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Miles KD, Barker CM, Russell KP, Appel BH, Doll CA. Electrical Synapses Mediate Embryonic Hyperactivity in a Zebrafish Model of Fragile X Syndrome. J Neurosci 2024; 44:e2275232024. [PMID: 38969506 PMCID: PMC11293453 DOI: 10.1523/jneurosci.2275-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 06/19/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024] Open
Abstract
Although hyperactivity is associated with a wide variety of neurodevelopmental disorders, the early embryonic origins of locomotion have hindered investigation of pathogenesis of these debilitating behaviors. The earliest motor output in vertebrate animals is generated by clusters of early-born motor neurons (MNs) that occupy distinct regions of the spinal cord, innervating stereotyped muscle groups. Gap junction electrical synapses drive early spontaneous behavior in zebrafish, prior to the emergence of chemical neurotransmitter networks. We use a genetic model of hyperactivity to gain critical insight into the consequences of errors in motor circuit formation and function, finding that Fragile X syndrome model mutant zebrafish are hyperexcitable from the earliest phases of spontaneous behavior, show altered sensitivity to blockade of electrical gap junctions, and have increased expression of the gap junction protein Connexin 34/35. We further show that this hyperexcitable behavior can be rescued by pharmacological inhibition of electrical synapses. We also use functional imaging to examine MN and interneuron (IN) activity in early embryogenesis, finding genetic disruption of electrical gap junctions uncouples activity between mnx1 + MNs and INs. Taken together, our work highlights the importance of electrical synapses in motor development and suggests that the origins of hyperactivity in neurodevelopmental disorders may be established during the initial formation of locomotive circuits.
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Affiliation(s)
- Kaleb D Miles
- Section of Developmental Biology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045
| | - Chase M Barker
- Section of Developmental Biology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045
| | - Kristen P Russell
- Section of Developmental Biology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045
| | - Bruce H Appel
- Section of Developmental Biology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045
| | - Caleb A Doll
- Section of Developmental Biology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045
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2
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Talvio K, Castrén ML. Astrocytes in fragile X syndrome. Front Cell Neurosci 2024; 17:1322541. [PMID: 38259499 PMCID: PMC10800791 DOI: 10.3389/fncel.2023.1322541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Astrocytes have an important role in neuronal maturation and synapse function in the brain. The interplay between astrocytes and neurons is found to be altered in many neurodevelopmental disorders, including fragile X syndrome (FXS) that is the most common inherited cause of intellectual disability and autism spectrum disorder. Transcriptional, functional, and metabolic alterations in Fmr1 knockout mouse astrocytes, human FXS stem cell-derived astrocytes as well as in in vivo models suggest autonomous effects of astrocytes in the neurobiology of FXS. Abnormalities associated with FXS astrocytes include differentiation of central nervous system cell populations, maturation and regulation of synapses, and synaptic glutamate balance. Recently, FXS-specific changes were found more widely in astrocyte functioning, such as regulation of inflammatory pathways and maintenance of lipid homeostasis. Changes of FXS astrocytes impact the brain homeostasis and function both during development and in the adult brain and offer opportunities for novel types of approaches for intervention.
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Affiliation(s)
| | - Maija L. Castrén
- Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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3
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Jordan TL, Bartholomay KL, Lee CHY, Lightbody AA, Reiss AL. Cognition, academic achievement, and adaptive behavior in school-aged girls with fragile X syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 143:104622. [PMID: 37939495 PMCID: PMC10842844 DOI: 10.1016/j.ridd.2023.104622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Fragile X syndrome (FXS) is the leading monogenic cause of intellectual disability and autism in males and females. Females with FXS typically display a milder cognitive phenotype than males, despite experiencing significant developmental, behavioral, and social-emotional issues. AIMS To measure and distinguish the cognitive-behavioral profile of girls with FXS relative to verbal IQ-matched peers. METHODS AND PROCEDURES Ninety-seven participants (NFXS=55, Ncomparison=42) six to 16 years of age completed assessments evaluating cognition, academic achievement, and adaptive behavior. The comparison group consisted of age-, sex-, and verbal IQ-matched peers. OUTCOMES AND RESULTS Consistent with previous studies, the FXS group demonstrated mean cognitive skills, academic achievement, and adaptive behavior in the borderline to low average range. On average, the FXS group showed poorer nonverbal reasoning, visual pattern recognition, verbal abstraction, math abilities, attention, inhibitory control, and working memory than the comparison group. There were no significant group differences in adaptive behavior. Different patterns of associations between cognition and selected outcomes emerged in each group. CONCLUSIONS AND IMPLICATIONS Results highlight the importance of identifying specific cognitive-behavioral profiles in girls with FXS to inform more targeted interventions for optimizing outcomes and quality of life in this population.
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Affiliation(s)
- Tracy L Jordan
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Kristi L Bartholomay
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Cindy Hsin-Yu Lee
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Amy A Lightbody
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Allan L Reiss
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA; Department of Radiology, Stanford University School of Medicine, USA; Department of Pediatrics, Stanford University School of Medicine, USA.
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4
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Rahmatullah N, Schmitt LM, De Stefano L, Post S, Robledo J, Chaudhari G, Pedapati E, Erickson C, Portera-Cailliau C, Goel A. Hypersensitivity to Distractors in Fragile X Syndrome from Loss of Modulation of Cortical VIP Interneurons. J Neurosci 2023; 43:8172-8188. [PMID: 37816596 PMCID: PMC10697397 DOI: 10.1523/jneurosci.0571-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/11/2023] [Accepted: 09/14/2023] [Indexed: 10/12/2023] Open
Abstract
Attention deficit is one of the most prominent and disabling symptoms in Fragile X syndrome (FXS). Hypersensitivity to sensory stimuli contributes to attention difficulties by overwhelming and/or distracting affected individuals, which disrupts activities of daily living at home and learning at school. We find that auditory or visual distractors selectively impair visual discrimination performance in humans and mice with FXS but not in typically developing controls. In both species, males and females were examined. Vasoactive intestinal polypeptide (VIP) neurons were significantly modulated by incorrect responses in the poststimulus period during early distractor trials in WT mice, consistent with their known role as error signals. Strikingly, however, VIP cells from Fmr1 -/- mice showed little modulation in error trials, and this correlated with their poor performance on the distractor task. Thus, VIP interneurons and their reduced modulatory influence on pyramidal cells could be a potential therapeutic target for attentional difficulties in FXS.SIGNIFICANCE STATEMENT Sensory hypersensitivity, impulsivity, and persistent inattention are among the most consistent clinical features of FXS, all of which impede daily functioning and create barriers to learning. However, the neural mechanisms underlying sensory over-reactivity remain elusive. To overcome a significant challenge in translational FXS research we demonstrate a compelling alignment of sensory over-reactivity in both humans with FXS and Fmr1 -/- mice (the principal animal model of FXS) using a novel analogous distractor task. Two-photon microscopy in mice revealed that lack of modulation by VIP cells contributes to susceptibility to distractors. Implementing research efforts we describe here can help identify dysfunctional neural mechanisms associated not only with sensory issues but broader impairments, including those in learning and cognition.
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Affiliation(s)
- Noorhan Rahmatullah
- Neuroscience Graduate Program, University of California, Riverside, Riverside, California 92521
- Department of Psychology, University of California, Riverside, Riverside, California 92521
| | - Lauren M Schmitt
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati OH 45267
| | - Lisa De Stefano
- Department of Psychiatry, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnatti, Ohio 45267
| | - Sam Post
- Department of Psychology, University of California, Riverside, Riverside, California 92521
| | - Jessica Robledo
- Department of Psychology, University of California, Riverside, Riverside, California 92521
| | - Gunvant Chaudhari
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
| | - Ernest Pedapati
- Department of Psychiatry, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnatti, Ohio 45267
- Department of Neurology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnatti, Ohio 45267
| | - Craig Erickson
- Department of Psychiatry, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnatti, Ohio 45267
| | - Carlos Portera-Cailliau
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
| | - Anubhuti Goel
- Neuroscience Graduate Program, University of California, Riverside, Riverside, California 92521
- Department of Psychology, University of California, Riverside, Riverside, California 92521
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Chari T, Hernandez A, Portera-Cailliau C. A Novel Head-Fixed Assay for Social Touch in Mice Uncovers Aversive Responses in Two Autism Models. J Neurosci 2023; 43:7158-7174. [PMID: 37669860 PMCID: PMC10601375 DOI: 10.1523/jneurosci.0226-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023] Open
Abstract
Social touch, an important aspect of social interaction and communication, is essential to kinship across animal species. How animals experience and respond to social touch has not been thoroughly investigated, in part because of the lack of appropriate assays. Previous studies that examined social touch in freely moving rodents lacked the necessary temporal and spatial control over individual touch interactions. We designed a novel head-fixed assay for social touch in mice, in which the experimenter has complete control to elicit highly stereotyped bouts of social touch between two animals. The user determines the number, duration, context, and type of social touch interactions, while monitoring an array of complex behavioral responses with high resolution cameras. We focused on social touch to the face because of its high translational relevance to humans. We validated this assay in two different models of autism spectrum disorder (ASD), the Fmr1 knock-out (KO) model of Fragile X syndrome (FXS) and maternal immune activation (MIA) mice. We observed higher rates of avoidance running, hyperarousal, and aversive facial expressions (AFEs) to social touch than to object touch, in both ASD models compared with controls. Fmr1 KO mice showed more AFEs to mice of the same sex but whether they were stranger or familiar mice mattered less. Because this new social touch assay for head-fixed mice can be used to record neural activity during repeated bouts of social touch it could be used to uncover underlying circuit differences.SIGNIFICANCE STATEMENT Social touch is important for communication in animals and humans. However, it has not been extensively studied and current assays to measure animals' responses to social touch have limitations. We present a novel head-fixed assay to quantify how mice respond to social facial touch with another mouse. We validated this assay in autism mouse models since autistic individuals exhibit differences in social interaction and touch sensitivity. We find that mouse models of autism exhibit more avoidance, hyperarousal, and aversive facial expressions (AFEs) to social touch compared with controls. Thus, this novel assay can be used to investigate behavioral responses to social touch and the underlying brain mechanisms in rodent models of neurodevelopmental conditions, and to evaluate therapeutic responses in preclinical studies.
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Affiliation(s)
- Trishala Chari
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
- Neuroscience Interdepartmental Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
| | - Ariana Hernandez
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
| | - Carlos Portera-Cailliau
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095
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6
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Hunt E, Hogan A, Will EA, Roberts JE. ADHD and ASD symptoms in young males with fragile X syndrome: associations with early trajectories of inhibitory control. Child Neuropsychol 2023; 29:760-786. [PMID: 36082630 PMCID: PMC9995619 DOI: 10.1080/09297049.2022.2120605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
Inhibitory control (IC), the ability to suppress inappropriate responses, emerges late in the first year of life and improves across typical development, concurrent with brain maturation. The development of IC is critical to various social-emotional and behavioral functions, with IC difficulties being linked to numerous neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Fragile X syndrome (FXS) is a single-gene disorder characterized by IC difficulties, and elevated rates of ADHD and ASD, making it a useful model for understanding the early development and consequences of IC. In this longitudinal study, we characterized IC trajectories across multiple time points between 16 and 71 months of age in young males with FXS (n = 79) relative to neurotypical (NT) controls (n=49). To explore the association between behavioral outcomes and IC, we identified a subsample of 50 children with longitudinal IC data and an outcome assessment for ADHD and ASD symptoms at age 5 (FXS: n = 26, NT: n = 24). Results indicated that, compared to their NT peers, young males with FXS exhibit differences in IC as early as 24 months, with group differences increasing through age 5. Additionally, we determined that lower IC levels at 24 months were associated with later ADHD symptoms and a decreasing slope in IC over time was associated with later ASD symptoms in male children with FXS. These findings help refine early developmental phenotypes of FXS and highlight IC as a potential target for early detection and intervention of ASD and ADHD symptoms in male children with FXS.
