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Radhoe TA, Agelink van Rentergem JA, Torenvliet C, Groenman AP, van der Putten WJ, Geurts HM. Finding Similarities in Differences Between Autistic Adults: Two Replicated Subgroups. J Autism Dev Disord 2024; 54:3449-3466. [PMID: 37438586 PMCID: PMC11362251 DOI: 10.1007/s10803-023-06042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/14/2023]
Abstract
Autism is heterogeneous, which complicates providing tailored support and future prospects. We aim to identify subgroups in autistic adults with average to high intelligence, to clarify if certain subgroups might need support. We included 14 questionnaire variables related to aging and/or autism (e.g., demographic, psychological, and lifestyle). Community detection analysis was used for subgroup identification in an original sample of 114 autistic adults with an adulthood diagnosis (autism) and 58 non-autistic adults as comparison group (COMP), and a replication sample (NAutism = 261; NCOMP = 287), both aged 30-89 years. Next, we identified subgroups and assessed external validity (for cognitive and psychological difficulties, and quality of life [QoL]) in the autism samples. To test specificity, we repeated the analysis after adding 123 adults with ADHD, aged 30-80 years. As expected, the autism and COMP groups formed distinct subgroups. Among autistic adults, we identified three subgroups of which two were replicated. One of these subgroups seemed most vulnerable on the cluster variables; this subgroup also reported the most cognitive and psychological difficulties, and lowest QoL. Adding the ADHD group did not alter results. Within autistic adults, one subgroup could especially benefit from support and specialized care, although this must be tested in future studies.
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Affiliation(s)
- Tulsi A Radhoe
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands.
| | - Joost A Agelink van Rentergem
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Carolien Torenvliet
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Annabeth P Groenman
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Research Institute for Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Wikke J van der Putten
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands
| | - Hilde M Geurts
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands
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Lazerwitz MC, Rowe MA, Trimarchi KJ, Garcia RD, Chu R, Steele MC, Parekh S, Wren-Jarvis J, Bourla I, Mark I, Marco EJ, Mukherjee P. Brief Report: Characterization of Sensory Over-Responsivity in a Broad Neurodevelopmental Concern Cohort Using the Sensory Processing Three Dimensions (SP3D) Assessment. J Autism Dev Disord 2024; 54:3185-3192. [PMID: 36180667 PMCID: PMC9524317 DOI: 10.1007/s10803-022-05747-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 12/01/2022]
Abstract
Sensory Over-Responsivity (SOR) is an increasingly recognized challenge among children with neurodevelopmental concerns (NDC). To investigate, we characterized the incidence of auditory and tactile over-responsivity (AOR, TOR) among 82 children with NDC. We found that 70% of caregivers reported concern for their child's sensory reactions. Direct assessment further revealed that 54% of the NDC population expressed AOR, TOR, or both - which persisted regardless of autism spectrum disorder (ASD) diagnosis. These findings support the high prevalence of SOR as well as its lack of specificity to ASD. Additionally, AOR is revealed to be over twice as prevalent as TOR. These conclusions present several avenues for further exploration, including deeper analysis of the neural mechanisms and genetic contributors to sensory processing challenges.
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Affiliation(s)
- Maia C Lazerwitz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
- Cortica Healthcare, San Rafael, CA, USA
| | - Mikaela A Rowe
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | | | | | - Robyn Chu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
- Growing Healthy Children Therapy Services, Rescue, CA, USA
| | | | - Shalin Parekh
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jamie Wren-Jarvis
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Ioanna Bourla
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Ian Mark
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Gigliotti F, Giovannone F, Belli A, Sogos C. Atypical Sensory Processing in Neurodevelopmental Disorders: Clinical Phenotypes in Preschool-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:875. [PMID: 39062324 PMCID: PMC11276037 DOI: 10.3390/children11070875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/07/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Sensory processing issues are frequent in neurodevelopmental disorders (NDDs), with very variable prevalence rates ranging from 20% to 95%. This study aimed to investigate sensory processing in preschool-aged children with NDDs, to clarify the epidemiology, and to identify associated or correlated clinical and psychometric variables. METHODS A total of 141 NDD children (age range 2-5 years old) were included and enrolled in two subgroups: 72 with ASD and 69 with other NDDs. A standardized neuropsychological evaluation was assessed (Griffiths III/WPPSI-III/Leiter-R, ADOS-2) and the parents completed the CBCL ½-5, the SPM-P, and the ADI-R. RESULTS Atypical sensory processing was reported in 39.7% of the total sample, more frequently in ASD (44.4%) than in other NDDs (34.8%). No statistically significant differences were found regarding gender and developmental level. A positive correlation was found between sensory processing abnormalities and behavioral problems (p < 0.01). CONCLUSIONS Compared to other NDDs, ASDs more frequently have atypical sensory processing and appear to present a specific vulnerability in the processing of proprioceptive and vestibular inputs. Our results suggest that sensory processing difficulties should be considered regardless of developmental level and in children with behavioral problems.
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Affiliation(s)
| | | | | | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (F.G.); (F.G.); (A.B.)
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Radhoe TA, van Rentergem JAA, Torenvliet C, Groenman AP, van der Putten WJ, Geurts HM. Comparison of network structures between autistic and non-autistic adults, and autism subgroups: A focus on demographic, psychological, and lifestyle factors. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1175-1189. [PMID: 37776020 PMCID: PMC11067416 DOI: 10.1177/13623613231198544] [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: 10/01/2023]
Abstract
LAY ABSTRACT There are large differences in the level of demographic, psychological, and lifestyle characteristics between autistic and non-autistic adults but also among autistic people. Our goal was to test whether these differences correspond to differences in underlying relationships between these characteristics-also referred to as network structure-to determine which characteristics (and relationships between them) are important. We tested differences in network structure in (1) autistic and non-autistic adults and (2) two previously identified subgroups of autistic adults. We showed that comparing networks of autistic and non-autistic adults provides subtle differences, whereas networks of the autism subgroups were similar. There were also no sex differences in the networks of the autism subgroups. Thus, the previously observed differences in the level of characteristics did not correspond to differences across subgroups in how these characteristics relate to one another (i.e. network structure). Consequently, a focus on differences in characteristics is not sufficient to determine which characteristics (and relationships between them) are of importance. Hence, network analysis provides a valuable tool beyond looking at (sub)group level differences. These results could provide hints for clinical practice, to eventually determine whether psychological distress, cognitive failures, and reduced quality of life in autistic adults can be addressed by tailored support. However, it is important that these results are first replicated before we move toward intervention or support.
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Affiliation(s)
| | | | | | | | - Wikke J van der Putten
- University of Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassia Groep), The Netherlands
| | - Hilde M Geurts
- University of Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassia Groep), The Netherlands
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Radhoe TA, Agelink van Rentergem JA, Torenvliet C, Groenman AP, van der Putten WJ, Geurts HM. The clinical relevance of subgroups of autistic adults: Stability and predictive value. Autism Res 2024; 17:747-760. [PMID: 38429933 DOI: 10.1002/aur.3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
Autism in adulthood is characterized by heterogeneity, complicating the provision of tailored support. In previous work, we aimed to capture this heterogeneity by determining subgroups of autistic adults that differed in clinical outcomes: cognitive failures, psychological difficulties, and quality of life (QoL). Two subgroups were identified: a "Feelings of Low Grip" subgroup characterized by experiencing a lower sense of mastery and a higher susceptibility to difficulties in daily life, and a "Feelings of High Grip" subgroup characterized by a higher sense of mastery and lower susceptibility to difficulties in daily life. The current pre-registered study involves a longitudinal extension to determine (a) stability and (b) predictive value of the previously identified two subgroups. Subgroups were identified using community detection based on 14 self-report measures related to demographic, psychological, and lifestyle characteristics in two samples (aged 31-86 years) that were analyzed separately: Sample 1 (NAutism = 80) measured 5 years after baseline and Sample 2 (NAutism = 241, NComparison = 211) measured 2 years after baseline. The stability over time was assessed based on (a) the number of subgroups, (b) subgroup profiles, and (c) subgroup membership. Predictive validity was assessed for cognitive failures, psychological difficulties, and QoL. Results indicated that autistic and non-autistic adults formed distinct subgroups. Within both autism samples, the two previously identified autism subgroups were replicated at follow-up. Subgroup profiles were similar for >50% of the variables at two-year follow-up, and 21% at five-year follow-up. Moreover, ≥76% remained in the same subgroup at two-year follow-up, and ≥ 57% after 5 years. Subgroup membership was predictive of external clinical outcomes up to 5 years. Thus, this study demonstrated the stability and predictive value of the autism subgroups, especially for the two-year follow-up. A further focus on their clinical utility might increase the aptness of support, and may provide more insight into the aging process when being autistic.
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Affiliation(s)
- Tulsi A Radhoe
- Dutch Autism & ADHD Research Center (d'Arc), Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, WS, Netherlands
| | - Joost A Agelink van Rentergem
- Dutch Autism & ADHD Research Center (d'Arc), Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, WS, Netherlands
| | - Carolien Torenvliet
- Dutch Autism & ADHD Research Center (d'Arc), Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, WS, Netherlands
| | - Annabeth P Groenman
- Dutch Autism & ADHD Research Center (d'Arc), Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, WS, Netherlands
- Research Institute for Child Development and Education, University of Amsterdam, Amsterdam, WS, Netherlands
| | - Wikke J van der Putten
- Dutch Autism & ADHD Research Center (d'Arc), Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, WS, Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Amsterdam, HN, Netherlands
| | - Hilde M Geurts
- Dutch Autism & ADHD Research Center (d'Arc), Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, WS, Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Amsterdam, HN, Netherlands
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Groenman AP, van der Oord S, Geurts HM. Navigating adolescence: pubertal development in autism spectrum conditions and its relation to mental health. Arch Womens Ment Health 2024:10.1007/s00737-023-01414-0. [PMID: 38225364 DOI: 10.1007/s00737-023-01414-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/15/2023] [Indexed: 01/17/2024]
Abstract
Adolescence is a period of social, psychological, and physiological change, including the onset of puberty. Differential pubertal onset has been linked to a myriad of problems, including mental health problems. Therefore, we aim to investigate deviating pubertal development in autism, and whether this is more pronounced in girls than in boys. A total of 68 individuals (nASC = 34, nCOM (comparisons) = 34) aged 12 to 16 years were administered test concerning pubertal development and mental health (i.e., sensory sensitivity, autistic traits, depression, anxiety, and externalizing problems). Frequentist and Bayesian ANOVA was used to examine deviations in pubertal development in ASC and possible sex effects. Regression analyses was used to test whether this asynchronicity was linked to mental health problems. Our (frequentist and Bayesian) analyses revealed earlier onset and slower development of pubertal development in ASC but we did not find any sex differences. Maturation disparity was linked to higher mental health problems in ASC, but not in COM. No sex differences in the relation with mental health outcomes was found. We found evidence for a slower development of "true" puberty in those with ASC compared to those without. Moreover, we show that disparities in pubertal development are related to mental health in ASC, suggesting a greater impact on mental health in autistic than in non-autistic teens. Longitudinal studies are necessary to elucidate important developmental trajectories in puberty in neurodiverse populations.
