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Debbaut E, Steyaert J, El Bakkali M. Autism spectrum disorder profiles in RASopathies: A systematic review. Mol Genet Genomic Med 2024; 12:e2428. [PMID: 38581124 PMCID: PMC10997847 DOI: 10.1002/mgg3.2428] [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: 09/22/2023] [Revised: 03/10/2024] [Accepted: 03/19/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND RASopathies are associated with an increased risk of autism spectrum disorder (ASD). For neurofibromatosis type 1 (NF1) there is ample evidence for this increased risk, while for other RASopathies this association has been studied less. No specific ASD profile has been delineated so far for RASopathies or a specific RASopathy individually. METHODS We conducted a systematic review to investigate whether a specific RASopathy is associated with a specific ASD profile, or if RASopathies altogether have a distinct ASD profile compared to idiopathic ASD (iASD). We searched PubMed, Web of Science, and Open Grey for data about ASD features in RASopathies and potential modifiers. RESULTS We included 41 articles on ASD features in NF1, Noonan syndrome (NS), Costello syndrome (CS), and cardio-facio-cutaneous syndrome (CFC). Individuals with NF1, NS, CS, and CFC on average have higher ASD symptomatology than healthy controls and unaffected siblings, though less than people with iASD. There is insufficient evidence for a distinct ASD phenotype in RASopathies compared to iASD or when RASopathies are compared with each other. We identified several potentially modifying factors of ASD symptoms in RASopathies. CONCLUSIONS Our systematic review found no convincing evidence for a specific ASD profile in RASopathies compared to iASD, or in a specific RASopathy compared to other RASopathies. However, we identified important limitations in the research literature which may also account for this result. These limitations are discussed and recommendations for future research are formulated.
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Affiliation(s)
- Edward Debbaut
- Center for Developmental Psychiatry, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Leuven Autism Research (LAuRes)KU LeuvenLeuvenBelgium
| | - Jean Steyaert
- Center for Developmental Psychiatry, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Leuven Autism Research (LAuRes)KU LeuvenLeuvenBelgium
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2
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Pino MC, Donne IL, Vagnetti R, Tiberti S, Valenti M, Mazza M. Using the Griffiths Mental Development Scales to Evaluate a Developmental Profile of Children with Autism Spectrum Disorder and Their Symptomatologic Severity. Child Psychiatry Hum Dev 2024; 55:117-126. [PMID: 35763176 PMCID: PMC10796491 DOI: 10.1007/s10578-022-01390-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/03/2022]
Abstract
Early diagnosis is crucial for Autism spectrum disorder (ASD) and is achieved through a screening of developmental indicators to recognise children who are at risk of autism. One of the most widely used instruments in clinical practice for assessing child development is the Griffiths Mental Development Scale (GMDS). We sought (a) to assess longitudinally whether children diagnosed with ASD, with a mean age of 33.50 months (SD 7.69 months), show a developmental delay of abilities measured by the GMDS over time and (b) to analyse which skills of the GMDS could be associate to the symptomatologic severity of ASD. Our results showed lower scores of General Quotient and all sub-quotients of GMDS from first (T0) to second assessment (T1), except for the Performance sub-quotient. Three sub-quotients (Personal-Social, Hearing and Language and Practical Reasoning) also associate symptom severity at the time when the diagnosis of ASD is made.
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Affiliation(s)
- Maria Chiara Pino
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy.
| | - Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
| | - Roberto Vagnetti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Sergio Tiberti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
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3
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Ziv I, Avni I, Dinstein I, Meiri G, Bonneh YS. Oculomotor randomness is higher in autistic children and increases with the severity of symptoms. Autism Res 2024; 17:249-265. [PMID: 38189581 DOI: 10.1002/aur.3083] [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: 07/17/2023] [Accepted: 12/09/2023] [Indexed: 01/09/2024]
Abstract
A variety of studies have suggested that at least some children with autism spectrum disorder (ASD) view the world differently. Differences in gaze patterns as measured by eye tracking have been demonstrated during visual exploration of images and natural viewing of movies with social content. Here we analyzed the temporal randomness of saccades and blinks during natural viewing of movies, inspired by a recent measure of "randomness" applied to micro-movements of the hand and head in ASD (Torres et al., 2013; Torres & Denisova, 2016). We analyzed a large eye-tracking dataset of 189 ASD and 41 typically developing (TD) children (1-11 years old) who watched three movie clips with social content, each repeated twice. We found that oculomotor measures of randomness, obtained from gamma parameters of inter-saccade intervals (ISI) and blink duration distributions, were significantly higher in the ASD group compared with the TD group and were correlated with the ADOS comparison score, reflecting increased "randomness" in more severe cases. Moreover, these measures of randomness decreased with age, as well as with higher cognitive scores in both groups and were consistent across repeated viewing of each movie clip. Highly "random" eye movements in ASD children could be associated with high "neural variability" or noise, poor sensory-motor control, or weak engagement with the movies. These findings could contribute to the future development of oculomotor biomarkers as part of an integrative diagnostic tool for ASD.
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Affiliation(s)
- Inbal Ziv
- School of Optometry and Vision Science, Faculty of Life Science, Bar-Ilan University, Ramat Gan, Israel
| | - Inbar Avni
- Cognitive and Brain Sciences Department, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Ilan Dinstein
- Cognitive and Brain Sciences Department, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Psychology Department, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Gal Meiri
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Pre-school Psychiatry Unit, Soroka Medical Center, Be'er Sheva, Israel
| | - Yoram S Bonneh
- School of Optometry and Vision Science, Faculty of Life Science, Bar-Ilan University, Ramat Gan, Israel
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4
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Tokatly Latzer I, Hanson E, Bertoldi M, García-Cazorla À, Tsuboyama M, MacMullin P, Rotenberg A, Roullet JB, Pearl PL. Autism spectrum disorder and GABA levels in children with succinic semialdehyde dehydrogenase deficiency. Dev Med Child Neurol 2023; 65:1596-1606. [PMID: 37246331 DOI: 10.1111/dmcn.15659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/30/2023]
Abstract
AIM To elucidate the etiological aspects of autism spectrum disorder (ASD) in succinic semialdehyde dehydrogenase deficiency (SSADHD), related to dysregulation of γ-aminobutyric acid (GABA) and the imbalance of excitatory and inhibitory neurotransmission. METHOD In this prospective, international study, individuals with SSADHD underwent neuropsychological assessments, as well as biochemical, neurophysiological, and neuroimaging evaluations. RESULTS Of the 29 individuals (17 females) enrolled (median age [IQR] 10 years 5 months [5 years 11 months-18 years 1 month]), 16 were diagnosed with ASD. ASD severity significantly increased with age (r = 0.67, p < 0.001) but was inversely correlated with plasma GABA (r = -0.67, p < 0.001) and γ-hydroxybutyrate levels (r = -0.538, p = 0.004), and resting motor threshold as measured by transcranial magnetic stimulation (r = -0.44, p = 0.03). A discriminative analysis indicated that an age older than 7 years 2 months (p = 0.004) and plasma GABA levels less than 2.47 μM (p = 0.01) are the threshold values beyond which the likelihood of ASD presenting in individuals with SSADHD is increased. INTERPRETATION ASD is prevalent but not universal in SSADHD, and it can be predicted by lower levels of plasma GABA and GABA-related metabolites. ASD severity in SSADHD increases with age and the loss of cortical inhibition. These findings add insight into the pathophysiology of ASD and may facilitate its early diagnosis and intervention in individuals with SSADHD.
