1
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Ben-Sasson A, Guedalia J, Ilan K, Shefer G, Cohen R, Gabis LV. Early developmental milestone clusters of autistic children based on electronic health records. Autism Res 2024. [PMID: 38932567 DOI: 10.1002/aur.3177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Autistic children vary in symptoms, co-morbidities, and response to interventions. This study aimed to identify clusters of autistic children with a distinct pattern of attaining early developmental milestones (EDMs). The clustering of 5836 autistic children was based on the attainment of 43 gross motor, fine motor, language, and social developmental milestones during the first 3 years of life as recorded in baby wellness visits. K-means cluster analysis detected four EDM clusters: mild (n = 1686); moderate (n = 1691); severe (n = 2265); and global (n = 194). The most prominent cluster differences were in the language domain. The global cluster showed earlier and greater developmental delay across domains, unique early gross motor delays, and more were born preterm via cesarean section. The severe cluster had poor language development prominently in the second year of life, and later fine motor delays. Moderate cluster had mainly language delays in the third year of life. The mild cluster mostly passed milestones. EDM clusters differed demographically, with higher socioeconomic status in mild cluster and lowest in global cluster. However, the severe cluster had more immigrant and non-Jewish mothers followed by the moderate cluster. The rates of parental concerns and provider developmental referrals were significantly higher in the global, followed by the severe, moderate, and mild EDM clusters. Autistic children's language and motor delay in the first 3 years can be grouped by common magnitude and onset profiles as distinct groups that may link to specific etiologies (like prematurity or genetics) and specific intervention programs. Early autism screening should be tailored to these different developmental profiles.
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Affiliation(s)
| | | | | | - Galit Shefer
- TIMNA-Israel Ministry of Health's Big Data Platform, Jerusalem, Israel
| | - Roe Cohen
- TIMNA-Israel Ministry of Health's Big Data Platform, Jerusalem, Israel
| | - Lidia V Gabis
- Maccabi Healthcare Services, Tel-Aviv, Israel
- Tel-Aviv University, Tel-Aviv, Israel
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2
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Beazley P. Excluding autism or excluding everything? The problem of broad definitions in the England and Wales Draft Mental Health Bill. BJPsych Bull 2024; 48:187-191. [PMID: 37408479 PMCID: PMC11134010 DOI: 10.1192/bjb.2023.60] [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: 03/27/2023] [Revised: 05/02/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
The recent Draft Mental Health Bill for England and Wales proposes changes to the Mental Health Act 1983 which will include, for the first time, a legal definition of autism. This article explores the specific potential issue that the definition, owing to its breadth, potentially encompasses a number of conditions other than autism, consequently leaving the definitionally dependent concept of 'psychiatric disorder' significantly narrowed in scope. The potential implications of this - primarily the concern that a range of other conditions and presentations could be unintentionally excluded from the scope of the civil powers in the Mental Health Act - are discussed.
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3
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Bouteldja AA, Penichet D, Srivastava LK, Cermakian N. The circadian system: A neglected player in neurodevelopmental disorders. Eur J Neurosci 2024. [PMID: 38816965 DOI: 10.1111/ejn.16423] [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: 02/14/2024] [Revised: 04/18/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024]
Abstract
Patients with neurodevelopmental disorders, such as autism spectrum disorder, often display abnormal circadian rhythms. The role of the circadian system in these disorders has gained considerable attention over the last decades. Yet, it remains largely unknown how these disruptions occur and to what extent they contribute to the disorders' development. In this review, we examine circadian system dysregulation as observed in patients and animal models of neurodevelopmental disorders. Second, we explore whether circadian rhythm disruptions constitute a risk factor for neurodevelopmental disorders from studies in humans and model organisms. Lastly, we focus on the impact of psychiatric medications on circadian rhythms and the potential benefits of chronotherapy. The literature reveals that patients with neurodevelopmental disorders display altered sleep-wake cycles and melatonin rhythms/levels in a heterogeneous manner, and model organisms used to study these disorders appear to support that circadian dysfunction may be an inherent characteristic of neurodevelopmental disorders. Furthermore, the pre-clinical and clinical evidence indicates that circadian disruption at the environmental and genetic levels may contribute to the behavioural changes observed in these disorders. Finally, studies suggest that psychiatric medications, particularly those prescribed for attention-deficit/hyperactivity disorder and schizophrenia, can have direct effects on the circadian system and that chronotherapy may be leveraged to offset some of these side effects. This review highlights that circadian system dysfunction is likely a core pathological feature of neurodevelopmental disorders and that further research is required to elucidate this relationship.
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Affiliation(s)
- Ahmed A Bouteldja
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Integrated Program in Neuroscience, McGill University, Montréal, Québec, Canada
| | - Danae Penichet
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Integrated Program in Neuroscience, McGill University, Montréal, Québec, Canada
| | - Lalit K Srivastava
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Nicolas Cermakian
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
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4
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Iacomino M, Houerbi N, Fortuna S, Howe J, Li S, Scorrano G, Riva A, Cheng KW, Steiman M, Peltekova I, Yusuf A, Baldassari S, Tamburro S, Scudieri P, Musante I, Di Ludovico A, Guerrisi S, Balagura G, Corsello A, Efthymiou S, Murphy D, Uva P, Verrotti A, Fiorillo C, Delvecchio M, Accogli A, Elsabbagh M, Houlden H, Scherer SW, Striano P, Zara F, Chou TF, Salpietro V. Allelic heterogeneity and abnormal vesicle recycling in PLAA-related neurodevelopmental disorders. Front Mol Neurosci 2024; 17:1268013. [PMID: 38650658 PMCID: PMC11033462 DOI: 10.3389/fnmol.2024.1268013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/16/2024] [Indexed: 04/25/2024] Open
Abstract
The human PLAA gene encodes Phospholipase-A2-Activating-Protein (PLAA) involved in trafficking of membrane proteins. Through its PUL domain (PLAP, Ufd3p, and Lub1p), PLAA interacts with p97/VCP modulating synaptic vesicles recycling. Although few families carrying biallelic PLAA variants were reported with progressive neurodegeneration, consequences of monoallelic PLAA variants have not been elucidated. Using exome or genome sequencing we identified PLAA de-novo missense variants, affecting conserved residues within the PUL domain, in children affected with neurodevelopmental disorders (NDDs), including psychomotor regression, intellectual disability (ID) and autism spectrum disorders (ASDs). Computational and in-vitro studies of the identified variants revealed abnormal chain arrangements at C-terminal and reduced PLAA-p97/VCP interaction, respectively. These findings expand both allelic and phenotypic heterogeneity associated to PLAA-related neurological disorders, highlighting perturbed vesicle recycling as a potential disease mechanism in NDDs due to genetic defects of PLAA.
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Affiliation(s)
- Michele Iacomino
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Nadia Houerbi
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Sara Fortuna
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Trieste, Italy
| | - Jennifer Howe
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Shan Li
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Giovanna Scorrano
- Department of Pediatrics, Sant'Annunziata Hospital, University "G. D'Annunzio", Chieti, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Antonella Riva
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Kai-Wen Cheng
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Mandy Steiman
- Montreal Neurological Institute-Hospital, Azrieli Centre for Autism Research, McGill University, Montreal, QC, Canada
| | - Iskra Peltekova
- McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Afiqah Yusuf
- Montreal Neurological Institute-Hospital, Azrieli Centre for Autism Research, McGill University, Montreal, QC, Canada
| | - Simona Baldassari
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Serena Tamburro
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Paolo Scudieri
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Ilaria Musante
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Armando Di Ludovico
- Department of Pediatrics, Sant'Annunziata Hospital, University "G. D'Annunzio", Chieti, Italy
| | - Sara Guerrisi
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Ganna Balagura
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Stephanie Efthymiou
- Department of Neuromuscular Diseases, UCL Institute of Neurology, London, United Kingdom
| | - David Murphy
- Department of Neuromuscular Diseases, UCL Institute of Neurology, London, United Kingdom
| | - Paolo Uva
- Clinical Bioinformatics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Chiara Fiorillo
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maurizio Delvecchio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Accogli
- Division of Medical Genetics, Department of Specialized Medicine, McGill University, Montreal, QC, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute-Hospital, Azrieli Centre for Autism Research, McGill University, Montreal, QC, Canada
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Institute of Neurology, London, United Kingdom
| | - Stephen W Scherer
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- McLaughlin Centre, University of Toronto, Toronto, ON, Canada
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Federico Zara
- Unit of Medical Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Tsui-Fen Chou
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States
- Proteome Exploration Laboratory, Beckman Institute, California Institute of Technology, Pasadena, CA, United States
| | - Vincenzo Salpietro
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Department of Neuromuscular Diseases, UCL Institute of Neurology, London, United Kingdom
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5
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Ben-Sasson A, Guedalia J, Nativ L, Ilan K, Shaham M, Gabis LV. A Prediction Model of Autism Spectrum Diagnosis from Well-Baby Electronic Data Using Machine Learning. CHILDREN (BASEL, SWITZERLAND) 2024; 11:429. [PMID: 38671647 PMCID: PMC11049145 DOI: 10.3390/children11040429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Early detection of autism spectrum disorder (ASD) is crucial for timely intervention, yet diagnosis typically occurs after age three. This study aimed to develop a machine learning model to predict ASD diagnosis using infants' electronic health records obtained through a national screening program and evaluate its accuracy. A retrospective cohort study analyzed health records of 780,610 children, including 1163 with ASD diagnoses. Data encompassed birth parameters, growth metrics, developmental milestones, and familial and post-natal variables from routine wellness visits within the first two years. Using a gradient boosting model with 3-fold cross-validation, 100 parameters predicted ASD diagnosis with an average area under the ROC curve of 0.86 (SD < 0.002). Feature importance was quantified using the Shapley Additive explanation tool. The model identified a high-risk group with a 4.3-fold higher ASD incidence (0.006) compared to the cohort (0.001). Key predictors included failing six milestones in language, social, and fine motor domains during the second year, male gender, parental developmental concerns, non-nursing, older maternal age, lower gestational age, and atypical growth percentiles. Machine learning algorithms capitalizing on preventative care electronic health records can facilitate ASD screening considering complex relations between familial and birth factors, post-natal growth, developmental parameters, and parent concern.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Joshua Guedalia
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Liat Nativ
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Keren Ilan
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Meirav Shaham
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Lidia V. Gabis
- Maccabi Healthcare Services, Tel-Aviv 6812509, Israel;
- Pediatrics, Faculty of Medicine and Health Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Keshet Autism Center Maccabi Wolfson, Holon 5822007, Israel
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6
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Viggiano M, Ceroni F, Visconti P, Posar A, Scaduto MC, Sandoni L, Baravelli I, Cameli C, Rochat MJ, Maresca A, Vaisfeld A, Gentilini D, Calzari L, Carelli V, Zody MC, Maestrini E, Bacchelli E. Genomic analysis of 116 autism families strengthens known risk genes and highlights promising candidates. NPJ Genom Med 2024; 9:21. [PMID: 38519481 PMCID: PMC10959942 DOI: 10.1038/s41525-024-00411-1] [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: 10/20/2023] [Accepted: 02/27/2024] [Indexed: 03/25/2024] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a strong genetic component in which rare variants contribute significantly to risk. We performed whole genome and/or exome sequencing (WGS and WES) and SNP-array analysis to identify both rare sequence and copy number variants (SNVs and CNVs) in 435 individuals from 116 ASD families. We identified 37 rare potentially damaging de novo SNVs (pdSNVs) in the cases (n = 144). Interestingly, two of them (one stop-gain and one missense variant) occurred in the same gene, BRSK2. Moreover, the identification of 8 severe de novo pdSNVs in genes not previously implicated in ASD (AGPAT3, IRX5, MGAT5B, RAB8B, RAP1A, RASAL2, SLC9A1, YME1L1) highlighted promising candidates. Potentially damaging CNVs (pdCNVs) provided support to the involvement of inherited variants in PHF3, NEGR1, TIAM1 and HOMER1 in neurodevelopmental disorders (NDD), although mostly acting as susceptibility factors with incomplete penetrance. Interpretation of identified pdSNVs/pdCNVs according to the ACMG guidelines led to a molecular diagnosis in 19/144 cases, although this figure represents a lower limit and is expected to increase thanks to further clarification of the role of likely pathogenic variants in ASD/NDD candidate genes not yet established. In conclusion, our study highlights promising ASD candidate genes and contributes to characterize the allelic diversity, mode of inheritance and phenotypic impact of de novo and inherited risk variants in ASD/NDD genes.
