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Ilen L, Delavari F, Feller C, Zanoletti O, Sandi C, Schneider M. Diurnal cortisol profiles in autistic adolescents and young adults: Associations with social difficulties and internalizing mental health symptoms. Autism Res 2024. [PMID: 38973713 DOI: 10.1002/aur.3184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/12/2024] [Indexed: 07/09/2024]
Abstract
Several autism-related characteristics, such as social difficulties, may contribute to high perceived stress and increased exposure to stressful life events in some autistic individuals. Repeated exposure to stress might lead to the dysfunction of the hypothalamic-pituitary-adrenocortical-axis and be a vulnerability factor for developing mental health difficulties. Previous studies show contradictory findings on salivary cortisol in autism. In the current study, we investigated diurnal cortisol profiles in autistic adolescents and young adults, as well as their associations with social difficulties, stress exposure, and mental health symptoms. Autistic (n = 48, Mage = 17.6) and nonautistic (n = 51, Mage = 18.4) participants collected salivary cortisol at home six times a day for 2 days. Social difficulties, exposure to stressful life events/bullying, and mental health symptoms were assessed with questionnaires and clinical interviews. Similar diurnal cortisol slopes (DCS) and cortisol awakening responses were observed between the groups, but autistic participants showed higher total cortisol output (AUCG, area under the curve with respect to ground) during the day (b = 19.09, p = 0.009). In the autistic group, more severe social difficulties were associated with flatter DCS (b = 0.01, p = 0.007). Finally, cortisol alterations were associated with self-reported mental health symptoms, especially in autistic females in analyses uncorrected for multiple comparisons. In conclusion, our results do not indicate autism-related group-level alterations in most diurnal cortisol measures, but autistic youth showed higher total cortisol (AUCG) compared with nonautistic peers. More detailed investigation of interindividual variability in cortisol profiles within autistic people might give us important insights into vulnerability to developing stress-related mental health difficulties.
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Affiliation(s)
- Laura Ilen
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Farnaz Delavari
- Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Clémence Feller
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Olivia Zanoletti
- Behavioral Genetics laboratory, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
| | - Carmen Sandi
- Behavioral Genetics laboratory, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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Muscatello RA, Pachol A, Romines A, Smith I, Corbett BA. Development and Parasympathetic Regulation in Male and Female Adolescents with Autism Spectrum Disorder: A Two-Timepoint Longitudinal Study. J Autism Dev Disord 2023; 53:3613-3626. [PMID: 35829945 PMCID: PMC9949914 DOI: 10.1007/s10803-022-05664-2] [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] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
Prolonged dysregulation of the autonomic nervous system (ANS) may increase propensity for physical or psychiatric illness. The current study examined differences in respiratory sinus arrhythmia (RSA) regulation in 215 adolescents with or without autism spectrum disorder (ASD) at Time 1 (T1; 10-13 years old) and 1 year later (Time 2; T2). Linear mixed effects models demonstrated lower RSA regulation in ASD, and a small interaction effect, showing blunted change in RSA from T1 to T2. Developmental differences in RSA regulation were particularly notable in females with ASD and those taking psychotropic medications. Results expand previous findings of reduced parasympathetic regulation in ASD by revealing a blunted developmental slope, indicating diagnostic differences may persist or worsen over time, particularly in females.
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Affiliation(s)
- Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Village at Vanderbilt, 1500 21st Avenue South, Nashville, TN, 37212, USA.
| | - Aaron Pachol
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Village at Vanderbilt, 1500 21st Avenue South, Nashville, TN, 37212, USA
| | - Alexandra Romines
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, USA
| | - Ian Smith
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, USA
| | - Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Village at Vanderbilt, 1500 21st Avenue South, Nashville, TN, 37212, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Corbett BA, McGonigle T, Muscatello RA, Liu J, Vandekar S. The developmental trajectory of diurnal cortisol in autistic and neurotypical youth. Dev Psychopathol 2023:1-12. [PMID: 37435752 PMCID: PMC10784411 DOI: 10.1017/s0954579423000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Increasing age and puberty affect the hypothalamic pituitary adrenal (HPA) axis maturation, which is likely associated with an increase in environmental demands (e.g., social) and vulnerability for the onset of psychiatric conditions (e.g., depression). There is limited research as to whether such patterns are consonant in youth with autism spectrum disorder (ASD), a condition marked by social challenges, dysregulation of the HPA axis, and higher rates of depression setting the stage for enhanced vulnerability during this developmental period.The current study interrogated diurnal cortisol by examining (1) cortisol expression longitudinally over the pubertal transition between autistic and neurotypical youth, (2) the trajectory of diurnal cortisol and the unique contributions of age vs. puberty, and (3) potential sex differences. As hypothesized, results indicate autistic compared to typically developing youth demonstrate a shallower diurnal slope and elevated evening cortisol. These differences were in the context of higher cortisol and flatter rhythms based on age and pubertal development. Also, sex-based differences emerged such that females in both groups had higher cortisol, flatter slopes, and higher evening cortisol than males. The results show that despite the trait-like stability of diurnal cortisol, HPA maturation is impacted by age, puberty, sex, as well as an ASD diagnosis.