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ellen Hanson
- Human Neurobehavioral Core Services, Division of Neurology, Boston Children's Hospital, Boston, MA, USA
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, MA, USA
| | - Mariarita Bertoldi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Àngeles García-Cazorla
- Neurometabolic Unit, Neurology Department, Institut de Recerca, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Melissa Tsuboyama
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul MacMullin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander Rotenberg
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- FM Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
| | - Jean-Baptiste Roullet
- Department of Pharmacotherapy, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Phillip L Pearl
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Nagai Y, Mizutani Y, Nomura K, Uemura O, Saitoh S, Iwata O. Autistic traits of children born very preterm assessed using Autism Diagnostic Observation Schedule, Second Edition. Early Hum Dev 2023; 176:105716. [PMID: 36708635 DOI: 10.1016/j.earlhumdev.2023.105716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/21/2023] [Accepted: 01/21/2023] [Indexed: 01/26/2023]
Abstract
Preterm birth has been linked with increased incidence of autism spectrum disorder (ASD). Despite the remarkable difference in the clinical backgrounds between ASD children born preterm and term, cross-sectional studies have found no striking difference in their autistic traits. To highlight autistic traits related with preterm birth, children born very preterm (prospective birth cohort, n = 50) and term (case cohort, n = 16), who were diagnosed as "Autism" by the Autism Diagnostic Observation Schedule (ADOS), 2nd edition, were compared using the calibrated severity scores of ADOS-2 and T-scores of the Social Responsiveness Scale, 2nd edition. No significant difference was found in the calibrated severity scores between ASD children born preterm and term. There was a trend that T-scores were smaller for the preterm cohort, which did not reach a statistical significance. Even when detailed cross-sectional information was obtained using ADOS-2, no difference in autistic traits was observed between children born very preterm and term. Our findings were consistent with a previous study, which assessed the entire prospective cohort of children born very preterm and found no difference in original ADOS scores. Further studies are warranted to delineate how preterm birth affects the autistic traits and their parental perception in a large prospective cohort.
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Affiliation(s)
- Yukiyo Nagai
- Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Aichi, Japan.
| | - Yuko Mizutani
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Kayo Nomura
- Department of Education, Gifu Shotoku Gakuen University, Gifu, Japan
| | - Osamu Uemura
- Department of Pediatrics, Ichinomiya Medical Treatment & Habilitation Center, Aichi, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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Hong JS, Singh V, Kalb L, Reetzke R, Ludwig NN, Pfeiffer D, Holingue C, Menon D, Lu Q, Ashkar A, Landa R. Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder. Autism Res 2022; 15:2181-2191. [PMID: 36054678 PMCID: PMC10246880 DOI: 10.1002/aur.2801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/15/2022] [Indexed: 02/06/2023]
Abstract
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians.
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Affiliation(s)
- Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute
| | - Luke Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Natasha N. Ludwig
- Department of Neuropsychology, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Danika Pfeiffer
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health
| | - Deepa Menon
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Qing Lu
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Johns Hopkins University School of Arts and Sciences
| | - Ahlam Ashkar
- Center for Autism and Related Disorders, Kennedy Krieger Institute
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
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Jameson C, Boulton KA, Silove N, Guastella AJ. Eczema and related atopic diseases are associated with increased symptom severity in children with autism spectrum disorder. Transl Psychiatry 2022; 12:415. [PMID: 36171195 PMCID: PMC9519885 DOI: 10.1038/s41398-022-02185-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Growing evidence indicates that autism spectrum disorder (ASD) has diverse genetic, neurological, and environmental factors that contribute to its neurodevelopmental course. Interestingly, childhood ASD is often accompanied by skin disorders, such as eczema, and other related atopic manifestations. This link may be due to the shared embryonic origin of epidermal and neural tissue. Accordingly, we consider the potential influence of a skin-brain co-vulnerability and ensuing atopic cascade on ASD symptomatology by investigating whether atopic disorders (asthma, allergies, eczema and hay fever) are associated with increased symptom severity in children with ASD. Overall, 45 atopic and 93 non-atopic children with ASD were assessed using the ADOS-2 on scores of total, social and non-social symptoms. Differences in ASD symptom severity were further evaluated as a function of atopic disease type. Atopic children displayed greater symptom severity overall and in the social domain, relative to non-atopic participants. Atopic children were 2.4 times more likely to experience overall impairments classified within the ADOS-2 highest-level severity bracket and 2.7 times more likely to show social difficulties in this range. Moreover, those reporting comorbid eczema displayed increased symptom severity relative to both their non-atopic peers and those reporting asthma and allergies. Taken together, findings indicate that atopic disorders, and particularly comorbid eczema, are associated with increases in ASD symptom severity. Findings provide grounds for future investigations into this link between childhood skin diseases and ASD symptom severity to advance our understanding of neurodevelopment and to develop targeted assessment and intervention opportunities.
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Affiliation(s)
- C. Jameson
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - K. A. Boulton
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - N. Silove
- grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia ,grid.413973.b0000 0000 9690 854XChild Development Unit, The Children’s Hospital at Westmead, Westmead, NSW 2145 Australia
| | - A. J. Guastella
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
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Improving the Annotation of the Venom Gland Transcriptome of Pamphobeteus verdolaga, Prospecting Novel Bioactive Peptides. Toxins (Basel) 2022; 14:toxins14060408. [PMID: 35737069 PMCID: PMC9228390 DOI: 10.3390/toxins14060408] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023] Open
Abstract
Spider venoms constitute a trove of novel peptides with biotechnological interest. Paucity of next-generation-sequencing (NGS) data generation has led to a description of less than 1% of these peptides. Increasing evidence supports the underestimation of the assembled genes a single transcriptome assembler can predict. Here, the transcriptome of the venom gland of the spider Pamphobeteus verdolaga was re-assembled, using three free access algorithms, Trinity, SOAPdenovo-Trans, and SPAdes, to obtain a more complete annotation. Assembler’s performance was evaluated by contig number, N50, read representation on the assembly, and BUSCO’s terms retrieval against the arthropod dataset. Out of all the assembled sequences with all software, 39.26% were common between the three assemblers, and 27.88% were uniquely assembled by Trinity, while 27.65% were uniquely assembled by SPAdes. The non-redundant merging of all three assemblies’ output permitted the annotation of 9232 sequences, which was 23% more when compared to each software and 28% more when compared to the previous P. verdolaga annotation; moreover, the description of 65 novel theraphotoxins was possible. In the generation of data for non-model organisms, as well as in the search for novel peptides with biotechnological interest, it is highly recommended to employ at least two different transcriptome assemblers.
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9
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Kalb LG, Singh V, Hong JS, Holingue C, Ludwig NN, Pfeiffer D, Reetzke R, Gross AL, Landa R. Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2). JAMA Netw Open 2022; 5:e229498. [PMID: 35471566 PMCID: PMC9044110 DOI: 10.1001/jamanetworkopen.2022.9498] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE There are long-standing disparities in the prevalence of autism spectrum disorder (ASD) across race and sex. Surprisingly, few studies have examined whether these disparities arise partially out of systematic biases in the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the reference standard measure of ASD. OBJECTIVE To examine differential item functioning (DIF) of ADOS-2 items across sex and race. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional study of children who were evaluated for ASD between 2014 and 2020 at a specialty outpatient clinic located in the Mid-Atlantic region of the US. Data were analyzed from July 2021 to February 2022. EXPOSURES Child race (Black/African American vs White) and sex (female vs male). MAIN OUTCOMES AND MEASURES Item-level biases across ADOS-2 harmonized algorithm items, including social affect (SA; 10 items) and repetitive/restricted behaviors (RRBs; 4 items), were evaluated across 3 modules. Measurement bias was identified by examining DIF and differential test functioning (DTF), within a graded response, item response theory framework. Statistical significance was determined by a likelihood ratio χ2 test, and a series of metrics was used to examine the magnitude of DIF and DTF. RESULTS A total of 6269 children (mean [SD] age, 6.77 [3.27] years; 1619 Black/African American [25.9%], 3151 White [50.3%], and 4970 male [79.4%]), were included in this study. Overall, 16 of 140 ADOS-2 diagnostic items (11%) had a significant DIF. For race, 8 items had a significant DIF, 6 of which involved SA. No single item showed DIF consistently across all modules. Most items with DIF had greater difficulty and poorer discrimination in Black/African American children compared with White children. For sex, 5 items showed significant DIF. DIF was split across SA and RRB. However, hand mannerisms evidenced DIF across all 5 algorithms, with generally greater difficulty. The magnitude of DIF was only moderate to large for 2 items: hand mannerisms (among female children) and repetitive interests (among Black/African American children). The overall estimated effect of DIF on total DTF was not large. CONCLUSIONS AND RELEVANCE These findings suggest that the ADOS-2 does not have widespread systematic measurement bias across race or sex. However, the findings raise some concerns around underdetection that warrant further research.