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Affiliation(s)
- Annabeth P Groenman
- Dutch Autism and ADHD Research Center, University of Amsterdam, Amsterdam, the Netherlands.
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands.
| | | | - Hilde M Geurts
- Dutch Autism and ADHD Research Center, University of Amsterdam, Amsterdam, the Netherlands
- Leo Kannerhuis, Youz/Parnassiagroep, Amsterdam, The Netherlands
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7
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Zeisel A, Thiel T, Gaigg SB, Roessner V, Ring M. Validation of the German Glasgow Sensory Questionnaire and replication of sensory processing differences in students with higher and lower Autism-Spectrum Quotient. BMC Psychiatry 2023; 23:426. [PMID: 37316778 DOI: 10.1186/s12888-023-04903-9] [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: 07/24/2022] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The Glasgow Sensory Questionnaire (GSQ) gives insight into sensory processing differences (hypo- and hyper-sensitivity across modalities), which is a clinically defining characteristic of autism spectrum disorder (ASD). Because there is no validated German version of this instrument, this study aimed at validating the German GSQ. Further, a replication of the GSQ's sensory processing differences was intended. METHODS University students of Technische Universität or Universitätsklinikum in Dresden, Germany, were recruited via email distribution or the university homepage and 297 German-speaking students completed the online survey, comprising the German GSQ, Autism-Spectrum Quotient (AQ) and Symptom-Checklist (SCL-90). For validation of the German GSQ, confirmatory factor analyses followed by exploratory factor analyses were applied. RESULTS The German GSQ has moderate to low validity, good to acceptable reliability, and a different internal structure from the original GSQ. Replicating the sensory processing differences in students with higher and lower AQ was not successful. CONCLUSIONS Results indicate that the GSQ, developed especially for individuals with ASD, is less informative for the general population if there are not enough individuals with higher AQ scores in the sample.
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Affiliation(s)
- Annalena Zeisel
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Tobias Thiel
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Sebastian B Gaigg
- Autism Research Group, Department of Psychology, City, University of London, London, UK
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Melanie Ring
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany.
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He JL, Williams ZJ, Harris A, Powell H, Schaaf R, Tavassoli T, Puts NAJ. A working taxonomy for describing the sensory differences of autism. Mol Autism 2023; 14:15. [PMID: 37041612 PMCID: PMC10091684 DOI: 10.1186/s13229-022-00534-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 12/14/2022] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Individuals on the autism spectrum have been long described to process sensory information differently than neurotypical individuals. While much effort has been leveraged towards characterizing and investigating the neurobiology underlying the sensory differences of autism, there has been a notable lack of consistency in the terms being used to describe the nature of those differences. MAIN BODY We argue that inconsistent and interchangeable terminology-use when describing the sensory differences of autism has become problematic beyond mere pedantry and inconvenience. We begin by highlighting popular terms that are currently being used to describe the sensory differences of autism (e.g. "sensitivity", "reactivity" and "responsivity") and discuss why poor nomenclature may hamper efforts towards understanding the aetiology of sensory differences in autism. We then provide a solution to poor terminology-use by proposing a hierarchical taxonomy for describing and referring to various sensory features. CONCLUSION Inconsistent terminology-use when describing the sensory features of autism has stifled discussion and scientific understanding of the sensory differences of autism. The hierarchical taxonomy proposed was developed to help resolve lack of clarity when discussing the sensory differences of autism and to place future research targets at appropriate levels of analysis.
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Affiliation(s)
- Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ashley Harris
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Helen Powell
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Roseann Schaaf
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, USA
| | - Teresa Tavassoli
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
| | - Nicolaas A J Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
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Hoffman T, Bar-Shalita T, Granovsky Y, Gal E, Kalingel-Levi M, Dori Y, Buxbaum C, Yarovinsky N, Weissman-Fogel I. Indifference or hypersensitivity? Solving the riddle of the pain profile in individuals with autism. Pain 2023; 164:791-803. [PMID: 36730631 DOI: 10.1097/j.pain.0000000000002767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Excitatory-inhibitory (E/I) imbalance is a mechanism that underlies autism spectrum disorder, but it is not systematically tested for pain processing. We hypothesized that the pain modulation profile (PMP) in autistic individuals is characterized by less efficient inhibitory processes together with a facilitative state, indicative of a pronociceptive PMP. Fifty-two adults diagnosed with autism and 52 healthy subjects, age matched and sex matched, underwent quantitative sensory testing to assess the function of the (1) pain facilitatory responses to phasic, repetitive, and tonic heat pain stimuli and (2) pain inhibitory processes of habituation and conditioned pain modulation. Anxiety, pain catastrophizing, sensory, and pain sensitivity were self-reported. The autistic group reported significantly higher pain ratings of suprathreshold single ( P = 0.001), repetitive (46°C- P = 0.018; 49°C- P = 0.003; 52°C- P < 0.001), and tonic ( P = 0.013) heat stimuli that were cross correlated ( r = 0.48-0.83; P < 0.001) and associated with sensitivity to daily life pain situations ( r = 0.39-0.45; P < 0.005) but not with psychological distress levels. Hypersensitivity to experimental pain was attributed to greater autism severity and sensory hypersensitivity to daily stimuli. Subjects with autism efficiently inhibited phasic but not tonic heat stimuli during conditioned pain modulation. In conclusion, in line with the E/I imbalance mechanism, autism is associated with a pronociceptive PMP expressed by hypersensitivity to daily stimuli and experimental pain and less-efficient inhibition of tonic pain. The latter is an experimental pain model resembling clinical pain. These results challenge the widely held belief that individuals with autism are indifferent to pain and should raise caregivers' awareness of pain sensitivity in autism.
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Affiliation(s)
- Tseela Hoffman
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Yelena Granovsky
- Department of Neurology, Rambam Health Care Center, Haifa, Israel
- Laboratory of Clinical Neurophysiology, Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Eynat Gal
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Merry Kalingel-Levi
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Yael Dori
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Chen Buxbaum
- Department of Neurology, Rambam Health Care Center, Haifa, Israel
| | - Natalya Yarovinsky
- Department of Cognitive Neurology, Rambam Health Care Center, Haifa, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Gunderson J, Worthley E, Byiers B, Symons F, Wolff J. Self and caregiver report measurement of sensory features in autism spectrum disorder: a systematic review of psychometric properties. J Neurodev Disord 2023; 15:5. [PMID: 36698071 PMCID: PMC9875408 DOI: 10.1186/s11689-022-09473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/16/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Unusual responses to sensory stimuli are considered a diagnostic symptom of autism spectrum disorder with mounting research efforts put towards understanding, characterizing, and treating such symptoms. METHODS This paper examines self and caregiver report tools used to measure sensory features in ASD through a systematic review of the psychometric evidence for their use. A total of 31 empirical papers were reviewed across 20 assessment tools. Substantial differences were identified in the specific sensory features defined across assessment tools. Sensory assessment questionnaires were evaluated against quality psychometric evidence criteria to provide a use recommendation. RESULTS Five assessments were identified to be "appropriate with conditions," while no sensory assessment tools were identified to have sufficient quality psychometric evidence to provide a recommendation of "Appropriate" for measuring sensory features in ASD. CONCLUSION Evidence from this review highlights potentially significant shortcomings among the current methods used to measure sensory features in ASD and suggests the need for more efforts in developing psychometrically sound sensory assessment tools for use in ASD populations.
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Affiliation(s)
- Jaclyn Gunderson
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA ,grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, 200 1St Street Southwest, Rochester, MN 55902 USA
| | - Emma Worthley
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Breanne Byiers
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Frank Symons
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Jason Wolff
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
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Turjeman-Levi Y, Kluger AN. Sensory-processing sensitivity versus the sensory-processing theory: Convergence and divergence. Front Psychol 2022; 13:1010836. [PMID: 36533027 PMCID: PMC9752870 DOI: 10.3389/fpsyg.2022.1010836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 08/08/2023] Open
Abstract
Two individual-difference theories focus on sensory sensitivity: one emanating from psychology-sensory-processing-sensitivity (SPS); and one from occupational therapy-sensory processing theory (SP). Each theory is coupled with its measure: the highly-sensitive-person scale (HSPS) and the adolescent adult sensory profile (ASP). The constructs of both theories were claimed to be independent of neuroticism. To assess the convergence of these measures, we recruited participants from a general population and a Facebook Group dedicated to people high in SPS. The participants, N = 1,702 M age = 26.9 (66.7% female), answered the HSPS, ASP, and neuroticism questionnaires. We subjected the HSPS and the APS to exploratory graph analysis. To assess the divergence of these measures from neuroticism, we performed meta-analyses. We also used a subsample obtained in an unrelated study, N = 490, to correlate HSPS and APS with the Big Five and additional measures. The results suggested that (a) the latent structure of these measures conforms to the theories only partially, (b) some of the sub-scales of these two measures correlated highly, r = 0.63, but low enough to suggest divergence, (c) both differentially predict membership in a Facebook group, and (d) both are not isomorphic with neuroticism. We concluded that HSPS primarily measures the emotional reaction to sensory stimulation, whereas ASP the behavioral reactions. We offer shorter yet reliable measures for both theories.
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Affiliation(s)
- Yaara Turjeman-Levi
- The Hebrew University Business School, The Hebrew University of Jerusalem, Jerusalem, Israel
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12
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Zhang W, Zhuo S, Li X, Peng W. Autistic Traits and Empathy for Others' Pain Among the General Population: Test of the Mediating Effects of First-Hand Pain Sensitivity. J Autism Dev Disord 2022; 53:2006-2020. [PMID: 35217943 DOI: 10.1007/s10803-022-05471-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 12/30/2022]
Abstract
Autism spectrum disorders (ASD) are characterized by reduced pain empathy-a process that is grounded in first-hand pain perception. Because autistic traits are continuously distributed in the general population, we hypothesized that first-hand pain sensitivity would mediate the link between autistic traits and pain empathy. After controlling for alexithymia, higher autistic traits were associated with lower cognitive and emotional empathy in response to others' pain, as well as lower sensitivity to cold and heat pain (higher cold pain tolerance and lower laser heat pain-intensity ratings). Importantly, pain sensitivity fully mediated the link between autistic traits and pain empathy. These findings highlight the role of atypical first-hand pain sensitivity in the lack of pain empathy observed in people with high autistic traits or ASD.
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Affiliation(s)
- Wenyun Zhang
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China
| | - Shiwei Zhuo
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China
| | - Xiaoyun Li
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China.