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Affiliation(s)
- Marta Viggiano
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Fabiola Ceroni
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italy
| | - Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Cristina Scaduto
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italy
| | - Laura Sandoni
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Irene Baravelli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Cinzia Cameli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Magali J Rochat
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Alessandra Maresca
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
| | - Alessandro Vaisfeld
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Bioinformatics and Statistical Genomic Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luciano Calzari
- Bioinformatics and Statistical Genomic Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Valerio Carelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
| | | | - Elena Maestrini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Elena Bacchelli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
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7
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Eapen V, Islam R, Azim SI, Masi A, Klein L, Karlov L. Factors Impacting Parental Quality of Life in Preschool Children on the Autism Spectrum. J Autism Dev Disord 2024; 54:943-954. [PMID: 36538128 DOI: 10.1007/s10803-022-05848-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
This study examined connections between parental quality of life (QoL) and features of children (autism severity, cognitive ability, behavioral profile, and sociodemographic factors). Parents of 97 children attending an autism-specific preschool completed the Quality of Life in Autism, Vineland Adaptive Behavior Scales and Child Behavior Checklist. The Autism Diagnostic Observation Schedule and Mullen Scales of Early Learning were also administered. Reduced restrictive/repetitive behavior and higher socialization and play/leisure scores were associated with better parental QoL. Better behavioral regulation and attention also predicted better QoL, as did stronger communication and reduced internalising behaviours. Findings indicate that a child's level of autism specific traits, adaptive functioning and behavioral profile has greater impact on parental QoL than cognitive level.
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Affiliation(s)
- Valsamma Eapen
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
- South Western Sydney Local Health District Academic, Unit of Child Psychiatry, Level 1, Mental Health Centre, Liverpool Hospital, Liverpool, NSW, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Raisa Islam
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Syeda Ishra Azim
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Anne Masi
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Louis Klein
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
- South Western Sydney Local Health District Academic, Unit of Child Psychiatry, Level 1, Mental Health Centre, Liverpool Hospital, Liverpool, NSW, Australia
| | - Lisa Karlov
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
- South Western Sydney Local Health District Academic, Unit of Child Psychiatry, Level 1, Mental Health Centre, Liverpool Hospital, Liverpool, NSW, Australia
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8
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Agron AM, Martin A, Gilmore AW. Scene construction and autobiographical memory retrieval in autism spectrum disorder. Autism Res 2024; 17:204-214. [PMID: 38037250 PMCID: PMC10922094 DOI: 10.1002/aur.3066] [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: 05/04/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023]
Abstract
Individuals with autism spectrum disorder (ASD) frequently exhibit difficulties in retrieving autobiographical memories (AMs) of specific events from their life. Such memory deficits are frequently attributed to underlying disruptions in self-referential or social cognition processes. This makes intuitive sense as these are hallmarks of ASD. However, an emerging literature suggests that parallel deficits also exist in ASD individuals' ability to reconstruct the rich spatial contexts in which events occur. This is a capacity known as scene construction, and in typically developing individuals is considered a core process in retrieving AMs. In this review, we discuss evidence of difficulties with scene construction in ASD, drawing upon experiments that involve AM retrieval, other forms of mental time travel, and spatial navigation. We also highlight aspects of extant data that cannot be accounted for using purely social explanations of memory deficits in ASD. We conclude by identifying key questions raised by our framework and suggest how they might be addressed in future research.
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Affiliation(s)
- Anna M. Agron
- Section on Cognitive Neuropsychology, Laboratory of Brain and Cognition, NIMH/NIH, Bethesda, MD 20892
| | - Alex Martin
- Section on Cognitive Neuropsychology, Laboratory of Brain and Cognition, NIMH/NIH, Bethesda, MD 20892
| | - Adrian W. Gilmore
- Section on Cognitive Neuropsychology, Laboratory of Brain and Cognition, NIMH/NIH, Bethesda, MD 20892
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9
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Boussetta A, Abida N, Jellouli M, Ziadi J, Gargah T. Delayed Graft Function in Pediatric Kidney Transplant: Risk Factors and Outcomes. EXP CLIN TRANSPLANT 2024; 22:110-117. [PMID: 38385384 DOI: 10.6002/ect.mesot2023.o20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES We aimed to identify risk factors and outcomes of delayed graft function in pediatric kidney transplant. MATERIALS AND METHODS This retrospective study included all kidney transplant recipients ≤19 years old followed up in our department for a period of 34 years, from January 1989 to December 2022. RESULTS We included 113 kidney transplant recipients. Delayed graft function occurred in 17 cases (15%). Posttransplant red blood cell transfusion was strongly associated with delayed graft function (adjusted odds ratio = 23.91; 95% CI, 2.889-197.915). Use of allografts with multiple arteries and cold ischemia time >20 hours were risk factors for delayed graft function (adjusted odds ratio = 52.51 and 49.4; 95% CI, 2.576-1070.407 and 1.833-1334.204, respectively). Sex-matched transplants and living donors were protective factors for delayed graft function (adjusted odds ratio = 0.043 and 0.027; 95% CI, 0.005-0.344 and 0.003-0.247, respectively). Total HLA mismatches <3 played a protective role for delayed graft function (adjusted odds ratio = 0.114; 95% CI, 0.020-0.662), whereas transplant within compatible but different blood types increased the risk of delayed graft function (adjusted odds ratio = 20.54; 95% CI, 1.960- 215.263). No significant correlation was shown between delayed graft function and allograft survival (P = .190). Our study suggested delayed graft function as a key factor in allograft rejection-free survival (adjusted odds ratio = 3.832; 95% CI, 1.186-12.377). Delayed graft function was a negative factor for early graft function; patients with delayed graft function had a lower estimated glomerular filtration rate at discharge (P = .024) and at 3 (P = .034), 6 (P = .019), and 12 months (P = .011) posttransplant. CONCLUSIONS Delayed graft function is a major determinant of early graft function and allograft rejection-free survival. Further research is required to establish proper preventive measures.
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Affiliation(s)
- Abir Boussetta
- From the Pediatric Nephrology Department, Charles Nicolle Hospital and the University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
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10
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Sommer M, Glaser B, Soldini E, Weber P, Ramelli GP. Age at initial diagnosis of autism spectrum disorders: a retrospective comparison of screening techniques between the southern and northwestern regions of Switzerland. Swiss Med Wkly 2023; 153:40131. [PMID: 38037847 DOI: 10.57187/smw.2023.40131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
AIMS Early diagnosis of autism spectrum disorders (ASD) offers the possibility of early intervention and, in turn, gains in adaptive behaviour, language and cognition. The aim of the present study was to analyse whether age at diagnosis of autism spectrum disorders decreased in two regions of Switzerland from 2006 to 2016 following the implementation of different screening and referral techniques. In southern Switzerland, systematic paediatric screening using the Modified Checklist for Autism (M-CHAT) in toddlers was implemented in 2013, whereas in northwestern Switzerland, periodic trainings were used to increase paediatrician awareness of ASD. We investigated which method was associated with a younger average age at diagnosis. METHODS We conducted a retrospective, two-centre study searching clinical records of children and adolescents (aged 0-16 years) diagnosed with ASD in two neuropaediatric departments at Swiss hospitals between January 2006 and December 2016. All patients were diagnosed via a standardised evaluation based on two approved diagnostic tests: the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R). RESULTS In southern Switzerland, training and subsequent widespread use of the M-CHAT among paediatricians appeared to contribute to a significantly younger age at diagnosis. Age at diagnosis did not significantly decrease during the same period in northwestern Switzerland. CONCLUSION Our results point to the possibility of successfully reducing age at diagnosis in specific geographic areas through the implementation of screening questionnaires, such as the M-CHAT, at year 2 well-baby visits.
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Affiliation(s)
- Michael Sommer
- Department of Paediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital, Basel, Switzerland
| | - Bronwyn Glaser
- Neuropediatrics Unit, Paediatric Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Emiliano Soldini
- Competence Centre for Healthcare Practices and Policies, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Peter Weber
- Department of Paediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital, Basel, Switzerland
| | - Gian Paolo Ramelli
- Neuropediatrics Unit, Paediatric Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
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11
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Fry R, Li X, Evans TC, Esterman M, Tanaka J, DeGutis J. Investigating the Influence of Autism Spectrum Traits on Face Processing Mechanisms in Developmental Prosopagnosia. J Autism Dev Disord 2023; 53:4787-4808. [PMID: 36173532 PMCID: PMC10812037 DOI: 10.1007/s10803-022-05705-w] [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: 07/24/2022] [Indexed: 10/14/2022]
Abstract
Autism traits are common exclusionary criteria in developmental prosopagnosia (DP) studies. We investigated whether autism traits produce qualitatively different face processing in 43 DPs with high vs. low autism quotient (AQ) scores. Compared to controls (n = 27), face memory and perception were similarly deficient in the high- and low-AQ DPs, with the high-AQ DP group additionally showing deficient face emotion recognition. Task-based fMRI revealed reduced occipito-temporal face selectivity in both groups, with high-AQ DPs additionally demonstrating decreased posterior superior temporal sulcus selectivity. Resting-state fMRI showed similar reduced face-selective network connectivity in both DP groups compared with controls. Together, this demonstrates that high- and low-AQ DP groups have very similar face processing deficits, with additional facial emotion deficits in high-AQ DPs.