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Affiliation(s)
- Luther G. Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
| | - Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
| | - Natasha N. Ludwig
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Danika Pfeiffer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alden L. Gross
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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10
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Chisholm AK, Haebich KM, Pride NA, Walsh KS, Lami F, Ure A, Maloof T, Brignell A, Rouel M, Granader Y, Maier A, Barton B, Darke H, Dabscheck G, Anderson VA, Williams K, North KN, Payne JM. Delineating the autistic phenotype in children with neurofibromatosis type 1. Mol Autism 2022; 13:3. [PMID: 34983638 PMCID: PMC8729013 DOI: 10.1186/s13229-021-00481-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background Existing research has demonstrated elevated autistic behaviours in children with neurofibromatosis type 1 (NF1), but the autistic phenotype and its relationship to other neurodevelopmental manifestations of NF1 remains unclear. To address this gap, we performed detailed characterisation of autistic behaviours in children with NF1 and investigated their association with other common NF1 child characteristics. Methods Participants were drawn from a larger cross-sectional study examining autism in children with NF1. The population analysed in this study scored above threshold on the Social Responsiveness Scale-Second Edition (T-score ≥ 60; 51% larger cohort) and completed the Autism Diagnostic Interview-Revised (ADI-R) and/or the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). All participants underwent evaluation of their intellectual function, and behavioural data were collected via parent questionnaires. Results The study cohort comprised 68 children (3–15 years). Sixty-three per cent met the ADOS-2 ‘autism spectrum’ cut-off, and 34% exceeded the more stringent threshold for ‘autistic disorder’ on the ADI-R. Social communication symptoms were common and wide-ranging, while restricted and repetitive behaviours (RRBs) were most commonly characterised by ‘insistence on sameness’ (IS) behaviours such as circumscribed interests and difficulties with minor changes. Autistic behaviours were weakly correlated with hyperactive/impulsive attention deficit hyperactivity disorder (ADHD) symptoms but not with inattentive ADHD or other behavioural characteristics. Language and verbal IQ were weakly related to social communication behaviours but not to RRBs. Limitations Lack of genetic validation of NF1, no clinical diagnosis of autism, and a retrospective assessment of autistic behaviours in early childhood. Conclusions Findings provide strong support for elevated autistic behaviours in children with NF1. While these behaviours were relatively independent of other NF1 comorbidities, the importance of taking broader child characteristics into consideration when interpreting data from autism-specific measures in this population is highlighted. Social communication deficits appear similar to those observed in idiopathic autism and are coupled with a unique RRB profile comprising prominent IS behaviours. This autistic phenotype and its relationship to common NF1 comorbidities such as anxiety and executive dysfunction will be important to examine in future research. Current findings have important implications for the early identification of autism in NF1 and clinical management. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00481-3.
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Affiliation(s)
- Anita K Chisholm
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Kristina M Haebich
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Natalie A Pride
- Kids Neuroscience Centre, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Karin S Walsh
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Michigan Avenue NW, Washington, DC, 20310, USA
| | - Francesca Lami
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Alex Ure
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.,Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Tiba Maloof
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Amanda Brignell
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Melissa Rouel
- Kids Neuroscience Centre, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Yael Granader
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Michigan Avenue NW, Washington, DC, 20310, USA
| | - Alice Maier
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Belinda Barton
- Kids Neuroscience Centre, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia.,Children's Hospital Education Research Institute, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Hayley Darke
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Gabriel Dabscheck
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Vicki A Anderson
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Katrina Williams
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Paediatrics, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.,Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Kathryn N North
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia. .,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia. .,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.
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11
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Mottron L. Les « traits autistiques » ne sont pas autistiques. ENFANCE 2021. [DOI: 10.3917/enf2.213.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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12
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Hong JS, Singh V, Kalb L, Ashkar A, Landa R. Replication study of ADOS-2 Toddler Module cut-off scores for autism spectrum disorder classification. Autism Res 2021; 14:1284-1295. [PMID: 33683018 DOI: 10.1002/aur.2496] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/08/2021] [Accepted: 02/21/2021] [Indexed: 01/27/2023]
Abstract
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been regarded as the gold standard assessment of autism spectrum disorder (ASD). While clinical validity of ADOS-2 Modules 1-4 have been extensively studied, there has been very limited research examining the clinical validity of ADOS-2 Toddler Module. The goal of this study was to examine alignment of the ADOS-2 Toddler Module classification with clinicians' determination of ASD, with assessing cut-off scores for diagnosing ASD in toddlers. A total of 412 toddlers ages 12-30 months who received ADOS-2 Toddler Module as well as a best estimate clinical (BEC) diagnosis, were included in this study. ADOS-2 Toddler Module cut-off scores were determined using the appropriate algorithms (Algorithm 1 for toddlers aged 12-20 months and those aged 21-30 months with <5 words, Algorithm 2 for toddlers aged 21-30 months with 5 words or more). Receiver operating characteristic (ROC) curves were used to assess cut-off scores that optimized sensitivity and specificity when compared against BEC diagnosis. The selected cut-off scores were examined using frequency tables to compare ADOS-2 classification against BEC diagnosis. For Algorithm 1, classification statistics were optimized at the cut-off score of 12 with an area under the curve (AUC) of 0.92. For Algorithm 2, classification statistics were optimized at the cut-off score of 10 with an AUC of 0.96. The ADOS-2 Toddler Module classification is strongly aligned with BEC diagnosis. The optimal cut-off scores identified in the current study reflect the same results configured by the prior study. LAY SUMMARY: ADOS-2 Toddler Module has been widely used for the ASD assessment, but there have been limited research on its clinical validity. This study is the first replication of the ADOS-2 Toddler Module with a large independent sample. We examined alignment of the ADOS-2 Toddler Module classification with clinicians' determination of ASD, with assessing cut-off scores, and confirmed the clinical validity of ADOS-2 Toddler Module. Cut-off scores of ADOS-2 Toddler Module cited in the manual yielded best clinical utility for diagnosing ASD in toddlers.
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Affiliation(s)
- Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Luke Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ahlam Ashkar
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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13
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Waizbard-Bartov E, Ferrer E, Young GS, Heath B, Rogers S, Wu Nordahl C, Solomon M, Amaral DG. Trajectories of Autism Symptom Severity Change During Early Childhood. J Autism Dev Disord 2021; 51:227-242. [PMID: 32410098 PMCID: PMC7810617 DOI: 10.1007/s10803-020-04526-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Autism symptom severity change was evaluated during early childhood in 125 children diagnosed with autism spectrum disorder (ASD). Children were assessed at approximately 3 and 6 years of age for autism symptom severity, IQ and adaptive functioning. Each child was assigned a change score, representing the difference between ADOS Calibrated Severity Scores (CSS) at the two ages. A Decreased Severity Group (28.8%) decreased by 2 or more points; a Stable Severity Group (54.4%) changed by 1 point or less; and an Increased Severity Group (16.8%) increased by 2 or more points. Girls tended to decrease in severity more than boys and increase in severity less than boys. There was no clear relationship between intervention history and membership in the groups.
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Affiliation(s)
- Einat Waizbard-Bartov
- Department of Psychology, University of California Davis, Davis, CA, USA
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Emilio Ferrer
- Department of Psychology, University of California Davis, Davis, CA, USA
| | - Gregory S Young
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Brianna Heath
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Sally Rogers
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Christine Wu Nordahl
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Marjorie Solomon
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - David G Amaral
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA.
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14
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Individual and Environmental Factors Affecting Adaptive Behavior of Toddlers with Autism Spectrum Disorder: Role of Parents' Socio-cultural Level. J Autism Dev Disord 2020; 51:3469-3482. [PMID: 33355882 PMCID: PMC8460517 DOI: 10.1007/s10803-020-04803-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
The effects of environmental factors [including Socio-Economic Status, Cultural Capital, and Social Capital (Socio-Cultural Level) of both parents] on the Vineland-II adaptive behavior dimensions of toddlers with autism spectrum disorder (ASD), in addition to individual factors, was investigated in 148 Italian toddlers (82% males), aged 18 to 37 months with ASD. Toddlers’ age and Griffiths Mental Development Scales general development affected all of the adaptive behavior dimensions, with negative and positive associations, respectively. The Child Behavior Checklist comorbid conditions were negatively associated with some adaptive behavior dimensions while the ADOS-2 Social affect only with the communication dimension. Mothers’ and fathers’ specific Socio-Cultural Level dimensions were positively associated with toddlers’ specific adaptive behavior dimensions with the same magnitude as comorbid conditions.