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Affiliation(s)
- Blythe A. Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Trey McGonigle
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael A. Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jinyuan Liu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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Mabry S, Wilson EN, Bradshaw JL, Gardner JJ, Fadeyibi O, Vera E, Osikoya O, Cushen SC, Karamichos D, Goulopoulou S, Cunningham RL. Sex and age differences in social and cognitive function in offspring exposed to late gestational hypoxia. RESEARCH SQUARE 2023:rs.3.rs-2507737. [PMID: 37333114 PMCID: PMC10275064 DOI: 10.21203/rs.3.rs-2507737/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Gestational sleep apnea affects 8-26% of pregnancies and can increase the risk for autism spectrum disorder (ASD) in offspring. ASD is a neurodevelopmental disorder associated with social dysfunction, repetitive behaviors, anxiety, and cognitive impairment. To examine the relationship between gestational sleep apnea and ASD-associated behaviors, we used a chronic intermittent hypoxia (CIH) protocol between gestational days (GD) 15-19 in pregnant rats to model late gestational sleep apnea. We hypothesized that late gestational CIH would produce sex- and age-specific social, mood, and cognitive impairments in offspring. Methods Timed pregnant Long-Evans rats were exposed to CIH or room air normoxia from GD 15-19. Behavioral testing of offspring occurred during either puberty or young adulthood. To examine ASD-associated phenotypes, we quantified ASD-associated behaviors (social function, repetitive behaviors, anxiety-like behaviors, and spatial memory and learning), hippocampal activity (glutamatergic NMDA receptors, dopamine transporter, monoamine oxidase-A, EGR-1, and doublecortin), and circulating hormones in offspring. Results Late gestational CIH induced sex- and age-specific differences in social, repetitive and memory functions in offspring. These effects were mostly transient and present during puberty. In female pubertal offspring, CIH impaired social function, increased repetitive behaviors, and increased circulating corticosterone levels, but did not impact memory. In contrast, CIH transiently induced spatial memory dysfunction in pubertal male offspring but did not impact social or repetitive functions. Long-term effects of gestational CIH were only observed in female offspring, wherein CIH induced social disengagement and suppression of circulating corticosterone levels in young adulthood. No effects of gestational CIH were observed on anxiety-like behaviors, hippocampal activity, circulating testosterone levels, or circulating estradiol levels, regardless of sex or age of offspring. Conclusions Our results indicate that hypoxia-associated pregnancy complications during late gestation can increase the risk for ASD-associated behavioral and physiological outcomes, such as pubertal social dysfunction, corticosterone dysregulation, and memory impairments.
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Affiliation(s)
- Steve Mabry
- UNTHSC: University of North Texas Health Science Center
| | | | | | | | | | - Edward Vera
- UNTHSC: University of North Texas Health Science Center
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He Q, Wang Y, Liu Z, Xia J, Yin H, Qiu Z, Wang H, Xu W, Xu Z, Xie J. Analysis of salivary steroid hormones in boys with autism spectrum disorder. BMC Psychiatry 2023; 23:105. [PMID: 36788524 PMCID: PMC9926760 DOI: 10.1186/s12888-023-04586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Autism spectrum disorders (ASD) is a neurodevelopmental disorder with high incidence rate and difficult diagnosis. The purpose of this study was to explore whether salivary cortisol, dehydroepiandrosterone (DHEA) and pregnenolone can be used as biomarkers of ASD children. METHODS The saliva samples of 55 boys with ASD were collected as the experimental group, and the saliva samples of 24 neurotypical boys were collected as the control group. The Child Behavior Checklist (CBCL), Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Repetitive Behavior Scale (RBS) were used to assess the severity of symptoms in boys with ASD. Cortisol, DHEA and pregnenolone concentrations in saliva were measured using an ABSSCIEX QTRAP® 6500 + LC/MS/MS system. SPSS 23.0 was used for statistical analysis. Comparisons between the two groups which conform to normal distribution were performed by T-test, and those which don't conform to normal distribution were performed by Mann-Whitney U test. Correlation analysis between two variables was performed using Spearman's correlation analysis. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the discriminatory sensitivity of each hormone between ASD and normal control groups. Logistic regression models were used to analyze whether DHEA and salivary pregnenolone can be used as a biomarker of ASD. RESULTS There were no significant differences in age, and weight between the ASD group and the normal control group. The ABC, SRS, RBS and CBCL scale scores in the ASD group were significantly higher than those in the normal control group. The salivary DHEA and pregnenolone concentrations in the ASD group were significantly higher than those in the normal control group, but there was no significant difference in cortisol. Spearman's correlation analysis showed that only pregnenolone associated with ABC. Logistic regression model analysis suggested that pregnenolone in saliva was an independent predictor of ASD. ROC analysis found that pregnenolone had good discrimination sensitivity between ASD and normal controls. CONCLUSION Gave salivary preoperative a space for utilization as biomarker as number of cases are limited to this high expectation.
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Affiliation(s)
- Qing He
- grid.410578.f0000 0001 1114 4286Department of Pediatrics, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000 China ,Guangyuan Central Hospital, Guangyuan, 628000 China
| | - Ying Wang
- Deyang Jingyang Maternal and Child Health Care and Family Planning Service Center, Deyang, 618000 China
| | - Zhichao Liu
- grid.460068.c0000 0004 1757 9645Chengdu Third People’s Hospital, Qinglong Street, Qingyang District, Chengdu, 610031 Sichuan China
| | - Jinrong Xia
- grid.460068.c0000 0004 1757 9645Chengdu Third People’s Hospital, Qinglong Street, Qingyang District, Chengdu, 610031 Sichuan China
| | - Heng Yin
- grid.460068.c0000 0004 1757 9645Chengdu Third People’s Hospital, Qinglong Street, Qingyang District, Chengdu, 610031 Sichuan China
| | - Zhongqing Qiu
- grid.460068.c0000 0004 1757 9645Chengdu Third People’s Hospital, Qinglong Street, Qingyang District, Chengdu, 610031 Sichuan China
| | - Hui Wang
- grid.460068.c0000 0004 1757 9645Chengdu Third People’s Hospital, Qinglong Street, Qingyang District, Chengdu, 610031 Sichuan China
| | - Wenming Xu
- grid.461863.e0000 0004 1757 9397West China Second University Hospital, Sichuan University, Chengdu, 610041 China
| | - Zhe Xu
- Guangyuan Central Hospital, Guangyuan, 628000 China
| | - Jiang Xie
- Department of Pediatrics, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, China. .,Chengdu Third People's Hospital, Qinglong Street, Qingyang District, Chengdu, 610031, Sichuan, China.