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Affiliation(s)
- Erin Hunt
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Abigail Hogan
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Elizabeth A Will
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Ranjan R, Jha S, Prajjwal P, Chaudhary A, Dudeja P, Vora N, Mateen MA, Yousuf MA, Chaudhary B. Neurological, Psychiatric, and Multisystemic Involvement of Fragile X Syndrome Along With Its Pathophysiology, Methods of Screening, and Current Treatment Modalities. Cureus 2023; 15:e35505. [PMID: 37007359 PMCID: PMC10050793 DOI: 10.7759/cureus.35505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 03/01/2023] Open
Abstract
Fragile X syndrome (FXS) is a hereditary disease that predominantly leads to intellectual disability (ID) in boys. It is the second prominent cause of ID, which manifests as a result of the atypical development of the cytosine-guanine-guanine (CGG) region. This irregular extension of the CGG region gives rise to methylation and silencing of the fragile X mental retardation 1 (FMR1) gene, causing a loss of the fragile X mental retardation 1 protein (FMRP). This reduction or loss of FMRP is the main cause of ID. It has a multisystemic involvement showing neuropsychiatric features such as ID, speech and language delay, autism spectrum disorder, sensory hyperarousal, social anxiety, abnormal eye contact, shyness, and aggressive behaviour. It is also known to cause musculoskeletal symptoms, ocular symptoms, cardiac abnormalities, and gastrointestinal symptoms. The management is challenging, and there is no known cure for the disease; hence an early diagnosis of the condition is needed through prenatal screening offered to couples with familial history of ID before conception. The management rests on non-pharmacological modalities, including applied behaviour analysis, physical therapy, occupational therapy, speech-language therapy, and pharmacologic management through symptomatic treatment of comorbid behaviours and psychiatric problems and some forms of targeted therapy.
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8
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Chari T, Hernandez A, Portera-Cailliau C. A novel head-fixed assay for social touch in mice uncovers aversive responses in two autism models. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.11.523491. [PMID: 36711563 PMCID: PMC9882020 DOI: 10.1101/2023.01.11.523491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Social touch, an important aspect of social interaction and communication, is essential to kinship across animal species. How animals experience and respond to social touch has not been thoroughly investigated, in part due to the lack of appropriate assays. Previous studies that examined social touch in freely moving rodents lacked the necessary temporal and spatial control over individual touch interactions. We designed a novel head-fixed assay for social touch in mice, in which the experimenter has complete control to elicit highly stereotyped bouts of social touch between two animals. The user determines the number, duration, context, and type of social touch interactions, while monitoring with high frame rate cameras an array of complex behavioral responses. We focused on social touch to the face because of their high translational relevance to humans. We validated this assay in two different models of autism spectrum disorder (ASD), the Fmr1 knockout model of Fragile X Syndrome and maternal immune activation mice. We observed increased avoidance, hyperarousal, and more aversive facial expressions to social touch, but not to object touch, in both ASD models compared to controls. Because this new social touch assay for head-fixed mice can be used to record neural activity during repeated bouts of social touch it should be of interest to neuroscientists interested in uncovering the underlying circuits.
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9
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Johnson D, Clark C, Hagerman R. Targeted Treatments for Fragile X Syndrome. ADVANCES IN NEUROBIOLOGY 2023; 30:225-253. [PMID: 36928853 DOI: 10.1007/978-3-031-21054-9_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
The histories of targeted treatment trials in fragile X syndrome (FXS) are reviewed in animal studies and human trials. Advances in understanding the neurobiology of FXS have identified a number of pathways that are dysregulated in the absence of FMRP and are therefore pathways that can be targeted with new medication. The utilization of quantitative outcome measures to assess efficacy in multiple studies has improved the quality of more recent trials. Current treatment trials including the use of cannabidiol (CBD) topically and metformin orally have positive preliminary data, and both of these medications are available clinically. The use of the phosphodiesterase inhibitor (PDE4D), BPN1440, which raised the level of cAMP that is low in FXS has very promising results for improving cognition in adult males who underwent a controlled trial. There are many more targeted treatments that will undergo trials in FXS, so the future looks bright for new treatments.
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Affiliation(s)
- Devon Johnson
- MIND Institute, University of California Davis Health, Sacramento, CA, USA
| | - Courtney Clark
- MIND Institute, University of California Davis Health, Sacramento, CA, USA
| | - Randi Hagerman
- MIND Institute, University of California Davis Health, Sacramento, CA, USA
- Department of Pediatrics, University of California Davis Health, Sacramento, CA, USA
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10
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Abolghasemi A, Carullo MP, Aguilera EC, Laroui A, Plantefeve R, Rojas D, Benachenhou S, Ramírez MV, Proteau-Lemieux M, Lepage JF, Corbin F, Plourde M, Farez M, Cogram P, Çaku A. Alteration of Fatty Acid Profile in Fragile X Syndrome. Int J Mol Sci 2022; 23:ijms231810815. [PMID: 36142726 PMCID: PMC9502195 DOI: 10.3390/ijms231810815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/28/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Fragile X Syndrome (FXS) is the most prevalent monogenic cause of Autism Spectrum Disorders (ASDs). Despite a common genetic etiology, the affected individuals display heterogenous metabolic abnormalities including hypocholesterolemia. Although changes in the metabolism of fatty acids (FAs) have been reported in various neuropsychiatric disorders, it has not been explored in humans with FXS. In this study, we investigated the FA profiles of two different groups: (1) an Argentinian group, including FXS individuals and age- and sex-matched controls, and (2) a French-Canadian group, including FXS individuals and their age- and sex-matched controls. Since phospholipid FAs are an indicator of medium-term diet and endogenous metabolism, we quantified the FA profile in plasma phospholipids using gas chromatography. Our results showed significantly lower levels in various plasma FAs including saturated, monosaturated, ω-6 polyunsaturated, and ω-3 polyunsaturated FAs in FXS individuals compared to the controls. A decrease in the EPA/ALA (eicosapentaenoic acid/alpha linoleic acid) ratio and an increase in the DPA/EPA (docosapentaenoic acid/eicosapentaenoic acid) ratio suggest an alteration associated with desaturase and elongase activity, respectively. We conclude that FXS individuals present an abnormal profile of FAs, specifically FAs belonging to the ω-3 family, that might open new avenues of treatment to improve core symptoms of the disorder.
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Affiliation(s)
- Armita Abolghasemi
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Maria Paulina Carullo
- Department of Child Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires C1428AQK, Argentina
| | - Ester Cisneros Aguilera
- Centre de Recherche sur le Vieillissement, Departments of Medicine, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
| | - Asma Laroui
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Rosalie Plantefeve
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Daniela Rojas
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Serine Benachenhou
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - María Victoria Ramírez
- Department of Child Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires C1428AQK, Argentina
| | - Mélodie Proteau-Lemieux
- Department of Pediatrics and Centre de Recherche du CHUS, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Jean-François Lepage
- Department of Pediatrics and Centre de Recherche du CHUS, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - François Corbin
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Mélanie Plourde
- Centre de Recherche sur le Vieillissement, Departments of Medicine, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
| | - Mauricio Farez
- Department of Child Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires C1428AQK, Argentina
| | - Patricia Cogram
- Biomedicine Division, Centre for Systems Biotechnology, Fraunhofer Chile Research Foundation, Santiago 7500588, Chile
| | - Artuela Çaku
- Centre de Recherche du CHUS, Department of Biochemistry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
- Correspondence:
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11
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Calub CA, Benyakorn S, Sun S, Iosif AM, Boyle LH, Solomon M, Hessl D, Schweitzer JB. Working Memory Training in Youth With Autism, Fragile X, and Intellectual Disability: A Pilot Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:369-389. [PMID: 36018768 PMCID: PMC9915337 DOI: 10.1352/1944-7558-127.5.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 08/03/2021] [Indexed: 06/15/2023]
Abstract
This pilot study sought to identify potential markers of improvement from pre-post treatment in response to computerized working memory (WM) training for youth (ages 8-18) with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) in a single arm, pre-post design. Participants included 26 children with ASD and 18 with comorbid ASD and fragile X syndrome (ASD+FXS). Analyses were adjusted for age and IQ. The ASD group demonstrated greater improvement on WM training relative to the ASD+FXS group. Participants improved on WM and far transfer outcomes, however, there were no significant group differences in improvement except for repetitive behavior. Higher hyperactivity/impulsivity ratings predicted lower performance on visuospatial WM. Findings suggest cognitive training may be beneficial for youth with ASD and ID, warranting further exploration.
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12
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Messina A, Potrich D, Perrino M, Sheardown E, Miletto Petrazzini ME, Luu P, Nadtochiy A, Truong TV, Sovrano VA, Fraser SE, Brennan CH, Vallortigara G. Quantity as a Fish Views It: Behavior and Neurobiology. Front Neuroanat 2022; 16:943504. [PMID: 35911657 PMCID: PMC9334151 DOI: 10.3389/fnana.2022.943504] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
An ability to estimate quantities, such as the number of conspecifics or the size of a predator, has been reported in vertebrates. Fish, in particular zebrafish, may be instrumental in advancing the understanding of magnitude cognition. We review here the behavioral studies that have described the ecological relevance of quantity estimation in fish and the current status of the research aimed at investigating the neurobiological bases of these abilities. By combining behavioral methods with molecular genetics and calcium imaging, the involvement of the retina and the optic tectum has been documented for the estimation of continuous quantities in the larval and adult zebrafish brain, and the contributions of the thalamus and the dorsal-central pallium for discrete magnitude estimation in the adult zebrafish brain. Evidence for basic circuitry can now be complemented and extended to research that make use of transgenic lines to deepen our understanding of quantity cognition at genetic and molecular levels.
