1
|
Joshi PT. James C. Harris, MD (1940-2021). J Am Acad Child Adolesc Psychiatry 2022:S0890-8567(22)00049-1. [PMID: 35158037 DOI: 10.1016/j.jaac.2022.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/15/2023]
Abstract
Sadly, Dr. James C. Harris passed away at his home in April 2021, peacefully and in the presence of his loving wife Catherine DeAngelis, MD, shortly after he was diagnosed with pancreatic cancer. He was born in Birmingham, Alabama, and received his medical degree in 1966 from the George Washington University School of Medicine in Washington, DC. This followed a year of internship at the Children's Hospital of Los Angeles in California and a residency in Pediatrics at Strong Memorial Hospital University of Rochester in New York State. He came to Johns Hopkins as a Senior Assistant Resident in Pediatrics in 1972, and it is then that Hopkins became his professional home, which he never left. He proceeded to complete his general psychiatry residency and child and adolescent psychiatry fellowship at Johns Hopkins as well. Dr. Harris was Professor of Psychiatry and Behavioral Sciences, and of Pediatrics, former Director of Child and Adolescent Psychiatry, founding director of the Developmental Neuropsychiatry Program at Hopkins and the Kennedy Krieger Institute, and a beloved mentor to so many of today's leaders in child and adolescent psychiatry. Jim was indeed a distinguished clinician, educator, scholar, investigator, and advocate; he was also my training director, mentor, and friend.
Collapse
|
2
|
Neo WS, Suzuki T, Kelleher BL. Structural validity of the Child Behavior Checklist (CBCL) for preschoolers with neurogenetic syndromes. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 109:103834. [PMID: 33360964 DOI: 10.1016/j.ridd.2020.103834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Psychologists routinely use the Child Behavior Checklist for Ages 1½-5 (CBCL) to assess challenging behaviors of preschoolers with developmental disabilities. However, the CBCL has not been thoroughly validated in neurogenetic syndromes (NGS). AIM We investigated the structural validity of the CBCL in NGS. METHODS Based on 152 preschoolers with Angelman, fragile X, Prader-Willi, and Williams syndromes, we employed confirmatory factor analysis (CFA) to evaluate the goodness-of-fit of CBCL narrowband, broadband, and DSM-oriented scales. RESULTS CFA models largely supported the unidimensionality of most narrowband scales and the two-factor structure of internalizing and externalizing broadband scales. However, there was limited evidence for the unidimensionality of most DSM-oriented scales. CONCLUSIONS Psychologists may consider using the CBCL as a psychometrically sound narrowband and broadband measure of challenging behaviors but should exercise caution when interpreting DSM-oriented scales for preschoolers with NGS. Our findings underscore a continued need to enhance assessment measures for identifying early precursors of child psychopathology in pediatric populations with atypical developmental trajectories.
Collapse
Affiliation(s)
- Wei Siong Neo
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN, 47907, USA.
| | - Takakuni Suzuki
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN, 47907, USA
| | - Bridgette L Kelleher
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN, 47907, USA
| |
Collapse
|
3
|
Hamrick LR, Tonnsen BL. Validating and Applying the CSBS-ITC in Neurogenetic Syndromes. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:263-285. [PMID: 31026205 PMCID: PMC7156276 DOI: 10.1352/1944-7558-124.3.263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Although social communication skills are commonly delayed in children with neurogenetic syndromes (NGS), skill profiles in very young children are largely under characterized, in part due to the lack of validated assessment measures appropriate for these populations. We addressed this gap by validating and applying a popular early social communication screening measure, the Communication and Symbolic Behavior Scales Developmental Profile - Infant-Toddler Checklist (CSBS-ITC) in three previously understudied neurogenetic groups: Angelman, Prader-Willi, and Williams syndromes. Our results suggest that when used within the appropriate scope of screening and surveillance, the CSBS-ITC detects meaningful variability in skills across ages in young children with NGS and may provide useful information about both individual- and population-level social communication profiles in these populations.