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Affiliation(s)
- Regan Fry
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, 150 S. Huntington Ave., 182JP, Boston, MA, 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Xian Li
- Psychological and Brain Science Department, Johns Hopkins University, Baltimore, MD, USA
| | - Travis C Evans
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, 150 S. Huntington Ave., 182JP, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Michael Esterman
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, 150 S. Huntington Ave., 182JP, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - James Tanaka
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Joseph DeGutis
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, 150 S. Huntington Ave., 182JP, Boston, MA, 02130, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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12
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Posar A, Visconti P. Autism Spectrum Disorder in 2023: A Challenge Still Open. Turk Arch Pediatr 2023; 58:566-571. [PMID: 37850666 PMCID: PMC10724724 DOI: 10.5152/turkarchpediatr.2023.23194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/05/2023] [Indexed: 10/19/2023]
Abstract
In this paper, we provide an update on autism spectrum disorder (ASD), including epidemiology, etiopathogenesis, clinical presentation, instrumental investigations, early signs, onset patterns, neuropsychological hypotheses, treatments, and long-term outcome. The prevalence of this condition has increased enormously over the last few decades. This increase prompted a search for possible environmental factors whose effects would add up to a genetic predisposition leading to the development of autism. But the genetic and environmental variables involved are extremely numerous, and conclusive data regarding the etiopathogenesis are still far away. Assuming that a well-defined etiology is still found today only in a minority of cases, numerous pathogenetic mechanisms have been hypothesized. Among these, we mention oxidative stress, mitochondrial dysfunction, alteration of the intestinal microbiota, immune dysregulation, and neuroinflammation. These pathogenetic mechanisms could alter epigenetic status and gene expression, finally leading to ASD. Inherent in the term spectrum is the great clinical heterogeneity of this condition, mainly due to the frequent comorbidity that characterizes it. The earlier the diagnosis is made and the earlier psychoeducational treatment begins, the better the prognosis. In this sense, the role of pediatricians can be decisive in making children with signs suggestive of autism undergo a specialist diagnostic course. The development of increasingly advanced cognitive-behavioral educational techniques has considerably improved the prognosis of affected individuals, even though only a small minority of them come off the autistic spectrum. Pharmacological therapies are used to treat comorbidities. During childhood, the most important prognostic factor for long-term outcome seems to be intellectual functioning.
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Affiliation(s)
- Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italy
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13
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Herkert D, Sullivan C, Zhu Y, Dawson G. Prevalence and nature of prior developmental and medical concerns in toddlers who screen positive for autism in primary care. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2361-2371. [PMID: 37838915 PMCID: PMC10593482 DOI: 10.1177/13623613231162146] [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] [Indexed: 10/16/2023]
Abstract
LAY ABSTRACT The American Academy of Pediatrics recommends that all children be screened for autism at their 18- and 24-month well-child visit. For children who screen positive for autism, it is unknown whether this usually represents the first time a developmental concern has been raised or if other developmental concerns typically precede a positive autism screen. Such knowledge could help guide providers in how to appropriately convey feedback regarding autism screening. This study found that, for close to 80% of children with a positive autism screen, caregivers or providers had a prior autism, language, motor, or other developmental concern documented in the electronic health record. Many also had other prior concerns frequently linked to autism, such as sleep and gastrointestinal problems, and received physical or speech therapy. On average, prior to screening children who received a positive Modified-Checklist for Autism in Toddlers had two documented concerns by at 1 year of age and three concerns by 2 years of age. These findings imply that screening for autism as a part of routine pediatric care likely takes place in the context of larger conversations regarding existing developmental concerns, allowing for a less stigmatizing discussion of autism. Framing the presence of prior concerns in the setting of a positive screen in this context may create a reaffirming space for existing caregiver concerns and a lessened emotional burden on caregivers.
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Affiliation(s)
- Darby Herkert
- Duke University School of Medicine, 8 Searle Center Dr, Durham, NC 27710
| | - Connor Sullivan
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, U.S.A
| | - YiQin Zhu
- Duke University School of Medicine, 8 Searle Center Dr, Durham, NC 27710
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, U.S.A
- Duke University School of Medicine, 8 Searle Center Dr, Durham, NC 27710
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14
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Bacchelli E, Viggiano M, Ceroni F, Visconti P, Posar A, Scaduto M, Sandoni L, Baravelli I, Cameli C, Rochat M, Maresca A, Vaisfeld A, Gentilini D, Calzari L, Carelli V, Zody M, Maestrini E. Whole genome analysis of rare deleterious variants adds further evidence to BRSK2 and other risk genes in Autism Spectrum Disorder. RESEARCH SQUARE 2023:rs.3.rs-3468592. [PMID: 37961520 PMCID: PMC10635364 DOI: 10.21203/rs.3.rs-3468592/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a strong genetic component in which rare variants contribute significantly to risk. We have performed whole genome and/or exome sequencing (WGS and WES) and SNP-array analysis to identify both rare sequence and copy number variants (SNVs and CNVs) in 435 individuals from 116 ASD families. We identified 37 rare potentially damaging de novo SNVs (pdSNVs) in cases (n = 144). Interestingly, two of them (one stop-gain and one missense variant) occurred in the same gene, BRSK2. Moreover, the identification of 9 severe de novo pdSNVs in genes not previously implicated in ASD (RASAL2, RAP1A, IRX5, SLC9A1, AGPAT3, MGAT3, RAB8B, MGAT5B, YME1L1), highlighted novel candidates. Potentially damaging CNVs (pdCNVs) provided support to the involvement of inherited variants in PHF3, NEGR1, TIAM1 and HOMER1 in neurodevelopmental disorders (NDD), although mostly acting as susceptibility factors with incomplete penetrance. Interpretation of identified pdSNVs/pdCNVs according to the ACMG guidelines led to a molecular diagnosis in 19/144 cases, but this figure represents a lower limit and is expected to increase thanks to further clarification of the role of likely pathogenic variants in new ASD/NDD candidates. In conclusion, our study strengthens the role of BRSK2 and other neurodevelopmental genes in ASD risk, highlights novel candidates and contributes to characterize the allelic diversity, mode of inheritance and phenotypic impact of de novo and inherited risk variants in ASD/NDD genes.
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Affiliation(s)
| | | | | | | | - Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna
| | - Maria Scaduto
- IRCCS Istituto delle Scienze Neurologiche di Bologna
| | | | | | | | - Magali Rochat
- IRCCS Istituto delle Scienze Neurologiche di Bologna
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15
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Han L, Guan L, Zhang Z, Li W, Li J, Bao C, Ye M, Tang M, Ke X. Risk factors and clinical characteristics of autism spectrum disorder with regression in China. Autism Res 2023; 16:1836-1846. [PMID: 37578311 DOI: 10.1002/aur.3008] [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: 06/01/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
Autism spectrum disorder with regression (ASD-R) is characterized by the loss of previously acquired skills during the initial year of life. This study aimed to investigate the clinical characteristics, patterns of regression, and potential risk factors associated with ASD-R in the Chinese Han population. A case-control study was conducted between September 2020 and March 2022. A total of 186 children were enrolled, including 58 children with ASD-R, 70 with ASD without regression (ASD-NR), and 58 typically developing children. Demographic information, clinical characteristics, and potential risk factors related to ASD-R were assessed using a combination of questionnaires, interviews, and physician assessments. The results revealed that children with ASD-R exhibited more severe impairments in social communication and stereotyped behaviors compared with those with ASD-NR. Language regression, constituting 40% of cases within the ASD-R group, was found to be the most common type of regression. Furthermore, our analysis revealed that fever (OR = 4.01, 95% CI: 1.26-12.76) and diarrhea (OR = 6.32, 95% CI: 1.38-29.03) were identified as significant risk factors for ASD-R. These findings contribute to our understanding of the heterogeneity of ASD and highlight the importance of considering immune responses and gastrointestinal factors in the etiology of ASD-R.
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Affiliation(s)
- Lu Han
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Luyang Guan
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ziyi Zhang
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenqing Li
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jinhui Li
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chenxi Bao
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Mei Ye
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing Jiangning District Maternal and Child Health Care Institute, Nanjing, China
| | - Min Tang
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing Jiangning District Maternal and Child Health Care Institute, Nanjing, China
| | - Xiaoyan Ke
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
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16
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Matthiesen M, Khlaifia A, Steininger CFD, Dadabhoy M, Mumtaz U, Arruda-Carvalho M. Maturation of nucleus accumbens synaptic transmission signals a critical period for the rescue of social deficits in a mouse model of autism spectrum disorder. Mol Brain 2023; 16:46. [PMID: 37226266 DOI: 10.1186/s13041-023-01028-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/20/2023] [Indexed: 05/26/2023] Open
Abstract
Social behavior emerges early in development, a time marked by the onset of neurodevelopmental disorders featuring social deficits, including autism spectrum disorder (ASD). Although social deficits are at the core of the clinical diagnosis of ASD, very little is known about their neural correlates at the time of clinical onset. The nucleus accumbens (NAc), a brain region extensively implicated in social behavior, undergoes synaptic, cellular and molecular alterations in early life, and is particularly affected in ASD mouse models. To explore a link between the maturation of the NAc and neurodevelopmental deficits in social behavior, we compared spontaneous synaptic transmission in NAc shell medium spiny neurons (MSNs) between the highly social C57BL/6J and the idiopathic ASD mouse model BTBR T+Itpr3tf/J at postnatal day (P) 4, P6, P8, P12, P15, P21 and P30. BTBR NAc MSNs display increased spontaneous excitatory transmission during the first postnatal week, and increased inhibition across the first, second and fourth postnatal weeks, suggesting accelerated maturation of excitatory and inhibitory synaptic inputs compared to C57BL/6J mice. BTBR mice also show increased optically evoked medial prefrontal cortex-NAc paired pulse ratios at P15 and P30. These early changes in synaptic transmission are consistent with a potential critical period, which could maximize the efficacy of rescue interventions. To test this, we treated BTBR mice in either early life (P4-P8) or adulthood (P60-P64) with the mTORC1 antagonist rapamycin, a well-established intervention for ASD-like behavior. Rapamycin treatment rescued social interaction deficits in BTBR mice when injected in infancy, but did not affect social interaction in adulthood.
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Affiliation(s)
- Melina Matthiesen
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, M1C1A4, Canada
| | - Abdessattar Khlaifia
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, M1C1A4, Canada
| | | | - Maryam Dadabhoy
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, M1C1A4, Canada
| | - Unza Mumtaz
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, M1C1A4, Canada
| | - Maithe Arruda-Carvalho
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, M1C1A4, Canada.
- Department of Cell and Systems Biology, University of Toronto, Toronto, ON, M5S3G5, Canada.
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17
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Mottron L, Gagnon D. Prototypical autism: New diagnostic criteria and asymmetrical bifurcation model. Acta Psychol (Amst) 2023; 237:103938. [PMID: 37187094 DOI: 10.1016/j.actpsy.2023.103938] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
The current "autism spectrum" DSM 5 diagnostic criteria and autism standardized diagnostic instruments promote considerable heterogeneity or clinical indecision and may be detrimental to the advancement of fundamental research on autism mechanisms. To increase clinical specificity and reorient research towards core autistic presentations, we propose new diagnostic criteria for prototypical autism during the age of 2- to 5-years. We include autism within other non-dominant, familiarly aggregated phenomena sharing asymmetrical developmental bifurcations, such as twin pregnancy, left handedness, and breech presentation/delivery. Following this model, nature, trajectory, and positive/negative signs structure of autism would result from the polarized problem of whether or not language and information is processed in a socially biased manner. Prototypical autism would follow a canonical developmental trajectory by which a gradual decline in social bias in the processing of incoming information, overtly beginning at the end of the first year, bifurcates into a prototypical autistic presentation in the second half of the second year of life. This bifurcation event is followed by a plateau, in which these atypicalities show maximal stringency and distinctiveness, and then ultimately, in most cases, by partial normalization. During the plateau period, the orientation towards, and processing of, information is considerably modified, with an absence of bias for social information, contrasting with a high level of interest in complex, unbiased information, independently of its social or non-social nature. Integrating autism into asymmetrical developmental bifurcations would explain the absence of deleterious neurological and genetic markers and the presence of familial transmission in canonical autistic presentations.