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15
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Dhanyamraju PK, Patel TN, Dovat S. Medulloblastoma: "Onset of the molecular era". Mol Biol Rep 2020; 47:9931-9937. [PMID: 33159234 DOI: 10.1007/s11033-020-05971-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Abstract
Among brain tumors, Medulloblastoma (MB) is one of the most common, malignant, pediatric tumors of the cerebellum. It accounts for ~20% of all childhood central nervous system (CNS) tumors. Despite, tremendous advances in drug development processes, as well as novel drugs for MB the morbidity and mortality rates, remain high. Craniospinal radiation, high-dose chemotherapy, and surgical resection are the primary therapeutic strategies. Tremendous progress in the field of "genomics" with vast amounts of data has led to the identification of four distinct molecular subgroups in medulloblastoma: WNT group, SHH group, group-III, and group-IV. The identification of these subgroups has led to individualized treatment strategies for each subgroup. Here, we discuss the various molecular subgroups of medulloblastoma as well as the differences between them. We also highlight the latest treatment strategies available for medulloblastoma.
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Affiliation(s)
- Pavan Kumar Dhanyamraju
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA.
| | - Trupti N Patel
- Department of Integrative Biology, Vellore Institute of Technology, Vellore, India
| | - Sinisa Dovat
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
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16
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Atypical communication characteristics among clinic-referred youth with and without autism spectrum disorder: Stability and associations with clinical correlates. Dev Psychopathol 2020; 32:1240-1253. [PMID: 32938518 DOI: 10.1017/s095457942000070x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Atypical communication characteristics (ACCs), such as speech delay, odd pitch, and pragmatic difficulties, are common features of autism spectrum disorder (ASD) as are the symptoms of a wide range of psychiatric disorders. Using a simple retrospective method, this study aimed to better understand the relation and stability of ACCs with a broad range of psychiatric symptoms among large, well-characterized samples of clinic-referred children and adolescents with and without ASD. Youth with ASD had higher rates and a more variable pattern of developmental change in ACCs than the non-ASD diagnostic group. Latent class analysis yielded three ACC stability subgroups within ASD: Stable ACCs, Mostly Current-Only ACCs, and Little Professors. Subgroups exhibited differences in severity of ASD symptomatology, co-occurring psychiatric symptoms, and other correlates. Our findings provide support for the clinical utility of characterizing caregiver-perceived changes in ACCs in identifying children at risk for co-occurring psychopathology and other clinically relevant variables.
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17
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Selective Extraction of Cannabinoid Compounds from Cannabis Seed Using Pressurized Hot Water Extraction. Molecules 2020; 25:molecules25061335. [PMID: 32183432 PMCID: PMC7144126 DOI: 10.3390/molecules25061335] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 01/03/2023] Open
Abstract
Phytochemicals of Cannabis sativa mainly for the use in the different industries are that of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Pressurized hot water extraction (PHWE) is seen as an efficient, fast, green extraction technique for the removal of polar and semi-polar compounds from plant materials. The PHWE technique was applied to extract cannabinoid compounds from Cannabis sativa seed. Response surface methodology was used to investigate the influence of extraction time (5-60 min), extraction temperature (50-200 °C) and collector vessel temperature (25-200 °C) on the recovery of delta-9-tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD), cannabichromene (CBG) and cannabigerol (CBC) from Cannabis sativa seed by PHWE. The identification and semi quantification of cannabinoid compounds were determined using GCXGC-TOFMS. The results obtained from different extractions show that the amount of THC and CBN was drastically decreasing in the liquid extract when the temperature rose from 140 to 160 °C in the extraction cell and the collector's vessel. The optimal conditions to extract more CBD, CBC, and CBG than THC and CBN were set at 150 °C, 160 °C and 45 min as extraction temperature, the temperature at collector vessel, and the extraction time, respectively. At this condition, the predicted and experimental ratio of THCt (THC + CBN)/CBDt (CBD + CBC+ CBG) was found to be 0.17 and 0.18, respectively. Therefore, PHWE can be seen as an alternative to the classic extraction approach as the efficiency is higher and it is environmentally friendly.
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18
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Geoffray MM, Falissard B, Green J, Kerr B, Evans DG, Huson S, Burkitt-Wright E, Garg S. Autism Spectrum Disorder Symptom Profile Across the RASopathies. Front Psychiatry 2020; 11:585700. [PMID: 33519543 PMCID: PMC7843573 DOI: 10.3389/fpsyt.2020.585700] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/16/2020] [Indexed: 01/12/2023] Open
Abstract
Dysregulation of the Ras MAPK signaling pathway is implicated in the pathogenesis of autism spectrum disorder (ASD). The RASopathies, a group of disorders caused by mutations of the Ras/MAPK pathway genes, share many overlapping clinical features. Studies suggest a high prevalence of ASD in the RASopathies, but detailed characterization of the ASD profile is lacking. The aim of this study was to compare the ASD symptom profile of three distinct RASopathies associated with both gain-of-function and loss-of-function mutations: neurofibromatosis type 1 (NF1), Noonan syndrome (NS), and cardiofaciocutaneous syndrome (CFC). Participants were drawn from existing databases if they had a diagnosis of a RASopathy, met the criteria for ASD, and were able to communicate verbally. We compared the phenotypic profile of NF1 + ASD (n = 48), NS + ASD (n = 11), and CFC + ASD (n = 7) on the Autism Diagnostic Inventory (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). We found subtle but non-significant group differences with higher levels of social impairments and lower restricted repetitive behaviors in the NF1 group as compared with the NS and CFC groups. We observed group differences in developmental milestones with most severe delays in CFC, followed by NS and NF1. Our results suggest that despite developmental differences, the ASD profile remains relatively consistent across the three RASopathies. Though our results need confirmation in larger samples, they suggest the possibility that treatment and mechanistic insights developed in the context of one RASopathy may be generalizable to others and possibly to non-syndromic ASD associated with dysregulation of Ras/MAPK pathway genes.
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Affiliation(s)
- Marie-Maude Geoffray
- Centre Hospitalier Le Vinatier, Bron, France.,Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Bruno Falissard
- CESP, INSERM U1018, Université Paris-Saclay, Villejuif, France
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Department of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Browyn Kerr
- Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - D Gareth Evans
- Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Division of Evolution and Genomic Science, Department of Genomic Medicine, St Mary's Hospital, University of Manchester, Manchester, United Kingdom
| | - Susan Huson
- Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Emma Burkitt-Wright
- Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Shruti Garg
- Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Department of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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19
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Clarkson T, Kang E, Capriola-Hall N, Lerner MD, Jarcho J, Prinstein MJ. Meta-Analysis of the RDoC Social Processing Domain across Units of Analysis in Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:297-321. [PMID: 31799882 DOI: 10.1080/15374416.2019.1678167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This meta-analysis advances a framework to understand correspondence among units of analysis of the social processing construct within Research Domain Criteria (RDoC). METHOD As requested for this special issue, eligible studies cited an RDoC-initiative paper or mentioned RDoC in the abstract, title, or keywords were empirical and peer reviewed, and described a correlation or regression analysis (r, β, or odds ratio) between two different units of analysis in the social processing domain in youth. We examined the frequency (descriptive statistics) and magnitude of correspondence between unit-pairs (random effects models), and predefined moderators (meta-regression). RESULTS Eight of the twenty-eight possible unit-by-unit pairs were identified, with subjective-by-behavior units being the most common. Of those, only subjective-by-circuit had significant correspondence between units. Moderator analysis revealed that the age and diagnosis of generalized anxiety disorder moderated correspondence between subjective-by-circuit units of analysis, and that a diagnosis of autism spectrum disorder moderated correspondence between subjective-by-gene units of analysis. Younger ages and inclusion of either diagnostic group reduced correspondence. CONCLUSIONS These findings indicate that the RDoC initiative has generated limited research within the social processing domain across units of analysis in youth to date. Moreover, National Institute of Mental Health (NIMH)-funded studies do not appear to be biased toward supporting the RDoC framework. However, the limited number of included studies precludes the generalizability of these findings and underscores the need for further research. Despite this, results suggest that the NIMH model for providing standard batteries of measurement tools may effectively reduce spurious correlations between subjective-by-behavior units of analysis.