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Mahony C, O'Ryan C. A molecular framework for autistic experiences: Mitochondrial allostatic load as a mediator between autism and psychopathology. Front Psychiatry 2022; 13:985713. [PMID: 36506457 PMCID: PMC9732262 DOI: 10.3389/fpsyt.2022.985713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Molecular autism research is evolving toward a biopsychosocial framework that is more informed by autistic experiences. In this context, research aims are moving away from correcting external autistic behaviors and toward alleviating internal distress. Autism Spectrum Conditions (ASCs) are associated with high rates of depression, suicidality and other comorbid psychopathologies, but this relationship is poorly understood. Here, we integrate emerging characterizations of internal autistic experiences within a molecular framework to yield insight into the prevalence of psychopathology in ASC. We demonstrate that descriptions of social camouflaging and autistic burnout resonate closely with the accepted definitions for early life stress (ELS) and chronic adolescent stress (CAS). We propose that social camouflaging could be considered a distinct form of CAS that contributes to allostatic overload, culminating in a pathophysiological state that is experienced as autistic burnout. Autistic burnout is thought to contribute to psychopathology via psychological and physiological mechanisms, but these remain largely unexplored by molecular researchers. Building on converging fields in molecular neuroscience, we discuss the substantial evidence implicating mitochondrial dysfunction in ASC to propose a novel role for mitochondrial allostatic load in the relationship between autism and psychopathology. An interplay between mitochondrial, neuroimmune and neuroendocrine signaling is increasingly implicated in stress-related psychopathologies, and these molecular players are also associated with neurodevelopmental, neurophysiological and neurochemical aspects of ASC. Together, this suggests an increased exposure and underlying molecular susceptibility to ELS that increases the risk of psychopathology in ASC. This article describes an integrative framework shaped by autistic experiences that highlights novel avenues for molecular research into mechanisms that directly affect the quality of life and wellbeing of autistic individuals. Moreover, this framework emphasizes the need for increased access to diagnoses, accommodations, and resources to improve mental health outcomes in autism.
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Affiliation(s)
| | - Colleen O'Ryan
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
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Muscatello RA, Kim A, Vandekar S, Corbett BA. Diagnostic and Physical Effects in Parasympathetic Response to Social Evaluation in Youth With and Without Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:3427-3442. [PMID: 34342805 PMCID: PMC8810894 DOI: 10.1007/s10803-021-05224-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 01/06/2023]
Abstract
Individuals with autism spectrum disorder (ASD) may demonstrate atypical autonomic (ANS) responses; however, research remains inconsistent. This study examined parasympathetic response during social evaluation in 241 youth (10-13 years) with ASD (n = 138) or typical development (TD; n = 103). Diagnosis, age, pubertal development, and body mass index (BMI) were hypothesized to be associated with ANS function. Linear mixed effects models demonstrated lower RSA in ASD relative to TD in a base model with no covariates. However, when accounting for differences in BMI, there was no evidence of atypical parasympathetic regulation in youth with ASD. As lower parasympathetic regulation may increase susceptibility for a number of conditions, it will be important to elucidate the link between BMI and the ANS, especially in ASD.
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Affiliation(s)
- Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, Nashville, TN,Correspondence to: Rachael A. Muscatello, Ph.D., Vanderbilt University Medical Center, 1500 21 Avenue South, Nashville, TN 37212, , Tel: (615) 343-2207, Fax: (615) 322-8236
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN
| | - Simon Vandekar
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN
| | - Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, Nashville, TN,Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN,Vanderbilt University, Department of Psychology, Nashville, TN
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Dell'Osso L, Massoni L, Battaglini S, Cremone IM, Carmassi C, Carpita B. Biological correlates of altered circadian rhythms, autonomic functions and sleep problems in autism spectrum disorder. Ann Gen Psychiatry 2022; 21:13. [PMID: 35534878 PMCID: PMC9082467 DOI: 10.1186/s12991-022-00390-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/15/2022] [Indexed: 02/05/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by a complex and multifaceted neurobehavioral syndrome. In the last decades, several studies highlighted an increased prevalence of sleep problems in ASD, which would be associated with autonomic system and circadian rhythm disruption. The present review aimed to summarize the available literature about sleep problems in ASD subjects and about the possible biological factors implicated in circadian rhythm and autonomic system deregulation in this population, as well as possible therapeutic approaches. Shared biological underpinnings between ASD symptoms and altered circadian rhythms/autonomic functions are also discussed. Studies on sleep showed how ASD subjects typically report more problems regarding insufficient sleep time, bedtime resistance and reduced sleep pressure. A link between sleep difficulties and irritability, deficits in social skills and behavioral problems was also highlighted. Among the mechanisms implicated, alteration in genes related to circadian rhythms, such as CLOCK genes, and in melatonin levels were reported. ASD subjects also showed altered hypothalamic pituitary adrenal (HPA) axis and autonomic functions, generally with a tendency towards hyperarousal and hyper sympathetic state. Intriguingly, some of these biological alterations in ASD individuals were not associated only with sleep problems but also with more autism-specific clusters of symptoms, such as communication impairment or repetitive behaviors Although among the available treatments melatonin showed promising results, pharmacological studies for sleep problems in ASD need to follow more standardized protocols to reach more repeatable and reliable results. Further research should investigate the issue of sleep problems in ASD in a broader perspective, taking into account shared pathophysiological mechanisms for core and associated symptoms of ASD.