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Affiliation(s)
- Laurent Mottron
- Department of Psychiatry and Addictology, University of Montreal, 2900 blvd Edouard-Montpetit, Montreal, Qc H3T 1J4, Canada; CIUSSS-NIM Research Center, Riviere-des-Prairies Hospital, 7070, blvd Perras, Montreal, QC H1E 1A4, Canada.
| | - David Gagnon
- Department of Psychiatry and Addictology, University of Montreal, 2900 blvd Edouard-Montpetit, Montreal, Qc H3T 1J4, Canada; CIUSSS-NIM Research Center, Riviere-des-Prairies Hospital, 7070, blvd Perras, Montreal, QC H1E 1A4, Canada
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18
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Granak S, Tuckova K, Kutna V, Vojtechova I, Bajkova L, Petrasek T, Ovsepian SV. Developmental effects of constitutive mTORC1 hyperactivity and environmental enrichment on structural synaptic plasticity and behaviour in a rat model of autism spectrum disorder. Eur J Neurosci 2023; 57:17-31. [PMID: 36380588 DOI: 10.1111/ejn.15864] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/18/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition causing a range of social and communication impairments. Although the role of multiple genes and environmental factors has been reported, the effects of the interplay between genes and environment on the onset and progression of the disease remains elusive. We housed wild-type (Tsc2+/+) and tuberous sclerosis 2 deficient (Tsc2+/-) Eker rats (ASD model) in individually ventilated cages or enriched conditions and conducted a series of behavioural tests followed by the histochemical analysis of dendritic spines and plasticity in three age groups (days 45, 90 and 365). The elevated plus-maze test revealed a reduction of anxiety by enrichment, whereas the mobility of young and adult Eker rats in the open field was lower compared to the wild type. In the social interaction test, an enriched environment reduced social contact in the youngest group and increased anogenital exploration in 90- and 365-day-old rats. Self-grooming was increased by environmental enrichment in young and adult rats and decreased in aged Eker rats. Dendritic spine counts revealed an increased spine density in the cingulate gyrus in adult Ekers irrespective of housing conditions, whereas spine density in hippocampal pyramidal neurons was comparable across all genotypes and groups. Morphometric analysis of dendritic spines revealed age-related changes in spine morphology and density, which were responsive to animal genotype and environment. Taken together, our findings suggest that under TSC2 haploinsufficiency and mTORC1 hyperactivity, the expression of behavioural signs and neuroplasticity in Eker rats can be differentially influenced by the developmental stage and environment.
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Affiliation(s)
- Simon Granak
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Klara Tuckova
- National Institute of Mental Health, Klecany, Czech Republic.,Faculty of Science, Charles University, Prague, Czech Republic
| | - Viera Kutna
- National Institute of Mental Health, Klecany, Czech Republic
| | - Iveta Vojtechova
- National Institute of Mental Health, Klecany, Czech Republic.,Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Laura Bajkova
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tomas Petrasek
- National Institute of Mental Health, Klecany, Czech Republic.,Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Saak V Ovsepian
- Faculty of Science and Engineering, University of Greenwich London, Chatham Maritime, UK
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19
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Case Report: Autism Risk Within the Context of Two Chromosome 15 Syndromes. J Autism Dev Disord 2023; 53:503-513. [PMID: 34997429 DOI: 10.1007/s10803-021-05422-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 02/03/2023]
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20
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Calabretta BT, Schneider JL, Iverson JM. Bidding on the go: Links between walking, social actions, and caregiver responses in infant siblings of children with autism spectrum disorder. Autism Res 2022; 15:2324-2335. [PMID: 36254470 DOI: 10.1002/aur.2830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022]
Abstract
The development of walking is associated with a shift in how neurotypical infants initiate social interactions. Walking infants are more likely to locate objects in distant places, carry them, and then share those objects by approaching caregivers and using gestures to show or offer their discoveries (i.e., moving bids). The simultaneous organization of the behaviors necessary to generate moving bids requires the coordination of multiple skills-walking, fine motor skills, and gesturing. Infants with an elevated likelihood (EL) for autism spectrum disorder (ASD) exhibit differences and delays in each of these behaviors. This study investigated interconnections between infant walking, social actions, and caregiver responses in 18-month-old EL infants with diverse developmental outcomes (ASD, non-ASD language delay, no diagnosis). We observed 85 infant-caregiver dyads at home during everyday activities for 45 minutes and identified all times when infants walked, instances of walking paired with social action (i.e., approaching the caregiver, approaching while carrying an object, producing a moving bid), and whether caregivers responded to their infants' social actions. There were no group differences in infants' production of social actions. Caregiver responses, however, were more clearly modulated by outcome group. While all caregivers were similarly and highly likely to respond to moving bids, caregivers of EL-ASD infants were substantially more likely to respond when their infants simply approached them (with or without an object in hand). Taken together, this research underscores the complexity of EL infant-caregiver interactions and highlights the role that each partner plays in shaping how they unfold.
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Affiliation(s)
- Bianca T Calabretta
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joshua L Schneider
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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21
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Characteristics and treatment patterns of autism spectrum disorder in China, 2020. Psychiatry Res 2022; 317:114879. [PMID: 36215776 DOI: 10.1016/j.psychres.2022.114879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/20/2022] [Accepted: 10/01/2022] [Indexed: 01/05/2023]
Abstract
This study aimed to investigate the characteristics of children diagnosed with ASD in China and to estimate ASD treatment patterns in 2020. This study used data from the 2020 Survey on Family Circumstance and Demand Support and Resources among Autistic Children in China. The study sample included 4,557 children diagnosed with ASD aged 2-16 years old. Data were collected through questionnaires completed by parents. Of the 4,557 children with ASD, there was a male-to-female ratio of 5.75:1, and the average age when ASD risk symptoms were first reported was 27.97(SD=10.83) months. Higher proportions of families with highly educated parents (college and above; around 58%) and advanced parental age at childbirth (≥35 years; over 50%) were found among autistic children. Additionally, about 41.05% of autistic children had an immediate family member diagnosed with mental/intellectual disorders. In terms of the treatment patterns for autistic children, 84.82% had received behavioral and developmental treatments and 77.74% had received therapy-based treatments, whereas 3% children had not received any treatment. Higher odds of non-treatment were found among children who were male (OR=1.69, 95% CI: 1.01,3.03) and had ASD diagnosed later on (OR= 1.02, 95% CI:1.01,1.03), as compared to their counterparts. Future studies will need to explore the etiology of the disparities of ASD, and policy efforts are critically needed to understand and address the barriers for children with ASD to receive appropriate treatments.
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22
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Pickles A, Wright N, Bedford R, Steiman M, Duku E, Bennett T, Georgiades S, Kerns CM, Mirenda P, Smith IM, Ungar WJ, Vaillancourt T, Waddell C, Zaidman‐Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. Predictors of language regression and its association with subsequent communication development in children with autism. J Child Psychol Psychiatry 2022; 63:1243-1251. [PMID: 35098539 PMCID: PMC9786608 DOI: 10.1111/jcpp.13565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Language regression, broadly defined as the loss of acquired language skills in early childhood, is a distinctive feature of autism. Little is known about the factors underlying regression or the prognosis of children who exhibit regression. We examine potential predictors of language regression and test its association with language development in a prospective longitudinal sample of children with autism spectrum disorder (ASD) from diagnosis to age 10 years. METHODS We analysed data from Pathways in ASD, a prospective longitudinal study of 421 children enrolled around the time of an autism diagnosis between 2 and 5 years. Autism Diagnostic Interview-Revised data were available for 408 children, of whom 90 (22%) were classified as having language regression. RESULTS Demographic and other health factors including caregiver education, family income, child sex, reported seizures, and age of enrolment did not differ between children with and without language regression. Children with language regression walked earlier and attained first words sooner than those without regression. However, both groups attained phrase speech at comparable ages. Those with regression exhibited greater delays in expressive and receptive communication over the follow-up period, although this effect was attenuated when accounting for baseline differences in motor and cognitive ability. Overall, those with language regression continued to exhibit expressive but not receptive communication delay compared to those without regression. Communication trajectories were heterogeneous to age 10 years, irrespective of regression status. CONCLUSIONS Although language regression can be alarming, our findings confirm that its occurrence does not necessarily foreshadow worse developmental outcomes relative to those without regression. Although a discrepancy in age-equivalent communication skills may persist, this can be expected to be of less practical importance with rising average levels of skills. Future studies need to account for the significant variability in language trajectories by considering factors beyond developmental regression.
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Affiliation(s)
- Andrew Pickles
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Nicola Wright
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | | | - Mandy Steiman
- Azrieli Centre for Autism ResearchMontreal Neurological HospitalMcGill UniversityMontrealQCCanada
| | | | | | | | | | - Pat Mirenda
- University of British ColumbiaVancouverBCCanada
| | | | - Wendy J. Ungar
- Hospital for Sick Children Research InstituteUniversity of TorontoTorontoONCanada
| | | | | | | | | | - Peter Szatmari
- Hospital for Sick Children Research InstituteUniversity of TorontoTorontoONCanada
| | - Mayada Elsabbagh
- Azrieli Centre for Autism ResearchMontreal Neurological HospitalMcGill UniversityMontrealQCCanada
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23
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Parenti M, Schmidt RJ, Ozonoff S, Shin HM, Tancredi DJ, Krakowiak P, Hertz-Picciotto I, Walker CK, Slupsky CM. Maternal Serum and Placental Metabolomes in Association with Prenatal Phthalate Exposure and Neurodevelopmental Outcomes in the MARBLES Cohort. Metabolites 2022; 12:829. [PMID: 36144233 PMCID: PMC9500898 DOI: 10.3390/metabo12090829] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 01/16/2023] Open
Abstract
Prenatal exposure to phthalates, a family of endocrine-disrupting plasticizers, is associated with disruption of maternal metabolism and impaired neurodevelopment. We investigated associations between prenatal phthalate exposure and alterations of both the maternal third trimester serum metabolome and the placental metabolome at birth, and associations of these with child neurodevelopmental outcomes using data and samples from the Markers of Autism Risk in Babies Learning Early Signs (MARBLES) cohort. The third trimester serum (n = 106) and placental (n = 132) metabolomes were investigated using 1H nuclear magnetic resonance spectroscopy. Children were assessed clinically for autism spectrum disorder (ASD) and cognitive development. Although none of the urinary phthalate metabolite concentrations were associated with maternal serum metabolites after adjustment for covariates, mixture analysis using quantile g-computation revealed alterations in placental metabolites with increasing concentrations of phthalate metabolites that included reduced concentrations of 2-hydoxybutyrate, carnitine, O-acetylcarnitine, glucitol, and N-acetylneuraminate. Child neurodevelopmental outcome was not associated with the third trimester serum metabolome, but it was correlated with the placental metabolome in male children only. Maternal phthalate exposure during pregnancy is associated with differences in the placental metabolome at delivery, and the placental metabolome is associated with neurodevelopmental outcomes in males in a cohort with high familial ASD risk.