Collapse
Affiliation(s)
- Lisa R Hamrick
- Lisa R. Hamrick, Purdue University, Department of Psychological Sciences and Bridgette L. Tonnsen, Department of Psychological Sciences, Purdue University
| | - Bridgette L Tonnsen
- Lisa R. Hamrick, Purdue University, Department of Psychological Sciences and Bridgette L. Tonnsen, Department of Psychological Sciences, Purdue University
| |
Collapse
|
4
|
|
5
|
Harris JC. The origin and natural history of autism spectrum disorders. Nat Neurosci 2018; 19:1390-1391. [PMID: 27786188 DOI: 10.1038/nn.4427] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- James C Harris
- Department of Psychiatry and Behavioral Sciences, Developmental Neuropsychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
6
|
Abstract
In 1943, Leo Kanner published the first systematic description of early infantile autism. He concluded that this was a neurodevelopmental disorder and that 'these children have come into the world with an innate inability to form the usual, biologically provided contact with people'. Moreover, his astute descriptions of parental behavior in his first publications were prescient and underlie later recognition of the importance of genetics. Our understanding has grown over the ensuing years with revisions in diagnostic classification, recognition of the broader autism phenotype in families, appreciation of the importance of developmental models, advances in genetic methodology, better understanding of the relationship to intellectual deficits, recognition of syndromic autism in neurogenetic sydromes, advances in neuroimaging, and advances in animal models, both mutant mouse models and transgenic non human primate models. Kanner recognized diagnostic heterogeneity and opined that the children had not read those diagnostic manuals and did not easily fall into clear cut categories. Such heterogeneity continues to confound our diagnostic efforts. Always an advocate for children, when reviewing the DSM III criteria in 1980, Kanner emphasized that no matter how well developed our criteria each child must be treated as a unique person.
Collapse
Affiliation(s)
- James Harris
- a Department of Psychiatry and Behavioral Sciences , The Johns Hopkins University School of Medicine , Baltimore , MD , USA
| |
Collapse
|
7
|
Perrino F, Licchelli S, Serra G, Piccini G, Caciolo C, Pasqualetti P, Cirillo F, Leoni C, Digilio MC, Zampino G, Tartaglia M, Alfieri P, Vicari S. Psychopathological features in Noonan syndrome. Eur J Paediatr Neurol 2018; 22:170-177. [PMID: 29037749 DOI: 10.1016/j.ejpn.2017.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 07/29/2017] [Accepted: 09/19/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Noonan syndrome (NS) is an autosomal dominant disorder characterized by short stature, skeletal and haematological/lymphatic defects, distinctive facies, cryptorchidism, and a wide spectrum of congenital heart defects. Recurrent features also include variable cognitive deficits and behavioural problems. Recent research has been focused on the assessment of prevalence, age of onset and characterization of psychiatric features in this disorder. Herein, we evaluated the prevalence of attention deficit and hyperactivity disorder (ADHD), anxiety and depressive symptoms and syndromes in a cohort of individuals with clinical and molecular diagnosis of NS. METHODS The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS PL) has been used for the assessment of psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI) have been assessed for the evaluation of anxiety and depressive symptoms and syndromes, whereas Conners Teacher and Parent Rating Scales-long version (CRS-R) have been used to evaluate ADHD. RESULTS The study included 27 individuals (67% males) with an average age of 10.4 years (range 6-18 years) receiving molecular diagnosis of NS or a clinically related condition, evaluated and treated at the Neuropsychiatric Unit of Children's Hospital Bambino Gesù and at the Center for Rare Diseases of Fondazione Policlinico Universitario Agostino Gemelli, in Rome. Twenty individuals showed mutations in PTPN11, five in SOS1 and two in SHOC2. The mean IQ was 94 (Standard Deviation = 17, min = 56, max = 130). Seventy percent of the individuals (n = 19; 95% Confidence Interval = 52-85%) showed ADHD features, with six individuals reaching DSM-IV-TR criteria for ADHD disorder, and thirteen showing subsyndromal traits. Symptoms or syndrome of anxiety were present in 37% of the cohort (n = 10; 95% Confidence Interval = 19-56%), with two individuals showing anxiety disorder and eight cases exhibiting subsyndromal traits. CONCLUSION Our results show individuals with NS do present a very high risk to develop psychiatric disorders or symptoms during paediatric age. Based on these findings, preschool assessment of inattentive, hyperactivity/impulsivity and anxiety/depressive symptoms is recommended in order to plan a personalized treatment for psychological/psychiatric issues in affected individuals. Dedicated prospective studies are required to confirm the present data and better characterize the psychopathological profile in NS.