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Affiliation(s)
- Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Simone Battaglini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy.
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Makris G, Agorastos A, Chrousos GP, Pervanidou P. Stress System Activation in Children and Adolescents With Autism Spectrum Disorder. Front Neurosci 2022; 15:756628. [PMID: 35095389 PMCID: PMC8793840 DOI: 10.3389/fnins.2021.756628] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
The mission of the human stress system is the maintenance of homeostasis in the presence of real or perceived, acute or chronic stressors. The hypothalamic–pituitary–adrenal (HPA) axis and the autonomic nervous system (ANS) are the stress system-related neuroendocrine pathways. There is abundant evidence that children and adolescents with autism spectrum disorder (ASD) may exhibit atypical function within the HPA axis and the ANS both at the resting state and during the presence of social and/or non-social stressors. The aim of this review is to provide an up-to-date summary of the findings regarding stress system alterations in children and adolescents with ASD. We focus on the variations of stress hormones circadian rhythms, specifically cortisol and alpha-amylase (i.e., a surrogate index of epinephrine/norepinephrine secretion), and on the alterations of stress system responsivity to different stressors. Also, we present imaging and immunological findings that have been associated with stress system dysregulation in children and adolescents with ASD. Finally, we review the pivotal role of HPA axis-ANS coordination, the developmental trajectory of the stress system in ASD, and the possible role of early life stress in the dysregulation of the stress system demonstrated in children and adolescents with ASD. This synthesis will hopefully provide researchers with a foundation for an integrated approach to future research into stress system variations in children and adolescents with ASD.
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Affiliation(s)
- Gerasimos Makris
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- *Correspondence: Gerasimos Makris,
| | - Agorastos Agorastos
- Department of Psychiatry II, Division of Neurosciences, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George P. Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Kemeny B, Burk S, Hutchins D, Gramlich C. Therapeutic Riding or Mindfulness: Comparative Effectiveness of Two Recreational Therapy Interventions for Adolescents with Autism. J Autism Dev Disord 2022; 52:2438-2462. [PMID: 34131850 PMCID: PMC8204925 DOI: 10.1007/s10803-021-05136-z] [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] [Accepted: 06/06/2021] [Indexed: 02/05/2023]
Abstract
Therapeutic riding (THR) and HeartMath (HM) mindfulness-based interventions have promise for reducing stress in adolescents with autism spectrum disorder. In three 10-week periods, this study compared THR, HM, and control on salivary cortisol, self-reported stress, parent-reported social responsiveness, and heart-rate variability. This crossover design included 27 participants (12-21 years) randomly assigned to order of intervention. Findings suggest that HM and THR manualized protocols are equally beneficial in decreasing cortisol levels immediately following a session, but HM sessions had more impact on heart-rate variability. There was no significant effect on follow-up cortisol levels within a week after either intervention, but THR had more impact on decreasing some self-reported stressors.
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Affiliation(s)
- Betsy Kemeny
- Department of Recreational Therapy, Slippery Rock University, 106 Patterson Hall, Slippery Rock, PA 16057 USA
| | - Steffanie Burk
- Department of Equine Science, Otterbein University, Westerville, USA
| | - Deborah Hutchins
- Department of Recreational Therapy, Slippery Rock University, 106 Patterson Hall, Slippery Rock, PA 16057 USA
| | - Courtney Gramlich
- Storm Harbor Equestrian Center, Slippery Rock University, Slippery Rock, USA
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Potential of Salivary Biomarkers in Autism Research: A Systematic Review. Int J Mol Sci 2021; 22:ijms221910873. [PMID: 34639213 PMCID: PMC8509590 DOI: 10.3390/ijms221910873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 12/14/2022] Open
Abstract
The diagnostic process for autism spectrum disorders (ASD) is based on a behavioral analysis of the suspected individual. Despite intensive research, no specific and valid biomarker has been identified for ASD, but saliva, with its advantages such as non-invasive collection, could serve as a suitable alternative to other body fluids. As a source of nucleic acid of both human and microbial origin, protein and non-protein molecules, saliva offers a complex view on the current state of the organism. Additionally, the use of salivary markers seems to be less complicated not only for ASD screening but also for revealing the etiopathogenesis of ASD, since enrolling neurotypical counterparts willing to participate in studies may be more feasible. The aim of the presented review is to provide an overview of the current research performed on saliva in relation to ASD, mutual complementing, and discrepancies that result in difficulties applying the observed markers in clinical practice. We emphasize the methodological limitations of saliva collection and processing as well as the lack of information regarding ASD diagnosis, which is critically discussed.