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Affiliation(s)
| | - Erin Kang
- Department of Psychology, Stony Brook University
| | | | | | | | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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20
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Williams ZJ, Failla MD, Davis SL, Heflin BH, Okitondo CD, Moore DJ, Cascio CJ. Thermal Perceptual Thresholds are typical in Autism Spectrum Disorder but Strongly Related to Intra-individual Response Variability. Sci Rep 2019; 9:12595. [PMID: 31467358 PMCID: PMC6715703 DOI: 10.1038/s41598-019-49103-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/20/2019] [Indexed: 01/16/2023] Open
Abstract
Individuals with autism spectrum disorder (ASD) are often reported to exhibit an apparent indifference to pain or temperature. Leading models suggest that this behavior is the result of elevated perceptual thresholds for thermal stimuli, but data to support these assertions are inconclusive. An alternative proposal suggests that the sensory features of ASD arise from increased intra-individual perceptual variability. In this study, we measured method-of-limits warm and cool detection thresholds in 142 individuals (83 with ASD, 59 with typical development [TD], aged 7-54 years), testing relationships with diagnostic group, demographics, and clinical measures. We also investigated the relationship between detection thresholds and a novel measure of intra-individual (trial-to-trial) threshold variability, a putative index of "perceptual noise." This investigation found no differences in thermal detection thresholds between individuals with ASD and typical controls, despite large differences between groups in sensory reactivity questionnaires and modest group differences in intra-individual variability. Lower performance IQ, male sex, and higher intra-individual variability in threshold estimates were the most significant predictors of elevated detection thresholds. Although no psychophysical measure was significantly correlated with questionnaire measures of sensory hyporeactivity, large intra-individual variability may partially explain the elevated psychophysical thresholds seen in a subset of the ASD population.
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Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, 37212, USA.
| | - Michelle D Failla
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, 37212, USA
| | - Samona L Davis
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, 37212, USA
| | - Brynna H Heflin
- Department of Psychology, Florida International University, Miami, FL, 33199, USA
| | - Christian D Okitondo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, 37212, USA
| | - David J Moore
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, L3 5UA, UK
| | - Carissa J Cascio
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, 37212, USA.,Vanderbilt Kennedy Center, Nashville, TN, 37203, USA
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21
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Righi G, Benevides J, Mazefsky C, Siegel M, Sheinkopf SJ, Morrow EM. Predictors of Inpatient Psychiatric Hospitalization for Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:3647-3657. [PMID: 28536960 DOI: 10.1007/s10803-017-3154-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism Spectrum Disorder (ASD) is associated with significant healthcare expenditures and a greater utilization of psychiatric health services. High utilization may not be evenly distributed across individuals with ASD. The objective of this study was to identify individual and family characteristics that increase the risk of psychiatric hospitalization. Naturalistic study of two age- and gender-matched ASD cohorts, inpatients enrolled in the Autism Inpatient Collection (AIC) and outpatients enrolled in the Rhode Island Consortium of Autism Research and Treatment (RI-CART), revealed a number of factors associated with hospitalization. Multiple logistic regression analyses revealed that adaptive functioning, ASD symptom severity, primary caregiver's marital status, the presence of mood disorders, and the presence of sleep problems independently increased the risk of psychiatric hospitalization.
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Affiliation(s)
- Giulia Righi
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA. .,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA. .,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.
| | - Jill Benevides
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA
| | - Carla Mazefsky
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Matthew Siegel
- Maine Medical Center Research Institute, Spring Harbor Hospital, Tufts University School of Medicine, 123 Andover Road, Westbrook, ME, 04092, USA
| | - Stephen J Sheinkopf
- Women and Infant's Hospital, 101 Dudley street, Providence, RI, 02905, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA.,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.,Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute, Alpert Medical School of Brown University, 101 Dudley street, Providence, RI, 02905, USA
| | - Eric M Morrow
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA.,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA
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22
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Sun C, Zou M, Wang X, Xia W, Ma Y, Liang S, Hao Y, Wu L, Fu S. FADS1-FADS2 and ELOVL2 gene polymorphisms in susceptibility to autism spectrum disorders in Chinese children. BMC Psychiatry 2018; 18:283. [PMID: 30180836 PMCID: PMC6122697 DOI: 10.1186/s12888-018-1868-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 08/29/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUD Autism spectrum disorders (ASD) are a complex group of neurodevelopmental disorders with a genetic basis. The role of long-chain polyunsaturated fatty acids (LC-PUFAs) and the occurrence of autism has been the focus of many recent studies. The present study investigates whether genetic variants of the fatty acid desaturase (FADS) 1/2 and elongation of very long-chain fatty acids protein (ELOVL) 2 genes, which are involved in LC-PUFA metabolism, are associated with ASD risk. METHODS A cohort of 243 ASD patients and 243 unrelated healthy controls were enrolled in this case control study. Sixteen tag single nucleotide polymorphisms from the FADS1-2 and ELOVL2 genes were genotyped using the Sequenom Mass Array. RESULTS There were significant differences in allelic distribution of FADS2 rs526126 (OR = 0.55, 95% CI = 0.42-0.72, pFDR < 0.05) between autistic children and controls. FADS2 rs526126 and ELOVL2 rs10498676 were associated with decreased ASD risk in recessive model (OR = 0.07, 95% CI = 0.02-0.22, pFDR < 0.01; OR = 0.56, 95% CI = 0.35-0.89, pFDR = 0.042), while ELOVL2 rs17606561, rs3756963, and rs9468304 were associated with increased ASD risk in overdominant model (OR = 1.63, 95% CI = 1.12-2.36, pFDR = 0.036; OR = 1.64, 95% CI = 1.14-2.37, pFDR = 0.039; OR = 1.75, 95% CI = 1.22-2.50, pFDR = 0.017). The A/A genotype of rs10498676 was correlated with a decline in the Autism Diagnostic Interview-Revised communication (verbal and nonverbal) domain. CONCLUSIONS These findings provide evidence of an association between FADS2 and ELOVL2 polymorphisms and ASD susceptibility in Chinese children.
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Affiliation(s)
- Caihong Sun
- 0000 0001 2204 9268grid.410736.7Department of Children’s and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081 China
| | - Mingyang Zou
- 0000 0001 2204 9268grid.410736.7Department of Children’s and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081 China
| | - Xuelai Wang
- 0000 0001 2204 9268grid.410736.7Department of Children’s and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081 China
| | - Wei Xia
- 0000 0001 2204 9268grid.410736.7Department of Children’s and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081 China
| | - Yongjuan Ma
- 0000 0001 2204 9268grid.410736.7Department of Children’s and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081 China
| | - Shuang Liang
- 0000 0001 2204 9268grid.410736.7Department of Children’s and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081 China
| | - Yanqiu Hao
- 0000 0001 2204 9268grid.410736.7Department of Pediatric, The Second Affiliated Hospital, Harbin Medical University, Harbin, 150081 China
| | - Lijie Wu
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin, 150081, China.
| | - Songbin Fu
- Laboratory of Medical Genetics, Harbin Medical University, Harbin, 150081, China.
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23
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Salguero DA, Barletta PA, Sierraalta W. Severe abdominal pain and diarrhea - unusual multiple myeloma presentation with a severe prognosis: a case report. J Med Case Rep 2018; 12:70. [PMID: 29549883 PMCID: PMC5857313 DOI: 10.1186/s13256-018-1598-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 01/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple myeloma is a hematologic disease with high mortality rates all over the world. The diagnosis has always been challenging since the first case was reported in 1844. For that reason the diagnostic criteria have evolved over years to include the features of the disease more comprehensively. Unusual presentations are infrequent and a diagnostic challenge. For this reason we report this rare case in which diarrhea and abdominal pain were the initial presenting symptoms of multiple myeloma with a plasmacytoma. CASE PRESENTATION An 87-year-old Hispanic man with a past medical history of hypertension, diabetes, and constipation, presented to an emergency department complaining of severe generalized abdominal pain and profuse diarrhea for 3 days. A physical examination revealed generalized pallor and dehydration but no signs of abdominal peritoneal irritation. Laboratory tests revealed neutrophilia and an elevated total protein. He received intravenously administered fluids and antibiotics. His abdominal pain became localized in the infraumbilical area and a small mass was palpated on the right lower quadrant on subsequent examination. An abdominal computed tomography scan showed a tumor lesion surrounded by fluid collection and a computed tomography-guided biopsy of the lesion confirmed it to be a plasmacytoma. A bone marrow biopsy revealed plasmatic cell augmentation but his beta-2 microglobulin levels were inconclusive. The diagnosis of multiple myeloma was finally confirmed with urine immunofixation. Bortezomib was initiated to decrease disease progression, but unfortunately 4 days later he developed acute pulmonary edema, had a cardiac arrest, and died. CONCLUSIONS This case illustrates the protean initial manifestations of multiple myeloma and the importance of an accurate diagnosis. Our patient's initial presentation with gastrointestinal complaints is rare and the plasmacytoma location is even rarer, providing a challenging diagnostic problem. Prompt recognition of multiple myeloma is critical to institute appropriate therapy and prevention of disease progression.