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Affiliation(s)
- Andrea Messina
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Davide Potrich
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Matilde Perrino
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Eva Sheardown
- Centre for Developmental Neurobiology, Institute of Psychiatry, Psychology and Neuroscience, New Hunt’s House, Kings College London, London, United Kingdom
| | | | - Peter Luu
- Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA, United States
| | - Anna Nadtochiy
- Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA, United States
| | - Thai V. Truong
- Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA, United States
| | - Valeria Anna Sovrano
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Scott E. Fraser
- Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA, United States
| | - Caroline H. Brennan
- School of Biological and Behavioral Sciences, Queen Mary University of London, London, United Kingdom
| | - Giorgio Vallortigara
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
- *Correspondence: Giorgio Vallortigara,
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13
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Movaghar A, Page D, Brilliant M, Mailick M. Advancing artificial intelligence-assisted pre-screening for fragile X syndrome. BMC Med Inform Decis Mak 2022; 22:152. [PMID: 35689224 PMCID: PMC9185893 DOI: 10.1186/s12911-022-01896-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fragile X syndrome (FXS), the most common inherited cause of intellectual disability and autism, is significantly underdiagnosed in the general population. Diagnosing FXS is challenging due to the heterogeneity of the condition, subtle physical characteristics at the time of birth and similarity of phenotypes to other conditions. The medical complexity of FXS underscores an urgent need to develop more efficient and effective screening methods to identify individuals with FXS. In this study, we evaluate the effectiveness of using artificial intelligence (AI) and electronic health records (EHRs) to accelerate FXS diagnosis. METHODS The EHRs of 2.1 million patients served by the University of Wisconsin Health System (UW Health) were the main data source for this retrospective study. UW Health includes patients from south central Wisconsin, with approximately 33 years (1988-2021) of digitized health data. We identified all participants who received a code for FXS in the form of International Classification of Diseases (ICD), Ninth or Tenth Revision (ICD9 = 759.83, ICD10 = Q99.2). Only individuals who received the FXS code on at least two occasions ("Rule of 2") were classified as clinically diagnosed cases. To ensure the availability of sufficient data prior to clinical diagnosis to test the model, only individuals who were diagnosed after age 10 were included in the analysis. A supervised random forest classifier was used to create an AI-assisted pre-screening tool to identify cases with FXS, 5 years earlier than the time of clinical diagnosis based on their medical records. The area under receiver operating characteristic curve (AUROC) was reported. The AUROC shows the level of success in identification of cases and controls (AUROC = 1 represents perfect classification). RESULTS 52 individuals were identified as target cases and matched with 5200 controls. AI-assisted pre-screening tool successfully identified cases with FXS, 5 years earlier than the time of clinical diagnosis with an AUROC of 0.717. A separate model trained and tested on UW Health cases achieved the AUROC of 0.798. CONCLUSIONS This result shows the potential utility of our tool in accelerating FXS diagnosis in real clinical settings. Earlier diagnosis can lead to more timely intervention and access to services with the goal of improving patients' health outcomes.
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Affiliation(s)
- Arezoo Movaghar
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
| | - David Page
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Murray Brilliant
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Marsha Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
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14
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White H, Heck A, Jubran R, Chroust A, Bhatt RS. Average fixation duration in infancy: Stability and predictive utility. INFANCY 2022; 27:866-886. [PMID: 35624554 DOI: 10.1111/infa.12483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 03/02/2022] [Accepted: 04/19/2022] [Indexed: 11/27/2022]
Abstract
The current study examined the stability, consistency, and predictive utility of average fixation durations in infancy. In Study 1, infants' (N = 80) average fixation duration when viewing social stimuli was found to show strong relative stability from 3.5 to 9 months of age. In Study 2, strong within-infant consistency was found in 3.5-month-old infants' (N = 73) average fixation durations to social and nonsocial stimuli. In Study 3, 3.5- to 9-month-old infants' (N = 89) average fixation duration was found to systematically vary with parent-reported symptoms of attention deficit hyperactivity disorder (ADHD) at 4-6 years of age. These results suggest that average fixation duration serves as a stable and systematic measure of individual differences in cognitive development beginning early in life.
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Affiliation(s)
- Hannah White
- Department of Psychological Sciences, University of Missouri, St. Louis, Missouri, USA
| | - Alison Heck
- Department of Psychology, Berea College, Berea, Kentucky, USA
| | - Rachel Jubran
- Department of Behavioral & Social Sciences, University of Montevallo, Montevallo, Alabama, USA
| | - Alyson Chroust
- College of Arts and Sciences, East Tennessee State University, Johnson City, Tennessee, USA
| | - Ramesh S Bhatt
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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15
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Klusek J, O'Connor SL, Hickey A, Hills KJ, Abbeduto L, Roberts JE. Attention/Deficit Hyperactivity Disorder in Adolescent and Young Adult Males With Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:213-230. [PMID: 35443049 PMCID: PMC9414675 DOI: 10.1352/1944-7558-127.3.213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/26/2021] [Indexed: 05/03/2023]
Abstract
This study characterized the rates of attention-deficit/hyperactivity disorder (ADHD) in adolescent and young adult males with fragile X syndrome (FXS) using a multi-method approach integrating a DSM-based parent interview (Children's Interview for Psychiatric Syndromes; P-ChIPS, Fristad et al., 1998) and a parent rating scale (Child Behavior Checklist; CBCL, Achenbach, 2001). Thirty-one males with FXS, aged 16-24 years, participated. Forty-two percent met DSM-5 criteria for ADHD and 35% exceeded the CBCL cut-offs. Agreement between the two classification methods was fair (κ = 0.38). Autism symptom severity and nonverbal cognitive ability did not predict ADHD diagnoses/symptoms. Results show high rates of ADHD in males with FXS during late adolescence and young adulthood, which are not accounted for by impaired nonverbal cognitive skills or autism symptom severity. DSM-based ADHD-specific scales are recommended over broadband symptom scales to improve accurate identification.
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Affiliation(s)
- Jessica Klusek
- Jessica Klusek, Shannon L. O'Connor, Alexandra Hickey and Kimberly J. Hills, University of South Carolina
| | - Shannon L O'Connor
- Jessica Klusek, Shannon L. O'Connor, Alexandra Hickey and Kimberly J. Hills, University of South Carolina
| | - Alexandra Hickey
- Jessica Klusek, Shannon L. O'Connor, Alexandra Hickey and Kimberly J. Hills, University of South Carolina
| | - Kimberly J Hills
- Jessica Klusek, Shannon L. O'Connor, Alexandra Hickey and Kimberly J. Hills, University of South Carolina
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16
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Electrophysiological and Behavioral Evidence for Hyper- and Hyposensitivity in Rare Genetic Syndromes Associated with Autism. Genes (Basel) 2022; 13:genes13040671. [PMID: 35456477 PMCID: PMC9027402 DOI: 10.3390/genes13040671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 01/27/2023] Open
Abstract
Our study reviewed abnormalities in spontaneous, as well as event-related, brain activity in syndromes with a known genetic underpinning that are associated with autistic symptomatology. Based on behavioral and neurophysiological evidence, we tentatively subdivided the syndromes on primarily hyper-sensitive (Fragile X, Angelman) and hypo-sensitive (Phelan–McDermid, Rett, Tuberous Sclerosis, Neurofibromatosis 1), pointing to the way of segregation of heterogeneous idiopathic ASD, that includes both hyper-sensitive and hypo-sensitive individuals. This segmentation links abnormalities in different genes, such as FMR1, UBE3A, GABRB3, GABRA5, GABRG3, SHANK3, MECP2, TSC1, TSC2, and NF1, that are causative to the above-mentioned syndromes and associated with synaptic transmission and cell growth, as well as with translational and transcriptional regulation and with sensory sensitivity. Excitation/inhibition imbalance related to GABAergic signaling, and the interplay of tonic and phasic inhibition in different brain regions might underlie this relationship. However, more research is needed. As most genetic syndromes are very rare, future investigations in this field will benefit from multi-site collaboration with a common protocol for electrophysiological and event-related potential (EEG/ERP) research that should include an investigation into all modalities and stages of sensory processing, as well as potential biomarkers of GABAergic signaling (such as 40-Hz ASSR).
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17
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Bissell S, Oliver C, Moss J, Heald M, Waite J, Crawford H, Kothari V, Rumbellow L, Walters G, Richards C. The behavioural phenotype of SATB2-associated syndrome: a within-group and cross-syndrome analysis. J Neurodev Disord 2022; 14:25. [PMID: 35350986 PMCID: PMC8966214 DOI: 10.1186/s11689-022-09426-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background SATB2-associated syndrome (SAS) is a multisystem neurodevelopmental disorder characterised by intellectual disability, speech delay, and craniofacial anomalies. Although the clinical presentation of SAS is well-delineated, behaviours associated with SAS are less well-defined. Given the varied social profile reported in SAS of a ‘jovial’ predisposition and autistic behaviours, there may be phenotypic overlap with both Angelman syndrome (AS) and non-syndromal autism. This study aimed to describe behaviours in SAS in relation to chronological age and level of ability and contrast aspects of the behavioural phenotype with AS and non-syndromal autism. Methods Informant report questionnaire measures of behaviour, emotion, and autism characteristics were completed for 81 individuals with SAS (aged 1–36 years; 43 male). Within-group associations were analysed, and categorical data were compared between pre-school (1–5 years), school-age (6–15 years), and adolescent and adult SAS sub-groups (16 years and over). Cross-syndrome subscale and item-level analyses were conducted for 63 individuals with SAS (aged 1–27 years; 31 male), who were matched according to age and level of ability to 63 individuals with AS (aged 2–25 years; 32 male) and 63 individuals with non-syndromal autism (aged 3–26 years; 53 male). Results In SAS, higher rates of overactivity were moderately associated with lower self-help ability, and higher general anxiety scores were reported for males compared with females. Cross-syndrome subscale analyses uncovered several significant differences (p < .01), with comparatively low rates of stereotyped behaviour, overactivity, insistence on sameness and positive affect, and comparatively greater interest and pleasure and compulsive behaviour in individuals with SAS. Item-level analyses revealed a distinct profile of repetitive and autistic behaviours. Limitations Developmental analysis was based on a cross-sectional rather than a longitudinal research design, the contribution of pain and sleep to behaviour was not explored, and molecular genetic testing to determine genotype–phenotype behavioural relationships was not possible. Conclusions This study highlights the importance of behavioural comparisons to well-delineated groups and the utility of fine-grained item-level analyses to elucidate aspects of behaviour that might be syndrome related or shared across neurodevelopmental disorders. Future research is needed to further describe the distinctive repetitive and autistic behavioural phenotype in SAS. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09426-0.
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Affiliation(s)
- Stacey Bissell
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Joanna Moss
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Mary Heald
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, Lancashire, UK
| | - Jane Waite
- School of Health and Life Sciences, Aston University, Birmingham, UK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Vishakha Kothari
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Lauren Rumbellow
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Grace Walters
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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18
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Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review. Genes (Basel) 2022; 13:genes13020280. [PMID: 35205326 PMCID: PMC8871871 DOI: 10.3390/genes13020280] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 02/06/2023] Open
Abstract
Fragile X syndrome (FXS) causes intellectual disability and is the known leading cause of autism. Common problems in FXS include behavior and social problems. Along with syndromic characteristics and autism comorbidity, environmental factors might influence these difficulties. This systematic review focuses on the last 20 years of studies concerning behavior and social problems in FXS, considering environmental and personal variables that might influence both problems. Three databases were reviewed, leading to fifty-one studies meeting the inclusion criteria. Attention deficit hyperactivity disorder (ADHD) problems remain the greatest behavior problems, with behavioral problems and social competence being stable during the 20 years. Some developmental trajectories might have changed due to higher methodological control, such as aggressive behavior and attention problems. The socialization trajectory from childhood to adolescence remains unclear. Comorbidity with autism in individuals with FXS increased behavior problems and worsened social competence profiles. At the same time, comparisons between individuals with comorbid FXS and autism and individuals with autism might help define the comorbid phenotype. Environmental factors and parental characteristics influenced behavior problems and social competence. Higher methodological control is needed in studies including autism symptomatology and parental characteristics. More studies comparing autism in FXS with idiopathic autism are needed to discern differences between conditions.
