Association of adverse childhood experiences and precuneus volume with intrusive reexperiencing in autism spectrum disorder

Rumination and altered reactivity to sensory input as vulnerability factors for developing post-traumatic stress symptoms among adults with autistic traits

OBJECTIVE

Recent literature has suggested that individuals with autism spectrum disorder (ASD) or autistic traits (ATs) would be more likely to encounter traumatic events in their lifetime and to develop post-traumatic stress disorder (PTSD). However, the nature of this relationship has not yet been fully elucidated. The aims of this study were to evaluate the relationship between AT and PTSD and to investigate which specific autistic dimension was more associated with trauma and stress-related symptoms.

METHODS

A total of 68 subjects with ASD and 64 healthy controls (HCs) were assessed with the Adult Autism Subthreshold Spectrum (AdAS Spectrum) and the Trauma and Loss Spectrum (TALS) questionnaires. Statistical analyses included Mann-Whitney U test, chi-square test, calculation of Spearman's coefficients, and logistic regression analysis.

RESULTS

Patients with significant AT reported a 30% rate of PTSD and higher TALS total and domain scores than HCs, among whom no PTSD was found instead. Significant positive correlations were reported between AdAS Spectrum and TALS-SR scores in the whole sample. AdAS Spectrum total scores were statistically predictive of the presence of PTSD. High scores at AdAS Spectrum Inflexibility and adherence to routine and Restrictive interest and rumination domains were identified as positive predictors of a probable PTSD.

CONCLUSION

Compared to HCs, subjects with significant AT are more likely to present symptoms of PTSD. In particular, AT related to ruminative thinking, narrow interests, and sensorial reactivity would seem to predict the presence of post-traumatic stress symptomatology.

The role of adverse childhood experiences in obesity among adolescents with autism spectrum disorder: National survey of Children's health 2018-2019

BACKGROUND

Adolescents with autism spectrum disorder (ASD) are at an increased risk of overweight/obesity and adverse childhood experiences (ACEs).

OBJECTIVE

This study examined whether ACEs increased the odds of overweight/obesity in adolescents with ASD.

METHODS

This cross-sectional study used National Survey of Children's Health (NSCH) 2018-2019 data (N = 31,533 children ages 10-17 years, including n = 480 children with mild ASD and n = 423 children with moderate/severe ASD with normal or overweight/obese BMI). Parent-reported body mass index (BMI) was coded as overweight/obesity vs. normal weight. The independent variable was the count of nine ACEs. Binary logistic regression was conducted, controlling for social ecological factors.

RESULTS

The odds of overweight/obesity in adolescents with ASD with 1-2 ACEs (OR 1.3, CI 1.1-1.4) and 3+ ACEs (OR 1.6, CI 1.3-2.0) were higher than those with 0 ACEs; odds increased with higher counts of ACEs. Household income level was the most significant sociodemographic influence on odds of obesity in adolescents with ASD (0-99 % Federal Poverty Level: OR 1.9, CI 1.6-2.3). Adolescents with moderate/severe ASD (OR 1.7, CI 1.2-2.5) and mild ASD (OR 1.6, CI 1.0-2.4) had higher odds of overweight/obesity after accounting for ACEs, race/ethnicity, sex, household income, and physical activity.

CONCLUSION

Findings indicated ACEs are associated with ASD, which calls for integration of ACEs information within trauma-informed care practices for obesity prevention and intervention for adolescents with ASD. Persistent disparities of overweight/obesity exist by race/ethnicity, sex, and household income within this population, which indicates the need for tailoring trauma-informed approaches to the unique needs of this population.

Investigation of altered spontaneous brain activity in patients with bronchial asthma using the percent amplitude of fluctuation method: a resting-state functional MRI study

Purpose

To explore the regions of aberrant spontaneous brain activity in asthma patients and their potential impacts using the Percent amplitude of fluctuation (PerAF) analysis method.

Patients and methods

In this study, a total of 31 bronchial asthma (BA) patients were ultimately included, comprising 17 males and 14 females. Subsequently, 31 healthy control subjects (HCS) were recruited, consisting of 17 males and 14 females, and they were matched with the BA group based on age, sex, and educational status. The PerAF analysis technique was employed to study the differences in spontaneous brain activity between the two groups. The SPM12 toolkit was used to carry out a two sample t-test on the collected fMRI data, in order to examine the differences in PerAF values between the asthma patients and the healthy controls. We employed the Montreal Cognitive Assessment (MoCA) scale and the Hamilton Depression Scale (HAMD) to evaluate the cognitive and emotional states of the two groups. Pearson correlation analysis was utilized to ascertain the relationship between changes in the PerAF values within specific brain regions and cognitive as well as emotional conditions.