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Affiliation(s)
- Douglas A Salguero
- Advance Simulation Center, University of Francisco Marroquin-UFM, 6 avenue zone 10, 01011, Guatemala, Guatemala.
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24
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Zou M, Sun C, Wang J, Kang J, Xu Z, Ma Y, Chen L, Zhang X, Xia W, Wu L. Factors influencing the severity of behavioral phenotype in autism spectrum disorders: Implications for research. Psychiatry Res 2018; 261:290-297. [PMID: 29329050 DOI: 10.1016/j.psychres.2017.12.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/25/2017] [Accepted: 12/31/2017] [Indexed: 11/26/2022]
Abstract
The phenotypic heterogeneity of Autism Spectrum Disorders (ASD) presents particular research challenges in the assessment of symptom severity, while the standardized Autism Diagnostic Observation Schedule (ADOS) scores present a severity metric, namely calibrated severity scores (CSS) that are relatively impervious to individual characteristics. To date, no studies have examined the convergent validity of CSS in Chinese sample populations. The present study investigated the validity of the ADOS-CSS using a sample of 321 children aged 2-18 years with ASD, and developed upon existing literature examining the influence of non-ASD-specific characteristics on other types of measures including Autism Diagnostic Interview-Revised (ADI-R), Social Responsiveness Scale (SRS), and Vineland Adaptive Behavior Scales (VABS). As expected, the findings revealed that the CSS were less influenced than ADOS-RAW scores by the demographic and developmental-level variables. Moreover, compared to the ADOS-CSS, the ADI-R, SRS and VABS were still strongly correlated with confounding factors, such as chronological age, intelligence quotients, and language-level. The results of this study corroborate the utilization of CSS as a more valid indicator of ASD severity than raw scores from ADOS and other instruments.
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Affiliation(s)
- Mingyang Zou
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Caihong Sun
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Jia Wang
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Jing Kang
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Zhanbin Xu
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Yongjuan Ma
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Lei Chen
- Department of Child Health Care, Dalian Maternal and Child Health Care Hospital, Dalian 116033, China
| | - Xinxi Zhang
- Department of Child Health Care, Yangzhou Maternal and Child Health Care Hospital, Yangzhou 225002, China
| | - Wei Xia
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China.
| | - Lijie Wu
- Department of Children's and Adolescent Health, Public Health College, Harbin Medical University, Harbin 150081, China.
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25
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Fulceri F, Grossi E, Contaldo A, Narzisi A, Apicella F, Parrini I, Tancredi R, Calderoni S, Muratori F. Motor Skills as Moderators of Core Symptoms in Autism Spectrum Disorders: Preliminary Data From an Exploratory Analysis With Artificial Neural Networks. Front Psychol 2018; 9:2683. [PMID: 30687159 PMCID: PMC6333655 DOI: 10.3389/fpsyg.2018.02683] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/13/2018] [Indexed: 02/05/2023] Open
Abstract
Motor disturbances have been widely observed in children with autism spectrum disorder (ASD), and motor problems are currently reported as associated features supporting the diagnosis of ASD in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Studies on this issue reported disturbances in different motor domains, including both gross and fine motor areas as well as coordination, postural control, and standing balance. However, they failed to clearly state whether motor impairments are related to demographical and developmental features of ASD. Both the different methodological approaches assessing motor skills and the heterogeneity in clinical features of participants analyzed have been implicated as contributors to variance in findings. However, the non-linearity of the relationships between variables may account for the inability of the traditional analysis to grasp the core problem suggesting that the "single symptom approach analysis" should be overcome. Artificial neural networks (ANNs) are computational adaptive systems inspired by the functioning processes of the human brain particularly adapted to solving non-linear problems. This study aimed to apply the ANNs to reveal the entire spectrum of the relationship between motor skills and clinical variables. Thirty-two male children with ASD [mean age: 48.5 months (SD: 8.8); age range: 30-60 months] were recruited in a tertiary care university hospital. A multidisciplinary comprehensive diagnostic evaluation was associated with a standardized assessment battery for motor skills, the Peabody Developmental Motor Scale-Second Edition. Exploratory analyses were performed through the ANNs. The findings revealed that poor motor skills were a common clinical feature of preschoolers with ASD, relating both to the high level of repetitive behaviors and to the low level of expressive language. Moreover, unobvious trends among motor, cognitive and social skills have been detected. In conclusion, motor abnormalities in preschoolers with ASD were widespread, and the degree of impairment may inform clinicians about the severity of ASD core symptoms. Understanding motor disturbances in children with ASD may be relevant to clarify neurobiological basis and ultimately to guide the development of tailored treatments.
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Affiliation(s)
- Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Institute, Tavernerio, Italy
| | | | | | | | | | | | - Sara Calderoni
- IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Sara Calderoni, ;
| | - Filippo Muratori
- IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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26
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Charman T, Loth E, Tillmann J, Crawley D, Wooldridge C, Goyard D, Ahmad J, Auyeung B, Ambrosino S, Banaschewski T, Baron-Cohen S, Baumeister S, Beckmann C, Bölte S, Bourgeron T, Bours C, Brammer M, Brandeis D, Brogna C, de Bruijn Y, Chakrabarti B, Cornelissen I, Acqua FD, Dumas G, Durston S, Ecker C, Faulkner J, Frouin V, Garcés P, Ham L, Hayward H, Hipp J, Holt RJ, Isaksson J, Johnson MH, Jones EJH, Kundu P, Lai MC, D’ardhuy XL, Lombardo MV, Lythgoe DJ, Mandl R, Mason L, Meyer-Lindenberg A, Moessnang C, Mueller N, O’Dwyer L, Oldehinkel M, Oranje B, Pandina G, Persico AM, Ruggeri B, Ruigrok ANV, Sabet J, Sacco R, Cáceres ASJ, Simonoff E, Toro R, Tost H, Waldman J, Williams SCR, Zwiers MP, Spooren W, Murphy DGM, Buitelaar JK. The EU-AIMS Longitudinal European Autism Project (LEAP): clinical characterisation. Mol Autism 2017; 8:27. [PMID: 28649313 PMCID: PMC5481972 DOI: 10.1186/s13229-017-0145-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/19/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The EU-AIMS Longitudinal European Autism Project (LEAP) is to date the largest multi-centre, multi-disciplinary observational study on biomarkers for autism spectrum disorder (ASD). The current paper describes the clinical characteristics of the LEAP cohort and examines age, sex and IQ differences in ASD core symptoms and common co-occurring psychiatric symptoms. A companion paper describes the overall design and experimental protocol and outlines the strategy to identify stratification biomarkers. METHODS From six research centres in four European countries, we recruited 437 children and adults with ASD and 300 controls between the ages of 6 and 30 years with IQs varying between 50 and 148. We conducted in-depth clinical characterisation including a wide range of observational, interview and questionnaire measures of the ASD phenotype, as well as co-occurring psychiatric symptoms. RESULTS The cohort showed heterogeneity in ASD symptom presentation, with only minimal to moderate site differences on core clinical and cognitive measures. On both parent-report interview and questionnaire measures, ASD symptom severity was lower in adults compared to children and adolescents. The precise pattern of differences varied across measures, but there was some evidence of both lower social symptoms and lower repetitive behaviour severity in adults. Males had higher ASD symptom scores than females on clinician-rated and parent interview diagnostic measures but not on parent-reported dimensional measures of ASD symptoms. In contrast, self-reported ASD symptom severity was higher in adults compared to adolescents, and in adult females compared to males. Higher scores on ASD symptom measures were moderately associated with lower IQ. Both inattentive and hyperactive/impulsive ADHD symptoms were lower in adults than in children and adolescents, and males with ASD had higher levels of inattentive and hyperactive/impulsive ADHD symptoms than females. CONCLUSIONS The established phenotypic heterogeneity in ASD is well captured in the LEAP cohort. Variation both in core ASD symptom severity and in commonly co-occurring psychiatric symptoms were systematically associated with sex, age and IQ. The pattern of ASD symptom differences with age and sex also varied by whether these were clinician ratings or parent- or self-reported which has important implications for establishing stratification biomarkers and for their potential use as outcome measures in clinical trials.