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19
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Kenny A, Wright D, Stanfield AC. EEG as a translational biomarker and outcome measure in fragile X syndrome. Transl Psychiatry 2022; 12:34. [PMID: 35075104 PMCID: PMC8786970 DOI: 10.1038/s41398-022-01796-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 12/01/2021] [Accepted: 01/12/2022] [Indexed: 01/08/2023] Open
Abstract
Targeted treatments for fragile X syndrome (FXS) have frequently failed to show efficacy in clinical testing, despite success at the preclinical stages. This has highlighted the need for more effective translational outcome measures. EEG differences observed in FXS, including exaggerated N1 ERP amplitudes, increased resting gamma power and reduced gamma phase-locking in the sensory cortices, have been suggested as potential biomarkers of the syndrome. These abnormalities are thought to reflect cortical hyper excitability resulting from an excitatory (glutamate) and inhibitory (GABAergic) imbalance in FXS, which has been the target of several pharmaceutical remediation studies. EEG differences observed in humans also show similarities to those seen in laboratory models of FXS, which may allow for greater translational equivalence and better predict clinical success of putative therapeutics. There is some evidence from clinical trials showing that treatment related changes in EEG may be associated with clinical improvements, but these require replication and extension to other medications. Although the use of EEG characteristics as biomarkers is still in the early phases, and further research is needed to establish its utility in clinical trials, the current research is promising and signals the emergence of an effective translational biomarker.
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Affiliation(s)
- Aisling Kenny
- Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, EH10 5HF, Edinburgh, UK.
| | - Damien Wright
- grid.4305.20000 0004 1936 7988Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, EH10 5HF Edinburgh, UK
| | - Andrew C. Stanfield
- grid.4305.20000 0004 1936 7988Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, EH10 5HF Edinburgh, UK
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20
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Dominick KC, Andrews HF, Kaufmann WE, Berry-Kravis E, Erickson CA. Psychotropic Drug Treatment Patterns in Persons with Fragile X Syndrome. J Child Adolesc Psychopharmacol 2021; 31:659-669. [PMID: 34818076 DOI: 10.1089/cap.2021.0042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: Psychiatric comorbidity is common in fragile X syndrome (FXS) and often addressed through pharmacological management. Here we examine data in the Fragile X Online Registry With Accessible Research Database (FORWARD) to characterize specific symptoms being treated with psychotropic medication, patterns of medication use, as well as the influence of gender, intellectual disability (ID), age, and autism spectrum disorder (ASD) diagnosis. Methods: Data were drawn from the 975 participants who have a completed clinician form. We explored the frequency of psychotropic medication use for the following symptom clusters: attention, hyperactivity, anxiety, hypersensitivity, obsessive-compulsive disorder (OCD), mood swings, irritability/agitation, aggression, and self-injury (IAAS). Results: A majority of participants (617 or 63.3%) were taking a psychotropic medication, including investigational drugs. Medications were often targeting multiple symptoms. Psychotropic medication use was more common in males, adolescents, and those with comorbid ID and ASD. Anxiety was the most frequently targeted symptom, followed by attention-deficit/hyperactivity disorder symptoms and IAAS. Selective serotonin reuptake inhibitors (SSRIs) were the most frequently prescribed medication class among all patients (n = 266, 43%), followed by stimulants (n = 235, 38%), each with no gender difference. Antipsychotics were the third most frequently prescribed medication class (n = 205, 33%), and were more frequently prescribed to males and those with ID and ASD. Conclusions: Anxiety, attention and hyperactivity were the most common symptom targets for psychopharmacologic intervention in FXS. Our results support clinical knowledge that males with comorbid ASD and ID have a more severe presentation requiring more intervention including medications. These results highlight the need for examination of symptom overlap and interaction.
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Affiliation(s)
- Kelli C Dominick
- Department of Psychiatry, University of Cincinnati College of Medicine. Cincinnati, Ohio, USA.,Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Howard F Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Walter E Kaufmann
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, and Rush University Medical Center, Chicago, Illinois, USA.,Department of Biochemistry, Rush University Medical Center, Chicago, Illinois, USA
| | - Craig A Erickson
- Department of Psychiatry, University of Cincinnati College of Medicine. Cincinnati, Ohio, USA.,Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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21
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Guy MW, Black CJ, Hogan AL, Coyle RE, Richards JE, Roberts JE. A single-session behavioral protocol for successful event-related potential recording in children with neurodevelopmental disorders. Dev Psychobiol 2021; 63:e22194. [PMID: 34674246 PMCID: PMC9523962 DOI: 10.1002/dev.22194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 12/22/2022]
Abstract
Event-related potentials (ERPs) are an ideal tool for measuring neural responses in a wide range of participants, including children diagnosed with neurodevelopmental disorders (NDDs). However, due to perceived barriers regarding participant compliance, much of this work has excluded children with low IQ and/or reduced adaptive functioning, significant anxiety symptoms, and/or sensory processing difficulties, including heterogeneous samples of children with autism spectrum disorder (ASD) and children with fragile X syndrome (FXS). We have developed a behavioral support protocol designed to obtain high-quality ERP data from children in a single session. Using this approach, ERP data were successfully collected from participants with ASD, FXS, and typical development (TD). Higher success rates were observed for children with ASD and TD than children with FXS. Unique clinical-behavioral characteristics were associated with successful data collection across these groups. Higher chronological age, nonverbal mental age, and receptive language skills were associated with a greater number of valid trials completed in children with ASD. In contrast, higher language ability, lower autism severity, increased anxiety, and increased sensory hyperresponsivity were associated with a greater number of valid trials completed in children with FXS. This work indicates that a "one-size-fits-all" approach cannot be taken to ERP research on children with NDDs, but that a single-session paradigm is feasible and is intended to promote increased representation of children with NDDs in neuroscience research through development of ERP methods that support inclusion of diverse and representative samples.
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Affiliation(s)
- Maggie W. Guy
- Department of Psychology, Loyola University Chicago, Chicago, Illinois 60660, USA
| | - Conner J. Black
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Abigail L. Hogan
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Ramsey E. Coyle
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - John E. Richards
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Jane E. Roberts
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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22
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Bush L, Scott MN. Neuropsychological and ASD phenotypes in rare genetic syndromes: A critical review of the literature. Clin Neuropsychol 2021; 36:993-1027. [PMID: 34569897 DOI: 10.1080/13854046.2021.1980111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by core deficits in social communication and restricted and repetitive behaviors and interests. Recent advances in clinical genetics have improved our understanding of genetic syndromes associated with ASD, which has helped clarify distinct etiologies of ASD and document syndrome-specific profiles of neurocognitive strengths and weaknesses. Pediatric neuropsychologists have the potential to be impactful members of the care team for children with genetic syndromes and their families. METHOD We provide a critical review of the current literature related to the neuropsychological profiles of children with four genetic syndromes associated with ASD, including Tuberous Sclerosis Complex (TSC), fragile X syndrome (FXS), 22q11.2 deletion syndrome, and Angelman syndrome. Recommendations for assessment, intervention, and future directions are provided. RESULTS There is vast heterogeneity in terms of the cognitive, language, and developmental abilities of these populations. The within- and across-syndrome variability characteristic of genetic syndromes should be carefully considered during clinical evaluations, including possible measurement limitations, presence of intellectual disability, and important qualitative differences in the ASD-phenotypes across groups. CONCLUSIONS Individuals with genetic disorders pose challenging diagnostic and assessment questions. Pediatric neuropsychologists with expertise in neurodevelopmental processes are well suited to address these questions and identify profiles of neurocognitive strengths and weaknesses, tailor individualized recommendations, and provide diagnostic clarification.
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Affiliation(s)
- Lauren Bush
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Megan N Scott
- The Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA
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23
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González-Cano SI, Camacho-Abrego I, Diaz A, de la Cruz F, Morales-Medina JC, Flores G. Prenatal exposure to propionic acid induces altered locomotion and reactive astrogliosis in male rats. J Chem Neuroanat 2021; 117:102011. [PMID: 34384873 DOI: 10.1016/j.jchemneu.2021.102011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
Autism spectrum disorder (ASD) is a range of neurodevelopmental disorders characterized by movement and social deficits with rapidly increasing incidence worldwide. Propionic acid (PPA) is a histone deacetylase inhibitor that regulates neuronal plasticity in the brain. Evaluation of the behavioral and cellular consequences of PPA exposure during a critical neurodevelopmental window is required. Therefore, in the present study we aimed to evaluate the effects of prenatal PPA exposure on locomotor behavior and astrocyte number, as well as on levels of nitric oxide (NO), synaptophysin (SYP; a marker of synaptic plasticity), and metallothionein 3 (MT-III; a marker of reactive oxygen species and zinc metabolism), in the prefrontal cortex (PFC) of male rats. All parameters were evaluated at three critical ages of development: postnatal days (PD) 21 (weaning age), PD35 (pre-pubertal age) and PD70 (post-pubertal age). Prenatal PPA exposure induced hypolocomotion and decreased rearing events at weaning age. Moreover, astrogliosis in the PFC was observed in PPA-treated rats at pre- and post-pubertal age. SYP levels were dramatically decreased in PPA-treated rats with simultaneous astrogliosis, suggesting reduced synaptic plasticity. MT-III expression was deregulated in PPA-treated rats. Finally, the expression of NO in the PFC remained unaltered in PPA-treated rats. These results mimic behavioral, neuronal and astrocytic characteristics observed in ASD patients.
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Affiliation(s)
- Sonia Irais González-Cano
- Lab. Neuropsiquiatría, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, San Manuel, 72570, Puebla, Mexico
| | - Israel Camacho-Abrego
- Lab. Neuropsiquiatría, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, San Manuel, 72570, Puebla, Mexico
| | - Alfonso Diaz
- Departamento de Farmacia, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, 72570, Puebla, Mexico
| | - Fidel de la Cruz
- Departamento de Fisiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Julio César Morales-Medina
- Centro de Investigación en Reproducción Animal, CINVESTAV- Universidad Autónoma de Tlaxcala, AP 62, CP 90000, Tlaxcala, Mexico
| | - Gonzalo Flores
- Lab. Neuropsiquiatría, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, San Manuel, 72570, Puebla, Mexico.
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24
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Individualization of attention-deficit/hyperactivity disorder treatment: pharmacotherapy considerations by age and co-occurring conditions. CNS Spectr 2021; 26:202-221. [PMID: 32054558 DOI: 10.1017/s1092852919001822] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that manifests in childhood and can persist into adolescence and adulthood. Impairments associated with ADHD can impact quality of life, social interactions, and increase the risk of morbidity and mortality; however, for many patients, effective treatment can lessen these effects. Pharmacotherapy with stimulants or nonstimulants is recommended in conjunction with psychosocial therapy for most patients. Determining the optimal pharmacotherapy can be complex, and the clinician needs to consider many factors such as the patient's age, comorbidities, and lifestyle. Furthermore, the needs of the patient with ADHD will change over time, with specific challenges to consider at each stage of life. A variety of Food and Drug Administration (FDA)-approved stimulant and nonstimulant formulations are available with different modes of delivery and durations of effect. This armamentarium of ADHD medications can be used to individualize ADHD treatment for each patient's needs. This article combines current information from the literature and the first-hand experience of the authors to provide guidance on ADHD treatment options for patients of different ages and for some of the more common comorbidities.