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Affiliation(s)
- Mariana Parenti
- Department of Nutrition, University of California, Davis, CA 95616, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, CA 95616, USA
| | - Sally Ozonoff
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, CA 95616, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95616, USA
| | - Hyeong-Moo Shin
- Department of Environmental Science, Baylor University, Waco, TX 76798, USA
| | - Daniel J. Tancredi
- Department of Pediatrics, School of Medicine, University of California, Davis, CA 95616, USA
| | - Paula Krakowiak
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, CA 95616, USA
| | - Cheryl K. Walker
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, CA 95616, USA
- Department of Obstetrics & Gynecology, School of Medicine, University of California, Davis, CA 95616, USA
| | - Carolyn M. Slupsky
- Department of Nutrition, University of California, Davis, CA 95616, USA
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA
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24
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Sung S, Fenoglio A, Wolff JJ, Schultz RT, Botteron KN, Dager SR, Estes AM, Hazlett HC, Zwaigenbaum L, Piven J, Elison JT. Examining the factor structure and discriminative utility of the Infant Behavior Questionnaire-Revised in infant siblings of autistic children. Child Dev 2022; 93:1398-1413. [PMID: 35485579 PMCID: PMC9544485 DOI: 10.1111/cdev.13781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Using the Infant Behavior Questionnaire-Revised in a longitudinal sample of infant siblings of autistic children (HR; n = 427, 171 female, 83.4% White) and a comparison group of low-risk controls (LR, n = 200, 86 female, 81.5% White), collected between 2007 and 2017, this study identified an invariant factor structure of temperament traits across groups at 6 and 12 months. Second, after partitioning the groups by familial risk and diagnostic outcome at 24 months, results reveal an endophenotypic pattern of Positive Emotionality at both 6 and 12 months, (HR-autism spectrum disorder [ASD] < HR-no-ASD < LR). Third, increased 'Duration of Orienting' at 12 months was associated with lower scores on the 24-month developmental outcomes in HR infants. These findings may augment efforts for early identification of ASD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Joseph Piven
- University of North Carolina—Chapel HillChapel HillNorth CarolinaUSA
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25
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A Mini-Review Regarding the Modalities to Study Neurodevelopmental Disorders-Like Impairments in Zebrafish—Focussing on Neurobehavioural and Psychological Responses. Brain Sci 2022; 12:brainsci12091147. [PMID: 36138883 PMCID: PMC9496774 DOI: 10.3390/brainsci12091147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Neurodevelopmental disorders (NDDs) are complex disorders which can be associated with many comorbidities and exhibit multifactorial-dependent phenotypes. An important characteristic is represented by the early onset of the symptoms, during childhood or young adulthood, with a great impact on the socio-cognitive functioning of the affected individuals. Thus, the aim of our review is to describe and to argue the necessity of early developmental stages zebrafish models, focusing on NDDs, especially autism spectrum disorders (ASD) and also on schizophrenia. The utility of the animal models in NDDs or schizophrenia research remains quite controversial. Relevant discussions can be opened regarding the specific characteristics of the animal models and the relationship with the etiologies, physiopathology, and development of these disorders. The zebrafish models behaviors displayed as early as during the pre-hatching embryo stage (locomotor activity prone to repetitive behavior), and post-hatching embryo stage, such as memory, perception, affective-like, and social behaviors can be relevant in ASD and schizophrenia research. The neurophysiological processes impaired in both ASD and schizophrenia are generally highly conserved across all vertebrates. However, the relatively late individual development and conscious social behavior exhibited later in the larval stage are some of the most important limitations of these model animal species.
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26
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Chellew T, Barbaro J, Freeman NC. The Early Childhood Signs of Autism in Females: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00337-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AbstractCompared to males, females are at a much greater likelihood of receiving a later diagnosis of autism, which impacts their opportunity to receive early support. To assist with early identification, this systematic literature review aimed to ascertain whether females differ from males in the early childhood signs of autism. The small number of heterogeneous studies made it difficult to draw conclusions, although it appears that females and males under 6 years of age are more similar than different in terms of their expression of autistic behaviours. Given the discrepant sex/gender ratio in autism, these findings highlight the importance of exploring whether there are different and/or specific, not yet identified, early signs of autism in females and males.
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27
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Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value? J Autism Dev Disord 2022:10.1007/s10803-022-05541-y. [PMID: 35579791 PMCID: PMC10214166 DOI: 10.1007/s10803-022-05541-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
Abstract
Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n = 167) and age, gender, and practice-matched children passing screens (n = 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone. Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development.
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28
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Shah MH, Salem S, Ahmed B, Ullah I, Rehman A, Zeeshan M, Fareed Z. Nexus Between Foreign Direct Investment Inflow, Renewable Energy Consumption, Ambient Air Pollution, and Human Mortality: A Public Health Perspective From Non-linear ARDL Approach. Front Public Health 2022; 9:814208. [PMID: 35096757 PMCID: PMC8793008 DOI: 10.3389/fpubh.2021.814208] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022] Open
Abstract
A huge foreign direct investment (FDI) inflow has been witnessed in China, though on the one hand, it brings a significant contribution to economic growth. On the other hand, it adversely affects the ambient air pollution that may affect human mortality in the country. Renewable energy (RE) usage meets the country's energy needs with no adverse effect on the environment. Therefore, this study is trying to empirically analyze the effect of FDI inflow on human morality and RE consumption in China. We used time-series data for 1998–2020 and applied a non-linear ARDL approach for the estimations. The empirical outcomes suggest that FDI inflow positively affects mortality and RE. There is also unidirectional causality running from RE and pollution to mortality. In addition, the relationship among the variable verifies the existence of a non-linear relationship. The government needs policy guidelines to further boost FDI inflow due to its positive aspects. However, to reduce the negative effect on the environment and human morality, the extensive usage of RE should be adopted. Indeed, proper legislation for foreign firms might be a good step toward quality environmental and longevity of human health in society.
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Affiliation(s)
| | - Sultan Salem
- Department of Economics, Birmingham Business School, College of Social Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Bilal Ahmed
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Irfan Ullah
- Reading Academy, Nanjing University of Information Science and Technology, Nanjing, China
| | - Alam Rehman
- Faculty of Management Sciences, National University of Modern Languages, Islamabad, Pakistan
| | - Muhammad Zeeshan
- College of Business Administration, Liaoning Technical University, Fuxin, China
| | - Zeeshan Fareed
- School of Economics and Management, Huzhou University, Huzhou, China
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29
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Chen B, Linke A, Olson L, Kohli J, Kinnear M, Sereno M, Müller RA, Carper R, Fishman I. Cortical Myelination in Toddlers and Preschoolers with Autism Spectrum Disorder. Dev Neurobiol 2022; 82:261-274. [PMID: 35348301 PMCID: PMC9325547 DOI: 10.1002/dneu.22874] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/22/2022] [Accepted: 03/17/2022] [Indexed: 11/07/2022]
Abstract
Intracortical myelin is thought to play a significant role in the development of neural circuits and functional networks, with consistent evidence of atypical network connectivity in children with autism spectrum disorders (ASD). However, little is known about the development of intracortical myelin in the first years of life in ASD, during the critical neurodevelopmental period when autism symptoms first emerge. Using T1-weighted (T1w) and T2-weighted (T2w) structural magnetic resonance imaging (MRI) in 21 young children with ASD and 16 typically developing (TD) children, ages 1.5 to 5.5 years, we demonstrate the feasibility of estimating intracortical myelin in vivo using the T1w/T2w ratio as a proxy. The resultant T1w/T2w maps were largely comparable with those reported in prior T1w/T2w studies in typically developing children and adults, and revealed no group differences between TD children and those with ASD. However, differential associations between T1w/T2w and age were identified in several early myelinated regions (e.g., visual, posterior cingulate, precuneus cortices) in the ASD and TD groups, with age-related increase in estimated myelin content across the toddler and preschool years detected in TD children, but not in children with ASD. The atypical age-related effects in intracortical myelin, suggesting a disrupted myelination in the first years of life in ASD, may be related to the aberrant brain network connectivity reported in young children with ASD in some of the same cortical regions and circuits. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bosi Chen
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Annika Linke
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University
| | - Lindsay Olson
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Jiwandeep Kohli
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Mikaela Kinnear
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University
| | - Martin Sereno
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Ralph-Axel Müller
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA.,Center for Autism and Developmental Disorders, San Diego State University
| | - Ruth Carper
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA.,Center for Autism and Developmental Disorders, San Diego State University
| | - Inna Fishman
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University.,Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA.,Center for Autism and Developmental Disorders, San Diego State University
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30
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Niedźwiecka A, Pisula E. Symptoms of Autism Spectrum Disorders Measured by the Qualitative Checklist for Autism in Toddlers in a Large Sample of Polish Toddlers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053072. [PMID: 35270764 PMCID: PMC8910243 DOI: 10.3390/ijerph19053072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 12/10/2022]
Abstract
This study aimed to assess some early symptoms of autism spectrum disorders (ASD) measured by a screening tool developed for an early detection of ASD. We investigated if the early symptoms were associated with toddlers’ age, gender or ASD familial risk status. We used the Polish version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT) to assess 1024 children aged 16 to 36 months. The sample included four groups of participants: typically developing toddlers, toddlers with parent-reported ASD-specific concerns, toddlers at risk for autism due to having an older sibling with ASD, and toddlers with a developmental delay. We found that mean Q-CHAT scores were significantly higher in boys than in girls. We did not find any associations between Q-CHAT scores and age. We observed that toddlers with a familial risk for ASD and those with a developmental delay scored significantly higher than controls. We collated these results with previous studies that used the Q-CHAT and other instruments.
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31
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Echeveste R, Ferrante E, Milone DH, Samengo I. Bridging physiological and perceptual views of autism by means of sampling-based Bayesian inference. Netw Neurosci 2022; 6:196-212. [PMID: 36605888 PMCID: PMC9810278 DOI: 10.1162/netn_a_00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/01/2021] [Indexed: 01/09/2023] Open
Abstract
Theories for autism spectrum disorder (ASD) have been formulated at different levels, ranging from physiological observations to perceptual and behavioral descriptions. Understanding the physiological underpinnings of perceptual traits in ASD remains a significant challenge in the field. Here we show how a recurrent neural circuit model that was optimized to perform sampling-based inference and displays characteristic features of cortical dynamics can help bridge this gap. The model was able to establish a mechanistic link between two descriptive levels for ASD: a physiological level, in terms of inhibitory dysfunction, neural variability, and oscillations, and a perceptual level, in terms of hypopriors in Bayesian computations. We took two parallel paths-inducing hypopriors in the probabilistic model, and an inhibitory dysfunction in the network model-which lead to consistent results in terms of the represented posteriors, providing support for the view that both descriptions might constitute two sides of the same coin.