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Price A, Sumner P, Powell G. Subjective sensory sensitivity and its relationship with anxiety in people with probable migraine. Headache 2021; 61:1342-1350. [PMID: 34669970 PMCID: PMC9889083 DOI: 10.1111/head.14219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To better characterize differences in interictal sensory experience in adults with migraine and more comprehensively describe the relevance of anxiety to these experiences. BACKGROUND Evidence suggests that sensitivity to sensory input may not be limited to migraine attacks but continues between them. However, there is a need to better understand whether this is the case across senses, and to clearly distinguish sensory experience from measured sensory threshold, which are not straightforwardly related. Previous literature also indicates a co-occurrence between sensory sensitivity, migraine, and anxiety, but this relationship remains to be fully elucidated. METHODS The present cross-sectional study used online questionnaires to investigate how self-reported sensory experiences relate to migraine in a large community sample including 117 individuals with probable migraine and 827 without. Mediation analyses were also used to determine whether any relationship between migraine and sensory sensitivity was mediated by anxiety. RESULTS Significant increases in subjective reports of sensory sensitivity (d = 0.80) and sensory avoidance (d = 0.71) were found in participants with migraine. Anxiety symptoms partially mediated the relationship between subjective sensory sensitivity and migraine. Finally, visual, movement, and auditory subscales were found to provide unique explanatory variance in analyses predicting the incidence of migraine (area under the curve = 0.73, 0.69, 0.62 respectively). CONCLUSION Subjective sensory sensitivities are present between attacks and across senses in individuals with migraine. Anxiety symptoms are relevant to this relationship; however, sensory sensitivities appear to exist independent of this affective influence. The implications of interictal sensitivities for the daily lives of those with migraine should, therefore, be considered in clinical management wherever appropriate.
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Affiliation(s)
- Alice Price
- School of PsychologyCardiff UniversityCardiffUK
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of PsychologyCardiff UniversityCardiffUK
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Characteristics of Older Autistic Adults: a Systematic Review of Literature. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00238-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Geurts HM, Agelink van Rentergem JA, Radhoe T, Torenvliet C, Van der Putten WJ, Groenman AP. Ageing and heterogeneity regarding autism spectrum conditions: a protocol paper of an accelerated longitudinal study. BMJ Open 2021; 11:e040943. [PMID: 33789848 PMCID: PMC8016100 DOI: 10.1136/bmjopen-2020-040943] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Autism spectrum conditions (ASC) develop early in life and are thought to last a lifetime. However, ASC research has two major knowledge gaps that hinder progression in understanding the concept of ASC and in providing proper support for autistic adults: (1) the majority of knowledge about ASC mainly stems from childhood studies so little is known about older autistic adults and (2) while it is broadly recognised that ASC is a heterogeneous condition, we do not yet understand the differences in trajectories leading to their future outcome. We aim to fill both knowledge gaps. METHODS AND ANALYSIS A multistage overlapping cohort design assessing (cognitive) ageing in ASC is designed to obtain an accelerated longitudinal data set. Data, including a multitude of questionnaires, diagnostics and cognitive tests, are collected over four waves within a 10-year time frame. This will provide information regarding actual changes in quality of life, co-occurring health conditions and cognition as well as the possibility to test external validity and temporal stability in newly formed behavioural subtypes. Participants consist of three groups of adults aged 20-90 years: (1) with a clinical diagnosis of ASC, (2) with a clinical diagnosis of attention deficit hyperactivity disorder (ADHD) but no ASC, (3) no ASC/ADHD (ie, comparison group). The sample size differs between waves and instruments. Detailed analysis plans will be preregistered in AsPredicted or at the Open Science Framework. ETHICS AND DISSEMINATION Ethical approval for this study was obtained from the ethical review board of the Department of Psychology of the University of Amsterdam (wave 1 2011-PN-1952 and 2013-PN-2668, wave 2 2015-BC-4270, waves 3 and 4 2018-BC-9285). In line with the funding policies of the grant organisation funding this study, future papers will be published open access.
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Affiliation(s)
- Hilde M Geurts
- Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz), Amsterdam, The Netherlands
| | | | - Tulsi Radhoe
- Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wikke J Van der Putten
- Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz), Amsterdam, The Netherlands
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16
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Paul S, Arora A, Midha R, Vu D, Roy PK, Belmonte MK. Autistic traits and individual brain differences: functional network efficiency reflects attentional and social impairments, structural nodal efficiencies index systemising and theory-of-mind skills. Mol Autism 2021; 12:3. [PMID: 33478557 PMCID: PMC7818759 DOI: 10.1186/s13229-020-00377-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 09/02/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Autism is characterised not only by impaired social cognitive 'empathising' but also by superior rule-based 'systemising'. These cognitive domains intertwine within the categorical diagnosis of autism, yet behavioural genetics suggest largely independent heritability, and separable brain mechanisms. We sought to determine whether quantitative behavioural measures of autistic traits are dimensionally associated with structural and functional brain network integrity, and whether brain bases of autistic traits vary independently across individuals. METHODS Thirty right-handed neurotypical adults (12 females) were administered psychometric (Social Responsiveness Scale, Autism Spectrum Quotient and Systemising Quotient) and behavioural (Attention Network Test and theory-of-mind reaction time) measures of autistic traits, and structurally (diffusion tensor imaging) and functionally (500 s of 2 Hz eyes-closed resting fMRI) derived graph-theoretic measures of efficiency of information integration were computed throughout the brain and within subregions. RESULTS Social impairment was positively associated with functional efficiency (r = .47, p = .006), globally and within temporo-parietal and prefrontal cortices. Delayed orienting of attention likewise was associated with greater functional efficiency (r = - .46, p = .0133). Systemising was positively associated with global structural efficiency (r = .38, p = 0.018), driven specifically by temporal pole; theory-of-mind reaction time was related to structural efficiency (r = - .40, p = 0.0153) within right supramarginal gyrus. LIMITATIONS Interpretation of these relationships is complicated by the many senses of the term 'connectivity', including functional, structural and computational; by the approximation inherent in group functional anatomical parcellations when confronted with individual variation in functional anatomy; and by the validity, sensitivity and specificity of the several survey and experimental behavioural measures applied as correlates of brain structure and function. CONCLUSIONS Functional connectivities highlight distributed networks associated with domain-general properties such as attentional orienting and social cognition broadly, associating more impaired behaviour with more efficient brain networks that may reflect heightened feedforward information flow subserving autistic strengths and deficits alike. Structural connectivity results highlight specific anatomical nodes of convergence, reflecting cognitive and neuroanatomical independence of systemising and theory-of-mind. In addition, this work shows that individual differences in theory-of-mind related to brain structure can be measured behaviourally, and offers neuroanatomical evidence to pin down the slippery construct of 'systemising' as the capacity to construct invariant contextual associations.
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Affiliation(s)
- Subhadip Paul
- MIND Research Network, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA.,National Brain Research Centre, NH-8, Nainwal Mode, Manesar, 122051, India
| | - Aditi Arora
- National Brain Research Centre, NH-8, Nainwal Mode, Manesar, 122051, India.,Centre for Cognitive Neuroscience, Universität Salzburg, Kapitelgasse 4-6, 5020, Salzburg, Austria
| | - Rashi Midha
- National Brain Research Centre, NH-8, Nainwal Mode, Manesar, 122051, India.,National Institute of Mental Health and Neuro Sciences, Hosur Road, Bangalore, 560029, India
| | - Dinh Vu
- Department of Psychology, University of Oslo, Harald Schjelderups hus, Forskningsveien 3A, 0373, Oslo, Norway.,Department of Psychology, Chaucer Bldg., Nottingham Trent University, Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Prasun K Roy
- National Brain Research Centre, NH-8, Nainwal Mode, Manesar, 122051, India.,School of Biomedical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, 221005, India
| | - Matthew K Belmonte
- National Brain Research Centre, NH-8, Nainwal Mode, Manesar, 122051, India. .,Department of Psychology, Chaucer Bldg., Nottingham Trent University, Shakespeare Street, Nottingham, NG1 4FQ, UK. .,The Com DEALL Trust, 224, 6th 'A' Main Road, near Specialist Hospital, 2nd Block, HRBR Layout, Bangalore, 560043, India.
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Abnormalities in pain sensitivity among individuals with autism spectrum disorder: Evidence from meta-analysis. ACTA PSYCHOLOGICA SINICA 2021. [DOI: 10.3724/sp.j.1041.2021.00613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Casanova EL, Baeza-Velasco C, Buchanan CB, Casanova MF. The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders. J Pers Med 2020; 10:E260. [PMID: 33271870 PMCID: PMC7711487 DOI: 10.3390/jpm10040260] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/29/2020] [Accepted: 11/29/2020] [Indexed: 12/12/2022] Open
Abstract
Considerable interest has arisen concerning the relationship between hereditary connective tissue disorders such as the Ehlers-Danlos syndromes (EDS)/hypermobility spectrum disorders (HSD) and autism, both in terms of their comorbidity as well as co-occurrence within the same families. This paper reviews our current state of knowledge, as well as highlighting unanswered questions concerning this remarkable patient group, which we hope will attract further scientific interest in coming years. In particular, patients themselves are demanding more research into this growing area of interest, although science has been slow to answer that call. Here, we address the overlap between these two spectrum conditions, including neurobehavioral, psychiatric, and neurological commonalities, shared peripheral neuropathies and neuropathologies, and similar autonomic and immune dysregulation. Together, these data highlight the potential relatedness of these two conditions and suggest that EDS/HSD may represent a subtype of autism.
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Affiliation(s)
- Emily L. Casanova
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29615, USA;
| | - Carolina Baeza-Velasco
- Laboratory of Psychopathology and Health Processes, University of Paris, 92100 Boulogne Billancourt, France;
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, 34000 Montpellier, France
| | | | - Manuel F. Casanova
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29615, USA;
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY 40292, USA
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Liu D, Fan HZ, Zhao WX, Wang YH, Li D, Wu JL, Yan TY, Tan SP. Deficits of Tactile Passive Perception Acuity in Patients With Schizophrenia. Front Psychiatry 2020; 11:519248. [PMID: 33192644 PMCID: PMC7652750 DOI: 10.3389/fpsyt.2020.519248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/09/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Scarce literature has yet to characterize the tactile discrimination capability as well as the underlying mechanism of tactile deficits in psychotic disorder. In particular, very little is known regarding the tactile perception acuity in schizophrenia. Methods: A total of 131 clinically stable patients with schizophrenia (SCZ) and 79 healthy control (HC) volunteers were enrolled in the study. All the participants were tested on a tactile stimulus device which could quantify the tactile discrimination capability with right index finger scanned over the angles via the passive finger-movement apparatus. The MATRICS Consensus Cognitive Battery (MCCB) was adapted to assess the neurocognition of the participants. Correlation analysis and multivariate linear regression analysis were performed to investigate the relationship between tactile perception performance and neurocognitive function. Results: It was discovered that there existed a significant deficits in the tactile passive perception acuity (i.e., tactile angle discrimination threshold) in patients with schizophrenia compared with their healthy controls (F (3, 206) = 11.458, P = 0.001,partial η2 = 0.053). The MCCB total score and its six domains were significantly lower in SCZ patients than those in HCs (all p < 0.001). In the SCZ group, the composite score of the MCCB (r = -0.312, P < 0.001) and domains of neurocognition including speed of processing (r = -0.191, P = 0.031), attention/vigilance (r = -0.177, P = 0.047), working memory (r = -0.316, P < 0.001), verbal learning (r = - 0.332, P < 0.001), visual learning (r = -0.260, P = 0.004), and reasoning and problem solving (r = -0.209, P = 0.018) showed significant negative correlations with the tactile angle discrimination threshold. Multivariate linear regression analysis revealed that neurocognition impairment, especially the decline of working memory (B = -0.312, P < 0.001),underpin the tactile perception discrimination deficits in patients with SCZ. Conclusion: To the best of our knowledge, this is the first study to unravel the deficits of tactile passive perception acuity and its underlying neurocognition basis in patients with SCZ. This finding adds novel evidence to the subtle variation in haptic discrimination skills in schizophrenia which contributes to a more comprehensive understanding of the sensory profiles of this disorder.