Collapse
Affiliation(s)
- Francesca Perrino
- Center for Rare Diseases, Department of Pediatrics, Polo Salute Donna e Bambino, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
| | - Serena Licchelli
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giulia Serra
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Italy; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Giorgia Piccini
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Cristina Caciolo
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Patrizio Pasqualetti
- Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy; Language and Communication Across Modalities Laboratory (LaCAM), Institute of Cognitive Sciences and Technologies (ISTC-CNR), Italy
| | - Flavia Cirillo
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Chiara Leoni
- Center for Rare Diseases, Department of Pediatrics, Polo Salute Donna e Bambino, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
| | - Maria Cristina Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Center for Rare Diseases, Department of Pediatrics, Polo Salute Donna e Bambino, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Alfieri
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Stefano Vicari
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| |
Collapse
|
8
|
Bryan AD, Jakicic JM, Hunter CM, Evans ME, Yanovski SZ, Epstein LH. Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management. Obesity (Silver Spring) 2017; 25:1653-1659. [PMID: 28948719 PMCID: PMC5657446 DOI: 10.1002/oby.21924] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. METHODS As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. RESULTS Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. CONCLUSIONS This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity.
Collapse
Affiliation(s)
| | | | - Christine M. Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Mary E. Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Susan Z. Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Leonard H. Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| |
Collapse
|
9
|
Segal P, Pode-Shakked B, Raas-Rothschild A. Elucidating the behavioral phenotype of patients affected with mucolipidosis IV: What can we learn from the parents? Eur J Med Genet 2017; 60:340-344. [PMID: 28392473 DOI: 10.1016/j.ejmg.2017.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 03/19/2017] [Accepted: 04/05/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Mucolipidosis type IV (ML-IV) is a rare autosomal recessive lysosomal storage disorder which presents with nonspecific developmental delay. Nowadays with the use of new tools such as next generation sequencing, more ML-IV affected patients are diagnosed. Still, identifying the behavioral phenotype might be of help for early diagnosis and anticipatory guidance, as well as for counseling of the families. OBJECTIVE Identification of the behavioral characteristics of 12 ML-IV patients, aged from 2.5 to 34 years, based on their caregivers' observations. METHODS The information was gathered from the patients' parents using an extensive semi-structured interview especially designed for this study. Each interview lasted approximately three hours. RESULTS Patients were uniformly described as friendly and show explicit pleasure from both social interactions and music. They all presented delays in psychomotor development, while their general health was reported as good. Parents reported that the patients present deterioration of motor and communication skills over the years. Episodes of ocular pain, with ipsilateral flushing of the face and tearing were frequently reported, as was shortening of the Achilles tendon. Since the identification of the ML-IV gene, diagnosis is made earlier in life. CONCLUSION We suggest that ML-IV be considered in the differential diagnosis of patients with developmental delay, who present the behavioral phenotype reported here. This pattern could also be useful for the ancitipatory guidance in the care of ML-IV affected patients. Further clinical research is warranted to confirm these preliminary findings.