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12
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Ji D, Flouri E, Papachristou E. Social cognition and cortisol in the general population: A systematic review and meta-analysis. Stress Health 2021; 37:415-430. [PMID: 34363741 DOI: 10.1002/smi.3013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/16/2020] [Accepted: 12/05/2020] [Indexed: 11/09/2022]
Abstract
This systematic review examines the evidence on the association between social cognition and cortisol in the general population. Literature was searched in six databases. Of the 401 studies identified, meta-analyses were conducted on 46 effect sizes (Pearson's correlation coefficients) from 19 studies, supplemented by a narrative review. Pooled estimates suggest that better emotion control is associated with increased cortisol concentrations [r = 0.083, 95% CI (0.033, 0.132)]. Emotion recognition or empathy were not significantly associated with cortisol concentrations [r = 0.072, 95% CI (-0.020, 0.165) and r = 0.004, 95% CI (-0.061, 0.068) respectively]. Subgroup analyses showed that the association between emotion control and cortisol concentrations is significant in males, for morning cortisol, when the cortisol data are transformed to correct for skewed distributions, or when participants are instructed to avoid food and drink intake for at least one hour before sample collection. There was no evidence for an association between social cognition with diurnal cortisol slope or cortisol awakening response. More validation work with greater standardization of methodological procedures is required.
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Affiliation(s)
- Dongying Ji
- Department of Psychology and Human Development, UCL Institute of Education, London, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, London, UK
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Bozkurt H, Şimşek Ş, Şahin S. Elevated levels of cortisol, brain-derived neurotropic factor and tissue plasminogen activator in male children with autism spectrum disorder. Autism Res 2021; 14:2078-2084. [PMID: 34291889 DOI: 10.1002/aur.2582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/04/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
Several studies demonstrated biological effects of cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) on human metabolism and central nervous system. Our study investigated the serum levels of tPA along with BDNF and cortisol in children with autism spectrum disorder (ASD). Thirty three male children with ASD ranging in age from 2 to 15 years were selected for the study group and 27 age-matched healthy male children were selected for the control group. The ASD severity was determined by the score on the Autism Behavior Checklist (ABC). The mean cortisol levels for the study group and the control group were 79.1 ± 30.2 ng/ml and 60.0 ± 25.1 ng/ml, respectively. The mean BDNF levels for the study group and the control group were 5.9 ± 2.8 ng/ml and 3.7 ± 1.8 ng/ml, respectively. The mean tPA levels for the study group and the control group were 32.9 ± 18.5 ng/ml and 25.5 ± 15.1 ng/ml, respectively. Cortisol, BDNF and tPA levels were significantly higher in the study group compared to the control group (p < 0.001). There was no statistically significant effect in terms of age, ABC total and subscale scores on serum cortisol, BDNF and tPA levels in the study group (p > 0.05). It may be suggested that elevations may indicate a role in the pathogenesis of ASD or it may be the case that ASD may alter the levels or pathways of these metabolic factors. LAY SUMMARY: The underlying mechanism or a specific metabolic target relevant to autism spectrum disorder (ASD) has not yet been identified. Cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) have biological effects on neuroplasticity but little is known about the role of cortisol and tPA-BDNF pathway in ASD. In the present study focused on male children with ASD, we have found higher blood levels of cortisol, BDNF and tPA than their healthy peers. This is the first clinical study to evaluate the serum tPA levels along with BDNF and cortisol in ASD. The results suggest that several neurotrophic and other related markers should be born in mind while examining children with ASD.
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Affiliation(s)
- Hasan Bozkurt
- Department of Child and Adolescent Psychiatry, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Şeref Şimşek
- Department of Child and Adolescent Psychiatry, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Serkan Şahin
- Department of Child and Adolescent Psychiatry, Gaziosmanpasa University School of Medicine, Tokat, Turkey
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14
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Corbett BA, Muscatello RA, Klemencic ME, Schwartzman JM. The impact of COVID-19 on stress, anxiety, and coping in youth with and without autism and their parents. Autism Res 2021; 14:1496-1511. [PMID: 33913261 PMCID: PMC8237027 DOI: 10.1002/aur.2521] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/06/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022]
Abstract
In the wake of COVID-19, the world has become a more uncertain environment-a breeding ground for stress and anxiety, especially for individuals with autism spectrum disorder (ASD). The study examined stress, anxiety, and coping in a data-driven, real-time assessment of 122 youth with and without ASD and their parents at the height of the COVID-19 shutdown and three-months later. Standardized measures were administered to ascertain stress and coping explicitly related to the pandemic (RSQ COVID-19-Child [self-report], Adult [self-report from the guardian of youth], Parent [report about child]) and anxiety (STAI-C, STAI-A). Multivariate, univariate analyses of variance and hierarchical regression were used. ASD youth endorsed more Trait anxiety and response to specific stressors (e.g., virus). Caregivers of youth with ASD (Adults) self-reported higher anxiety, yet scores were elevated for both groups. Adults of youth with ASD reported more stress, especially related to the virus, access to healthcare, and concern for the future. In the TD group, youth and adults used more Primary and Secondary Control Coping whereas ASD youth and adults used more Disengagement Coping. Adult stress was the primary predictor of parent perception of child stress as well as Child self-reported stress. While the ASD group was consistently high compared to the TD group, there were no significant changes over time for stress or anxiety. Results reveal striking differences in youth with ASD and their parents regarding stress, anxiety, and coping. Findings highlight the need for essential support, access to services, and strategies to enhance psychological and emotional well-being. LAY SUMMARY: This study examined stress, anxiety, and coping related to the COVID-19 pandemic in 61 youth with autism spectrum disorder (ASD) and 61 youth with typical development (TD) and their parents. Results showed that ASD youth reported more anxiety and stress. Adults of youth with ASD indicated higher self-reported anxiety and stress than adults of TD youth. TD youth and their parents reported using more adaptive coping strategies. Findings highlight the need for strategies to enhance psychological and emotional well-being.
