Pathologies in functional connectivity, feedback control and robustness: a global workspace perspective on autism spectrum disorders

The Natural History of Cervical Intraepithelial Neoplasia Grades 1, 2, and 3: A Systematic Review and Meta-analysis

OBJECTIVE

The aim of the study was to obtain an updated overview of regression, persistence, and progression rates of conservatively managed cervical intraepithelial neoplasia grade 1 (CIN 1)/CIN 2/CIN 3.

METHODS

Data sources were MEDLINE, Embase, and Cochrane (January 1, 1973-April 14, 2020). Two reviewers extracted data and assessed risk of bias. To estimate outcome rates, we pooled proportions of the individual study results using random-effects meta-analysis, resulting in point estimates and corresponding 95% CIs. Heterogeneity was quantified by the I2 and τ2 measures.

RESULTS

Eighty-nine studies were included, 63 studies on CIN 1 (n = 6,080-8,767), 42 on CIN 2 (n = 2,909-3,830), and 7 on CIN 3 (n = 245-351). The overall regression, persistence, and progression to CIN 2 or worse and CIN 3 or worse rates for women with conservatively managed CIN 1 were 60% (95% CI = 55-65, I2 = 92%), 25% (95% CI = 20-30, I2 = 94%), 11% (95% CI = 8-13, I2 = 89%), and 2% (95% CI = 1-3, I2 = 82%), respectively. The overall regression, persistence, and progression rates for CIN 2 were 55% (95% CI = 50-60, I2 = 85%), 23% (95% CI = 19-28, I2 = 83%), and 19% (95% CI = 15-23, I2 = 88%), respectively. Finally, for CIN 3, these were 28% (95% CI = 17-41, I2 = 68%), 67% (95% CI = 36-91, I2 = 84%), and 2% (95% CI = 0-25, I2 = 95%), respectively. Cervical intraepithelial neoplasia grade 2 regression was significantly higher in women 30 years or younger and high-risk human papillomavirus-negative women (66%, 95% CI = 62-70, I2 = 76%; 94%, 95% CI = 84-99, I2 = 60%). Only 2/7,180 (0.03%) and 10/3,037 (0.3%) of the CIN 1 and CIN 2 cases progressed to cervical cancer.

CONCLUSIONS

Most CIN 1/CIN 2 will regress spontaneously in less than 24 months, with the highest rates in high-risk human papillomavirus-negative and young women, whereas progression to cancer is less than 0.5%. Conservative management should be considered, especially in fertile women and with expected high compliance. Given the heterogeneity in regression rates of high-grade histology, this should be classified as CIN 2 or CIN 3 to guide management.

Differences in Brain Structural Covariance Network Characteristics in Children and Adults With Autism Spectrum Disorder

Systematically describing the structural topological configuration of human brain during development is an essential task. Autism spectrum disorder (ASD) represents a powerful challenge for psychiatry and neuroscience researchers. In this study, we investigated variations in the structural covariance network properties of 441 patients with ASD ranging in age from 7 to 45 years and in 426 age-matched healthy controls (HCs) using structural magnetic resonance neuroimaging from the ABIDE database. We applied a sliding window approach to study topological variation during development using comprehensive graph theoretical analysis. The main findings are as follows: (1) Cross-sectional trajectories of the network characteristics exhibited inverted U-shapes in both HCs and participants with ASD, with the latter exhibiting a 7-year delay in reaching the maximum value, (2) network resilience to targeted attacks peaked at 18' and 19' in the HCs and at 25' in the participants with ASD, and the weakest resilience occurred at age 7', (3) the HCs and participants with ASD exhibited normalized mean degree differences in the right amygdala, and (4) significant differences in the network characteristics were observed in the 18' age group at most of the densities analyzed. We used cross-sectional analysis to infer distinct neurodevelopmental trajectories in ASD in the brain structural connectome. Our findings are consistent with the notion that adolescence is a sensitive period of brain development with strong potential for brain plasticity, offering opportunities for environmental adaptation and social integration and for increasing vulnerability. ASD may be a product of susceptibility. LAY SUMMARY: We used cross-sectional analysis to preliminarily infer distinct neurodevelopmental trajectories in ASD in the brain structural connectome. The main findings are as follows: (1) Cross-sectional trajectories of the network characteristics exhibited inverted U-shapes in both HCs and participants with ASD, with the latter exhibiting a 7-year delay in reaching the maximum value, (2) Network resilience to targeted attacks peaked at 18' and 19' in the HCs and at 25' in the participants with ASD, and the weakest resilience occurred at age 7', (3) The HCs and participants with ASD exhibited normalized mean degree differences in the right amygdala, and (4) significant differences in the network characteristics were observed in the 18' age group at most of the densities analyzed.