Collapse
Affiliation(s)
- Perri Segal
- Department of Psychology, Hebrew University, Jerusalem, Israel
| | - Ben Pode-Shakked
- Institute of Rare Diseases & Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, Israel
| | - Annick Raas-Rothschild
- Institute of Rare Diseases & Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
10
|
Fox J, Ben-Shachar S, Uliel S, Svirsky R, Saitsu H, Matsumoto N, Fattal-Valevski A. Rare familial TSC2 gene mutation associated with atypical phenotype presentation of Tuberous Sclerosis Complex. Am J Med Genet A 2017; 173:744-748. [PMID: 28127866 DOI: 10.1002/ajmg.a.38027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/07/2016] [Indexed: 12/24/2022]
Abstract
Tuberous sclerosis complex (TSC) is a neurocutaneous disorder that results from mutations within either the TSC1 gene or the TSC2 gene. Diagnosis is based on well-established clinical criteria or genetic criteria. We describe an 18-month-old boy who presented with seizures and a single hypopigmented macule. He did not meet consensus criteria for the clinical diagnosis of TSC. Exome sequencing revealed a heterozygous TSC2 mutation (c.5138G>A (p.Arg1713His)) in the patient. This heterozygous alteration was detected in his mother as well as several other maternal family members. The mother and other family members with the mutation were asymptomatic except for the presence of hypopigmented macules. The phenotypic characteristics of the individuals in this family were not suggestive of a TSC2 mutation as none satisfied the clinical criteria for even a diagnosis of possible TSC. This case provides evidence for a unique TSC2 mutation that resulted in an atypical clinical presentation and indicates potential shortcomings of the current diagnostic criteria for TSC. These findings may have implications for genetic counseling and screening. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Jonah Fox
- New York State/American Program, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shay Ben-Shachar
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shimrit Uliel
- Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel Aviv, Israel
| | - Ran Svirsky
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Aviva Fattal-Valevski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel Aviv, Israel
| |
Collapse
|
11
|
Hare DJ, Vahey C, Walker S, Wittkowski A. Clinical psychologists' attitudes towards the biology and 'new genetics' of intellectual and developmental disabilities: a pilot study using Q-methodology. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:1054-1065. [PMID: 26929020 DOI: 10.1111/jir.12261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 11/09/2015] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The current study investigated how ideas and models from the 'New Genetics' and associated fields of developmental neuroscience and behavioural phenotypes are perceived by clinical psychologists working with people with intellectual and developmental disabilities (IDD). As well as examining the take-up and influence of such ideas, it also examines barriers, both personal and institutional, to the widespread adoption of such concepts and research findings in services for people with IDD. METHODS A Q-methodology study was undertaken with 31 qualified and 16 trainee clinical psychologists in the North West of England using a specifically developed 81-item Q set. RESULTS Three factors were identified and labelled Integration of social and medical models, Social model of disability is more helpful and Genetic advances in conflict with recognising the value of people with IDD. CONCLUSION There was a lack of consensus in clinical psychologists working with people with IDD, with amount and type of professional experience affecting the factor loadings, which may need to be considered in developing clinical applications of genetic IDD research.
Collapse
Affiliation(s)
- D J Hare
- School of Psychology, Cardiff University, Cardiff, Wales, UK.
| | | | - S Walker
- Socrates Clinical Psychology, Huddersfield, UK
| | - A Wittkowski
- School of Psychological Sciences, University of Manchester, Manchester, UK
| |
Collapse
|
12
|
Clinical and molecular delineation of duplication 9p24.3q21.11 in a patient with psychotic behavior. Gene 2015; 560:124-7. [PMID: 25667990 DOI: 10.1016/j.gene.2015.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 02/01/2015] [Accepted: 02/06/2015] [Indexed: 12/11/2022]
Abstract
This article describes a 19-year-old female with mild facial dysmorphism, asociality, decreased school performance, and psychotic behavior in whom the karyotype showed an extra-chromosomal marker characterized as 9p24.3-9q21.11 duplication by array-CGH. The 69Mbp duplicated segment in this patient includes the critical 9p duplication syndrome region, the GLDC and C90RF72 genes associated with psychotic behavior and other conduct disorders, and a potential locus for autism.
Collapse
|
13
|
Swillen A, de Ravel T, Oliver C. Social phenotypes in genetic syndromes. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2012; 56:919-921. [PMID: 22973833 DOI: 10.1111/j.1365-2788.2012.01620.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
14
|
Van Balkom IDC, Vuijk PJ, Franssens M, Hoek HW, Hennekam RCM. Development, cognition, and behaviour in Pitt-Hopkins syndrome. Dev Med Child Neurol 2012; 54:925-31. [PMID: 22712893 DOI: 10.1111/j.1469-8749.2012.04339.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM The aim of the study was to collect detailed data on behavioural, adaptive, and psychological functioning in 10 individuals with Pitt-Hopkins syndrome (PTHS), with specific attention to manifestations of autism spectrum disorder (ASD). METHOD The participants (four females, six males), residing in the Netherlands and Belgium, were ascertained through the Dutch national PTHS support group. Median age of participants was 10 years, the age range was between 32 and 289 months. They underwent psychiatric examinations and neuropsychological measurements using a comprehensive assessment battery. Additionally, parental information was gathered through standardized interviews and questionnaires. Findings were compared with those from the literature. RESULTS All participants showed profound intellectual disability, amiable demeanour with minimal maladaptive behaviours, severe impairments of communication and language, and intense, frequent motor stereotypies. Impairments in all participants were beyond what would be expected for cognitive abilities, fitting a classification of ASD. INTERPRETATION Patients with PTHS are characterized not only by specific physical and genetic manifestations but also by specific behavioural and cognitive characteristics. Studying behaviour and cognition may improve diagnosis and prognosis, allows recognition of comorbidities, and contributes to adequate counselling of families.