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Affiliation(s)
- Blythe A. Corbett
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt University Medical Center, Vanderbilt Kennedy CenterNashvilleTennesseeUSA
- Department of PsychologyVanderbilt UniversityNashvilleTennesseeUSA
| | - Rachael A. Muscatello
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Mark E. Klemencic
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Jessica M. Schwartzman
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
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15
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Dallman AR, Bailliard A, Harrop C. Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study. J Autism Dev Disord 2021; 52:291-303. [PMID: 33677729 PMCID: PMC7970812 DOI: 10.1007/s10803-021-04935-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/28/2022]
Abstract
Depression is a common comorbidity in autism spectrum disorder (ASD). Little is known about risk factors for depression and depressive symptoms in this population. Ecological momentary assessment (EMA) has been used in the typically developing population to identify risk factors for depression, but has been rarely applied in ASD populations. In this exploratory study, 17 autistic adolescents participated in an EMA protocol in which they reported on their current activities and emotions six times per day for seven consecutive days. Results suggested that negative affect is predicted by momentary quality of social interaction and enjoyment of the current activity (p < 0.05). Additionally, affective instability predicted depressive symptoms. These results provide insights into risk factors for depression in this vulnerable population.
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Affiliation(s)
- Aaron R Dallman
- Department of Occupational Therapy and Occupational Science, College of Health Professions, Towson University, 8000 York Rd, Towson, MD, USA.
| | - Antoine Bailliard
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clare Harrop
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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16
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Corbett BA, Muscatello RA, Kim A, Patel K, Vandekar S. Developmental effects in physiological stress in early adolescents with and without autism spectrum disorder. Psychoneuroendocrinology 2021; 125:105115. [PMID: 33352474 PMCID: PMC7904615 DOI: 10.1016/j.psyneuen.2020.105115] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/10/2020] [Accepted: 12/13/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Humans place high value on how they are socially evaluated by others. The Trier Social Stress Test (TSST) is a well-established measure of social evaluative threat that promotes activation of the hypothalamic pituitary adrenal (HPA) axis and release of cortisol. Higher cortisol responses in typically developing (TD) adolescents are influenced by age and pubertal development especially in later stages. Children with ASD have been shown to exhibit blunted cortisol in response to the TSST although adults with ASD show a more prototypical response. The current study examined physiological stress in early adolescents with ASD and TD. It was hypothesized that TD youth would show elevated cortisol in response to the TSST influenced by age and pubertal stage. In contrast, youth with ASD would show a more diminished stress response yet still show effects for age and pubertal development METHODS: The sample included 241 youth, 138 with ASD (median age=11.25) and 103 TD (median age=11.67). Standardized diagnostic and pubertal development (genital/breast (GB), and pubic hair (PH) stage) physical exams were performed. Salivary cortisol was collected before and after the TSST. Linear mixed effects models examined the effects of baseline cortisol, time, age, sex, pubertal stage, and diagnosis. RESULTS We did not find an effect of early pubertal development stage (GB or PH) on cortisol response. There was an interaction between age and TSST timepoint, showing stronger effects for older children across the timeline especially during the stressor. Finally, there was a significant diagnosis by TSST timepoint interaction characterized by a blunted cortisol stress response in youth with ASD compared to TD participants who showed higher cortisol. DISCUSSION We found evidence that age contributes to an increase in cortisol in response to social evaluative threat during early adolescence. TD youth exhibit an adaptive elevated stress response to psychosocial threat whereas youth with ASD do not. There may exist a developmental lag in the perception of and stress responsivity to social evaluation which may emerge in older adolescents with ASD.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences,Vanderbilt University Medical Center, Vanderbilt Kennedy Center,Vanderbilt University, Department of Psychology
| | - Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of Biostatistics
| | | | - Simon Vandekar
- Vanderbilt University Medical Center, Department of Biostatistics
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17
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Worsham W, Dalton S, Bilder DA. The Prenatal Hormone Milieu in Autism Spectrum Disorder. Front Psychiatry 2021; 12:655438. [PMID: 34276434 PMCID: PMC8280339 DOI: 10.3389/fpsyt.2021.655438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/17/2021] [Indexed: 01/03/2023] Open
Abstract
Though the etiology of autism spectrum disorder (ASD) remains largely unknown, recent findings suggest that hormone dysregulation within the prenatal environment, in conjunction with genetic factors, may alter fetal neurodevelopment. Early emphasis has been placed on the potential role of in utero exposure to androgens, particularly testosterone, to theorize ASD as the manifestation of an "extreme male brain." The relationship between autism risk and obstetric conditions associated with inflammation and steroid dysregulation merits a much broader understanding of the in utero steroid environment and its potential influence on fetal neuroendocrine development. The exploration of hormone dysregulation in the prenatal environment and ASD development builds upon prior research publishing associations with obstetric conditions and ASD risk. The insight gained may be applied to the development of chronic adult metabolic diseases that share prenatal risk factors with ASD. Future research directions will also be discussed.