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25
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Behavioural Measures of Infant Activity but Not Attention Associate with Later Preschool ADHD Traits. Brain Sci 2021; 11:brainsci11050524. [PMID: 33919004 PMCID: PMC8143002 DOI: 10.3390/brainsci11050524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
Mapping infant neurocognitive differences that precede later ADHD-related behaviours is critical for designing early interventions. In this study, we investigated (1) group differences in a battery of measures assessing aspects of attention and activity level in infants with and without a family history of ADHD or related conditions (ASD), and (2) longitudinal associations between the infant measures and preschool ADHD traits at 3 years. Participants (N = 151) were infants with or without an elevated likelihood for ADHD (due to a family history of ADHD and/or ASD). A multi-method assessment protocol was used to assess infant attention and activity level at 10 months of age that included behavioural, cognitive, physiological and neural measures. Preschool ADHD traits were measured at 3 years of age using the Child Behaviour Checklist (CBCL) and the Child Behaviour Questionnaire (CBQ). Across a broad range of measures, we found no significant group differences in attention or activity level at 10 months between infants with and without a family history of ADHD or ASD. However, parent and observer ratings of infant activity level at 10 months were positively associated with later preschool ADHD traits at 3 years. Observable behavioural differences in activity level (but not attention) may be apparent from infancy in children who later develop elevated preschool ADHD traits.
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Movaghar A, Page D, Scholze D, Hong J, DaWalt LS, Kuusisto F, Stewart R, Brilliant M, Mailick M. Artificial intelligence-assisted phenotype discovery of fragile X syndrome in a population-based sample. Genet Med 2021; 23:1273-1280. [PMID: 33772223 PMCID: PMC8257481 DOI: 10.1038/s41436-021-01144-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Fragile X syndrome (FXS), the most prevalent inherited cause of intellectual disability, remains underdiagnosed in the general population. Clinical studies have shown that individuals with FXS have a complex health profile leading to unique clinical needs. However, the full impact of this X-linked disorder on the health of affected individuals is unclear and the prevalence of co-occurring conditions is unknown. METHODS We mined the longitudinal electronic health records from more than one million individuals to investigate the health characteristics of patients who have been clinically diagnosed with FXS. Additionally, using machine-learning approaches, we created predictive models to identify individuals with FXS in the general population. RESULTS Our discovery-oriented approach identified the associations of FXS with a wide range of medical conditions including circulatory, endocrine, digestive, and genitourinary, in addition to mental and neurological disorders. We successfully created predictive models to identify cases five years prior to clinical diagnosis of FXS without relying on any genetic or familial data. CONCLUSION Although FXS is often thought of primarily as a neurological disorder, it is in fact a multisystem syndrome involving many co-occurring conditions, some primary and some secondary, and they are associated with a considerable burden on patients and their families.
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Affiliation(s)
- Arezoo Movaghar
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - David Page
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Danielle Scholze
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.,Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jinkuk Hong
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Ron Stewart
- Morgridge Institute for Research, Madison, WI, USA
| | - Murray Brilliant
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.,Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Marsha Mailick
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
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Hall SS, Monlux KD, Rodriguez AB, Jo B, Pollard JS. Telehealth-enabled behavioral treatment for problem behaviors in boys with fragile X syndrome: a randomized controlled trial. J Neurodev Disord 2020; 12:31. [PMID: 33218305 PMCID: PMC7679978 DOI: 10.1186/s11689-020-09331-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/07/2020] [Indexed: 01/18/2023] Open
Abstract
Background Children with fragile X syndrome (FXS) are at increased risk for exhibiting problem behaviors such as aggression and self-injury. However, many children with FXS have limited access to behavioral treatments that have known efficacy due to the low availability of treatment providers and the wide geographical dispersion of families with FXS across the country. Telehealth may offer a cost-effective and practical solution to overcome these significant barriers. We examined the effect of administering an established behavior analytic intervention called functional communication training (FCT) via telehealth on levels of problem behaviors exhibited by boys with FXS. We also examined treatment acceptability, as well as the effect of the treatment on levels of parenting stress. Methods Boys with FXS, aged 3 to 10 years, who displayed problem behaviors daily, were randomized to receive FCT via telehealth (n = 30) or treatment as usual (n = 27) over 12 weeks. Outcome measures included in-session observations of problem behavior, the Aberrant Behavior Checklist—Community (ABC-C), the Treatment Acceptability Rating Form—Revised (TARF-R), and the Parenting Stress Index, 4th edition (PSI-4). Results Intention-to-treat analyses indicated that scores on the irritability subscale of the ABC-C, our primary outcome measure, decreased significantly for boys who received FCT via telehealth compared to boys who received treatment as usual (p < .001, Cohen’s d = 0.65). In-session observations conducted for those who received treatment showed that levels of problem behavior decreased by 91% from baseline. Levels of parenting stress related to child behavioral problems were also lower following FCT treatment, and caregivers reported that the intervention was acceptable. Conclusions These findings support telehealth-enabled FCT as a framework for expanding access to behavioral treatments for problem behaviors in children with FXS. Expanded delivery of behavior analytic treatment via telehealth also has the potential to lower healthcare costs, improve child and family quality of life, and lead to advances in the treatment of problem behavior in the broader population of individuals with neurodevelopmental disorders. Trial registration ClinicalTrials.gov, NCT03510156. Registered 27 April 2018
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Affiliation(s)
- Scott S Hall
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Katerina D Monlux
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Arlette Bujanda Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Behavior Change Institute, Oakland, CA, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Joy S Pollard
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Behavior Change Institute, Oakland, CA, USA
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Abstract
Prospective longitudinal studies of idiopathic autism spectrum disorder (ASD) have provided insights into early symptoms and predictors of ASD during infancy, well before ASD can be diagnosed at age 2-3 years. However, research on the emergence of ASD in disorders with a known genetic etiology, contextualized in a developmental framework, is currently lacking. Using a biobehavioral multimethod approach, we (a) determined the rate of ASD in N = 51 preschoolers with fragile X syndrome (FXS) using a clinical best estimate (CBE) procedure with differential diagnoses of comorbid psychiatric disorders and (b) investigated trajectories of ASD symptoms and physiological arousal across infancy as predictors of ASD in preschoolers with FXS. ASD was not diagnosed if intellectual ability or psychiatric disorders better accounted for the symptoms. Our results determined that 60.7% of preschoolers with FXS met the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-5) criteria for ASD using the CBE procedure. In addition, 92% of these preschoolers presented with developmental delay and 45.4% also met criteria for psychiatric disorders, either anxiety, ADHD, or both. ASD diagnoses in preschoolers with FXS were predicted by elevated scores on traditional ASD screeners in addition to elevated autonomic arousal and avoidant eye contact from infancy.
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29
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Van Remmerden MC, Hoogland L, Mous SE, Dierckx B, Coesmans M, Moll HA, Lubbers K, Lincken CR, Van Eeghen AM. Growing up with Fragile X Syndrome: Concerns and Care Needs of Young Adult Patients and Their Parents. J Autism Dev Disord 2020; 50:2174-2187. [PMID: 30879259 PMCID: PMC7261272 DOI: 10.1007/s10803-019-03973-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Little is known about care needs of young adults with Fragile X Syndrome (FXS). Patient-driven information is needed to improve understanding and support of young adults with FXS. A qualitative study was performed in 5 young adult patients (aged 18–30), and 33 parents of young adults. Concerns and care needs were categorized using the International Classification of Functioning, Disability, and Health. Results indicated concerns on 14 domains for males, and 13 domains for females, including physical, psychological and socio-economical issues. In both groups parents reported high stress levels and a lack of knowledge of FXS in adult care providers. This study revealed concerns on various domains, requiring gender-specific, multidisciplinary transitional care and adult follow-up for patients with FXS.
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Affiliation(s)
- M C Van Remmerden
- The Hartekamp Groupe, Care and Service Center for People with Intellectual Disabilities, Haarlem, The Netherlands
| | - L Hoogland
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.,ASVZ, Care and Service Center for People with Intellectual Disabilities, Sliedrecht, The Netherlands
| | - S E Mous
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - B Dierckx
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - M Coesmans
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - H A Moll
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of General Pediatrics, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - K Lubbers
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C R Lincken
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands.,Department of General Pediatrics, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A M Van Eeghen
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus Medical Center, Room SP-1536, Wytemaweg 80, 3015CN, Rotterdam, The Netherlands. .,Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands. .,'s Heeren Loo Zorggroep, Care and Service Center for People with Intellectual Disabilities, Amersfoort, The Netherlands.
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Doherty BR, Longhi E, Cole V, Karmiloff-Smith A, Cornish K, Scerif G. Disentangling autism spectrum and attention-deficit/hyperactivity symptoms over development in fragile X syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103692. [PMID: 32505083 DOI: 10.1016/j.ridd.2020.103692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 06/11/2023]
Abstract
Even genetic disorders associated with monogenic aetiologies are characterized by complex and variable risk for poor outcomes, highlighting the need to follow trajectories longitudinally. Here, we investigated the longitudinal relationships between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) symptoms in a population at high risk for both: boys with fragile X syndrome. 59 boys with fragile X syndrome aged 3-10 years old at entry participated in this study, and were followed up one and two years after their first visit. As expected, we found strong relationships over three timepoints for ADHD symptoms (as measured by the parent-rated Conners scale) and ASD symptoms (as measured by the Social Communication Questionnaire [SCQ]). In addition, using structural equation modeling (SEM) we found that ADHD symptoms at time 2 predicted ASD symptoms at time 3, suggestive of a causal relationship. Importantly, these relationships hold when including chronological age at entry to the study, as well as when including severity of impairment as measured by IQ, and their effects on both ASD and ADHD symptoms do not reach significance. This result highlights the need to study outcomes longitudinally and it informs the comorbidity of the two symptom domains in FXS as well as their potential directionality, both of which have been little researched. In addition, our findings may suggest a future need to study how ADHD symptoms and their treatment impact individuals with ASD.
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Affiliation(s)
| | - Elena Longhi
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Victoria Cole
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Annette Karmiloff-Smith
- Department of Experimental Psychology, University of Oxford, United Kingdom; Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, United Kingdom.
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31
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Kramvis I, van Westen R, Lammertse HCA, Riga D, Heistek TS, Loebel A, Spijker S, Mansvelder HD, Meredith RM. Dysregulated Prefrontal Cortex Inhibition in Prepubescent and Adolescent Fragile X Mouse Model. Front Mol Neurosci 2020; 13:88. [PMID: 32528248 PMCID: PMC7264168 DOI: 10.3389/fnmol.2020.00088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/28/2020] [Indexed: 11/13/2022] Open
Abstract
Changes in excitation and inhibition are associated with the pathobiology of neurodevelopmental disorders of intellectual disability and autism and are widely described in Fragile X syndrome (FXS). In the prefrontal cortex (PFC), essential for cognitive processing, excitatory connectivity and plasticity are found altered in the FXS mouse model, however, little is known about the state of inhibition. To that end, we investigated GABAergic signaling in the Fragile X Mental Retardation 1 (FMR1) knock out (Fmr1-KO) mouse medial PFC (mPFC). We report changes at the molecular, and functional levels of inhibition at three (prepubescence) and six (adolescence) postnatal weeks. Functional changes were most prominent during early postnatal development, resulting in stronger inhibition, through increased synaptic inhibitory drive and amplitude, and reduction of inhibitory short-term synaptic depression. Noise analysis of prepubescent post-synaptic currents demonstrated an increased number of receptors opening during peak current in Fmr1-KO inhibitory synapses. During adolescence amplitudes and plasticity changes normalized, however, the inhibitory drive was now reduced in Fmr1-KO, while synaptic kinetics were prolonged. Finally, adolescent GABAA receptor subunit α2 and GABAB receptor subtype B1 expression levels were different in Fmr1-KOs than WT littermate controls. Together these results extend the degree of synaptic GABAergic alterations in FXS, now to the mPFC of Fmr1-KO mice, a behaviourally relevant brain region in neurodevelopmental disorder pathology.