Collapse
Affiliation(s)
- Ingrid D C Van Balkom
- Jonx Department of Youth Mental Health, Lentis Psychiatric Institute, Zuidlaren, the Netherlands.
| | | | | | | | | |
Collapse
|
15
|
Mawson AR. Toward a theory of childhood learning disorders, hyperactivity, and aggression. ISRN PSYCHIATRY 2012; 2012:589792. [PMID: 23762766 PMCID: PMC3671718 DOI: 10.5402/2012/589792] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/14/2012] [Indexed: 02/03/2023]
Abstract
Learning disorders are often associated with persistent hyperactivity and aggression and are part of a spectrum of neurodevelopmental disorders. A potential clue to understanding these linked phenomena is that physical exercise and passive forms of stimulation are calming, enhance cognitive functions and learning, and are recommended as complementary treatments for these problems. The theory is proposed that hyperactivity and aggression are intense stimulation-seeking behaviors (SSBs) driven by increased brain retinergic activity, and the stimulation thus obtained activates opposing nitrergic systems which inhibit retinergic activity, induce a state of calm, and enhance cognition and learning. In persons with cognitive deficits and associated behavioral disorders, the retinergic system may be chronically overactivated and the nitrergic system chronically underactivated due to environmental exposures occurring pre- and/or postnatally that affect retinoid metabolism or expression. For such individuals, the intensity of stimulation generated by SSB may be insufficient to activate the inhibitory nitrergic system. A multidisciplinary research program is needed to test the model and, in particular, to determine the extent to which applied physical treatments can activate the nitrergic system directly, providing the necessary level of intensity of sensory stimulation to substitute for that obtained in maladaptive and harmful ways by SSB, thereby reducing SSB and enhancing cognitive skills and performance.
Collapse
Affiliation(s)
- Anthony R. Mawson
- School of Health Sciences, College of Public Service, Jackson State University, 350 West Woodrow Wilson Drive, Room 229, Jackson, MS 39213, USA
| |
Collapse
|
16
|
Bezuidenhout H, Wiysonge CS, Bentley JM. Risperidone for disruptive behaviour disorders in children with intellectual disabilities. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Heidre Bezuidenhout
- Red Cross Hospital, University of Cape Town; Western Cape Provincial Administration; 201 Bayviews Clifford Road, Seapoint Cape Town Western South Africa 8500
| | - Charles Shey Wiysonge
- University of Cape Town; Institute of Infectious Disease and Molecular Medicine & Division of Medical Microbiology; Anzio Road Observatory South Africa 7925
| | - Judith M Bentley
- University of Cape Town; Department of Psychiatry and Mental Health; 51 Washington Road Claremont Cape Town Western Cape South Africa 7708
| |
Collapse
|
17
|
Kinast L, von der Ohe J, Burhenne H, Seifert R. Impairment of adenylyl cyclase 2 function and expression in hypoxanthine phosphoribosyltransferase-deficient rat B103 neuroblastoma cells as model for Lesch-Nyhan disease: BODIPY-forskolin as pharmacological tool. Naunyn Schmiedebergs Arch Pharmacol 2012; 385:671-83. [PMID: 22552731 DOI: 10.1007/s00210-012-0759-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 04/19/2012] [Indexed: 12/17/2022]
Abstract
Hypoxanthine phosphoribosyl transferase (HPRT) deficiency results in Lesch-Nyhan disease (LND). The link between the HPRT defect and the self-injurious behavior in LND is still unknown. HPRT-deficient rat B103 neuroblastoma cells serve as a model system for LND. In B103 cell membranes, HPRT deficiency is associated with a decrease of basal and guanosine triphosphate-stimulated adenylyl cyclase (AC) activity (Pinto and Seifert, J Neurochem 96:454-459, 2006). Since recombinant AC2 possesses a high basal activity, we tested the hypothesis that AC2 function and expression is impaired in HPRT deficiency. We examined AC regulation in B103 cell membranes, cAMP accumulation in intact B103 cells, AC isoform expression, and performed morphological studies. As most important pharmacological tool, we used 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene forskolin (BODIPY-FS) that inhibits recombinant AC2 but activates ACs 1 and 5 (Erdorf et al., Biochem Pharmacol 82:1673-1681, 2011). In B103 control membranes, BODIPY-FS reduced catalysis, but in HPRT(-) membranes, BODIPY-FS was rather stimulatory. 