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Affiliation(s)
- Whitney Worsham
- University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Susan Dalton
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, United States
| | - Deborah A Bilder
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
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18
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Clawson A, Strang JF, Wallace GL, Gomez-Lobo V, Jack A, Webb SJ, Pelphrey KA. Parent-Child Concordance on the Pubertal Development Scale in Typically Developing and Autistic Youth. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 77:101610. [PMID: 32863862 PMCID: PMC7449027 DOI: 10.1016/j.rasd.2020.101610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Characterizing puberty in autism spectrum disorder (ASD) is critical given the direct impacts of pubertal progression on neural, cognitive, and physical maturation. Limited information is available about the utility and parent-child concordance of the self-report and parent-report Pubertal Development Scale (PDS) in ASD, an economical and easily administered measure. METHOD The primary aim of this study was to examine the concordance between self-report and parent-report PDS ratings in autistic males and females ages 8-17y compared to typically developing (TD) youth, including using the PDS to derive informant-based estimates of adrenal and gonadal development. We hypothesized that there would be greater parent-youth discrepancies in pubertal ratings among autistic males. Our second aim was exploratory; we examined whether individual characteristics impact PDS concordance and hypothesized that lower intellectual and adaptive skills, higher autistic traits, and reduced self-awareness/monitoring would correlate with lower concordance. RESULTS There were no significant diagnostic group differences in parent-youth concordance for overall PDS scores among males and females. Autistic males had significantly lower inter-item agreement with their parents than TD males and had lower agreement for both adrenal and gonadal aspects of pubertal maturation (adrenal κ=.48; gonadal κ=.55). CONCLUSIONS The PDS is a feasible measure in ASD. Greater parent-youth discrepancies in autistic males may be due to reduced parental awareness or reduced insight into pubertal maturation among autistic males. Future research is needed to further elucidate individual and/or environmental characteristics that influence youth- and parent-reported PDS scores, including differences in self-perception and insight.
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Affiliation(s)
- Ann Clawson
- Department of Neuropsychology, Children’s National
Hospital
| | - John F. Strang
- Department of Neuropsychology, Children’s National
Hospital
| | - Gregory L. Wallace
- Department of Speech, Language, and Hearing Sciences, The
George Washington University
| | | | - Allison Jack
- Department of Psychology, George Mason University
| | - Sara J. Webb
- Department of Psychology, University of Washington
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19
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Peters SU, Fu C, Neul JL, Granger DA. Cortisol profiles and clinical severity in MECP2 duplication syndrome. J Neurodev Disord 2020; 12:19. [PMID: 32698758 PMCID: PMC7376951 DOI: 10.1186/s11689-020-09322-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/21/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND MECP2 duplication syndrome (MDS) is a rare X-linked genomic disorder primarily affecting males which is caused by interstitial chromosomal duplications at Xq28 encompassing the MECP2 gene. Core clinical features of MDS include choreiform movements, progressive spasticity, recurrent respiratory infections, developmental delays in the first 6 months of life, hypotonia, vasomotor disturbances, constipation, drooling, and bruxism. Prior studies suggest that HPA axis activity may be altered in MDS and measures of HPA axis activity may offer insight into disease severity. METHODS To ascertain whether cortisol profiles are a potential biomarker of clinical severity, diurnal profiles of cortisol and the cortisol awakening response were examined from saliva samples in 31 participants with MDS (ages 2-24 years), and 27 of these samples were usable. Documentation of a positive diagnostic test for MECP2 duplication was required for entry into the study. Samples were collected on each of two consecutive weekdays at four time points during the day: immediately after waking, 30 min after waking, between 3 and 4 PM, and in the evening before bedtime. Correlations with duplication size, clinical severity, sleep problems, and behavior were also examined. RESULTS Results revealed that a majority of participants with MDS exhibit a declining cortisol awakening response (n = 17). A declining CAR was significantly associated with increased clinical severity scores (r = - .508; p = .03), larger duplication size, waking later, and an increased number of hospitalizations for infections. CONCLUSIONS Future mechanistic studies will have to determine whether the declining CAR in MDS is attributable to problems with "flip-flop switching" of regional brain activation (involving the suprachiasmatic nucleus and the hippocampus, and the HPA axis) that is responsible for the switch from reduced to increased adrenal sensitivity. Taken together, results suggest the possibility that cortisol profiles could potentially be a biomarker of clinical severity and utilized for the purposes of patient stratification for future clinical trials in MDS.
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Affiliation(s)
- Sarika U Peters
- Vanderbilt University Medical Center, Nashville, USA.
- Deparment of Pediatrics, Vanderbilt University Medical Center, Vanderbilt Kennedy Center, PMB 74, 230 Appleton Place, Nashville, TN, 37203-5721, USA.
| | - Cary Fu
- Vanderbilt University Medical Center, Nashville, USA
| | | | - Douglas A Granger
- University of California, Irvine, and Johns Hopkins University, Baltimore, USA
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20
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Muscatello RA, Andujar J, Taylor JL, Corbett BA. Exploring Key Physiological System Profiles at Rest and the Association with Depressive Symptoms in Autism Spectrum Disorder. J Autism Dev Disord 2020; 51:15-29. [PMID: 32350791 DOI: 10.1007/s10803-020-04516-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is often associated with dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Individuals with autism spectrum disorder (ASD) may experience physiological dysregulation and psychological comorbidities; however, the extent to which the interactions between these systems predict internalizing symptoms in ASD has not been investigated. The study examined interactions with the HPA axis and ANS in 10-13-year-old children with ASD (n = 41) and typical development (TD; n = 46). The interrelated systems uniquely contributed to depressive symptoms in ASD above and beyond any system in isolation. A reciprocal, parasympathetic-dominant ANS was related to fewer affective symptoms in ASD. Findings highlight the importance of examining arousal across multiple systems to more precisely identify profiles associated with maladaptive psychiatric outcomes in ASD.