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Affiliation(s)
- Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Eva Loth
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Julian Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Daisy Crawley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Caroline Wooldridge
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - David Goyard
- Neurospin Centre CEA, Saclay, 91191 Gif sur Yvette France
| | - Jumana Ahmad
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Bonnie Auyeung
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
- The School of Philosophy, Psychology, and Language Sciences, University of Edinburgh, Dugald Stewart Building, 3 Charles Street, Edinburgh, EH8 9AD UK
| | - Sara Ambrosino
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, J5, 68159 Mannheim, Germany
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
| | - Sarah Baumeister
- Child and Adolescent Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, J5, 68159 Mannheim, Germany
| | - Christian Beckmann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Sven Bölte
- Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Stockholm, Sweden
- Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Thomas Bourgeron
- Institut Pasteur, Human Genetics and Cognitive Functions Unit, 25 Rue du Docteur Roux, Paris, Cedex 15 France
| | - Carsten Bours
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Michael Brammer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Daniel Brandeis
- Child and Adolescent Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, J5, 68159 Mannheim, Germany
| | - Claudia Brogna
- University Campus Bio-Medico, Via Álvaro del Portillo, 21, Rome, Italy
| | - Yvette de Bruijn
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Bhismadev Chakrabarti
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights, Reading, RG6 6AL UK
| | - Ineke Cornelissen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Flavio Dell’ Acqua
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Guillaume Dumas
- Institut Pasteur, Human Genetics and Cognitive Functions Unit, 25 Rue du Docteur Roux, Paris, Cedex 15 France
| | - Sarah Durston
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Christine Ecker
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt am Main, Goethe University, Deutschordenstrasse 50, 60528 Frankfurt, Germany
| | - Jessica Faulkner
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Vincent Frouin
- Neurospin Centre CEA, Saclay, 91191 Gif sur Yvette France
| | - Pilar Garcés
- Roche Pharma Research and Early Development, Neuroscience, Ophthalmology and Rare Diseases, Roche Innovation Center Basel, Grenzacherstrasse 124, B.001 N.667, CH-4070 Basel, Switzerland
| | - Lindsay Ham
- Regulatory Affairs, Pharmaceutical Development, F. Hoffmann-La Roche Pharmaceuticals, Grenzacherstrasse 124, CH-4070 Basel, Switzerland
| | - Hannah Hayward
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Joerg Hipp
- Roche Pharma Research and Early Development, Neuroscience, Ophthalmology and Rare Diseases, Roche Innovation Center Basel, Grenzacherstrasse 124, B.001 N.667, CH-4070 Basel, Switzerland
| | - Rosemary J. Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
| | - Johan Isaksson
- Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Stockholm, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Mark H. Johnson
- Centre for Brain and Cognitive Development, Birkbeck, University of London, 32 Torrington Square, London, WC1E 7JL UK
| | - Emily J. H. Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, 32 Torrington Square, London, WC1E 7JL UK
| | - Prantik Kundu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Meng-Chuan Lai
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
- Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Xavier Liogier D’ardhuy
- Roche Pharma Research and Early Development, Neuroscience, Ophthalmology and Rare Diseases, Roche Innovation Center Basel, Grenzacherstrasse 124, B.001 N.667, CH-4070 Basel, Switzerland
| | - Michael V. Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
- Center for Applied Neuroscience, Department of Psychology, University of Cyprus, PO Box 20537, 1678 Nicosia, Cyprus
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - René Mandl
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Luke Mason
- Centre for Brain and Cognitive Development, Birkbeck, University of London, 32 Torrington Square, London, WC1E 7JL UK
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Nico Mueller
- Child and Adolescent Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, J5, 68159 Mannheim, Germany
| | - Laurence O’Dwyer
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Marianne Oldehinkel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Bob Oranje
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Gahan Pandina
- Janssen Research & Development, 1125 Trenton Harbourton Road, Titusville, NJ 08560 USA
| | - Antonio M. Persico
- University Campus Bio-Medico, Via Álvaro del Portillo, 21, Rome, Italy
- Child and Adolescent Neuropsychiatry Unit, “Gaetano Martino” University Hospital, University of Messina, via Consolare Valeria 1, I-98125 Messina, Italy
| | - Barbara Ruggeri
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Denmark Hill, London, UK
| | - Amber N. V. Ruigrok
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
| | - Jessica Sabet
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Roberto Sacco
- University Campus Bio-Medico, Via Álvaro del Portillo, 21, Rome, Italy
| | - Antonia San Jóse Cáceres
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8LF UK
| | - Roberto Toro
- Institut Pasteur, Human Genetics and Cognitive Functions Unit, 25 Rue du Docteur Roux, Paris, Cedex 15 France
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Jack Waldman
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH UK
| | - Steve C. R. Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Marcel P. Zwiers
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Will Spooren
- Roche Pharmaceutical Research and Early Development, NORD Discovery and Translational Area, Roche Innovation Center Basel, Grenzacherstrasse 124, CH-4070 Basel, Switzerland
| | - Declan G. M. Murphy
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Jan K. Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
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27
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Bal VH, Katz T, Bishop SL, Krasileva K. Understanding definitions of minimally verbal across instruments: evidence for subgroups within minimally verbal children and adolescents with autism spectrum disorder. J Child Psychol Psychiatry 2016; 57:1424-1433. [PMID: 27473432 DOI: 10.1111/jcpp.12609] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Minimally verbal (MV) children with autism spectrum disorder (ASD) are often assumed to be profoundly cognitively impaired and excluded from analyses due to challenges completing standardized testing protocols. A literature aimed at increasing understanding of this subgroup is emerging; however, the many methods used to define MV status make it difficult to compare studies. Understanding how different instruments and definitions used to identify MV children affect sample composition is critical to advance research on this understudied clinical population. METHOD The MV status of 1,470 school-aged children was defined using five instruments commonly used in ASD research. MV sample composition was compared across instruments. Analyses examined the proportion of overlap across MV subgroups and the extent to which child characteristics varied across MV subgroups defined using different definitions or combinations of measures. RESULTS A total of 257 children were classified as MV on at least one instrument. Proportion of overlap between definitions ranged from 3% to 100%. The stringency of definition (i.e. few-to-no vs. some words) was associated with differences in cognitive and adaptive functioning; more stringent definitions yielded greater consistency of MV status across instruments. Cognitive abilities ranged from profoundly impaired to average intelligence; 16% had NVIQ ≥ 70. Approximately half exhibited verbal skills commensurate with nonverbal cognitive ability, whereas half had verbal abilities significantly lower than their estimated NVIQ. CONCLUSIONS Future studies of MV children must carefully consider the methods used to identify their sample, acknowledging that definitions including children with 'some words' may yield larger samples with a wider range of language and cognitive abilities. Broadly defined MV samples may be particularly important to delineate factors interfering with language development in the subgroup of children whose expressive impairments are considerably below their estimated nonverbal cognitive abilities.