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Affiliation(s)
- Dan Liu
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Hong Zhen Fan
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Wen Xuan Zhao
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Yun Hui Wang
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Dong Li
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Jing Long Wu
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Tian Yi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Shu Ping Tan
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
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Chien YL, Chao CC, Wu SW, Hsueh HW, Chiu YN, Tsai WC, Gau SSF, Hsieh ST. Small fiber pathology in autism and clinical implications. Neurology 2020; 95:e2697-e2706. [PMID: 33055277 DOI: 10.1212/wnl.0000000000010932] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 07/15/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To investigate small fiber innervation of the skin and its relationships with clinicometry of autism and peripheral afferents for contact heat-evoked potential (CHEP) and psychophysical measures of thermal thresholds. METHODS We recruited 32 men with autism (26.5 ± 5.9 years) and conducted small fiber assessments of skin biopsy with quantifying intraepidermal nerve fiber (IENF) density, CHEP, quantitative sensory testing, and large fiber physiology of nerve conduction studies. Results were compared with age-matched controls and analyzed with clinical measures of autism. RESULTS Patients with autism showed a lower IENF density than controls (5.53 ± 2.09 vs 11.13 ± 3.49 fibers/mm, p < 0.0001). The IENF density was reduced in 17 (53.1%) men with autism classified as skin denervation group. On psychophysics, 9 (28%) men with autism had elevated thermal thresholds, and the warm threshold of the big toe was negatively correlated with IENF density (p = 0.0073), indicating functional impairments of small fiber sensory nerves. IENF density was negatively correlated with CHEP amplitude in autism (p = 0.003), in contrast to the pattern of positive correlation in controls, indicating different processing of nociceptive afferent in autism. Clinically, IENF density was related to distinct tactile symptom patterns in the skin denervation vs normal innervation group, respectively. Furthermore, IENF density was associated with autistic symptoms measured by the Autism Spectrum Quotient in a U-shaped model (p = 0.014). CONCLUSIONS These observations indicated that a substantial portion of individuals with autism had small fiber pathology, which was associated with tactile and autistic symptoms, providing structural and physiologic evidence for the involvement of peripheral sensory nerves in autism.
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Affiliation(s)
- Yi-Ling Chien
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Chi-Chao Chao
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Shao-Wei Wu
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Hsueh-Wen Hsueh
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Yen-Nan Chiu
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Wen-Che Tsai
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Susan Shur-Fen Gau
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei
| | - Sung-Tsang Hsieh
- From the Departments of Psychiatry (Y.-L.C., Y.-N.C., W.-C.T., S.S.-F.G.) and Neurology (C.-C.C., S.-W.W., H.-W.H., S.-T.H.), College of Medicine, National Taiwan University Hospital; and Graduate Institute of Clinical Medicine (Y.-L.C., S.S.-F.G., S.-T.H.), Graduate Institute of Brain and Mind Sciences (S.S.-F.G., S.-T.H.), Department of Anatomy and Cell Biology (S.-T.H.), and Center of Precision Medicine (S.-T.H.), College of Medicine, National Taiwan University, Taipei.
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21
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Autism and Migraine: An Unexplored Association? Brain Sci 2020; 10:brainsci10090615. [PMID: 32899972 PMCID: PMC7565535 DOI: 10.3390/brainsci10090615] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
Autism spectrum disorder is characterized by neurological, psychiatric and medical comorbidities—some conditions co-occur so frequently that comorbidity in autism is the rule rather than the exception. The most common autism co-occurring conditions are intellectual disability, language disorders, attention-deficit hyperactivity disorder, epilepsy, gastrointestinal problems, sleep disorders, anxiety, depression, obsessive-compulsive disorder, psychotic disorders, oppositional defiant disorder, and eating disorders. They are well known and studied. Migraine is the most common brain disease in the world, but surprisingly only a few studies investigate the comorbidity between autism and migraine. The aim of this narrative review is to explore the literature reports about the comorbidity between autism and migraine and to investigate the common neurotransmitter, immune, anatomical and genetic abnormalities at the base of these two conditions.
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Keith JM, Jamieson JP, Bennetto L. The Importance of Adolescent Self-Report in Autism Spectrum Disorder: Integration of Questionnaire and Autonomic Measures. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:741-754. [PMID: 30073571 DOI: 10.1007/s10802-018-0455-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety and sensory symptoms are highly prevalent and meaningful in the daily lives of individuals with autism spectrum disorder (ASD). Despite the importance of carefully measuring, researching, and treating these symptoms, current methods in ASD seldom include self-report. This study investigated the consistency of adolescent and parent reports of anxiety and auditory sensitivity in individuals with ASD, and examined their validity via comparisons with sympathetic arousal at baseline and in response to an auditory challenge. Fifty adolescent-parent dyads (n = 26 ASD, n = 24 typically developing; 12-16 years old; IQ>80) completed parallel versions of both anxiety and auditory hypersensitivity scales, which were compared to heart rate collected at rest and during an aversive noise task. Adolescents with ASD exhibited greater anxiety and auditory hypersensitivity than their peers, based on both self and parent report. Across groups, self-report was higher than parent report. In individuals with ASD, a significant relationship was found between self-reported anxiety and autonomic arousal at rest, and between self-reported auditory sensitivity and autonomic reactivity during the noise task. These relationships were not significant for parent-report. These findings extend past work by demonstrating greater self-reported (than parent-reported) anxiety and sensory symptoms. Furthermore, the presence of significant correlations between self-reported symptoms and sympathetic arousal supports the validity of self-report in adolescents with ASD with average or above average cognitive abilities. This indicates that adolescents with ASD have a unique perspective on their internal experience, which can complement parent reports and provide a more comprehensive assessment of symptoms in research and clinical settings.
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Affiliation(s)
- Jessica M Keith
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, 14627, USA.
| | - Jeremy P Jamieson
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, 14627, USA
| | - Loisa Bennetto
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, 14627, USA
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Sensory Abnormality and Quantitative Autism Traits in Children With and Without Autism Spectrum Disorder in an Epidemiological Population. J Autism Dev Disord 2020; 50:180-188. [PMID: 31583623 PMCID: PMC6946727 DOI: 10.1007/s10803-019-04237-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Sensory abnormalities (SAs) are recognized features in Autism Spectrum Disorder (ASD), and a relationship between SAs and ASD traits is also suggested in general population. Our aims were to estimate the prevalence of SAs in three different settings, and to study the association between SAs and quantitative autism traits (QAT) using the Autism Spectrum Screening Questionnaire (ASSQ) and a parental questionnaire. In an epidemiological population of 8-year-old children (n = 4397), the prevalence of SAs was 8.3%, in an ASD sample (n = 28), 53.6%, and in a non-ASD sample (n = 4369), 8.0%, respectively. Tactile and auditory hypersensitivity predicted an ASD diagnosis. The ASSQ was able to differentiate children with and without SA. In conclusion, QAT level and SAs were associated in all study samples.
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Nagase K. The traits of autism spectrum disorder in the general population influence humor appreciation: Using the autism-spectrum quotient and HSPS-J19. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1696000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Kai Nagase
- Faculty of Social Welfare, Yamaguchi Prefectural University, Yamaguchi, Japan
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25
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Atypical Response to Caregiver Touch in Infants at High Risk for Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:2946-2955. [PMID: 31016672 DOI: 10.1007/s10803-019-04021-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Atypical response to tactile input is associated with greater socio-communicative impairments in individuals with autism spectrum disorder (ASD). The current study examined overt orienting to caregiver-initiated touch in 12-month-olds at high risk for ASD (HRA) with (HRA+) and without (HRA-) a later diagnosis of ASD compared to low-risk comparison infants. Findings indicate that infants that go on to receive a diagnosis of ASD may more frequently fail to shift their attention in response to caregiver touch and when they do, they may be more likely to orient away from touch. Additionally, failure to respond to touch predicts ADOS severity scores at outcome suggesting that atypical response to touch may be an early indicator of autism severity.
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Zetler NK, Cermak SA, Engel-Yeger B, Gal E. Somatosensory Discrimination in People With Autism Spectrum Disorder: A Scoping Review. Am J Occup Ther 2019; 73:7305205010p1-7305205010p14. [PMID: 31484025 DOI: 10.5014/ajot.2019.029728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Sensory symptoms in people with autism spectrum disorder (ASD) are commonly reported by researchers. However, an often overlooked sensory aspect of ASD is sensory discrimination in general, and somatosensory discrimination in particular. OBJECTIVE To examine what has and what has not yet been learned concerning the somatosensory discrimination abilities of people with ASD and to reveal gaps warranting further research. DESIGN Scoping review of clinical studies published 1995-2017 located through searches of PsycNET, PubMed, ERIC, and Google Scholar. Inclusion criteria were English-language peer-reviewed studies with (1) participants diagnosed with ASD, (2) a specific somatosensory discrimination measure, and (3) a comparison group. No age or intellectual exclusion criteria were established; studies were excluded if they were theoretical or descriptive, did not incorporate a control group, focused only on neurology or genetics, or used simple threshold detection measures or somatosensory measures integrated with other measures. The final search yielded 12 comparative articles discussing tactile and proprioceptive discrimination in people with ASD. RESULTS Overall, most results showed atypical somatosensory discrimination in people with ASD, especially among young children. The relationship between sensory discrimination abilities and other sensory symptoms and ASD symptoms is briefly discussed. CONCLUSIONS AND RELEVANCE Heterogeneous findings concerning somatosensory discrimination in people with ASD shed light on underlying mechanisms of these disorders and can contribute to improvement of occupational therapy intervention for this population. WHAT THIS ARTICLE ADDS The occupational therapy evaluation of people with ASD can benefit from addressing somatosensory discrimination and its contribution to other clinical symptoms. This type of assessment can help improve intervention strategies for people with ASD by promoting a focus on the effect of discrimination deficits on daily function.
