218 DOI: 10.1136/archdischild-2013-304083] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 07/16/2013] [Accepted: 07/31/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate longitudinal sleep patterns in children with autistic spectrum disorders (ASDs). STUDY DESIGN Prospective longitudinal study using Avon Longitudinal Study of Parents and Children, an English cohort born in 1991-1992. Parental reports of sleep duration were collected by questionnaires at 8 time points from 6 months to 11 years. Children with an ASD diagnosis at age 11 years (n=73) were identified from health and education records. RESULTS From aged 30 months to 11 years old, children with ASD slept for 17-43 min less each day than contemporary controls. No significant difference in total sleep duration was found in infancy, but from 30 months of age children with ASD slept less than their peers, a difference that remained significant after adjusting for sex, ethnicity, high parity and epilepsy. The reduction in total sleep was wholly due to changes in night rather than daytime sleep duration. Night-time sleep duration was shortened by later bedtimes and earlier waking times. Frequent waking (3 or more times a night) was also evident among the children with ASD from 30 months of age. Age-specific decreases of >1SD within individuals in sleep duration across adjacent time points was a predictor of ASD between 18 months and 30 months of age (p=0.04) and from 30 months to 42 months (p=0.02). CONCLUSIONS Sleep duration in children with ASD is reduced from 30 months of age and persists until adolescence.
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112
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Moss AHB, Gordon JE, O’Connell A. Impact of Sleepwise: An Intervention for Youth with Developmental Disabilities and Sleep Disturbance. J Autism Dev Disord 2014; 44:1695-707. [DOI: 10.1007/s10803-014-2040-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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113
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Axelsson EL, Hill CM, Sadeh A, Dimitriou D. Sleep problems and language development in toddlers with Williams syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3988-3996. [PMID: 24029809 DOI: 10.1016/j.ridd.2013.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/08/2013] [Accepted: 08/14/2013] [Indexed: 06/02/2023]
Abstract
Sleep and related maternal beliefs were assessed in a narrow age range of 18 children with Williams syndrome (WS) and 18 typically developing (TD) children. WS is a rare genetic disorder characterised by a complex physical, cognitive and behavioural phenotype. High prevalence of sleep difficulties in older children and adults with WS have been reported. Parents completed 6 questionnaires: the Brief Infant Sleep Questionnaire, Infant Sleep Vignettes Interpretation Scale, Pittsburgh Sleep Quality Index of Parents, Child Behaviour Checklist, MacArthur Communicative Development Inventory for Infants - Words and Gestures, and the Major (ICD-10) Depression Inventory. Compared to TD children, those with WS had shorter night sleep, more night wakings and wakefulness according to parental report. Regression analyses revealed that a proportion of the variance in language development scores in WS children could be explained by night sleep duration. Compared to control parents, the mothers of the WS group were more likely to describe their child's sleep as problematic and had higher rates of involvement with child sleep, yet they had a lesser tendency to interpret sleep problems as signs of distress and a greater tendency to emphasise limit setting. Approximately half of both groups of mothers experienced poor sleep quality. This was also related to maternal mood, and night wakefulness in the children with WS. This is the first study to quantify sleep difficulties in young children with WS in a narrow age range using maternal report. The possible negative effects on maternal sleep and mood, and the link between night sleep and language development in young children with WS, requires further detailed investigation.
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Affiliation(s)
- Emma L Axelsson
- University of New South Wales, School of Psychiatry, Faculty of Medicine, Australia
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114
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Treatment strategies for complex behavioral insomnia in children with neurodevelopmental disorders. Curr Opin Pulm Med 2013; 19:616-25. [DOI: 10.1097/mcp.0b013e328365ab89] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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115
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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.
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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.)
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Stores G, Stores R. Sleep disorders in children with traumatic brain injury: a case of serious neglect. Dev Med Child Neurol 2013; 55:797-805. [PMID: 23662906 DOI: 10.1111/dmcn.12163] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2013] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to review the basic aspects of sleep disturbance in children with traumatic brain injury (TBI). METHOD A search was performed on reports of sleep disturbances in children who had suffered TBI. Adults with TBI were also considered to anticipate the nature and significance of such disturbances in younger patients. Types of reported sleep disturbance were noted and their possible aetiology and management considered. RESULTS Sleep disturbance has consistently been associated with TBI but the literature suggests that this aspect of patient care is often inadequately considered and there has been little research on the subject, especially in relation to children. Excessive daytime sleepiness is often mentioned, less so insomnia and parasomnias, but there is little information about the specific sleep disorders underlying these problems. INTERPRETATION Sleep disorders with potentially important developmental consequences have been neglected in the care of children with TBI. Screening for sleep problems should be routine and followed, if indicated, by a detailed diagnosis of the child's underlying specific sleep disorder, the possible aetiology of which includes neuropathology and potential medical, psychological, or psychiatric comorbidities. Appropriate assessments and modern treatment options are now well defined although generally underutilized. Further well-designed research is needed for which guidelines are available.
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Affiliation(s)
- Gregory Stores
- Department of Psychiatry, University of Oxford, Oxford, UK.
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Affiliation(s)
- Imti Choonara
- Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, UK
| | - Tom Kenny
- National Institute for Health Research, National Evaluation Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK
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Abstract
The ways in which sleep can affect epilepsy, and epilepsy can influence sleep and wakefulness, are described. Different forms of sleep disturbance have been reported in patients with epilepsy, depending on the type of seizure disorder. Confusions between epilepsy and non-epileptic parasomnias can be a particular diagnostic problem but they can be avoided. Untreated sleep disturbance is likely to have harmful psychological, physical and family effects. Screening for sleep disturbance should be routine, and leading, if indicated, to precise diagnosis of the underlying sleep disorder on which choice of advice and treatment depends.
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Affiliation(s)
- Gregory Stores
- Department of Psychiatry, University of Oxford, c/o North Gate House, 55 High Street, Dorchester on Thames, Oxon X10 7HN, UK.
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119
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Abstract
PURPOSE OF REVIEW Current revision of the two major psychiatric classification systems has elicited particular comment on neurodevelopmental disorders, which have seen increased provision of specialist clinical services, user group activity, fictional and biographical accounts, and research. Philosophical scrutiny of autism research and literature provides an additional perspective. RECENT FINDINGS Neurodevelopmental disorders show considerable overlap neuropsychologically, physiologically and genetically. They overlap diagnostically with schizophrenia, personality disorders, anxiety and depression. Of the two main diagnostic groups, there is more evidence of change with maturation in autism spectrum disorder than attention-deficit hyperactivity disorder. Interventions should combine cognitive, affective and embodied aspects of these disorders, and encompass the individual and their social environment. There is considerable evidence of the toll that caring for people with neurodevelopmental disorders exerts on parents. SUMMARY Neurodevelopmental disorders are multifaceted: research addressed to connection rather than further Balkanization is more likely to be fruitful. Clinicians should consider which facets are displayed symptomatically to enable people to grow through rather than surrender to their impairments. Social scaffolding optimizes functional well being. Future research should take into account the tensions in the relationship between research and user groups, and examine the experiences of adults and of the spouses and partners of those affected.
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