Behavioral comparisons in Autism Spectrum Disorder and Developmental Coordination Disorder: A systematic literature review

BACKGROUND

Autism Spectrum Disorder (ASD) and Developmental Coordination Disorder (DCD) are developmental disorders that, since the DSM-5, can be diagnosed as co-occurring conditions. While some recent studies suggest that ASD and DCD have similar traits, others show clear behavioral distinctions between the two conditions. By gathering all studies that included (1) an ASD group and a DCD group, (2) an ASD+DCD group and a DCD group, or (3) ASD, ASD+DCD, and DCD groups, we aimed to identify similarities and differences in behaviors between the two disorders.

METHOD

We used a systematic search of PubMed (1946 -), Scopus (1970 -), PsycINFO (via EBSCO, 1600 -), CINAHL (via EBSCO, 1937 -), SportDiscus (via EBSCO, 1985 -), and WorldCat (via FirstSearch) in addition to reference list and author name searching PubMed, Scopus, PsycINFO, CINAHL, SportDiscus, and WorldCat to identify original studies that met the following criteria: (1) an ASD group and a DCD group, (2) an ASD+DCD group and a DCD group, or (3) ASD, ASD+DCD, and DCD groups.

RESULTS

From the 1,598 articles screened, 11 were included in the qualitative analysis. The articles included reported more differences than similarities in individuals with ASD and DCD, with clear distinctions for working memory ability, gestural performance, grip selection, and cortical thickness. Only two studies reported similarities in face processing abilities and perceived competence, and the interventional studies showed group similarities in behavior improvement, such as intelligence and attention.

CONCLUSIONS

Based on the articles reviewed, we conclude that while DCD and ASD share some behavioral symptoms, the symptom profiles of each disorder are unique and separable. We recommend that the evaluation of potential DCD in individuals with ASD be performed systematically and thoroughly, so as to distinguish this co-occurring condition from sensorimotor symptoms associated with ASD.

Disrupted development and imbalanced function in the global neuronal workspace: a positive-feedback mechanism for the emergence of ASD in early infancy

Autism spectrum disorder (ASD) is increasingly being conceptualized as a spectrum disorder of connectome development. We review evidence suggesting that ASD is characterized by a positive feedback loop that amplifies small functional variations in early-developing sensory-processing pathways into structural and functional imbalances in the global neuronal workspace. Using vision as an example, we discuss how early functional variants in visual processing may be feedback-amplified to produce variant object categories and disrupted top-down expectations, atypically large expectation-to-perception mismatches, problems re-identifying individual people and objects, socially inappropriate, generally aversive emotional responses and disrupted sensory-motor coordination. Viewing ASD in terms of feedback amplification of small functional variants allows a number of recent models of ASD to be integrated with neuroanatomical, neurofunctional and genetic data.

Behavioral, perceptual, and neural alterations in sensory and multisensory function in autism spectrum disorder

Although sensory processing challenges have been noted since the first clinical descriptions of autism, it has taken until the release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 for sensory problems to be included as part of the core symptoms of autism spectrum disorder (ASD) in the diagnostic profile. Because sensory information forms the building blocks for higher-order social and cognitive functions, we argue that sensory processing is not only an additional piece of the puzzle, but rather a critical cornerstone for characterizing and understanding ASD. In this review we discuss what is currently known about sensory processing in ASD, how sensory function fits within contemporary models of ASD, and what is understood about the differences in the underlying neural processing of sensory and social communication observed between individuals with and without ASD. In addition to highlighting the sensory features associated with ASD, we also emphasize the importance of multisensory processing in building perceptual and cognitive representations, and how deficits in multisensory integration may also be a core characteristic of ASD.

What makes you think you are conscious? An agnosticist manifesto

The qualitative character of consciousness, its "what-it-is-likeness", is a contested issue, both in philosophy and psychology. I argue that, rather than by conceptual analyses, the status of "what-it-is-likeness" has to be decided by empirical investigation. Pending the outcome, we should maintain an agnostic stance, in order to remove the bias in favor of fictionalism from our study of consciousness,. I illustrate this with the notion of "ownership unity". People adhere to the belief of a single, unified self as the owner of their experiences, in spite of abundant dis-unities in the informational content of their experience. On one reading, this supports the notion that the unity of experience is no more than a convenient fiction, based on an illusory experience of unity. Cognitive neuroscience is slanted in favor of such understanding, insofar it emphasizes functional specialization and localization. To restore the balance, I present a complementary perspective: the view that the experience of unity is afforded by the intrinsic, multiscale brain dynamics. This approach offers a biological substrate for unity of experience as a regular scenario within certain boundary conditions, as well mechanisms that may let it go astray.