2'(3')-O-(N-methylanthraniloyl) (MANT)-nucleoside 5'-[γ-thio]triphosphates inhibit recombinant ACs 1 and 5 more potently than AC2. In B103 control membranes, MANT-guanosine 5'-[γ-thio]triphosphate inhibited catalysis in control membranes less potently than in HPRT(-) membranes. Quantitative real-time PCR revealed that in HPRT deficiency, AC2 was virtually absent. In contrast, AC5 was up-regulated. Forskolin (FS) and BODIPY-FS induced cell clustering and rounding and neurite extension in B103 cells. The effects of FS and BODIPY-FS were much more prominent in control than in HPRT(-) cells, indicative for a differentiation defect in HPRT deficiency. Neither FS nor BODIPY-FS significantly changed cAMP concentrations in intact B103 cells. Collectively, our data show that HPRT deficiency in B103 cells is associated with impaired AC2 function and expression and reduced sensitivity to differentiation induced by FS and BODIPY-FS. We discuss the pathophysiological implications of our data for LND.
Collapse
Affiliation(s)
- Liz Kinast
- Institute of Pharmacology, Medical School of Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | | | | | | |
Collapse
|
18
|
Weselake SV, Wevrick R. Co-morbidity of complex genetic disorders and hypersomnias of central origin: lessons from the underlying neurobiology of wake and sleep. Clin Genet 2012; 82:379-87. [PMID: 22533571 DOI: 10.1111/j.1399-0004.2012.01886.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Appropriate wake and sleep cycles are important to physical well-being, and are modulated by neuronal networks in the brain. A variety of medical conditions can disrupt sleep or cause excessive daytime sleepiness. Clinical diagnostic classification schemes have historically lumped genetic disorders together into a category that considers the sleep dysfunction to be secondary to a medical condition. The unique nature of sleep endophenotypes that occur more frequently in particular genetic disorders has been underappreciated. Increased understanding of the pathophysiology of wake/sleep dysfunction in rare genetic disorders could inform studies of the neurological mechanisms that underlie more common forms of wake and sleep dysfunction. In this review, we highlight genetic developmental disorders in which sleep endophenotypes have been described, and then consider genetic neurodegenerative disorders with sleep characteristics that set them apart from the disruptions to sleep that are typically associated with aging and dementia.
Collapse
Affiliation(s)
- S V Weselake
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada T6G 2H7
| | | |
Collapse
|
19
|
Ekstein S, Glick B, Weill M, Kay B, Berger I. Down syndrome and attention-deficit/hyperactivity disorder (ADHD). J Child Neurol 2011; 26:1290-5. [PMID: 21628698 DOI: 10.1177/0883073811405201] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Clinicians might minimize the prevalence of behavioral disorders among mentally retarded people. Decreased attention, hyperactivity, and impulsivity are frequently reported in children with Down syndrome, yet the exact prevalence of attention-deficit/hyperactivity disorder (ADHD) has not been clearly estimated in this population. The objective of this study was to estimate the prevalence of ADHD in children with Down syndrome and to emphasize the possible relationship between ADHD symptoms and the level of mental retardation and common medical comorbidity. In this study, the prevalence of ADHD among Down syndrome children was very high, reaching 43.9%. No significant correlation was found between ADHD symptoms and the level of mental retardation, but significant correlation was found with ophthalmologic problems. We conclude that children with Down syndrome are at increased risk for ADHD. When evaluating children with Down syndrome for attention deficits, psychiatric comorbidity as well as medical problems should be carefully taken into consideration.
Collapse
Affiliation(s)
- Sivan Ekstein
- Pediatric Neurology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | | | | | | |
Collapse
|