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Affiliation(s)
- Vanessa Hus Bal
- University of California San Francisco Department of Psychiatry, San Francisco, CA, USA.,STAR Center for ASD & NDD, University of California San Francisco, San Francisco, CA, USA
| | - Terry Katz
- Developmental Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Somer L Bishop
- University of California San Francisco Department of Psychiatry, San Francisco, CA, USA.,STAR Center for ASD & NDD, University of California San Francisco, San Francisco, CA, USA
| | - Kate Krasileva
- University of California San Francisco Department of Psychiatry, San Francisco, CA, USA
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28
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Havdahl KA, Bal VH, Huerta M, Pickles A, Øyen AS, Stoltenberg C, Lord C, Bishop SL. Multidimensional Influences on Autism Symptom Measures: Implications for Use in Etiological Research. J Am Acad Child Adolesc Psychiatry 2016; 55:1054-1063.e3. [PMID: 27871640 PMCID: PMC5131801 DOI: 10.1016/j.jaac.2016.09.490] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/12/2016] [Accepted: 09/21/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Growing awareness that symptoms of autism spectrum disorder (ASD) transcend multiple diagnostic categories, and major advances in the identification of genetic syndromes associated with ASD, have led to widespread use of ASD symptom measures in etiologic studies of neurodevelopmental disorders. Insufficient consideration of potentially confounding factors such as cognitive ability or behavior problems can have important negative consequences in interpretation of findings, including erroneous estimation of associations between ASD and etiologic factors. METHOD Participants were 388 children 2 to 13 years old with diagnoses of ASD or another neurodevelopmental disorder without ASD. Receiver operating characteristics methods were used to assess the influence of IQ and emotional and behavioral problems on the discriminative ability of 3 widely used ASD symptom measures: the Social Responsiveness Scale (SRS), the Autism Diagnostic Interview-Revised (ADI-R), and the Autism Diagnostic Observation Schedule (ADOS). RESULTS IQ influenced the discriminative thresholds of the SRS and ADI-R, and emotional and behavioral problems affected the discriminative thresholds of the SRS, ADI-R, and ADOS. This resulted in low specificity of ASD cutoffs on the SRS and ADI-R for children with intellectual disability without ASD (27-42%) and low specificity across all 3 instruments for children without ASD with increased emotional and behavioral problems (36-59%). Adjustment for these characteristics resulted in improved discriminative ability for all of the ASD measures. CONCLUSION The findings indicate that scores on ASD symptom measures reflect far more than ASD symptoms. Valid interpretation of scores on these measures requires steps to account for the influences of IQ and emotional and behavioral problems.
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Affiliation(s)
| | | | | | | | - Anne-Siri Øyen
- Norwegian Institute of Public Health and Lovisenberg Hospital, Oslo, Norway
| | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Oslo, Norway and University of Bergen, Norway
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29
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Francis SM, Kim SJ, Kistner-Griffin E, Guter S, Cook EH, Jacob S. ASD and Genetic Associations with Receptors for Oxytocin and Vasopressin- AVPR1A, AVPR1B, and OXTR. Front Neurosci 2016; 10:516. [PMID: 27920663 PMCID: PMC5118619 DOI: 10.3389/fnins.2016.00516] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/26/2016] [Indexed: 01/09/2023] Open
Abstract
Background: There are limited treatments available for autism spectrum disorder (ASD). Studies have reported significant associations between the receptor genes of oxytocin (OT) and vasopressin (AVP) and ASD diagnosis, as well as ASD-related phenotypes. Researchers have also found the manipulation of these systems affects social and repetitive behaviors, core characteristics of ASD. Consequently, research involving the oxytocin/vasopressin pathways as intervention targets has increased. Therefore, further examination into the relationship between these neuropeptides and ASD was undertaken. In this study, we examined associations between variants in the receptor genes of vasopressin (AVPR1A, AVPR1B), oxytocin (OXTR), and ASD diagnosis along with related subphenotypes. Methods: Probands were assessed using Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, and clinical DSM-IV-TR criteria. Single nucleotide polymorphisms (SNPs) in AVPR1B and OXTR, and microsatellites in AVPR1A were genotyped in ~200 families with a proband with ASD. Family-based association testing (FBAT) was utilized to determine associations between variants and ASD. Haplotypes composed of OXTR SNPs (i.e., rs53576-rs2254298-rs2268493) were also analyzed due to previously published associations. Results: Using the additive inheritance model in FBAT we found associations between AVPR1B SNPs (rs28632197, p = 0.005, rs35369693, p = 0.025) and diagnosis. As in other studies, OXTR rs2268493 (p = 0.050) was associated with diagnosis. rs2268493 was also associated with ASD subphenotypes of social withdrawal (p = 0.013) and Insistence on Sameness (p = 0.039). Further analyses demonstrated that the haplotype, rs2254298–rs2268493 was found to be significantly associated with diagnosis (A-T; p = 0.026). FBAT was also used to analyze AVPR1A microsatellites (RS1 and RS3). Both length variants were found to be associated with restrictive, repetitive behaviors, but not overall diagnosis. Correction for multiple comparisons was performed for SNPs tested in each gene region, only AVPR1B SNPs remained significantly associated with ASD diagnosis. Conclusions: Autism is a heterogeneous disorder with many genes and pathways that contribute to its development. SNPs and microsatellites in the receptor genes of OT and AVP are associated with ASD diagnosis and measures of social behavior as well as restricted repetitive behaviors. We reported a novel association with ASD and AVPR1B SNPs. Understanding of genotype-phenotype relationships may be helpful in the development of pharmacological interventions for the OT/AVP system.
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Affiliation(s)
- Sunday M Francis
- Department of Psychiatry, University of Minnesota Minneapolis, MN, USA
| | - Soo-Jeong Kim
- Department of Psychiatry and Behavioral Sciences, University of Washington WA, USA
| | - Emily Kistner-Griffin
- Biostatistics Shared Resource, Hollings Cancer Center, Medical University of South Carolina Charleston, SC, USA
| | - Stephen Guter
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago Chicago, IL, USA
| | - Edwin H Cook
- Department of Psychiatry, Institute of Juvenile Research, University of Illinois at Chicago Chicago, IL, USA
| | - Suma Jacob
- Department of Psychiatry, University of Minnesota Minneapolis, MN, USA
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30
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Polanco M, Rivas C, Aguilera L, Peñalonzo M. Aplicación del Programa de Tamizaje para el diagnóstico de Hipotiroidismo Neonatal en el Hospital San Juan de Dios Guatemala. REVISTA DE LA FACULTAD DE MEDICINA 2016. [DOI: 10.37345/23045329.v1i26.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Introducción: El diagnóstico de hipotiroidismo neonatal es una condición considerada de urgencia por el grave daño cerebral que induce la falta de hormonas tiroideas al no ser reemplazadas. Objetivo: El presente trabajo tuvo como propósito evaluar la metodología y la aplicación del programa de tamizaje para el diagnóstico de hipotiroidismo neonatal y determinar su incidencia en el Hospital General San Juan de Dios de Guatemala (HGSD). Metodología: Estudio de cohorte, retrospectivo, analizando los resultados de TSH de los neonatos nacidos vivos del 1 de enero al 31 de diciembre del año 2017, que fueron tamizados, utilizando la base de datos del laboratorio del HGSD. El valor de corte de TSH utilizado, fue ≥ 20 µU/ml. El diagnóstico fue confirmado con una segunda medición de TSH, utilizando el mismo valor de corte, iniciando ese mismo día el tratamiento hormonal de reemplazo. Resultados. La incidencia de hipotiroidismo neonatal fue de 1:3,707 recién nacidos y la aplicación del programa de tamizaje fue del 96.1% durante el período de estudio. Conclusiones. La cobertura del programa es buena y comparable con la reportada en otros países. El programa de tamizaje debe contar con personal propio, pues sólo de esta manera, podrá lograrse el 100% de cobertura y acortar el período de tiempo para confirmar el diagnóstico e iniciar el tratamiento. Palabras clave: hipotiroidismo neonatal, TSH, valor de corte
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31
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Louwerse A, Eussen MLJM, Van der Ende J, de Nijs PFA, Van Gool AR, Dekker LP, Verheij C, Verheij F, Verhulst FC, Greaves-Lord K. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation. J Autism Dev Disord 2016; 45:3908-18. [PMID: 26395112 PMCID: PMC4653230 DOI: 10.1007/s10803-015-2595-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administered in childhood (ages 6-12) and in adolescence (ages 12-20) to 72 individuals with a pervasive developmental disorder-not otherwise specified (PDD-NOS). ADOS calibrated severity scores showed a large stability (r = .51). Psychiatric comorbidity in childhood and adolescence were not associated with ASD severity in adolescence. Mental health care use (87 %) and special education needs were high (71 %). Reevaluation of ASD severity and psychiatric comorbidity later in life seem useful when PDD-NOS is diagnosed in childhood.
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Affiliation(s)
- A Louwerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands. .,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands.
| | - M L J M Eussen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
| | - J Van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - P F A de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - A R Van Gool
- Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
| | - L P Dekker
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
| | - C Verheij
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - F Verheij
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - K Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
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