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Affiliation(s)
- Rachael A Muscatello
- Vanderbilt Brain Institute, Neuroscience Graduate Program, 1500 21st Avenue S., Nashville, TN, 37212, USA.
| | - Justin Andujar
- Vanderbilt University, Nashville, TN, USA.,Department of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julie L Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Blythe A Corbett
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychology, Vanderbilt University, Nashville, TN, USA
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21
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Pinato L, Galina Spilla CS, Markus RP, da Silveira Cruz-Machado S. Dysregulation of Circadian Rhythms in Autism Spectrum Disorders. Curr Pharm Des 2020; 25:4379-4393. [DOI: 10.2174/1381612825666191102170450] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 10/31/2019] [Indexed: 12/12/2022]
Abstract
Background:
The alterations in neurological and neuroendocrine functions observed in the autism
spectrum disorder (ASD) involves environmentally dependent dysregulation of neurodevelopment, in interaction
with multiple coding gene defects. Disturbed sleep-wake patterns, as well as abnormal melatonin and glucocorticoid
secretion, show the relevance of an underlying impairment of the circadian timing system to the behavioral
phenotype of ASD. Thus, understanding the mechanisms involved in the circadian dysregulation in ASD could
help to identify early biomarkers to improve the diagnosis and therapeutics as well as providing a significant
impact on the lifelong prognosis.
Objective:
In this review, we discuss the organization of the circadian timing system and explore the connection
between neuroanatomic, molecular, and neuroendocrine responses of ASD and its clinical manifestations. Here
we propose interconnections between circadian dysregulation, inflammatory baseline and behavioral changes in
ASD. Taking into account, the high relevancy of melatonin in orchestrating both circadian timing and the maintenance
of physiological immune quiescence, we raise the hypothesis that melatonin or analogs should be considered
as a pharmacological approach to suppress inflammation and circadian misalignment in ASD patients.
Strategy:
This review provides a comprehensive update on the state-of-art of studies related to inflammatory
states and ASD with a special focus on the relationship with melatonin and clock genes. The hypothesis raised
above was analyzed according to the published data.
Conclusion:
Current evidence supports the existence of associations between ASD to circadian dysregulation,
behavior problems, increased inflammatory levels of cytokines, sleep disorders, as well as reduced circadian
neuroendocrine responses. Indeed, major effects may be related to a low melatonin rhythm. We propose that
maintaining the proper rhythm of the circadian timing system may be helpful to improve the health and to cope
with several behavioral changes observed in ASD subjects.
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Affiliation(s)
- Luciana Pinato
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), 17525-900, Marilia, SP, Brazil
| | - Caio Sergio Galina Spilla
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), 17525-900, Marilia, SP, Brazil
| | - Regina Pekelmann Markus
- Laboratory of Chronopharmacology, Department of Physiology, Institute of Biosciences, University of São Paulo (USP), 05508-090, São Paulo, SP, Brazil
| | - Sanseray da Silveira Cruz-Machado
- Laboratory of Chronopharmacology, Department of Physiology, Institute of Biosciences, University of São Paulo (USP), 05508-090, São Paulo, SP, Brazil
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22
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Baker EK, Richdale AL, Hazi A, Prendergast LA. Assessing a hyperarousal hypothesis of insomnia in adults with autism spectrum disorder. Autism Res 2019; 12:897-910. [DOI: 10.1002/aur.2094] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 02/16/2019] [Accepted: 02/28/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Emma K. Baker
- School of Psychology and Public Health, Olga Tennison Autism Research CentreLa Trobe University Bundoora VIC Australia
- Diagnosis and DevelopmentMurdoch Children's Research Institute Parkville VIC Australia
- Department of PaediatricsUniversity of Melbourne Parkville VIC Australia
| | - Amanda L. Richdale
- School of Psychology and Public Health, Olga Tennison Autism Research CentreLa Trobe University Bundoora VIC Australia
| | - Agnes Hazi
- School of Psychology and Public HealthLa Trobe University Bundoora VIC Australia
| | - Luke A. Prendergast
- Department of Mathematics and StatisticsLa Trobe University Bundoora VIC Australia
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23
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Corbett BA, Muscatello RA, Baldinger C. Comparing stress and arousal systems in response to different social contexts in children with ASD. Biol Psychol 2019; 140:119-130. [PMID: 30557600 PMCID: PMC6471662 DOI: 10.1016/j.biopsycho.2018.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 12/28/2022]
Abstract
Response to psychological stress can vary based on the extent to which the context is perceived as stressful, especially under different social conditions. The purpose of this preliminary study was to compare physiological stress (cortisol) and regulation (respiratory sinus arrhythmia, RSA) of 10-12 year old children with autism spectrum disorder (ASD, n = 31) or typical development (TD, n = 25) when exposed to two social stress protocols. The extent to which perceived emotion (affect recognition) and anxiety (state and trait) mediate the stress response was also explored. Results revealed different patterns of stress responses dependent on the type of stressor. During a friendly social interaction, both groups generally showed an adaptive, synergistic response between cortisol and RSA. In response to social evaluation, however, the ASD group did not show correlating responses between physiological systems, which was likely due to a blunted stress response to the social evaluative stressor. The ability to recognize neutral faces mediated the relationship between diagnostic group and physiological response to social evaluation, indicating that perception of threat is essential to triggering a stress response. The current study emphasizes the need to consider the important role of social context, social perception, and perceived anxiety when examining social interaction and stress.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States.
| | | | - Charles Baldinger
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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