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Affiliation(s)
- Neta Katz Zetler
- Neta Katz Zetler, MSc, is Occupational Therapist, Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel;
| | - Sharon A Cermak
- Sharon A. Cermak, EdD, is Professor and Occupational Therapist, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Batya Engel-Yeger
- Batya Engel-Yeger, PhD, is Professor and Occupational Therapist, Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Eynat Gal
- Eynat Gal, PhD, is Doctor and Occupational Therapist, Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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De Meo-Monteil R, Nordahl CW, Amaral DG, Rogers SJ, Harootonian SK, Martin J, Rivera SM, Saron CD. Differential Altered Auditory Event-Related Potential Responses in Young Boys on the Autism Spectrum With and Without Disproportionate Megalencephaly. Autism Res 2019; 12:1236-1250. [PMID: 31157516 PMCID: PMC7282708 DOI: 10.1002/aur.2137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 01/08/2023]
Abstract
Autism spectrum disorder (ASD), characterized by impairments in social communication and repetitive behaviors, often includes altered responses to sensory inputs as part of its phenotype. The neurobiological basis for altered sensory processing is not well understood. The UC Davis Medical Investigation of Neurodevelopmental Disorders Institute Autism Phenome Project is a longitudinal, multidisciplinary study of young children with ASD and age-matched typically developing (TD) controls. Previous analyses of the magnetic resonance imaging data from this cohort have shown that ∼15% of boys with ASD have disproportionate megalencephaly (DM) or brain size to height ratio, that is 1.5 standard deviations above the TD mean. Here, we investigated electrophysiological responses to auditory stimuli of increasing intensity (50-80 dB) in young toddlers (27-48 months old). Analyses included data from 36 age-matched boys, of which 24 were diagnosed with ASD (12 with and 12 without DM; ASD-DM and ASD-N) and 12 TD controls. We found that the two ASD subgroups differed in their electrophysiological response patterns to sounds of increasing intensity. At early latencies (55-115 ms), ASD-N does not show a loudness-dependent response like TD and ASD-DM, but tends to group intensities by soft vs. loud sounds, suggesting differences in sensory sensitivity in this group. At later latencies (145-195 ms), only the ASD-DM group shows significantly higher amplitudes for loud sounds. Because no similar effects were found in ASD-N and TD groups, this may be related to their altered neuroanatomy. These results contribute to the effort to delineate ASD subgroups and further characterize physiological responses associated with observable phenotypes. Autism Res 2019, 12: 1236-1250. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Approximately 15% of boys with ASD have much bigger brains when compared to individuals with typical development. By recording brain waves (electroencephalography) we compared how autistic children, with or without big brains, react to sounds compared to typically developing controls. We found that brain responses in the big-brained group are different from the two other groups, suggesting that they represent a specific autism subgroup.
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Affiliation(s)
| | - Christine Wu Nordahl
- UC Davis Health MIND Institute, Medical Center, Sacramento, California
- UC Davis Department of Psychiatry and Behavioral Sciences, School of Medicine, Sacramento, California
| | - David G Amaral
- UC Davis Health MIND Institute, Medical Center, Sacramento, California
- UC Davis Department of Psychiatry and Behavioral Sciences, School of Medicine, Sacramento, California
| | - Sally J Rogers
- UC Davis Health MIND Institute, Medical Center, Sacramento, California
- UC Davis Department of Psychiatry and Behavioral Sciences, School of Medicine, Sacramento, California
| | | | - Joshua Martin
- UC Davis Center for Mind and Brain, Davis, California
| | - Susan M Rivera
- UC Davis Center for Mind and Brain, Davis, California
- UC Davis Health MIND Institute, Medical Center, Sacramento, California
- UC Davis Department of Psychology, Davis, California
| | - Clifford D Saron
- UC Davis Center for Mind and Brain, Davis, California
- UC Davis Health MIND Institute, Medical Center, Sacramento, California
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Roestorf A, Bowler D, Deserno M, Howlin P, Klinger L, McConachie H, Parr J, Powell P, Van Heijst B, Geurts H. "Older Adults with ASD: The Consequences of Aging." Insights from a series of special interest group meetings held at the International Society for Autism Research 2016-2017. RESEARCH IN AUTISM SPECTRUM DISORDERS 2019; 63:3-12. [PMID: 31275429 PMCID: PMC6559228 DOI: 10.1016/j.rasd.2018.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/18/2018] [Accepted: 08/25/2018] [Indexed: 05/21/2023]
Abstract
A special interest group (SIG) entitled "Older Adults with ASD: The Consequences of Aging" was held at the International Society for Autism Research (INSAR) annual meetings in 2016 and 2017. The SIG and subsequent meetings brought together, for the first time, international delegates who were members of the autistic community, researchers, practitioners and service providers. Based on aging autism research that is already underway in UK, Europe, Australia and North America, discussions focussed on conceptualising the parameters of aging when referring to autism, and the measures that are appropriate to use with older adults when considering diagnostic assessment, cognitive factors and quality of life in older age. Thus, the aim of this SIG was to progress the research agenda on current and future directions for autism research in the context of aging. A global issue on how to define 'aging' when referring to ASD was at the forefront of discussions. The 'aging' concept can in principle refer to all developmental transitions. However, in this paper we focus on the cognitive and physical changes that take place from mid-life onwards. Accordingly, it was agreed that aging and ASD research should focus on adults over the age of 50 years, given the high rates of co-occurring physical and mental health concerns and increased risk of premature death in some individuals. Moreover, very little is known about the cognitive change, care needs and outcomes of autistic adults beyond this age. Discussions on the topics of diagnostic and cognitive assessments, and of quality of life and well-being were explored through shared knowledge about which measures are currently being used and which background questions should be asked to obtain comprehensive and informative developmental and medical histories. Accordingly, a survey was completed by SIG delegates who were representatives of international research groups across four continents, and who are currently conducting studies with older autistic adults. Considerable overlap was identified across different research groups in measures of both autism and quality of life, which pointed to combining data and shared learnings as the logical next step. Regarding the background questions that were asked, the different research groups covered similar topics but the groups differed in the way these questions were formulated when working with autistic adults across a range of cognitive abilities. It became clear that continued input from individuals on the autism spectrum is important to ensure that questionnaires used in ongoing and future are accessible and understandable for people across the whole autistic spectrum, including those with limited verbal abilities.
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Affiliation(s)
- A. Roestorf
- The Ageing with Autism Project, Autism Research Group, Department of Psychology, City, University of London, United Kingdom
| | - D.M. Bowler
- The Ageing with Autism Project, Autism Research Group, Department of Psychology, City, University of London, United Kingdom
| | - M.K. Deserno
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| | - P. Howlin
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Brain and Mind Centre, The University of Sydney, Australia
| | - L. Klinger
- University of North Carolina at Chapel Hill, TEACCH Autism Program, Department of Psychiatry, USA
| | - H. McConachie
- Institute of Health and Society, Newcastle University, United Kingdom
| | - J.R. Parr
- Institute of Neuroscience, Newcastle University, United Kingdom
| | - P. Powell
- Georgia Institute of Technology, School of Psychology, Atlanta, GA, USA
| | - B.F.C. Van Heijst
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| | - H.M. Geurts
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
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Abstract
Pain is a universal, multidimensional experience with sensory, emotional, cognitive, and social components, which is fundamental to our environmental learning when functioning typically. Understanding pain processing in psychiatric conditions could provide unique insight into the underlying pathophysiology or psychiatric disease, especially given the psychobiological overlap with pain processing pathways. Studying pain in psychiatric conditions is likely to provide important insights, yet, there is a limited understanding beyond the work in depression and anxiety. This is a missed opportunity to describe psychiatric conditions in terms of neurobiological alterations. To examine the research into the pain experiences of these groups and the extent to which a-typicality is present, a systematic review was conducted. An electronic search strategy was developed and conducted in several databases. The current systematic review included 46 studies covering five Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) disorders: autism, attention-deficit hyperactivity disorder (ADHD), schizophrenia, personality disorder, and eating disorders, confirming tentative evidence of altered pain and touch processing. Specifically, hyposensitivity is reported in schizophrenia, personality disorder and eating disorder, hypersensitivity in ADHD, and mixed results for autism. Review of the research highlights a degree of methodological inconsistency in the utilization of comprehensive protocols, the lack of which fails to allow us to understand whether a-typicality is systemic or modality specific.
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30
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Fu Z, Tu Y, Di X, Du Y, Sui J, Biswal BB, Zhang Z, de Lacy N, Calhoun VD. Transient increased thalamic-sensory connectivity and decreased whole-brain dynamism in autism. Neuroimage 2019; 190:191-204. [PMID: 29883735 PMCID: PMC6281849 DOI: 10.1016/j.neuroimage.2018.06.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 05/31/2018] [Accepted: 06/03/2018] [Indexed: 11/19/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with social communication deficits and restricted/repetitive behaviors and is characterized by large-scale atypical subcortical-cortical connectivity, including impaired resting-state functional connectivity between thalamic and sensory regions. Previous studies have typically focused on the abnormal static connectivity in ASD and overlooked potential valuable dynamic patterns in brain connectivity. However, resting-state brain connectivity is indeed highly dynamic, and abnormalities in dynamic brain connectivity have been widely identified in psychiatric disorders. In this study, we investigated the dynamic functional network connectivity (dFNC) between 51 intrinsic connectivity networks in 170 individuals with ASD and 195 age-matched typically developing (TD) controls using independent component analysis and a sliding window approach. A hard clustering state analysis and a fuzzy meta-state analysis were conducted respectively, for the exploration of local and global aberrant dynamic connectivity patterns in ASD. We examined the group difference in dFNC between thalamic and sensory networks in each functional state and group differences in four high-dimensional dynamic measures. The results showed that compared with TD controls, individuals with ASD show an increase in transient connectivity between hypothalamus/subthalamus and some sensory networks (right postcentral gyrus, bi paracentral lobule, and lingual gyrus) in certain functional states, and diminished global meta-state dynamics of the whole-brain functional network. In addition, these atypical dynamic patterns are significantly associated with autistic symptoms indexed by the Autism Diagnostic Observation Schedule. These converging results support and extend previous observations regarding hyperconnectivity between thalamic and sensory regions and stable whole-brain functional configuration in ASD. Dynamic brain connectivity may serve as a potential biomarker of ASD and further investigation of these dynamic patterns might help to advance our understanding of behavioral differences in this complex neurodevelopmental disorder.
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Affiliation(s)
- Zening Fu
- The Mind Research Network, Albuquerque, NM, USA; School of Biomedical Engineering, Shenzhen University, Shenzhen, China.
| | - Yiheng Tu
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; School of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Yuhui Du
- The Mind Research Network, Albuquerque, NM, USA; School of Computer & Information Technology, Shanxi University, Taiyuan, China
| | - Jing Sui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Zhiguo Zhang
- School of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - N de Lacy
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - V D Calhoun
- The Mind Research Network, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
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31
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Abstract
Ward (this issue) proposes four (non-mutually-exclusive) theories for how sensory sensitivity, as commonly seen in autism and other neurodevelopmental disorders, may be linked to atypical neural responses to sensory stimuli. As presently laid out, these theories do not fully account for the complexity and heterogeneity of neural responses to sensory information seen in autism. We describe the important role of attention and regulation in atypical neural and behavioral responses to sensory stimuli, and how these higher-order functions might fit into some of the proposed theories.