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Affiliation(s)
- Ioannis Kramvis
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Rhodé van Westen
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Hanna C A Lammertse
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Danai Riga
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Tim S Heistek
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Alex Loebel
- Department of Neurobiology, Ludwig-Maximilians Universitat, Munich, Germany
| | - Sabine Spijker
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Huibert D Mansvelder
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
| | - Rhiannon M Meredith
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, Amsterdam, Netherlands
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Hilvert E, Hoover J, Sterling A, Schroeder S. Comparing Tense and Agreement Productivity in Boys With Fragile X Syndrome, Children With Developmental Language Disorder, and Children With Typical Development. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1181-1194. [PMID: 32282263 PMCID: PMC7242987 DOI: 10.1044/2019_jslhr-19-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/16/2019] [Accepted: 12/19/2019] [Indexed: 06/11/2023]
Abstract
Purpose This study compared and characterized the tense and agreement productivity of boys with fragile X syndrome (FXS), children with developmental language disorder (DLD), and children with typical development (TD) matched on mean length of utterance. Method Twenty-two boys with FXS (M age = 12.22 years), 19 children with DLD (M age = 4.81 years), and 20 children with TD (M age = 3.23 years) produced language samples that were coded for their productive use of five tense markers (i.e., third-person singular, past tense -ed, copula BE, auxiliary BE, and auxiliary DO) using the tense and agreement productivity score. Children also completed norm-referenced cognitive and linguistic assessments. Results Children with DLD generally used tense and agreement markers less productively than children with TD, particularly third-person singular and auxiliary BE. However, boys with FXS demonstrated a more complicated pattern of productivity, where they were similar to children with DLD and TD, depending on the tense marker examined. Results revealed that children with DLD and TD showed a specific developmental sequence of the individual tense markers that aligns with patterns documented by previous studies, whereas boys with FXS demonstrated a more even profile of productivity. Conclusions These findings help to further clarify areas of overlap and discrepancy in tense and agreement productivity among boys with FXS and children with DLD. Additional clinical implications of these results are discussed.
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Affiliation(s)
| | - Jill Hoover
- Department of Communication Disorders, University of Massachusetts Amherst
| | - Audra Sterling
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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33
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Swanson MR, Hazlett HC. White matter as a monitoring biomarker for neurodevelopmental disorder intervention studies. J Neurodev Disord 2019; 11:33. [PMID: 31839003 PMCID: PMC6912948 DOI: 10.1186/s11689-019-9295-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Early intervention is a valuable tool to support the development of toddlers with neurodevelopmental disorders. With recent research advances in early identification that allow for pre-symptomatic detection of autism in infancy, scientists are looking forward to intervention during infancy. These advances may be supported by the identification of biologically based treatment and outcome measures that are sensitive and dimensional. The purpose of this review is to evaluate white matter neurodevelopment as a monitoring biomarker for early treatment of neurodevelopmental disorders. Fragile X syndrome (FXS) and autism spectrum disorder (ASD) as used as exemplars. White matter has unique neurobiology, including a prolonged period of dynamic development. This developmental pattern may make white matter especially responsive to treatment. White matter develops aberrantly in children with ASD and FXS. Histologic studies in rodents have provided targets for FXS pharmacological intervention. However, pharmaceutical clinical trials in humans failed to garner positive clinical results. In this article, we argue that the use of neurobiological monitoring biomarkers may overcome some of these limitations, as they are objective, not susceptible to placebo effects, and are dimensional in nature. SHORT CONCLUSION As the field moves towards earlier detection and early intervention for neurodevelopmental disorders, we encourage scientists to consider the advantages of using neurobiological features as monitoring biomarkers.
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Affiliation(s)
- Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, GR41, 800 W. Campbell Road, Richardson, TX, 75080-3021, USA.
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 27599, NC, USA
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Doll CA, Yergert KM, Appel BH. The RNA binding protein fragile X mental retardation protein promotes myelin sheath growth. Glia 2019; 68:495-508. [PMID: 31626382 DOI: 10.1002/glia.23731] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/20/2019] [Accepted: 09/22/2019] [Indexed: 12/13/2022]
Abstract
During development, oligodendrocytes in the central nervous system extend a multitude of processes that wrap axons with myelin. The highly polarized oligodendrocytes generate myelin sheaths on many different axons, which are far removed from the cell body. Neurons use RNA binding proteins to transport, stabilize, and locally translate mRNA in distal domains of neurons. Local synthesis of synaptic proteins during neurodevelopment facilitates the rapid structural and functional changes underlying neural plasticity and avoids extensive protein transport. We hypothesize that RNA binding proteins also regulate local mRNA regulation in oligodendrocytes to promote myelin sheath growth. Fragile X mental retardation protein (FMRP), an RNA binding protein that plays essential roles in the growth and maturation of neurons, is also expressed in oligodendrocytes. To determine whether oligodendrocytes require FMRP for myelin sheath development, we examined fmr1-/- mutant zebrafish and drove FMR1 expression specifically in oligodendrocytes. We found oligodendrocytes in fmr1-/- mutants developed myelin sheaths of diminished length, a phenotype that can be autonomously rescued in oligodendrocytes with FMR1 expression. Myelin basic protein (Mbp), an essential myelin protein, was reduced in myelin tracts of fmr1-/- mutants, but loss of FMRP function did not impact the localization of mbpa transcript in myelin. Finally, expression of FMR1-I304N, a missense allele that abrogates FMRP association with ribosomes, failed to rescue fmr1-/- mutant sheath growth and induced short myelin sheaths in oligodendrocytes of wild-type larvae. Taken together, these data suggest that FMRP promotes sheath growth through local regulation of translation.
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Affiliation(s)
- Caleb A Doll
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Katie M Yergert
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Bruce H Appel
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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The Persistence of Self-injurious and Aggressive Behavior in Males with Fragile X Syndrome Over 8 Years: A Longitudinal Study of Prevalence and Predictive Risk Markers. J Autism Dev Disord 2019; 49:2913-2922. [PMID: 31020491 PMCID: PMC6606661 DOI: 10.1007/s10803-019-04002-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Self-injurious and aggressive behaviors are common in fragile X syndrome (FXS). However, little is known about the persistence of these behaviors and associated risk markers. We established the prevalence and persistence of self-injurious and aggressive behaviors over eight years in males with FXS, and associations with risk markers. Results showed 77% and 69% persistence rates for self-injurious and aggressive behavior, respectively. Baseline levels of repetitive behavior predicted persistent self-injurious behavior. Chronological age, impulsivity and overactivity were associated with persistent aggressive behavior but only impulsivity predicted persistence. This is the first study to document the persistence of self-injurious and aggressive behavior in FXS over the medium to long term and to identify behavioral risk markers that might facilitate targeted early intervention.
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Callari A, Miniati M. Clinical and Therapeutic Challenges when Psychiatric Disorders Occur in Neurological Diseases: A Narrative Review. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1573400515666190411142109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:Over the course of the 20th century, neurology and psychiatry diverged and became two separate disciplines. Subsequently, the continuous progress of neurosciences confused their boundaries. However, with ‘the splitting’ and ‘the lumping’ approaches, relevant difficulties remain in targeting clinical and therapeutic goals, when psychiatric signs and symptoms co-occur with neurological diseases.Objective:The study summarize current evidence on psychiatric signs and symptoms comorbid with neurological diseases, with the aim to provide information on diagnostic problems and available therapeutic options.Methods:Finding from searches of publications on ‘PsycInfo’, ‘Medline’, and ‘Science Direct’, from January 1993 to December 2018 (25 years) is summarized in a narrative manner on six main neurological areas: congenital neurological illnesses (n=16), dementias (n=15), basal ganglia diseases (n=30), epilepsy (n=22), strokes/focal brain injuries (n=29), and neurological neoplastic/paraneoplastic diseases (n=15).Results:Clinical phenotypes of psychiatric syndromes are frequently described in neurological studies. Little evidence is provided on the most adequate therapeutic approaches.Conclusion:Psychiatric syndromes in comorbidity with neurological diseases are heterogeneous and severe; evidence-based treatments are scarce. Despite a model supporting an equal approach between psychiatric and neurological syndromes, psychiatric syndromes in neurological diseases have been described, to a relevant degree, as less important, leading to a hierarchical primate of the neurological manifestations, and thus, in our opinion, limiting the systematic studies on psychopharmacological treatments in this area.
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Affiliation(s)
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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Cannabidiol (CBD) reduces anxiety-related behavior in mice via an FMRP-independent mechanism. Pharmacol Biochem Behav 2019; 181:93-100. [DOI: 10.1016/j.pbb.2019.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/21/2019] [Accepted: 05/01/2019] [Indexed: 11/18/2022]
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Roberts JE, Crawford H, Will EA, Hogan AL, McQuillin S, Tonnsen BL, O'Connor S, Roberts DA, Brewe AM. Infant Social Avoidance Predicts Autism but Not Anxiety in Fragile X Syndrome. Front Psychiatry 2019; 10:199. [PMID: 31133885 PMCID: PMC6514151 DOI: 10.3389/fpsyt.2019.00199] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/20/2019] [Indexed: 01/01/2023] Open
Abstract
Objective: Autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and anxiety are three of the most common childhood psychiatric disorders. Early trajectories of social avoidance have been linked with these psychiatric disorders in previous studies, but it remains unclear how social avoidance differentially predicts comorbid disorders in a high-risk genetic subgroup. Here, we delineate the association between trajectories of social avoidance from infancy and subsequent ASD, ADHD, and anxiety outcomes at preschool in children with fragile X syndrome (FXS), a well-characterized single-gene disorder highly associated with social avoidance as well as elevated rates of ASD, ADHD, and anxiety. Method: Males with FXS (n = 78) aged 4-62 months participated in a longitudinal study resulting in 201 assessments. The Social Avoidance Scale (SAS) documented socially avoidant behaviors from infancy in three domains-physical movement, facial expression, and eye contact during both the first minute and the last hour of an interaction. ASD, ADHD, and anxiety symptom outcomes at preschool were measured via parent-report questionnaires. Results: Increased social avoidance across infancy and preschool predicted elevated ASD symptom severity but reduced ADHD and anxiety symptom severity in males with FXS. Conclusion: ASD, ADHD, and anxiety symptoms relate inconsistently to social avoidance behaviors, providing new insight toward the debate of independence or overlap among these disorders in FXS and other disorders (i.e., ASD). The results suggest that the nuanced profile of the developmental and temporal aspects of social avoidance may inform more the accuracy of differential diagnoses of comorbid psychiatric disorders in FXS.
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Affiliation(s)
- Jane E. Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Hayley Crawford
- Centre for Innovative Research Across the Life Course, Coventry University, Coventry, United Kingdom
| | - Elizabeth A. Will
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Abigail L. Hogan
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Samuel McQuillin
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Bridgette L. Tonnsen
- Department of Psychological Science, Purdue University, West Lafayette, IN, United States
| | - Shannon O'Connor
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | | | - Alexis M. Brewe
- Department of Psychology, University of South Carolina, Columbia, SC, United States
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Jalnapurkar I, Cochran DM, Frazier JA. New Therapeutic Options for Fragile X Syndrome. Curr Treat Options Neurol 2019; 21:12. [PMID: 30809735 DOI: 10.1007/s11940-019-0551-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of current research and clinical practice guidelines in fragile X syndrome (FXS) with regard to therapeutic approaches in the management of this condition. The authors summarize and discuss findings from relevant preclinical studies and results from clinical trials in human subjects with FXS. Additionally, we provide an outline of the basic framework for understanding and providing educational and psychosocial supports for these individuals. RECENT FINDINGS Current treatments in FXS are largely symptom based and focused on managing associated psychiatric and behavioral co-morbidities. While data from animal studies has been promising in providing targeted treatments to correct the underlying deficits at the cellular level, there have not been as robust findings in human trials. There are several targeted treatments for FXS currently under development. Individuals with FXS present with several behavioral challenges including anxiety, social withdrawal, ADHD, hyperarousal, self-injury, and aggression. Therapeutic services are often necessary, such as behavioral intervention, speech and language therapy, occupational therapy, and individualized educational support; adjunctive psychopharmacologic treatment is often helpful as well. It is important to address these symptoms and weigh the evidence for the use of medications that target the underlying neurobiology and pathophysiology of the syndrome.