Results

Compared with the healthy control group, areas of the brain with reduced PerAF in asthma patients included the inferior cerebellum, fusiform gyrus, right inferior orbital frontal gyrus, left middle orbital frontal gyrus, left/right middle frontal gyrus (MFG), dorsal lateral superior frontal gyrus (SFGdl), left superior temporal gyrus (STG), precuneus, right inferior parietal lobule (IPL), and left/right angular gyrus. BA patients exhibit mild cognitive impairments and a propensity for emotional disturbances. Furthermore, the perAF values of the SFGdl region are significantly positively correlated with the results of the MoCA cognitive assessment, while negatively correlated with the HAMD evaluation.

Conclusion

Through the application of PerAF analysis methods, we discovered that several brain regions in asthma patients that control the amplitude of respiration, vision, memory, language, attention, and emotional control display abnormal changes in intrinsic brain activity. This helps characterize the neural mechanisms behind cognitive, sensory, and motor function impairments in asthma patients, providing valuable insights for potential therapeutic targets and disease management strategies.

Specific brain imaging alterations underlying autistic traits in children with attention-deficit/hyperactivity disorder

BACKGROUND

Autistic traits (ATs) are frequently reported in children with Attention-Deficit/Hyperactivity Disorder (ADHD). This study aimed to examine ATs in children with ADHD from both behavioral and neuroimaging perspectives.

METHODS

We used the Autism Spectrum Screening Questionnaire (ASSQ) to assess and define subjects with and without ATs. For behavioral analyses, 67 children with ADHD and ATs (ADHD + ATs), 105 children with ADHD but without ATs (ADHD - ATs), and 44 typically developing healthy controls without ATs (HC - ATs) were recruited. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data and analyzed the mean amplitude of low-frequency fluctuation (mALFF) values (an approach used to depict different spontaneous brain activities) in a sub-sample. The imaging features that were shared between ATs and ADHD symptoms or that were unique to one or the other set of symptoms were illustrated as a way to explore the "brain-behavior" relationship.

RESULTS

Compared to ADHD-ATs, the ADHD + ATs group showed more global impairment in all aspects of autistic symptoms and higher hyperactivity/impulsivity (HI). Partial-correlation analysis indicated that HI was significantly positively correlated with all aspects of ATs in ADHD. Imaging analyses indicated that mALFF values in the left middle occipital gyrus (MOG), left parietal lobe (PL)/precuneus, and left middle temporal gyrus (MTG) might be specifically related to ADHD, while those in the right MTG might be more closely associated with ATs. Furthermore, altered mALFF in the right PL/precuneus correlated with both ADHD and ATs, albeit in diverse directions.

CONCLUSIONS

The co-occurrence of ATs in children with ADHD manifested as different behavioral characteristics and specific brain functional alterations. Assessing ATs in children with ADHD could help us understand the heterogeneity of ADHD, further explore its pathogenesis, and promote clinical interventions.

Association of adverse childhood experiences and cortical neurite density alterations with posttraumatic stress disorder symptoms in autism spectrum disorder

Background

Posttraumatic stress disorder (PTSD) can be a source of significant social and daily distress in autism spectrum disorder (ASD). Compared to typically developed (TD) individuals, people with ASD are at an increased risk of adverse childhood experiences (ACEs), which can result in abnormal neuronal development. However, whether or how ACEs influence abnormal neural development and PTSD symptoms in ASD has not been fully elucidated.

Methods

Thirty-nine TD individuals and 41 individuals with ASD underwent T1-weighted magnetic resonance imaging and neurite orientation dispersion and density imaging (NODDI), with axonal and dendritic densities assessed in terms of the orientation dispersion index and neurite density index (NDI), respectively. Voxel-based analyses were performed to explore the brain regions associated with PTSD symptoms, and the relationships between the severity of ACEs and PTSD symptoms and NODDI parameters in the extracted brain regions were examined.

Results

There was a significant positive association between PTSD symptom severity and NDI in the bilateral supplementary motor area; right superior frontal, left supramarginal, and right superior temporal gyrus; and right precuneus in the ASD group, but not in the TD group. ACE severity was significantly associated with NDI in the right superior frontal and left supramarginal gyrus and right precuneus in the ASD group. Moreover, NDI in the right precuneus mainly predicted the severity of PTSD symptoms in the ASD group, but not the TD group.

Conclusion

These results suggest that ACE-associated higher neurite density is of clinical importance in the pathophysiology of PTSD symptoms in ASD.