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Affiliation(s)
- Shulamite A Green
- a Jane and Terry Semel Institute for Neuroscience & Human Behavior , University of California , Los Angeles.,b Psychiatry and Biobehavioral Sciences , University of California , Los Angeles
| | - Emily T Wood
- a Jane and Terry Semel Institute for Neuroscience & Human Behavior , University of California , Los Angeles.,b Psychiatry and Biobehavioral Sciences , University of California , Los Angeles
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32
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Urbano MR, Teal Raffaele C, Kreiser NL, Flaherty JM, Hartmann K. Clinical considerations for the inclusion of individuals with autism spectrum disorder in clinical trials. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:295-302. [PMID: 30290207 DOI: 10.1016/j.pnpbp.2018.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 10/28/2022]
Abstract
Diagnoses of autism spectrum disorder (ASD) have increased considerably over the past 20 years. Because of this rise and the inherent complexity of ASD, there is a need for an increased number of scientifically valid basic and clinical research studies addressing this disorder. This manuscript serves as an introduction to the clinical presentation of ASD as well as the unique challenges and modifications required to conduct clinical research with this population. This includes detailing the current diagnostic criteria, process of receiving an ASD diagnosis, information on assessment measures, and special considerations when developing research. It is the hope that this information will provide researchers interested in conducting clinical trials with those with ASD with baseline information and considerations when developing their research topics and methodology.
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Affiliation(s)
- Maria R Urbano
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States.
| | - C Teal Raffaele
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Nicole L Kreiser
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Jennifer M Flaherty
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Kathrin Hartmann
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
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33
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Tavassoli T, Brandes-Aitken A, Chu R, Porter L, Schoen S, Miller LJ, Gerdes MR, Owen J, Mukherjee P, Marco EJ. Sensory over-responsivity: parent report, direct assessment measures, and neural architecture. Mol Autism 2019; 10:4. [PMID: 30740199 PMCID: PMC6360663 DOI: 10.1186/s13229-019-0255-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
Background Sensory processing difficulties are common across neurodevelopmental disorders. Thus, reliable measures are needed to understand the biological underpinnings of these differences. This study aimed to define a scoring methodology specific to auditory (AOR) and tactile (TOR) over-responsivity. Second, in a pilot cohort using MRI Diffusion Tensor Imaging, we performed a proof of concept study of whether children with AOR showed measurable differences in their white matter integrity. Methods This study included children with AOR and TOR from a mixed neurodevelopmental disorder cohort including autism and sensory processing dysfunction (n = 176) as well as neurotypical children (n = 128). We established cohorts based on sensory over-responsivity using parent report (Short Sensory Profile (SSP)) and direct assessment (Sensory Processing-Three Dimensions: Assessment (SP-3D:A)) measures. With a subset of the children (n = 39), group comparisons, based on AOR phenotype, were conducted comparing the white matter fractional anisotropy in 23 regions of interest. Results Using direct assessment, 31% of the children with neurodevelopmental disorders had AOR and 27% had TOR. The inter-test agreement between SSP and SP-3D:A for AOR was 65% and TOR was 50%. Children with AOR had three white matter tracts showing decreased fractional anisotropy relative to children without AOR. Conclusions This study identified cut-off scores for AOR and TOR using the SSP parent report and SP-3D:A observation. A combination of questionnaire and direct observation measures should be used in clinical and research settings. The SSP parent report and SP-3D:A direct observation ratings overlapped moderately for sensory related behaviors. Based on these preliminary structural neuroimaging results, we suggest a putative neural network may contribute to AOR.
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Affiliation(s)
- Teresa Tavassoli
- 1Department of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Robyn Chu
- Sensory Therapies and Research (STAR) Institute, Greenwood Village, CO USA
| | - Lisa Porter
- Sensory Therapies and Research (STAR) Institute, Greenwood Village, CO USA
| | - Sarah Schoen
- Sensory Therapies and Research (STAR) Institute, Greenwood Village, CO USA.,Rocky Mountain University of Health Professionals, Provo, UT USA
| | - Lucy Jane Miller
- Sensory Therapies and Research (STAR) Institute, Greenwood Village, CO USA.,4University of Colorado Denver, Denver, CO USA.,Rocky Mountain University of Health Professionals, Provo, UT USA
| | - Molly Rae Gerdes
- 6Department of Neurology, University of California San Francisco, San Francisco, CA USA
| | - Julia Owen
- 7Department of Radiology, University of Washington, Seattle, WA USA
| | - Pratik Mukherjee
- 8Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Elysa J Marco
- 6Department of Neurology, University of California San Francisco, San Francisco, CA USA.,9Department of Pediatrics, University of California San Francisco, San Francisco, CA USA.,Research Division, Cortica Healthcare, San Rafael, CA USA
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DeSerisy M, Hirsch E, Roy AK. The Contribution of Sensory Sensitivity to Emotional Lability in Children with ADHD Symptoms. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2019; 4:319-327. [PMID: 33033744 DOI: 10.1080/23794925.2019.1647122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Emotional lability and sensory sensitivity have been shown to contribute to the overall clinical picture in children with attention deficit hyperactivity disorder (ADHD; Dunn & Bennett, 2002; Sobanski et al., 2010). Further, both of these characteristics have been individually demonstrated to contribute to poorer quality of life, increased functional impairment, and poorer treatment response (Anastopoulos et al., 2010; Boterberg & Warreyn, 2016). However, to date, no study has evaluated the relationship among all three of these factors. The current study hypothesized that increased sensory sensitivity would moderate the relationship between hyperactive/impulsive symptoms of ADHD and emotional lability in youth. Results indicate that heightened sensory sensitivity strengthens the relationship between hyperactive/impulsive symptoms of ADHD and emotional lability in children with three or more clinically impairing ADHD symptoms. This dimensional approach was taken in accordance with growing evidence that even children with sub-threshold ADHD experience significant functional impairment and high rates of sensory sensitivity (Hong et al., 2014). These findings suggest that clinicians treating children with ADHD symptoms and emotional lability should consider assessing for sensory sensitivity as integration of multi-sensory techniques or referral to concurrent occupational therapy may significantly improve treatment outcomes and quality of life for these children and their families.
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Affiliation(s)
- Mariah DeSerisy
- Department of Psychology, Fordham University, Bronx, N.Y., USA
| | - Emily Hirsch
- Department of Psychology, Fordham University, Bronx, N.Y., USA
| | - Amy Krain Roy
- Department of Psychology, Fordham University, Bronx, N.Y., USA.,Department of Child and Adolescent Psychiatry, NYU Langone School of Medicine, New York, N.Y., USA
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35
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Garcia-Villamisar D, Moore D, Garcia-Martínez M. Internalizing Symptoms Mediate the Relation Between Acute Pain and Autism in Adults. J Autism Dev Disord 2018; 49:270-278. [PMID: 30264376 DOI: 10.1007/s10803-018-3765-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research on pain in autism spectrum disorder (ASD) is in its infancy, with almost nothing known about how individual differences may predicting pain response in ASD. In the present study, 45 adults (28 male, age 22-48 years) with diagnoses of autism and intellectual delay were observed during vaccination or dental cleaning and their pain behaviours coded and measures of autism symptom severity, anxiety, depression and obsessivity taken. Our findings showed that greater autism severity predicted greater pain response which was partially mediated by anxiety and depression. These data suggest that mental health symptoms are important when considering pain response in autism. Mood must therefore be considered in future research on pain in ASD as well as clinical pain management.
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Affiliation(s)
- D Garcia-Villamisar
- Unit of Psychopathology, Department of Personality and Clinical Psychology, Complutense University of Madrid, Madrid, Spain.
- Asociación Nuevo Horizonte, 28231, Las Rozas, Madrid, Spain.
| | - D Moore
- Psychology Department, School of Natural Science and Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, UK
| | - M Garcia-Martínez
- Unit of Psychopathology, Department of Personality and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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36
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Kuiper MWM, Verhoeven EWM, Geurts HM. The Dutch Glasgow Sensory Questionnaire: Psychometric properties of an autism-specific sensory sensitivity measure. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:922-932. [DOI: 10.1177/1362361318788065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sensory sensitivity is common in autistic people and since the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), hypo- and hyper-responsiveness to sensory stimuli are part of one of the criteria domains for an autism spectrum disorder classification. For scientific research and the clinical practice, one needs reliable and valid questionnaires that measure sensory sensitivity and can distinguish between hypo- and hyper-responsiveness. We translated the Glasgow Sensory Questionnaire into Dutch. The aim was to examine the psychometric properties and the clinical use of the Dutch Glasgow Sensory Questionnaire in 78 autistic and 68 typically developing adults (18–45 years; IQ > 70). Just like the original Glasgow Sensory Questionnaire, the Dutch Glasgow Sensory Questionnaire is a reliable and valid questionnaire. The Dutch Glasgow Sensory Questionnaire had reliable hypo- and hyper-responsiveness subscales, reasonable to good modality subscales and was stable over time. Moreover, using the 95th percentile of the typically developing group as cut-off, we showed that two thirds of the autistic adults had heightened sensory sensitivity. We also showed that hypo- and hyper-responsiveness do co-exist in both autistic and typically developing adults. In sum, we conclude that the Dutch Glasgow Sensory Questionnaire is suitable to be used in scientific research as well as in the clinical practice.
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Affiliation(s)
- Marieke WM Kuiper
- Dr. Leo Kannerhuis, The Netherlands
- University van Amsterdam, The Netherlands
| | | | - Hilde M Geurts
- Dr. Leo Kannerhuis, The Netherlands
- University van Amsterdam, The Netherlands
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37
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Abstract
Autism spectrum disorder (ASD) characteristics seem to abate over time, but whether this protracts until late adulthood is largely unknown. We cross-sectionally investigated self- and other-reported ASD characteristics of adults with (ASD: Nmax-self = 237, Nmax-other = 130) and without ASD (COM: Nmax-self = 198, Nmax-other = 148) aged 19-79 years. Within the ASD group, self-reported ASD characteristics, and sensory sensitivities were highest in middle adulthood, while age was not associated to empathy. Sex differences were also found. However, age-and sex-related differences were not revealed by others and self- and other-report were poorly concordant. These results show that ASD characteristics in adulthood are differently perceived across age, sex, and informants and suggest that it is important to repeatedly assess self-reported ASD characteristics during adulthood.
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Affiliation(s)
- Anne G Lever
- Department of Psychology, Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS, Amsterdam, The Netherlands
- Department of Psychiatry, VU Medical Center, Amsterdam, The Netherlands
- Dimence, Deventer, The Netherlands
| | - Hilde M Geurts
- Department of Psychology, Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS, Amsterdam, The Netherlands.
- Dr. Leo Kannerhuis, Research Development & Innovation, Doorwerth, The Netherlands.