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Affiliation(s)
- Rodrigo Echeveste
- Research Institute for Signals, Systems, and Computational Intelligence sinc(i) (FICH-UNL/CONICET), Santa Fe, Argentina,* Corresponding Author:
| | - Enzo Ferrante
- Research Institute for Signals, Systems, and Computational Intelligence sinc(i) (FICH-UNL/CONICET), Santa Fe, Argentina
| | - Diego H. Milone
- Research Institute for Signals, Systems, and Computational Intelligence sinc(i) (FICH-UNL/CONICET), Santa Fe, Argentina
| | - Inés Samengo
- Medical Physics Department and Balseiro Institute (CNEA-UNCUYO/CONICET), Bariloche, Argentina
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32
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Mundy P, Bullen J. The Bidirectional Social-Cognitive Mechanisms of the Social-Attention Symptoms of Autism. Front Psychiatry 2022; 12:752274. [PMID: 35173636 PMCID: PMC8841840 DOI: 10.3389/fpsyt.2021.752274] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Differences in social attention development begin to be apparent in the 6th to 12th month of development in children with Autism Spectrum Disorder (ASD) and theoretically reflect important elements of its neurodevelopmental endophenotype. This paper examines alternative conceptual views of these early social attention symptoms and hypotheses about the mechanisms involved in their development. One model emphasizes mechanism involved in the spontaneous allocation of attention to faces, or social orienting. Alternatively, another model emphasizes mechanisms involved in the coordination of attention with other people, or joint attention, and the socially bi-directional nature of its development. This model raises the possibility that atypical responses of children to the attention or the gaze of a social partner directed toward themselves may be as important in the development of social attention symptoms as differences in the development of social orienting. Another model holds that symptoms of social attention may be important to early development, but may not impact older individuals with ASD. The alterative model is that the social attention symptoms in infancy (social orienting and joint attention), and social cognitive symptoms in childhood and adulthood share common neurodevelopmental substrates. Therefore, differences in early social attention and later social cognition constitute a developmentally continuous axis of symptom presentation in ASD. However, symptoms in older individuals may be best measured with in vivo measures of efficiency of social attention and social cognition in social interactions rather than the accuracy of response on analog tests used in measures with younger children. Finally, a third model suggests that the social attention symptoms may not truly be a symptom of ASD. Rather, they may be best conceptualized as stemming from differences domain general attention and motivation mechanisms. The alternative argued for here that infant social attention symptoms meet all the criteria of a unique dimension of the phenotype of ASD and the bi-directional phenomena involved in social attention cannot be fully explained in terms of domain general aspects of attention development.
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Affiliation(s)
- Peter Mundy
- Department of Learning and Mind Sciences, School of Education, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Science and The MIND Institute, UC Davis School of Medicine, Sacramento, CA, United States
| | - Jenifer Bullen
- Department of Human Development, School of Human Ecology, University of California, Davis, Davis, CA, United States
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33
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Pivotal Response Treatment (PRT) - Parent Group Training for Young Children with Autism Spectrum Disorder: A Qualitative Study on Perspectives of Parents. J Autism Dev Disord 2022; 52:5414-5427. [PMID: 35083605 PMCID: PMC8791680 DOI: 10.1007/s10803-021-05397-8] [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] [Accepted: 12/04/2021] [Indexed: 01/31/2023]
Abstract
Pivotal Response Treatment (PRT) is considered to be an empirically supported parent-mediated treatment for children with autism spectrum disorder (ASD), but research on parental experiences is lacking. This qualitative study examined the perspectives of parents of young children with ASD who participated in a 14-week PRT with parent group training (PRT-PG). Semi-structured interviews (n = 12) were carried out, based on Grounded Theory principles. Results indicated that facilitators and barriers were related to timing and expectations, training setting and characteristics, and participant characteristics. Perceived effects were related to improved child’s social-communication skills and well-being, parental insights into their child’s needs and own habitual patterns in communication and behavior, and positive changes in family cohesion. The findings indicate that in general parents value PRT-PG as feasible and effective.
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34
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Sturner R, Howard B, Bergmann P, Attar S, Stewart-Artz L, Bet K, Allison C, Baron-Cohen S. Autism screening at 18 months of age: a comparison of the Q-CHAT-10 and M-CHAT screeners. Mol Autism 2022; 13:2. [PMID: 34980240 PMCID: PMC8722322 DOI: 10.1186/s13229-021-00480-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/07/2021] [Indexed: 01/04/2023] Open
Abstract
Background Autism screening is recommended at 18- and 24-month pediatric well visits. The Modified Checklist for Autism in Toddlers—Revised (M-CHAT-R) authors recommend a follow-up interview (M-CHAT-R/F) when positive. M-CHAT-R/F may be less accurate for 18-month-olds than 24-month-olds and accuracy for identification prior to two years is not known in samples that include children screening negative. Since autism symptoms may emerge gradually, ordinally scoring items based on the full range of response options, such as in the 10-item version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10), might better capture autism signs than the dichotomous (i.e., yes/no) items in M-CHAT-R or the pass/fail scoring of Q-CHAT-10 items. The aims of this study were to determine and compare the accuracy of the M-CHAT-R/F and the Q-CHAT-10 and to describe the accuracy of the ordinally scored Q-CHAT-10 (Q-CHAT-10-O) for predicting autism in a sample of children who were screened at 18 months.
Methods This is a community pediatrics validation study with screen positive (n = 167) and age- and practice-matched screen negative children (n = 241) recruited for diagnostic evaluations completed prior to 2 years old. Clinical diagnosis of autism was based on results of in-person diagnostic autism evaluations by research reliable testers blind to screening results and using the Autism Diagnostic Observation Schedule—Second Edition (ADOS-2) Toddler Module and Mullen Scales of Early Learning (MSEL) per standard guidelines.
Results While the M-CHAT-R/F had higher specificity and PPV compared to M-CHAT-R, Q-CHAT-10-O showed higher sensitivity than M-CHAT-R/F and Q-CHAT-10. Limitations Many parents declined participation and the sample is over-represented by higher educated parents. Results cannot be extended to older ages. Conclusions Limitations of the currently recommended two-stage M-CHAT-R/F at the 18-month visit include low sensitivity with minimal balancing benefit of improved PPV from the follow-up interview. Ordinal, rather than dichotomous, scoring of autism screening items appears to be beneficial at this age. The Q-CHAT-10-O with ordinal scoring shows advantages to M-CHAT-R/F with half the number of items, no requirement for a follow-up interview, and improved sensitivity. Yet, Q-CHAT-10-O sensitivity is less than M-CHAT-R (without follow-up) and specificity is less than the two-stage procedure. Such limitations are consistent with recognition that screening needs to recur beyond this age. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00480-4.
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Affiliation(s)
- Raymond Sturner
- Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA. .,Center for Promotion of Child Development Through Primary Care, Baltimore, MD, USA.
| | - Barbara Howard
- Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA.,CHADIS, Inc., 6017 Altamont Place, Baltimore, MD, USA
| | - Paul Bergmann
- CHADIS, Inc., 6017 Altamont Place, Baltimore, MD, USA.,Foresight Logic, Inc., St. Paul, MN, USA
| | - Shana Attar
- CHADIS, Inc., 6017 Altamont Place, Baltimore, MD, USA.,University of Washington, Seattle, WA, USA
| | - Lydia Stewart-Artz
- Center for Promotion of Child Development Through Primary Care, Baltimore, MD, USA
| | - Kerry Bet
- Center for Promotion of Child Development Through Primary Care, Baltimore, MD, USA.,CHADIS, Inc., 6017 Altamont Place, Baltimore, MD, USA
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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35
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Yang JH, Strodl E, Wu CA, Yin XN, Wen GM, Sun DL, Xian DX, Chen JY, Chen YJ, Chen J, Chen WQ. Association between prenatal exposure to indoor air pollution and autistic-like behaviors among preschool children. INDOOR AIR 2022; 32:e12953. [PMID: 34738663 DOI: 10.1111/ina.12953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Indoor air pollution is a recognized risk factor for a range of negative health outcomes. This study aimed to investigate the association between maternal prenatal exposure to indoor air pollution and the presence of autistic-like behaviors among preschool children. Data were obtained from the Longhua Child Cohort Study in 2017, in which we enrolled a total of 65 317 preschool children. Associations between maternal exposure to four sources of indoor air pollution (e.g., cooking, environmental tobacco smoke (ETS), mosquito coils, and home decoration) during pregnancy and preschool children's autistic traits were analyzed using multivariate logistic regression. Our results showed that maternal exposure to indoor air pollution from four different sources during pregnancy was associated with the presence of children's autistic-like behaviors. There was dose-response relationship between the accumulative exposure to the four different indoor air pollution sources and the risk of autistic-like behaviors. Furthermore, we found a significant additive interaction between prenatal exposure to both cooking and mosquito coil incense on the risk of autistic-like behaviors. Maternal prenatal exposure to the indoor air pollution from four sources might increase with the risk of autistic-like behaviors being present among preschool children, with an additive interaction effect between some pollution sources.
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Affiliation(s)
- Jian-Hui Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Chuan-An Wu
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Xiao-Na Yin
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Guo-Min Wen
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Deng-Li Sun
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Dan-Xia Xian
- Women's and Children's Hospital of Longhua District of Shenzhen, Shenzhen, China
| | - Jing-Yi Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying-Jie Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou, China
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Nygren G, Linnsand P, Hermansson J, Dinkler L, Johansson M, Gillberg C. Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population. Front Pediatr 2021; 9:780680. [PMID: 34966704 PMCID: PMC8710696 DOI: 10.3389/fped.2021.780680] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
We examined feeding problems, including Avoidant Restrictive Food Intake Disorder (ARFID), in preschool children with Autism Spectrum Disorder (ASD). Data were collected from a prospective longitudinal study of 46 children with ASD in a multiethnic, low resource area in Gothenburg, Sweden. Feeding problems were found in 76% of the children with ASD, and in 28%, the criteria for ARFID were met. The study highlights early onset age, the heterogeneity of feeding problems, and the need for multidisciplinary assessments in ASD as well as in feeding problems, and also the need for further elaboration of feeding disorder classifications in children.
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Affiliation(s)
- Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Petra Linnsand
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Jonas Hermansson
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Johansson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Tarnowska K, Gruczyńska-Sękowska E, Kowalska D, Majewska E, Kozłowska M, Winkler R. The opioid excess theory in autism spectrum disorders - is it worth investigating further? Crit Rev Food Sci Nutr 2021:1-14. [PMID: 34702104 DOI: 10.1080/10408398.2021.1996329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorders (ASD) are defined as neurodevelopmental disorders, which are highly variable in nature and do not form a uniform picture, either in terms of symptomatology or depth of the disturbance. Diagnosis of ASD is made for children who show signs of impairment in social interaction, communication and cognitive skills. The exact cause of autism spectrum disorders has not been determined to date. Although there is no cure for ASD, a variety interventions have been proposed. The most commonly used restrictive dietary intervention is the gluten-free casein-free diet (GFCF), which is based on the opioid excess theory. This paper summarizes and discusses research on the core elements of the opioid excess theory in ASD: increased levels of opioid peptides in body fluids in ASD patients, increased intestinal permeability, altered peptidase activity and the effectiveness of GFCF diet in alleviating symptoms of ASD. Furthermore, we discuss the difficulties and their causes in conducting research with ASD patients. The assumptions of the opioid excess theory have neither been definitively confirmed nor disproved. Research in this area should continue, taking into account the highest possible quality standards and the specific needs and abilities of patients with ASD and their families.