The hierarchical organization of the precuneus captured by functional gradients

The precuneus shows considerable heterogeneity in multiple dimensions including anatomy, function, and involvement in brain disorders. Leveraging the state-of-the-art functional gradient approach, we aimed to investigate the hierarchical organization of the precuneus, which may hold promise for a unified understanding of precuneus heterogeneity. Resting-state functional MRI data from 793 healthy individuals were used to discover and validate functional gradients of the precuneus, which were calculated based on the voxel-wise precuneus-to-cerebrum functional connectivity patterns. Then, we further explored the potential relationships of the precuneus functional gradients with cortical morphology, intrinsic geometry, canonical functional networks, and behavioral domains. We found that the precuneus principal and secondary gradients showed dorsoanterior-ventral and ventroposterior-dorsal organizations, respectively. Concurrently, the principal gradient was associated with cortical morphology, and both the principal and secondary gradients showed geometric distance dependence. Importantly, precuneus functional subdivisions corresponding to canonical functional networks (behavioral domains) were distributed along both gradients in a hierarchical manner, i.e., from the sensorimotor network (somatic movement and sensation) at one extreme to the default mode network (abstract cognitive functions) at the other extreme for the principal gradient and from the visual network (vision) at one end to the dorsal attention network (top-down control of attention) at the other end for the secondary gradient. These findings suggest that the precuneus functional gradients may provide mechanistic insights into the multifaceted nature of precuneus heterogeneity.

The atypical functional connectivity of Broca's area at multiple frequency bands in autism spectrum disorder

As a developmental disorder, autism spectrum disorder (ASD) has drawn much attention due to its severe impacts on one's language capacity. Broca's area, an important brain region of the language network, is largely involved in language-related functions. Using the Autism Brain Image Data Exchange (ABIDE) dataset, a mega-analysis was performed involving a total of 1454 participants (including 618 individuals with ASD and 836 healthy controls (HCs). To detect the neural pathophysiological mechanism of ASD from the perspective of language, we conducted a functional connectivity (FC) analysis with Broca's area as the seed in multiple frequency bands (conventional: 0.01-0.08 Hz; slow-4: 0.027-0.073 Hz; slow-5: 0.01-0.027 Hz). We found that compared with HC, ASD patients demonstrated increased FC in the left thalamus, left precuneus, left anterior cingulate and paracingulate gyri, and left medial orbital of the superior frontal gyrus in the conventional frequency band (0.01-0.08 Hz). The results of the slow-5 frequency band (0.01-0.027 Hz) presented increased FC values of the left precuneus, left medial orbital of the superior frontal gyrus, right medial orbital of the superior frontal gyrus and right thalamus. No significant cluster was detected in the slow-4 frequency band (0.027-0.073 Hz). In conclusion, the abnormal functional connectivity in patients with ASD has frequency-specific properties. Furthermore, the slow-5 frequency band (0.01-0.027 Hz) mainly contributed to the findings of the conventional frequency band (0.01-0.08 Hz). The current study might shed new light on the neural pathophysiological mechanism of language impairments in people with ASD.

Scene Construction and Spatial Processing in Post-traumatic Stress Disorder

Introduction

Post-traumatic stress disorder (PTSD) is associated with hippocampal system structural and functional impairments. Neurobiological models of PTSD posit that contextual memory for traumatic events is impaired due to hippocampal system dysfunction whilst memory of sensory details is enhanced due to amygdalar impact on sensory cortices. If hippocampal system dysfunction is a core feature of PTSD, then non-traumatic hippocampal-dependent cognitive functions such as scene construction, spatial processing, and memory should also be impaired in individuals with PTSD.

Methods

Forty-six trauma survivors, half diagnosed with PTSD, performed two tasks that involved spatial processing. The first was a scene construction task which requires conjuring-up spatially coherent multimodal scenarios, completed by all participants. Twenty-six participants (PTSD: n = 13) also completed a navigation task in a virtual environment, and underwent structural T1, T2 and diffusion-tensor MRI to quantify gray and white matter integrity. We examined the relationship between spatial processing, neural integrity, and symptom severity in a multiple factor analysis.

Results

Overall, patients with PTSD showed impaired performance in both tasks compared to controls. Scenes imagined by patients were less vivid, less detailed, and generated less sense of presence; importantly they had disproportionally reduced spatial coherence between details. Patients also made more errors during virtual navigation. Two components of the multiple factor analysis captured group differences. The first component explained 25% of the shared variance: participants that constructed less spatially coherent scenes also made more navigation errors and had reduced white matter integrity to long association tracts and tracts connecting the hippocampus, thalamus, and cingulate. The second component explained 20% of the variance: participants who generated fewer scene details, with less spatial coherence between them, had smaller hippocampal, parahippocampal and isthmus cingulate volumes. These participants also had increased white matter integrity to the right hippocampal cingulum bundle.

Conclusion

Our results suggest that patients with PTSD are impaired at imagining even neutral spatially coherent scenes and navigating through a complex spatial environment. Patients that showed reduced spatial processing more broadly had reduced hippocampal systems volumes and abnormal white matter integrity to tracts implicated in multisensory integration.