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38
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Mayer JL. The Relationship Between Autistic Traits and Atypical Sensory Functioning in Neurotypical and ASD Adults: A Spectrum Approach. J Autism Dev Disord 2017; 47:316-327. [PMID: 27848052 DOI: 10.1007/s10803-016-2948-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Sensory processing atypicalities are a common feature in Autism Spectrum Disorders (ASD) and have previously been linked to a range of behaviours in individuals with ASD and atypical neurological development. More recently research has demonstrated a relationship between autistic traits in the neurotypical (NT) population and increased levels of atypical sensory behaviours. The aim of the present study is to extend previous research by examining specific patterns across aspects of autistic traits and sensory behaviours within both ASD and NT populations. The present study recruited 580 NT adults and 42 high-functioning ASD adults with a confirmed diagnosis to investigate the relationship between specific aspects of autistic traits and sensory processing using the subscales of the autism spectrum quotient (AQ) and adult/adolescent sensory profile (AASP). Results showed a significant relationship between all subscales except for attention to detail and imagination on the AQ and provided the first evidence that the strength and pattern of this relationship is identical between NT and ASD adults. These data also provided support for the broader autism phenotype, uncovering a clear progression of sensory atypicalities in line with an increase in autistic traits, regardless of diagnostic status, which has potential implications for the spectrum approach to ASD and how sensory behaviours across the whole of the neurotypical population are conceptualised.
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Affiliation(s)
- Jennifer L Mayer
- Department of Psychology, Whitelands College, University of Roehampton, Holyborne Avenue, London, SW15 4JD, UK.
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39
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DuBois D, Lymer E, Gibson BE, Desarkar P, Nalder E. Assessing Sensory Processing Dysfunction in Adults and Adolescents with Autism Spectrum Disorder: A Scoping Review. Brain Sci 2017; 7:brainsci7080108. [PMID: 28825635 PMCID: PMC5575628 DOI: 10.3390/brainsci7080108] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/04/2017] [Accepted: 08/14/2017] [Indexed: 12/11/2022] Open
Abstract
Sensory reactivity is a diagnostic criterion for Autism Spectrum Disorder (ASD), and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. Yet, there is little consensus on best practice approaches to assessing sensory processing dysfunction in adolescents and adults with ASD. Despite growing evidence that sensory symptoms persist into adolescence and adulthood, there is a lack of norms for older age groups, and pediatric assessments may not target appropriate functional outcomes or environments. This review identified approaches used to measure sensory processing in the scientific literature, and to describe and compare these approaches to current best practice guidelines that can be incorporated into evidence-based practice. Method and Analysis: A search of scientific databases and grey literature (professional association and ASD society websites), from January 1987–May 2017, uncovered 4769 articles and 12 clinical guidelines. Study and sample characteristics were extracted, charted, and categorized according to assessment approach. Results: There were 66 articles included after article screening. Five categories of assessment approaches were identified: Self- and Proxy-Report Questionnaires, Psychophysical Assessment, Direct Behavioral Observation, Qualitative Interview Techniques, and Neuroimaging/EEG. Sensory research to date has focused on individuals with high-functioning ASD, most commonly through the use of self-report questionnaires. The Adolescent and Adult Sensory Profile (AASP) is the most widely used assessment measure (n = 22), however, a number of other assessment approaches may demonstrate strengths specific to the ASD population. Multi-method approaches to assessment (e.g., combining psychophysical or observation with questionnaires) may have clinical applicability to interdisciplinary clinical teams serving adolescents and adults with ASD. Contribution: A comprehensive knowledge of approaches is critical in the clinical assessment of a population characterized by symptomatic heterogeneity and wide-ranging cognitive profiles. This review should inform future development of international interdisciplinary clinical guidelines on sensory processing assessment in ASD across the lifespan.
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Affiliation(s)
- Denise DuBois
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada.
- Adult Neurodevelopmental Service, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada.
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada.
| | - Erin Lymer
- Adult Neurodevelopmental Service, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada.
| | - Barbara E Gibson
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada.
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada.
| | - Pushpal Desarkar
- Adult Neurodevelopmental Service, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada.
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health; Toronto, ON M6J 1H4, Canada.
| | - Emily Nalder
- Adult Neurodevelopmental Service, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada.
- March of Dimes Canada, Toronto, ON M4H 1A4, Canada.
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40
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Sartorato F, Przybylowski L, Sarko DK. Improving therapeutic outcomes in autism spectrum disorders: Enhancing social communication and sensory processing through the use of interactive robots. J Psychiatr Res 2017; 90:1-11. [PMID: 28213292 DOI: 10.1016/j.jpsychires.2017.02.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/03/2017] [Indexed: 11/20/2022]
Abstract
For children with autism spectrum disorders (ASDs), social robots are increasingly utilized as therapeutic tools in order to enhance social skills and communication. Robots have been shown to generate a number of social and behavioral benefits in children with ASD including heightened engagement, increased attention, and decreased social anxiety. Although social robots appear to be effective social reinforcement tools in assistive therapies, the perceptual mechanism underlying these benefits remains unknown. To date, social robot studies have primarily relied on expertise in fields such as engineering and clinical psychology, with measures of social robot efficacy principally limited to qualitative observational assessments of children's interactions with robots. In this review, we examine a range of socially interactive robots that currently have the most widespread use as well as the utility of these robots and their therapeutic effects. In addition, given that social interactions rely on audiovisual communication, we discuss how enhanced sensory processing and integration of robotic social cues may underlie the perceptual and behavioral benefits that social robots confer. Although overall multisensory processing (including audiovisual integration) is impaired in individuals with ASD, social robot interactions may provide therapeutic benefits by allowing audiovisual social cues to be experienced through a simplified version of a human interaction. By applying systems neuroscience tools to identify, analyze, and extend the multisensory perceptual substrates that may underlie the therapeutic benefits of social robots, future studies have the potential to strengthen the clinical utility of social robots for individuals with ASD.
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Affiliation(s)
- Felippe Sartorato
- Osteopathic Medical Student (OMS-IV), Edward Via College of Osteopathic Medicine (VCOM), Spartanburg, SC, USA
| | - Leon Przybylowski
- Osteopathic Medical Student (OMS-IV), Edward Via College of Osteopathic Medicine (VCOM), Spartanburg, SC, USA
| | - Diana K Sarko
- Department of Anatomy, Southern Illinois University School of Medicine, Carbondale, IL, USA; Department of Psychology, Southern Illinois University School of Medicine, Carbondale, IL, USA.
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41
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Burns CO, Dixon DR, Novack M, Granpeesheh D. A Systematic Review of Assessments for Sensory Processing Abnormalities in Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0109-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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42
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Attenuated contact heat-evoked potentials associated with sensory and social-emotional symptoms in individuals with autism spectrum disorder. Sci Rep 2017; 7:36887. [PMID: 28139664 PMCID: PMC5282530 DOI: 10.1038/srep36887] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/26/2016] [Indexed: 02/06/2023] Open
Abstract
Sensory disturbance is associated with socio-emotional problems in individuals with autism spectrum disorder (ASD). Most studies assess sensory symptoms by self-reports, which are largely limited by the language ability and self-awareness of the individuals. This study aims to investigate sensory disturbance by contact heat-evoked potentials (CHEP) in ASD individuals, and to examine the clinical correlates of CHEP parameters. We compared the CHEP parameters and reported pain between 31 ASD individuals (aged 20.5 ± 5.2 years) and and 22 typically-developing controls (TD, aged 21.4 ± 2.6), and correlated the CHEP parameters with self-reported sensory symptoms and attention/socio-emotional symptoms. We found that ASD individuals showed smaller P2-wave amplitudes than TD, even though they reported a similar level of pain. In TD individuals, a smaller P2-wave amplitude was related to higher scores on ‘low registration,’ ‘attention to detail,’ and ‘attention switching difficulties.’ In ASD individuals, longer N2-wave latency was related to higher scores on ‘sensory sensitivity’ and socio-emotional problems; while higher reported pain was associated with higher scores on ‘low registration,’ overall autistic severity, and longer N2-wave latency. Our findings of attenuated CHEP response in ASD, which was associated with sensory symptoms and socio-emotional problems, suggest a potential role for CHEP in studying sensory disturbances in ASD.
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43
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Chmielewski WX, Wolff N, Mückschel M, Roessner V, Beste C. Effects of multisensory integration processes on response inhibition in adolescent autism spectrum disorder. Psychol Med 2016; 46:2705-2716. [PMID: 27425148 DOI: 10.1017/s0033291716001008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In everyday life it is often required to integrate multisensory input to successfully conduct response inhibition (RI) and thus major executive control processes. Both RI and multisensory processes have been suggested to be altered in autism spectrum disorder (ASD). It is, however, unclear which neurophysiological processes relate to changes in RI in ASD and in how far these processes are affected by possible multisensory integration deficits in ASD. METHOD Combining high-density EEG recordings with source localization analyses, we examined a group of adolescent ASD patients (n = 20) and healthy controls (n = 20) using a novel RI task. RESULTS Compared to controls, RI processes are generally compromised in adolescent ASD. This aggravation of RI processes is modulated by the content of multisensory information. The neurophysiological data suggest that deficits in ASD emerge in attentional selection and resource allocation processes related to occipito-parietal and middle frontal regions. Most importantly, conflict monitoring subprocesses during RI were specifically modulated by content of multisensory information in the superior frontal gyrus. CONCLUSIONS RI processes are overstrained in adolescent ASD, especially when conflicting multisensory information has to be integrated to perform RI. It seems that the content of multisensory input is important to consider in ASD and its effects on cognitive control processes.
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Affiliation(s)
- W X Chmielewski
- Cognitive Neurophysiology,Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Germany
| | - N Wolff
- Cognitive Neurophysiology,Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Germany
| | - M Mückschel
- Cognitive Neurophysiology,Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Germany
| | - V Roessner
- Cognitive Neurophysiology,Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Germany
| | - C Beste
- Cognitive Neurophysiology,Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Germany
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44
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In the Eye of the Beholder: Rapid Visual Perception of Real-Life Scenes by Young Adults with and Without ASD. J Autism Dev Disord 2016; 46:2635-2652. [DOI: 10.1007/s10803-016-2802-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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45
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Parental-reported pain insensitivity in Dup15q. Epilepsy Behav 2016; 55:124-7. [PMID: 26773682 DOI: 10.1016/j.yebeh.2015.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/06/2015] [Accepted: 10/08/2015] [Indexed: 11/23/2022]
Abstract
Parents of children with chromosome 15q duplication syndrome (Dup15q) have anecdotally reported high pain threshold as a feature of the disorder. The purpose of this study was to document parental-reported estimates of the frequency of high pain tolerance and the stimuli that fail to evoke a normal pain response. We sent an online survey to 840 families with children with Dup15q to explore the frequency and clinical manifestations of high pain threshold. There were 216 respondents (25.7%). A high pain threshold was reported in 87% of children at some time. There was a trend (p=0.06) for high pain threshold to be more commonly observed among children with the isodicentric (85.6%) and other genetic variants (95%) than interstitial (69.6%) duplications. There was no association between reports of high pain threshold and reports of an intellectual disability (91% of cases), autism spectrum disorder (83% of cases), or self-injurious behavior (40% of cases). Reports included many dramatic cases such as severe burns, broken bones, and electrical traumas, which were associated with little or no evidence of a painful stimulus. A high pain threshold is reported in other disorders associated with intellectual disability and autism; the underlying mechanism in Dup15q and other disorders remains undefined.