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Affiliation(s)
- Isha Jalnapurkar
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA. .,Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA.
| | - David M Cochran
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA.,Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA
| | - Jean A Frazier
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA.,Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA
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40
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Angelakos CC, Tudor JC, Ferri SL, Jongens TA, Abel T. Home-cage hypoactivity in mouse genetic models of autism spectrum disorder. Neurobiol Learn Mem 2019; 165:107000. [PMID: 30797034 DOI: 10.1016/j.nlm.2019.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 11/28/2018] [Accepted: 02/19/2019] [Indexed: 11/16/2022]
Abstract
Genome-wide association and whole exome sequencing studies from Autism Spectrum Disorder (ASD) patient populations have implicated numerous risk factor genes whose mutation or deletion results in significantly increased incidence of ASD. Behavioral studies of monogenic mutant mouse models of ASD-associated genes have been useful for identifying aberrant neural circuitry. However, behavioral results often differ from lab to lab, and studies incorporating both males and females are often not performed despite the significant sex-bias of ASD. In this study, we sought to investigate the simple, passive behavior of home-cage activity monitoring across multiple 24-h days in four different monogenic mouse models of ASD: Shank3b-/-, Cntnap2-/-, Pcdh10+/-, and Fmr1 knockout mice. Relative to sex-matched wildtype (WT) littermates, we discovered significant home-cage hypoactivity, particularly in the dark (active) phase of the light/dark cycle, in male mice of all four ASD-associated transgenic models. For Cntnap2-/- and Pcdh10+/- mice, these activity alterations were sex-specific, as female mice did not exhibit home-cage activity differences relative to sex-matched WT controls. These home-cage hypoactivity alterations differ from activity findings previously reported using short-term activity measurements in a novel open field. Despite circadian problems reported in human ASD patients, none of the mouse models studied had alterations in free-running circadian period. Together, these findings highlight a shared phenotype across several monogenic mouse models of ASD, outline the importance of methodology on behavioral interpretation, and in some genetic lines parallel the male-enhanced phenotypic presentation observed in human ASDs.
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Affiliation(s)
- Christopher C Angelakos
- Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Jennifer C Tudor
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19104, United States; Department of Biology, Saint Joseph's University, Philadelphia, PA 19131, United States
| | - Sarah L Ferri
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19104, United States; Molecular Physiology and Biophysics, Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, United States
| | - Thomas A Jongens
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Ted Abel
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19104, United States; Molecular Physiology and Biophysics, Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, United States.
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41
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Schmitt LM, Shaffer RC, Hessl D, Erickson C. Executive Function in Fragile X Syndrome: A Systematic Review. Brain Sci 2019; 9:E15. [PMID: 30654486 PMCID: PMC6356760 DOI: 10.3390/brainsci9010015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/17/2022] Open
Abstract
Executive function (EF) supports goal-directed behavior and includes key aspects such as working memory, inhibitory control, cognitive flexibility, attention, processing speed, and planning. Fragile X syndrome (FXS) is the leading inherited monogenic cause of intellectual disability and is phenotypically characterized by EF deficits beyond what is expected given general cognitive impairments. Yet, a systematic review of behavioral studies using performance-based measures is needed to provide a summary of EF deficits across domains in males and females with FXS, discuss clinical and biological correlates of these EF deficits, identify critical limitations in available research, and offer suggestions for future studies in this area. Ultimately, this review aims to advance our understanding of the underlying pathophysiological mechanisms contributing to EF in FXS and to inform the development of outcome measures of EF and identification of new treatment targets in FXS.
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Affiliation(s)
- Lauren M Schmitt
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | - Rebecca C Shaffer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
| | - David Hessl
- MIND Institute, Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95616, USA.
| | - Craig Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
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Chromik LC, Quintin EM, Lepage JF, Hustyi KM, Lightbody AA, Reiss AL. The Influence of Hyperactivity, Impulsivity, and Attention Problems on Social Functioning in Adolescents and Young Adults With Fragile X Syndrome. J Atten Disord 2019; 23:181-188. [PMID: 25731183 PMCID: PMC5758425 DOI: 10.1177/1087054715571739] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Individuals with fragile X syndrome (FXS) present primarily with cognitive and social deficits in addition to symptoms of ADHD. The relationship between symptoms of ADHD, cognitive functioning, and social skills has never been explicitly studied. METHOD Here, we analyzed both longitudinal ( n = 70; Time 1: ages 6-18; Time 2: ages 15-26) and cross-sectional ( n = 73; Time 2 only) data using hierarchical linear regression to assess how global intellectual functioning (IQ) and symptoms of ADHD influence social functioning in individuals with FXS. RESULTS We found that ADHD symptoms at Times 1 and 2 consistently predict social functioning in both males and females with FXS at Time 2. CONCLUSION Our results suggest that addressing ADHD symptoms in childhood may have positive, long-term effects on the social functioning of adolescents and young adults with FXS.
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Affiliation(s)
- Lindsay C. Chromik
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Eve-Marie Quintin
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA,Educational and Counselling Psychology Department, McGill University, Montreal, Quebec, Canada
| | - Jean-François Lepage
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Kristin M. Hustyi
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Amy A. Lightbody
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Allan L. Reiss
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
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Fernández E, Gennaro E, Pirozzi F, Baldo C, Forzano F, Turolla L, Faravelli F, Gastaldo D, Coviello D, Grasso M, Bagni C. FXS-Like Phenotype in Two Unrelated Patients Carrying a Methylated Premutation of the FMR1 Gene. Front Genet 2018; 9:442. [PMID: 30450110 PMCID: PMC6224343 DOI: 10.3389/fgene.2018.00442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/14/2018] [Indexed: 12/31/2022] Open
Abstract
Fragile X syndrome (FXS) is mostly caused by two distinct events that occur in the FMR1 gene (Xq27.3): an expansion above 200 repeats of a CGG triplet located in the 5′UTR of the gene, and methylation of the cytosines located in the CpG islands upstream of the CGG repeats. Here, we describe two unrelated families with one FXS child and another sibling presenting mild intellectual disability and behavioral features evocative of FXS. Genetic characterization of the undiagnosed sibling revealed mosaicism in both the CGG expansion size and the methylation levels in the different tissues analyzed. This report shows that in the same family, two siblings carrying different CGG repeats, one in the full-mutation range and the other in the premutation range, present methylation mosaicism and consequent decreased FMRP production leading to FXS and FXS-like features, respectively. Decreased FMRP levels, more than the number of repeats seem to correlate with the severity of FXS clinical phenotypes.
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Affiliation(s)
- Esperanza Fernández
- Center for Human Genetics, KU Leuven, Leuven, Belgium.,VIB & KU Leuven Center for Brain & Disease Research, Leuven, Belgium
| | - Elena Gennaro
- Laboratorio di Genetica Umana, Ospedali Galliera, Genoa, Italy
| | - Filomena Pirozzi
- Center for Human Genetics, KU Leuven, Leuven, Belgium.,VIB & KU Leuven Center for Brain & Disease Research, Leuven, Belgium
| | - Chiara Baldo
- Laboratorio di Genetica Umana, Ospedali Galliera, Genoa, Italy
| | - Francesca Forzano
- Clinical Genetics Department, Borough Wing Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,S.S.D. Genetica Medica, Ospedali Galliera, Genoa, Italy
| | - Licia Turolla
- U.O.S. Genetica Medica, Azienda ULSS 2, Treviso, Italy
| | - Francesca Faravelli
- Clinical Genetics Department, Great Ormond Street Hospital, London, United Kingdom
| | - Denise Gastaldo
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | | | - Marina Grasso
- Laboratorio di Genetica Umana, Ospedali Galliera, Genoa, Italy
| | - Claudia Bagni
- Center for Human Genetics, KU Leuven, Leuven, Belgium.,VIB & KU Leuven Center for Brain & Disease Research, Leuven, Belgium.,Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland.,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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44
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Bélanger SA, Andrews D, Gray C, Korczak D. Le TDAH chez les enfants et les adolescents, partie 1 : l’étiologie, le diagnostic et la comorbidité. Paediatr Child Health 2018; 23:454-461. [PMCID: PMC6199646 DOI: 10.1093/pch/pxy110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
Le trouble de déficit de l’attention/hyperactivité (TDAH) est un trouble neurodéveloppemental chronique. La Société canadienne de pédiatrie a préparé trois documents de principes après avoir effectué des analyses bibliographiques systématiques. Leurs objectifs s’établissent comme suit : 1) Résumer les données probantes cliniques à jour sur le TDAH. 2) Établir une norme pour les soins du TDAH. 3) Aider les cliniciens canadiens à prendre des décisions éclairées et fondées sur des données probantes pour rehausser la qualité des soins aux enfants et aux adolescents qui présentent cette affection. Les thèmes abordés dans la partie 1, qui est axée sur le diagnostic, incluent la prévalence, la génétique, la physiopathologie, le diagnostic différentiel, ainsi que les troubles psychiatriques et les troubles du développement comorbides. En plus des recherches dans les bases de données, les auteurs ont analysé les directives les plus récentes de l’American Academy of Pediatrics , de l’American Academy of Child and Adolescent Psychiatry , du National Institute for Health and Clinical Excellence , du Scottish Intercollegiate Guidelines Network et de l’Eunethydis European ADHD Guidelines Group . Puisque le TDAH est un trouble hétérogène, son évaluation médicale complète devrait toujours inclure une anamnèse fouillée, un examen physique et une évaluation approfondie du diagnostic différentiel et des comorbidités connexes. Les auteurs proposent des recommandations précises sur la récolte d’information, les tests à effectuer et les orientations vers divers services.
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Affiliation(s)
- Stacey A Bélanger
- Société canadienne de pédiatrie, comité de la santé mentale et des troubles du développement, Ottawa (Ontario)
| | - Debbi Andrews
- Société canadienne de pédiatrie, comité de la santé mentale et des troubles du développement, Ottawa (Ontario)
| | - Clare Gray
- Société canadienne de pédiatrie, comité de la santé mentale et des troubles du développement, Ottawa (Ontario)
| | - Daphne Korczak
- Société canadienne de pédiatrie, comité de la santé mentale et des troubles du développement, Ottawa (Ontario)
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45
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Bélanger SA, Andrews D, Gray C, Korczak D. ADHD in children and youth: Part 1-Etiology, diagnosis, and comorbidity. Paediatr Child Health 2018; 23:447-453. [PMID: 30681669 PMCID: PMC6199644 DOI: 10.1093/pch/pxy109] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder. Three position statements have been developed by the Canadian Paediatric Society, following systematic literature reviews. Statement objectives are to: 1) Summarize the current clinical evidence regarding ADHD,2) Establish a standard for ADHD care, and3) Assist Canadian clinicians in making well-informed, evidence-based decisions to enhance care of children and youth with this condition. Specific topics reviewed in Part 1, which focuses on diagnosis, include: prevalence, genetics, pathophysiology, differential diagnosis and comorbid psychiatric disorders and developmental disorders. In addition to database searches, the most recent guidelines of the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the National Institute for Health and Clinical Excellence, the Scottish Intercollegiate Guidelines Network, and the Eunethydis European ADHD Guidelines Group, were reviewed. Because ADHD is a heterogeneous disorder, comprehensive medical assessment for ADHD should always include a complete history, a physical examination, and a thorough consideration of differential diagnosis and related comorbidities. Specific recommendations for information gathering, testing, and referral are offered.