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Affiliation(s)
- Katarzyna Tarnowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Eliza Gruczyńska-Sękowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Dorota Kowalska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Ewa Majewska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Mariola Kozłowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Renata Winkler
- Department of Organizational Behaviors, Cracow University of Economics, Cracow, Poland
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38
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Terzic B, Davatolhagh MF, Ho Y, Tang S, Liu YT, Xia Z, Cui Y, Fuccillo MV, Zhou Z. Temporal manipulation of Cdkl5 reveals essential postdevelopmental functions and reversible CDKL5 deficiency disorder-related deficits. J Clin Invest 2021; 131:143655. [PMID: 34651584 DOI: 10.1172/jci143655] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/05/2021] [Indexed: 12/23/2022] Open
Abstract
CDKL5 deficiency disorder (CDD) is an early onset, neurodevelopmental syndrome associated with pathogenic variants in the X-linked gene encoding cyclin-dependent kinase-like 5 (CDKL5). CDKL5 has been implicated in neuronal synapse maturation, yet its postdevelopmental necessity and the reversibility of CDD-associated impairments remain unknown. We temporally manipulated endogenous Cdkl5 expression in male mice and found that postdevelopmental loss of CDKL5 disrupts numerous behavioral domains, hippocampal circuit communication, and dendritic spine morphology, demonstrating an indispensable role for CDKL5 in the adult brain. Accordingly, restoration of Cdkl5 after the early stages of brain development using a conditional rescue mouse model ameliorated CDD-related behavioral impairments and aberrant NMDA receptor signaling. These findings highlight the requirement of CDKL5 beyond early development, underscore the potential for disease reversal in CDD, and suggest that a broad therapeutic time window exists for potential treatment of CDD-related deficits.
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Affiliation(s)
| | - M Felicia Davatolhagh
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | - Marc V Fuccillo
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Almasri J, Barazi A, King KS, Walther-Antonio MRS, Wang Z, Murad MH, Murray JA, Absah I. Peripartum Antibiotics Exposure and the Risk of Autoimmune and Autism Disorders in the Offspring. Avicenna J Med 2021; 11:118-125. [PMID: 34646788 PMCID: PMC8500092 DOI: 10.1055/s-0041-1732485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background As the use of antibiotics during the peripartum period increases, the incidence of autoimmune disorders and autism spectrum disorders (ASDs) is also increasing. In this study, we aim to assess if antibiotic exposure during the peripartum period affects the incidence of autoimmune diseases and ASD in the offspring. Methods We identified children (< 18 years of age) born in Olmsted County from January 1, 2003 through December 31, 2012. Offspring with celiac disease (CD), inflammatory bowel disease (IBD), or ASD diagnoses were matched to two controls on birth date, index date, mother's age at delivery, and sex. Data from the mother's medical records were retrieved to determine peripartum antibiotics use. Results A total of 242 cases and 484 matched controls were included in this study. Median age at the last follow-up was 11.3 years (range: 0.5-14.9), 73% were males in both groups. Odds of CD diagnosis was not statistically different between vaginal delivery with antibiotics compared with vaginal delivery with no antibiotics (odds ratio [OR] = 0.76, 95% confidence interval [CI]: 0.32-1.85), similarly in IBD (OR = 2.41, 95% CI: 0.53-10.98) and ASD (OR = 1.00, 95% CI:0.55-1.79). Preeclampsia or eclampsia was associated with offspring CD (OR = 3.20, 95% CI: 1.05-9.78). Smoking history and diabetes mellitus were associated with offspring ASD (OR = 1.84, 95% CI: 1.22-2.77 and OR = 2.01, 95% CI: 1.03-3.91, respectively). Conclusion In this cohort, we found no statistically significant association between peripartum antibiotics exposure and the development of CD, IBD, or ASD.
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Affiliation(s)
- Jehad Almasri
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, United States
| | - Ahmed Barazi
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Katherine S King
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States
| | - Marina R S Walther-Antonio
- Microbiome Program, Center for Individualized Medicine, Division of Obstetrics and Gynecology, Department of Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Zhen Wang
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, United States
| | - Mohammad H Murad
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, United States
| | - Joseph A Murray
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Imad Absah
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
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Tunç B, Pandey J, John TS, Meera SS, Maldarelli JE, Zwaigenbaum L, Hazlett HC, Dager SR, Botteron KN, Girault JB, McKinstry RC, Verma R, Elison JT, Pruett JR, Piven J, Estes AM, Schultz RT. Diagnostic shifts in autism spectrum disorder can be linked to the fuzzy nature of the diagnostic boundary: a data-driven approach. J Child Psychol Psychiatry 2021; 62:1236-1245. [PMID: 33826159 PMCID: PMC8601115 DOI: 10.1111/jcpp.13406] [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] [Accepted: 01/06/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Diagnostic shifts at early ages may provide invaluable insights into the nature of separation between autism spectrum disorder (ASD) and typical development. Recent conceptualizations of ASD suggest the condition is only fuzzily separated from non-ASD, with intermediate cases between the two. These intermediate cases may shift along a transition region over time, leading to apparent instability of diagnosis. METHODS We used a cohort of children with high ASD risk, by virtue of having an older sibling with ASD, assessed at 24 months (N = 212) and 36 months (N = 191). We applied machine learning to empirically characterize the classification boundary between ASD and non-ASD, using variables quantifying developmental and adaptive skills. We computed the distance of children to the classification boundary. RESULTS Children who switched diagnostic labels from 24 to 36 months, in both directions, (dynamic group) had intermediate phenotypic profiles. They were closer to the classification boundary compared to children who had stable diagnoses, both at 24 months (Cohen's d = .52) and at 36 months (d = .75). The magnitude of change in distance between the two time points was similar for the dynamic and stable groups (Cohen's d = .06), and diagnostic shifts were not associated with a large change. At the individual level, a few children in the dynamic group showed substantial change. CONCLUSIONS Our results suggested that a diagnostic shift was largely due to a slight movement within a transition region between ASD and non-ASD. This fact highlights the need for more vigilant surveillance and intervention strategies. Young children with intermediate phenotypes may have an increased susceptibility to gain or lose their diagnosis at later ages, calling attention to the inherently dynamic nature of early ASD diagnoses.
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Affiliation(s)
- Birkan Tunç
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.,Correspondence to: Birkan Tunç, PhD,
| | - Juhi Pandey
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tanya St. John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA
| | - Shoba S. Meera
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Jennifer E. Maldarelli
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Heather C. Hazlett
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, , NC 27599, USA
| | - Stephen R. Dager
- Department of Radiology and Bioengineering, University of Washington, Seattle, WA 98195, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jessica B. Girault
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, , NC 27599, USA
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ragini Verma
- DiCIPHR (Diffusion and Connectomics in Precision Healthcare Research) Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Joseph Piven
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, , NC 27599, USA
| | - Annette M. Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA.,Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Robert T. Schultz
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Pediatrics, University of Pennsylvania, Philadelphia, PA 19104, USA
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Qiu W, Go KA, Wen Y, Duarte-Guterman P, Eid RS, Galea LAM. Maternal fluoxetine reduces hippocampal inflammation and neurogenesis in adult offspring with sex-specific effects of periadolescent oxytocin. Brain Behav Immun 2021; 97:394-409. [PMID: 34174336 DOI: 10.1016/j.bbi.2021.06.012] [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: 01/12/2021] [Revised: 06/14/2021] [Accepted: 06/19/2021] [Indexed: 12/22/2022] Open
Abstract
Untreated perinatal depression can have severe consequences for the mother and her children. However, both the efficacy to mothers and safety to exposed infants of pharmacological antidepressants such as selective serotonin reuptake inhibitors (SSRIs), have been questioned. We previously reported that maternal SSRI exposure increased hippocampal IL-1β levels, which may be tied to limited efficacy of SSRIs during the postpartum to the dam but is not yet known whether maternal postpartum SSRIs affect the neuroinflammatory profile of adult offspring. In addition, although controversial, perinatal SSRI exposure has been linked to increased risk of autism spectrum disorder (ASD) in children. Oxytocin (OT) is under investigation as a treatment for ASD, but OT is a large neuropeptide that has difficulty crossing the blood-brain barrier (BBB). TriozanTM is a nanoformulation that can facilitate OT to cross the BBB. Thus, we investigated the impact of maternal postpartum SSRIs and offspring preadolescent OT treatment on adult offspring neuroinflammation, social behavior, and neurogenesis in the hippocampus. Using a model of de novo postpartum depression, corticosterone (CORT) was given in the postpartum to the dam with or without treatment with the SSRI, fluoxetine (FLX) for 21 days postpartum. Offspring were then subsequently treated with either OT, OT + TriozanTM, or vehicle for 10 days prior to adolescence (PD25-34). Maternal FLX decreased hippocampal IL-10 and IL-13 and neurogenesis in both sexes, whereas maternal CORT increased hippocampal IL-13 in both sexes. Maternal CORT treatment shifted the neuroimmune profile towards a more proinflammatory profile in offspring hippocampus, whereas oxytocin, independent of formulation, normalized this profile. OT treatment increased hippocampal neurogenesis in adult males but not in adult females, regardless of maternal treatment. OT treatment increased the time spent with a novel social stimulus animal (social investigation) in both adult male and female offspring, although this effect depended on maternal CORT. These findings underscore that preadolescent exposure to OT can reverse some of the long-lasting effects of postpartum maternal CORT and FLX treatments in the adult offspring. In addition, we found that maternal treatments that reduce (CORT) or increase (FLX) hippocampal inflammation in dams resulted in opposing patterns of hippocampal inflammation in adult offspring.
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Affiliation(s)
- Wansu Qiu
- Graduate Program in Neuroscience, University of British Columbia, Canada
| | - Kimberly A Go
- Department of Psychology, University of British Columbia, Canada
| | - Yanhua Wen
- Department of Psychology, University of British Columbia, Canada
| | | | - Rand S Eid
- Graduate Program in Neuroscience, University of British Columbia, Canada
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Canada; Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada.
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Heimann M, Holmer E. Neonatal Imitation, Intersubjectivity, and Children With Atypical Development: Do Observations on Autism and Down Syndrome Change Our Understanding? Front Psychol 2021; 12:701795. [PMID: 34512459 PMCID: PMC8430258 DOI: 10.3389/fpsyg.2021.701795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
Almost all studies on neonatal imitation to date seem to have focused on typically developing children, and we thus lack information on the early imitative abilities of children who follow atypical developmental trajectories. From both practical and theoretical perspectives, these abilities might be relevant to study in children who develop a neuropsychiatric diagnosis later on or in infants who later show impaired ability to imitate. Theoretical in the sense that it will provide insight into the earliest signs of intersubjectivity—i.e., primary intersubjectivity—and how this knowledge might influence our understanding of children following atypical trajectories of development. Practical in the sense that it might lead to earlier detection of certain disabilities. In the present work, we screen the literature for empirical studies on neonatal imitation in children with an Autism spectrum disorder (ASD) or Down syndrome (DS) as well as present an observation of neonatal imitation in an infant that later was diagnosed with autism and a re-interpretation of previously published data on the phenomenon in a small group of infants with DS. Our findings suggest that the empirical observations to date are too few to draw any definite conclusions but that the existing data suggests that neonatal imitation can be observed both in children with ASD and in children with DS. Thus, neonatal imitation might not represent a useful predictor of a developmental deficit. Based on current theoretical perspectives advocating that neonatal imitation is a marker of primary intersubjectivity, we propose tentatively that an ability to engage in purposeful exchanges with another human being exists in these populations from birth.