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46
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Baum SH, Stevenson RA, Wallace MT. Behavioral, perceptual, and neural alterations in sensory and multisensory function in autism spectrum disorder. Prog Neurobiol 2015; 134:140-60. [PMID: 26455789 PMCID: PMC4730891 DOI: 10.1016/j.pneurobio.2015.09.007] [Citation(s) in RCA: 231] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/21/2015] [Accepted: 09/05/2015] [Indexed: 01/24/2023]
Abstract
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.
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Affiliation(s)
- Sarah H Baum
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Ryan A Stevenson
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Mark T Wallace
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA; Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA; Department of Psychology, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA.
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47
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Stevenson RA, Segers M, Ferber S, Barense MD, Camarata S, Wallace MT. Keeping time in the brain: Autism spectrum disorder and audiovisual temporal processing. Autism Res 2015; 9:720-38. [PMID: 26402725 DOI: 10.1002/aur.1566] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/22/2015] [Accepted: 08/29/2015] [Indexed: 12/21/2022]
Abstract
A growing area of interest and relevance in the study of autism spectrum disorder (ASD) focuses on the relationship between multisensory temporal function and the behavioral, perceptual, and cognitive impairments observed in ASD. Atypical sensory processing is becoming increasingly recognized as a core component of autism, with evidence of atypical processing across a number of sensory modalities. These deviations from typical processing underscore the value of interpreting ASD within a multisensory framework. Furthermore, converging evidence illustrates that these differences in audiovisual processing may be specifically related to temporal processing. This review seeks to bridge the connection between temporal processing and audiovisual perception, and to elaborate on emerging data showing differences in audiovisual temporal function in autism. We also discuss the consequence of such changes, the specific impact on the processing of different classes of audiovisual stimuli (e.g. speech vs. nonspeech, etc.), and the presumptive brain processes and networks underlying audiovisual temporal integration. Finally, possible downstream behavioral implications, and possible remediation strategies are outlined. Autism Res 2016, 9: 720-738. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Ryan A Stevenson
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Magali Segers
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Susanne Ferber
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Rotman Research Institute, Toronto, Ontario, Canada
| | - Morgan D Barense
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Rotman Research Institute, Toronto, Ontario, Canada
| | - Stephen Camarata
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark T Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee.,Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychology, Vanderbilt University, Nashville, Tennessee.,Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee
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48
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Green RR, Bigler ED, Froehlich A, Prigge MBD, Travers BG, Cariello AN, Anderson JS, Zielinski BA, Alexander A, Lange N, Lainhart JE. Beery VMI performance in autism spectrum disorder. Child Neuropsychol 2015; 22:795-817. [PMID: 26292997 DOI: 10.1080/09297049.2015.1056131] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Few studies have examined the visuomotor integration (VMI) abilities of individuals with autism spectrum disorder (ASD). An all-male sample consisting of 56 ASD participants (ages 3-23 years) and 36 typically developing (TD) participants (ages 4-26 years) completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) as part of a larger neuropsychological battery. Participants were also administered standardized measures of intellectual functioning and the Social Responsiveness Scale (SRS), which assesses autism and autism-like traits. The ASD group performed significantly lower on the Beery VMI and on all IQ measures compared to the TD group. VMI performance was significantly correlated with full scale IQ (FSIQ), performance IQ (PIQ), and verbal IQ (VIQ) in the TD group only. However, when FSIQ was taken into account, no significant Beery VMI differences between groups were observed. Only one TD participant scored 1.5 standard deviations (SDs) below the Beery VMI normative sample mean, in comparison to 21% of the ASD sample. As expected, the ASD group was rated as having significantly higher levels of social impairment on the SRS compared to the TD group across all major domains. However, level of functioning on the SRS was not associated with Berry VMI performance. These findings demonstrate that a substantial number of individuals with ASD experience difficulties compared to TD in performing VMI-related tasks, and that VMI is likely affected by general cognitive ability. The fact that lowered Beery VMI performance occurred only within a subset of individuals with ASD and did not correlate with SRS would indicate that visuomotor deficits are not a core feature of ASD, even though they present at a higher rate of impairment than observed in TD participants.
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Affiliation(s)
- Ryan R Green
- a Department of Psychology , Brigham Young University , Provo , UT , USA
| | - Erin D Bigler
- a Department of Psychology , Brigham Young University , Provo , UT , USA.,b Neuroscience Center , Brigham Young University , Provo , UT , USA.,c Department of Psychiatry , University of Utah , Salt Lake City , UT , USA
| | - Alyson Froehlich
- c Department of Psychiatry , University of Utah , Salt Lake City , UT , USA
| | - Molly B D Prigge
- c Department of Psychiatry , University of Utah , Salt Lake City , UT , USA
| | - Brittany G Travers
- d Waisman Laboratory for Brain Imaging and Behavior , University of Wisconsin , Madison , WI , USA
| | - Annahir N Cariello
- c Department of Psychiatry , University of Utah , Salt Lake City , UT , USA
| | - Jeffrey S Anderson
- e Department of Radiology , University of Utah , Salt Lake City , UT , USA
| | - Brandon A Zielinski
- f Department of Pediatrics and Neurology, School of Medicine , University of Utah , Salt Lake City , UT , USA
| | - Andrew Alexander
- d Waisman Laboratory for Brain Imaging and Behavior , University of Wisconsin , Madison , WI , USA.,g Department of Medical Physics , University of Wisconsin , Madison , WI , USA.,h Department of Psychiatry , University of Wisconsin , Madison , WI , USA
| | - Nicholas Lange
- i Departments of Psychiatry and Biostatistics , Harvard University , Boston , MA , USA.,j Neurostatistics Laboratory , McLean Hospital , Belmont , MA , USA
| | - Janet E Lainhart
- d Waisman Laboratory for Brain Imaging and Behavior , University of Wisconsin , Madison , WI , USA.,h Department of Psychiatry , University of Wisconsin , Madison , WI , USA
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Cerliani L, Mennes M, Thomas RM, Di Martino A, Thioux M, Keysers C. Increased Functional Connectivity Between Subcortical and Cortical Resting-State Networks in Autism Spectrum Disorder. JAMA Psychiatry 2015; 72:767-77. [PMID: 26061743 PMCID: PMC5008437 DOI: 10.1001/jamapsychiatry.2015.0101] [Citation(s) in RCA: 211] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
IMPORTANCE Individuals with autism spectrum disorder (ASD) exhibit severe difficulties in social interaction, motor coordination, behavioral flexibility, and atypical sensory processing, with considerable interindividual variability. This heterogeneous set of symptoms recently led to investigating the presence of abnormalities in the interaction across large-scale brain networks. To date, studies have focused either on constrained sets of brain regions or whole-brain analysis, rather than focusing on the interaction between brain networks. OBJECTIVES To compare the intrinsic functional connectivity between brain networks in a large sample of individuals with ASD and typically developing control subjects and to estimate to what extent group differences would predict autistic traits and reflect different developmental trajectories. DESIGN, SETTING, AND PARTICIPANTS We studied 166 male individuals (mean age, 17.6 years; age range, 7-50 years) diagnosed as having DSM-IV-TR autism or Asperger syndrome and 193 typical developing male individuals (mean age, 16.9 years; age range, 6.5-39.4 years) using resting-state functional magnetic resonance imaging (MRI). Participants were matched for age, IQ, head motion, and eye status (open or closed) in the MRI scanner. We analyzed data from the Autism Brain Imaging Data Exchange (ABIDE), an aggregated MRI data set from 17 centers, made public in August 2012. MAIN OUTCOMES AND MEASURES We estimated correlations between time courses of brain networks extracted using a data-driven method (independent component analysis). Subsequently, we associated estimates of interaction strength between networks with age and autistic traits indexed by the Social Responsiveness Scale. RESULTS Relative to typically developing control participants, individuals with ASD showed increased functional connectivity between primary sensory networks and subcortical networks (thalamus and basal ganglia) (all t ≥ 3.13, P < .001 corrected). The strength of such connections was associated with the severity of autistic traits in the ASD group (all r ≥ 0.21, P < .0067 corrected). In addition, subcortico-cortical interaction decreased with age in the entire sample (all r ≤ -0.09, P < .012 corrected), although this association was significant only in typically developing participants (all r ≤ -0.13, P < .009 corrected). CONCLUSIONS AND RELEVANCE Our results showing ASD-related impairment in the interaction between primary sensory cortices and subcortical regions suggest that the sensory processes they subserve abnormally influence brain information processing in individuals with ASD. This might contribute to the occurrence of hyposensitivity or hypersensitivity and of difficulties in top-down regulation of behavior.
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Affiliation(s)
- Leonardo Cerliani
- Department of Neuroscience, University of Groningen, The University Medical Center, Groningen, the Netherlands,Social Brain Laboratory, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Maarten Mennes
- Radboud University, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, the Netherlands
| | - Rajat M. Thomas
- Social Brain Laboratory, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Adriana Di Martino
- Autism Spectrum Disorder Research and Clinical Program and Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience at The Child Study Center, New York University Langone Medical Center, New York
| | - Marc Thioux
- Department of Neuroscience, University of Groningen, The University Medical Center, Groningen, the Netherlands,Social Brain Laboratory, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Christian Keysers
- Department of Neuroscience, University of Groningen, The University Medical Center, Groningen, the Netherlands,Social Brain Laboratory, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
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50
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Stevenson RA, Siemann JK, Woynaroski TG, Schneider BC, Eberly HE, Camarata SM, Wallace MT. Evidence for diminished multisensory integration in autism spectrum disorders. J Autism Dev Disord 2015; 44:3161-7. [PMID: 25022248 DOI: 10.1007/s10803-014-2179-6] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Individuals with autism spectrum disorders (ASD) exhibit alterations in sensory processing, including changes in the integration of information across the different sensory modalities. In the current study, we used the sound-induced flash illusion to assess multisensory integration in children with ASD and typically-developing (TD) controls. Thirty-one children with ASD and 31 age and IQ matched TD children (average age = 12 years) were presented with simple visual (i.e., flash) and auditory (i.e., beep) stimuli of varying number. In illusory conditions, a single flash was presented with 2-4 beeps. In TD children, these conditions generally result in the perception of multiple flashes, implying a perceptual fusion across vision and audition. In the present study, children with ASD were significantly less likely to perceive the illusion relative to TD controls, suggesting that multisensory integration and cross-modal binding may be weaker in some children with ASD. These results are discussed in the context of previous findings for multisensory integration in ASD and future directions for research.
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Affiliation(s)
- Ryan A Stevenson
- Department of Hearing and Speech Sciences, Vanderbilt Kennedy Center, Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN, USA,
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