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Affiliation(s)
- Stacey A Bélanger
- Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario
| | - Debbi Andrews
- Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario
| | - Clare Gray
- Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario
| | - Daphne Korczak
- Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario
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46
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Crawford H, Moss J, Stinton C, Singla G, Oliver C. Overactivity, impulsivity and repetitive behaviour in males with fragile X syndrome: contrasting developmental trajectories in those with and without elevated autism symptoms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:672-683. [PMID: 29722449 DOI: 10.1111/jir.12488] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/07/2018] [Accepted: 03/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Hyperactivity and repetitive behaviour are characteristic features of fragile X syndrome (FXS). However, little is known about the influence of autism symptomatology on how these characteristics develop over time. We investigate the profiles and developmental trajectories of overactivity, impulsivity and repetitive behaviour, in males with FXS over three time points spanning 8 years. METHOD Participants formed two subgroups, those who displayed elevated symptoms of autism at Time 1 (n = 37; Mage = 16.32; age range = 6.61-43.51) and those who did not (n = 32; Mage = 8.43; age range = 8.94-47.49). RESULTS Participants without elevated symptoms of autism showed a reduction in impulsivity and repetitive questioning over time, whereas those with elevated symptoms of autism did not. Differences between the two subgroups in several topographies of repetitive behaviour emerged at Time 3 only. CONCLUSIONS These results further understanding of the relationship between autistic phenomenology and behavioural characteristics in FXS.
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Affiliation(s)
- H Crawford
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - J Moss
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - C Stinton
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - G Singla
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - C Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
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Lumaka A, Lubala TK, Race V, Peeters H, Lukusa P, Devriendt K. Usefulness of fragile X checklist and CGG distribution in specialized institutions in Kinshasa, DR Congo. J Community Genet 2018; 10:153-159. [PMID: 29974402 DOI: 10.1007/s12687-018-0374-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/20/2018] [Indexed: 11/27/2022] Open
Abstract
Screening for fragile X syndrome (FXS) is essential in children with developmental delay or intellectual disability (ID). In addition, using clinical screening checklists remains of high interest in resource-limited settings. We aimed to gain insight into the prevalence of FXS and the distribution of CGG alleles and to evaluate the usefulness of three checklists in specialized institutions in Kinshasa, DR Congo. We recruited 80 males and 25 females from six specialized institutions in Kinshasa and administered a questionnaire comprising items from the following FXS checklists: Hagerman, Maes, and Guruju. FMR1 CGG repeats were assessed for every patient. About 37% of patients were referable for FX testing based on Hagerman's checklist, 35% for Maes', and 43.80% for Guruju's, but none of them was molecularly confirmed to have FXS. Thus, specificities were 62.86, 64.76, and 56.5%, respectively, for Hagerman, Maes, and Guruju, respectively. The mean CGG allele size was 28.55 ± 2.83 (ranges, 17-48). The 29 CGG was the most frequent allele (24.61%). Thus, existing checklists should not be automatically applied to Congolese patients without adjustments. The distribution of CGG repeats and the number of CGG alleles are similar to other African studies.
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Affiliation(s)
- Aimé Lumaka
- Centre for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.,Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4500, Liège, Belgium.,Department of Pediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.,Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Toni Kasole Lubala
- Division of Dysmorphology and Birth Defects, Department of Pediatrics, University of Lubumbashi, Lubumbashi, Congo
| | - Valérie Race
- Centre for Human Genetics, University Hospitals, University of Leuven, Herestraat 49, Bus 602, 3000, Leuven, Belgium
| | - Hilde Peeters
- Centre for Human Genetics, University Hospitals, University of Leuven, Herestraat 49, Bus 602, 3000, Leuven, Belgium
| | - Prosper Lukusa
- Centre for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.,Department of Pediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.,Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo.,Centre for Human Genetics, University Hospitals, University of Leuven, Herestraat 49, Bus 602, 3000, Leuven, Belgium
| | - Koenraad Devriendt
- Centre for Human Genetics, University Hospitals, University of Leuven, Herestraat 49, Bus 602, 3000, Leuven, Belgium.
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48
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Swanson MR, Wolff JJ, Shen MD, Styner M, Estes A, Gerig G, McKinstry RC, Botteron KN, Piven J, Hazlett HC. Development of White Matter Circuitry in Infants With Fragile X Syndrome. JAMA Psychiatry 2018; 75:505-513. [PMID: 29617515 PMCID: PMC6026861 DOI: 10.1001/jamapsychiatry.2018.0180] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Fragile X syndrome (FXS) is a genetic neurodevelopmental disorder and the most common inherited cause of intellectual disability in males. However, there are no published data on brain development in children with FXS during infancy. OBJECTIVE To characterize the development of white matter at ages 6, 12, and 24 months in infants with FXS compared with that of typically developing controls. DESIGN, SETTING, AND PARTICIPANTS Longitudinal behavioral and brain imaging data were collected at 1 or more time points from 27 infants with FXS and 73 typically developing controls between August 1, 2008, and June 14, 2016, at 2 academic medical centers. Infants in the control group had no first- or second-degree relatives with intellectual or psychiatric disorders, including FXS and autism spectrum disorder. MAIN OUTCOMES AND MEASURES Nineteen major white matter pathways were defined in common atlas space based on anatomically informed methods. Diffusion parameters, including fractional anisotropy, were compared between groups using linear mixed effects modeling. Fiber pathways showing group differences were subsequently examined in association with direct measures of verbal and nonverbal development. RESULTS There were significant differences in the development of 12 of 19 fiber tracts between the 27 infants with FXS (22 boys and 5 girls) and the 73 infants in the control group (46 boys and 27 girls), with lower fractional anisotropy in bilateral subcortical-frontal, occipital-temporal, temporal-frontal, and cerebellar-thalamic pathways, as well as 4 of 6 subdivisions of the corpus callosum. For all 12 of these pathways, there were significant main effects between groups but not for the interaction of age × group, indicating that lower fractional anisotropy was present and stable from age 6 months in infants with FXS. Lower fractional anisotropy values in the uncinate fasciculi were correlated with lower nonverbal developmental quotient in the FXS group (left uncinate, F = 10.06; false discovery rate-corrected P = .03; right uncinate, F = 21.8; P = .004). CONCLUSIONS AND RELEVANCE The results substantiate in human infants the essential role of fragile X gene expression in the early development of white matter. The findings also suggest that the neurodevelopmental effects of FXS are well established at 6 months of age.
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Affiliation(s)
- Meghan R. Swanson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis
| | - Mark D. Shen
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill,Department of Computer Science, University of North Carolina at Chapel Hill
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Guido Gerig
- Department of Computer Science and Engineering, New York University, Brooklyn
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, Missouri
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri,Department of Radiology, Washington University in St Louis, St Louis, Missouri
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill
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Will EA, Caravella KE, Hahn LJ, Fidler DJ, Roberts JE. Adaptive behavior in infants and toddlers with Down syndrome and fragile X syndrome. Am J Med Genet B Neuropsychiatr Genet 2018; 177:358-368. [PMID: 29399949 PMCID: PMC7294771 DOI: 10.1002/ajmg.b.32619] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/08/2018] [Indexed: 12/23/2022]
Abstract
Individuals with Down syndrome (DS) experience deficits across all domains of adaptive functioning, however little is known about the emergence and age-related changes of these impairments compared to other neurogenetic disorders with similar intellectual disability impairments, such as fragile X syndrome (FXS). Adaptive behavior is key for optimal functioning in these populations. Participants aged 5-45 months comprised three age-matched groups, DS (n = 64), FXS (n = 69), and typically developing controls (TD; n = 69). Adaptive behavior was measured on the Vineland Adaptive Behavior Scales-II. Regressions were used to examine adaptive behavior in a cross-sectional design across age. DS infants and toddlers evidenced deficits across all areas of adaptive behaviors compared to the age-matched TD group, with clear impairments present in the first year of life. Motor skills were the area of greatest weakness in children with DS with significant impairment evident at 12 months of age that remained low through 3 years. Compared to age-matched children with FXS, children with DS showed initially lower standard scores at 12 months of age, but slower declines in standard scores across age, resulting in less impaired functioning at 36 months. This is the first study to compare adaptive behavior in infants and toddlers with DS to FXS, and demonstrate the phenotypic specificity of adaptive profiles in this diagnostic group. These findings provide evidence that adaptive behavior should be a major target of intervention in children with FXS and DS, and that these differences are potentially driven by unique etiologies attributable to each disorder.
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Affiliation(s)
- Elizabeth A Will
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Kelly E Caravella
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Laura J Hahn
- Department of Speech and Hearing Science, University of Illinois Urbana Champaign, Champaign, Illinois
| | - Deborah J Fidler
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, Columbia, South Carolina
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Boutet I, Collin CA, MacLeod LS, Messier C, Holahan MR, Berry-Kravis E, Gandhi RM, Kogan CS. Utility of the Hebb-Williams Maze Paradigm for Translational Research in Fragile X Syndrome: A Direct Comparison of Mice and Humans. Front Mol Neurosci 2018; 11:99. [PMID: 29643767 PMCID: PMC5882825 DOI: 10.3389/fnmol.2018.00099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/13/2018] [Indexed: 11/26/2022] Open
Abstract
To generate meaningful information, translational research must employ paradigms that allow extrapolation from animal models to humans. However, few studies have evaluated translational paradigms on the basis of defined validation criteria. We outline three criteria for validating translational paradigms. We then evaluate the Hebb–Williams maze paradigm (Hebb and Williams, 1946; Rabinovitch and Rosvold, 1951) on the basis of these criteria using Fragile X syndrome (FXS) as model disease. We focused on this paradigm because it allows direct comparison of humans and animals on tasks that are behaviorally equivalent (criterion #1) and because it measures spatial information processing, a cognitive domain for which FXS individuals and mice show impairments as compared to controls (criterion #2). We directly compared the performance of affected humans and mice across different experimental conditions and measures of behavior to identify which conditions produce comparable patterns of results in both species. Species differences were negligible for Mazes 2, 4, and 5 irrespective of the presence of visual cues, suggesting that these mazes could be used to measure spatial learning in both species. With regards to performance on the first trial, which reflects visuo-spatial problem solving, Mazes 5 and 9 without visual cues produced the most consistent results. We conclude that the Hebb–Williams mazes paradigm has the potential to be utilized in translational research to measure comparable cognitive functions in FXS humans and animals (criterion #3).
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Affiliation(s)
- Isabelle Boutet
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Claude Messier
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | | | - Elizabeth Berry-Kravis
- Pediatrics, Biochemistry, and Neurology, Rush University Medical Center, Chicago, IL, United States
| | - Reno M Gandhi
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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