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Affiliation(s)
- Mikael Heimann
- Infant and Child Lab, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Emil Holmer
- Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
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An ethical analysis of divergent clinical approaches to the application of genetic testing for autism and schizophrenia. Hum Genet 2021; 141:1069-1084. [PMID: 34453583 DOI: 10.1007/s00439-021-02349-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/16/2021] [Indexed: 12/27/2022]
Abstract
Genetic testing to identify genetic syndromes and copy number variants (CNVs) via whole genome platforms such as chromosome microarray (CMA) or exome sequencing (ES) is routinely performed clinically, and is considered by a variety of organizations and societies to be a "first-tier" test for individuals with developmental delay (DD), intellectual disability (ID), or autism spectrum disorder (ASD). However, in the context of schizophrenia, though CNVs can have a large effect on risk, genetic testing is not typically a part of routine clinical care, and no clinical practice guidelines recommend testing. This raises the question of whether CNV testing should be similarly performed for individuals with schizophrenia. Here we consider this proposition in light of the history of genetic testing for ID/DD and ASD, and through the application of an ethical analysis designed to enable robust, accountable and justifiable decision-making. Using a systematic framework and application of relevant bioethical principles (beneficence, non-maleficence, autonomy, and justice), our examination highlights that while CNV testing for the indication of ID has considerable benefits, there is currently insufficient evidence to suggest that overall, the potential harms are outweighed by the potential benefits of CNV testing for the sole indications of schizophrenia or ASD. However, although the application of CNV tests for children with ASD or schizophrenia without ID/DD is, strictly speaking, off-label use, there may be clinical utility and benefits substantive enough to outweigh the harms. Research is needed to clarify the harms and benefits of testing in pediatric and adult contexts. Given that genetic counseling has demonstrated benefits for schizophrenia, and has the potential to mitigate many of the potential harms from genetic testing, any decisions to implement genetic testing for schizophrenia should involve high-quality evidence-based genetic counseling.
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Zampella CJ, Wang LAL, Haley M, Hutchinson AG, de Marchena A. Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review. Curr Psychiatry Rep 2021; 23:64. [PMID: 34387753 DOI: 10.1007/s11920-021-01280-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD). RECENT FINDINGS Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.
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Affiliation(s)
- Casey J Zampella
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Leah A L Wang
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret Haley
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anne G Hutchinson
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley de Marchena
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, USA
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Hansen AS, Kjaersdam Telléus G, Lauritsen MB. Changes in referral patterns to outpatient child and adolescent psychiatric services from 2005-2018. Nord J Psychiatry 2021; 75:437-446. [PMID: 33586612 DOI: 10.1080/08039488.2021.1880636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION There has been a steep increase in referrals to child and adolescent psychiatric (CAP) services across Western countries. To fit CAP services to the increasing demand, it is important to gain more knowledge about the background for the increase in referrals and to investigate changes in referral patterns over time. METHODS Cross-sectional observational study comparing referrals to outpatient CAP services from 2005, 2010 and 2018 to the only CAP center in the North Denmark Region. RESULTS There was a 3.9 times increase in referrals from 2005 to 2018. Referrals for disorders with onset in early childhood (primarily autism and ADHD/ADD) increased from 2005 to 2010 but decreased from 2010 to 2018. There was an increase in the proportion of referrals for emotional disorders from 2010 to 2018. The proportion of girls referred for disorders with onset in early childhood increased from 2005 to 2018. The referral age for these disorders remained relatively high, and this was most pronounced for girls. CONCLUSIONS There has been significant changes in the referral pattern to outpatient CAP services. The increasing referral rates for girls for disorders with onset in early childhood could indicate improved ability in primary settings to recognize these symptoms in girls. However, late referral to CAP services for these disorders remains an issue. Educational services play an increasing role in referring children for these disorders, and it is important to ensure that they have the competences to identify children in need of assessment by CAP services.
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Affiliation(s)
- Anna Sofie Hansen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Gry Kjaersdam Telléus
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Psychology, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Marlene Briciet Lauritsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Bahado-Singh RO, Vishweswaraiah S, Aydas B, Radhakrishna U. Placental DNA methylation changes and the early prediction of autism in full-term newborns. PLoS One 2021; 16:e0253340. [PMID: 34260616 PMCID: PMC8279352 DOI: 10.1371/journal.pone.0253340] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/03/2021] [Indexed: 12/23/2022] Open
Abstract
Autism spectrum disorder (ASD) is associated with abnormal brain development during fetal life. Overall, increasing evidence indicates an important role of epigenetic dysfunction in ASD. The placenta is critical to and produces neurotransmitters that regulate fetal brain development. We hypothesized that placental DNA methylation changes are a feature of the fetal development of the autistic brain and importantly could help to elucidate the early pathogenesis and prediction of these disorders. Genome-wide methylation using placental tissue from the full-term autistic disorder subtype was performed using the Illumina 450K array. The study consisted of 14 cases and 10 control subjects. Significantly epigenetically altered CpG loci (FDR p-value <0.05) in autism were identified. Ingenuity Pathway Analysis (IPA) was further used to identify molecular pathways that were over-represented (epigenetically dysregulated) in autism. Six Artificial Intelligence (AI) algorithms including Deep Learning (DL) to determine the predictive accuracy of CpG markers for autism detection. We identified 9655 CpGs differentially methylated in autism. Among them, 2802 CpGs were inter- or non-genic and 6853 intragenic. The latter involved 4129 genes. AI analysis of differentially methylated loci appeared highly accurate for autism detection. DL yielded an AUC (95% CI) of 1.00 (1.00-1.00) for autism detection using intra- or intergenic markers by themselves or combined. The biological functional enrichment showed, four significant functions that were affected in autism: quantity of synapse, microtubule dynamics, neuritogenesis, and abnormal morphology of neurons. In this preliminary study, significant placental DNA methylation changes. AI had high accuracy for the prediction of subsequent autism development in newborns. Finally, biologically functional relevant gene pathways were identified that may play a significant role in early fetal neurodevelopmental influences on later cognition and social behavior.
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Affiliation(s)
- Ray O. Bahado-Singh
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States of America
| | - Sangeetha Vishweswaraiah
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States of America
| | - Buket Aydas
- Department of Healthcare Analytics, Meridian Health Plans, Detroit, MI, United States of America
| | - Uppala Radhakrishna
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States of America
- * E-mail:
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Gagnon D, Zeribi A, Douard É, Courchesne V, Rodríguez-Herreros B, Huguet G, Jacquemont S, Loum MA, Mottron L. Bayonet-shaped language development in autism with regression: a retrospective study. Mol Autism 2021; 12:35. [PMID: 33985558 PMCID: PMC8117564 DOI: 10.1186/s13229-021-00444-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 05/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis. Methods We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels. Results ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR. Limitations This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention. Conclusions For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00444-8.
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Affiliation(s)
- David Gagnon
- Research Center of the CIUSSS-NIM, Hôpital Rivière-Des-Prairies, 7070, Boul. Perras, Montreal, QC, H2E 1A4, Canada.,Department of psychiatry, University of Montreal, 2900 Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Abderrahim Zeribi
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,University of Sherbrooke, 2500, Boul. de L'Université, Sherbrooke, QC, J1K 2R1, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Élise Douard
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Valérie Courchesne
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada
| | - Borja Rodríguez-Herreros
- Centre Cantonal Autisme, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland
| | - Guillaume Huguet
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Sébastien Jacquemont
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Mor Absa Loum
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Laurent Mottron
- Research Center of the CIUSSS-NIM, Hôpital Rivière-Des-Prairies, 7070, Boul. Perras, Montreal, QC, H2E 1A4, Canada. .,Department of psychiatry, University of Montreal, 2900 Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.
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48
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Jonsdottir SL, Saemundsen E, Jonsson BG, Rafnsson V. Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-up in a Population Sample of 30-Month-Old Children in Iceland: A Prospective Approach. J Autism Dev Disord 2021; 52:1507-1522. [PMID: 33945117 DOI: 10.1007/s10803-021-05053-1] [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] [Accepted: 04/26/2021] [Indexed: 01/24/2023]
Abstract
The Modified Checklist for Autism in Toddlers, Revised with Follow-up was validated on a population sample in Reykjavik, Iceland. The participants (N = 1585) were screened in well-child care at age 30 months and followed up for at least 2 years to identify autism cases. The sensitivity, specificity, positive and negative predictive values were 0.62, 0.99, 0.72, and 0.99, respectively. True-positive children were diagnosed 10 months earlier than false-negative children. Autism symptom severity and the proportions of children with verbal and performance IQs/DQs < 70 were similar between groups. Although the sensitivity was suboptimal, the screening contributed to lowering the age at diagnosis for many children. Adding autism-specific screening to the well-child care program should be considered.
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Affiliation(s)
- Sigridur Loa Jonsdottir
- State Diagnostic and Counseling Center, Digranesvegur 5, 200, Kopavogur, Iceland. .,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Evald Saemundsen
- State Diagnostic and Counseling Center, Digranesvegur 5, 200, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Brynjolfur Gauti Jonsson
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Vilhjalmur Rafnsson
- Department of Preventive Medicine, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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49
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Gangi DN, Boterberg S, Schwichtenberg AJ, Solis E, Young GS, Iosif AM, Ozonoff S. Declining Gaze to Faces in Infants Developing Autism Spectrum Disorder: Evidence From Two Independent Cohorts. Child Dev 2021; 92:e285-e295. [PMID: 33615438 PMCID: PMC8169511 DOI: 10.1111/cdev.13471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/02/2020] [Accepted: 07/05/2020] [Indexed: 12/30/2022]
Abstract
Two independent cohorts (N = 155, N = 126) of infants at high and low risk for autism spectrum disorder (ASD) were followed prospectively between 6 and 36 months of age, when n = 46 were diagnosed with ASD. Gaze to adult faces was coded-during a developmental assessment (Cohort 1) or a play interaction (Cohort 2). Across both cohorts, most children developing ASD showed sharp declines in gaze to faces over time, relative to children without ASD. These findings suggest that declining developmental trajectories may be more common than previously recognized by retrospective methods. Trajectory-based screening methods could potentially identify children in the early stages of symptom onset and allow for early intervention before the full disorder has developed.
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50
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Whiteley P, Carr K, Shattock P. Research, Clinical, and Sociological Aspects of Autism. Front Psychiatry 2021; 12:481546. [PMID: 33995134 PMCID: PMC8116543 DOI: 10.3389/fpsyt.2021.481546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
The concept of autism continues to evolve. Not only have the central diagnostic criteria that define autism evolved but understanding of the label and how autism is viewed in research, clinical and sociological terms has also changed. Several key issues have emerged in relation to research, clinical and sociological aspects of autism. Shifts in research focus to encompass the massive heterogeneity covered under the label and appreciation that autism rarely exists in a diagnostic vacuum have brought about new questions and challenges. Diagnostic changes, increasing moves towards early diagnosis and intervention, and a greater appreciation of autism in girls and women and into adulthood and old age have similarly impacted on autism in the clinic. Discussions about autism in socio-political terms have also increased, as exemplified by the rise of ideas such as neurodiversity and an increasingly vocal dialogue with those diagnosed on the autism spectrum. Such changes are to be welcomed, but at the same time bring with them new challenges. Those changes also offer an insight into what might be further to come for the label of autism.
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Affiliation(s)
- Paul Whiteley
- ESPA Research, Unit 133i Business Innovation Centre, The Robert Luff Laboratory, Education & Services for People With Autism Research, Sunderland, United Kingdom
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