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West MJ, Angwin AJ, Copland DA, Arnott WL, Nelson NL. Effects of emotional cues on novel word learning in typically developing children in relation to broader autism traits. JOURNAL OF CHILD LANGUAGE 2022; 49:503-521. [PMID: 33722310 DOI: 10.1017/s0305000921000192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Emotion can influence various cognitive processes. Communication with children often involves exaggerated emotional expressions and emotive language. Children with autism spectrum disorder often show a reduced tendency to attend to emotional information. Typically developing children aged 7 to 9 years who varied in their level of autism-like traits learned the nonsense word names of nine novel toys, which were presented with either happy, fearful, or neutral emotional cues. Emotional cues had no influence on word recognition or recall performance. Eye-tracking data showed differences in visual attention depending on the type of emotional cues and level of autism-like traits. The findings suggest that the influence of emotion on attention during word learning differs according to whether the children have lower or higher levels of autism-like traits, but this influence does not affect word learning outcomes.
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Affiliation(s)
- Melina J West
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Anthony J Angwin
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - David A Copland
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- University of Queensland Center for Clinical Research, Brisbane, Australia
| | - Wendy L Arnott
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Nicole L Nelson
- School of Psychology, University of Queensland, Brisbane, Australia
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2
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Shaffer R, Thurman AJ, Ronco L, Cadavid D, Raines S, Kim SH. Social communication in fragile X syndrome: pilot examination of the Brief Observation of Social Communication Change (BOSCC). J Neurodev Disord 2022; 14:4. [PMID: 35034602 PMCID: PMC8903546 DOI: 10.1186/s11689-021-09411-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 12/08/2021] [Indexed: 12/17/2022] Open
Abstract
Background Social communication is a key area of difficulty in fragile X syndrome (FXS) and there are not yet adequate outcome measurement tools. Appropriate outcome measures for FXS have been identified as a key area of research interest in order to evaluate future therapeutic trials. The Brief Observation of Social Communication Change-Minimally Verbal (BOSCC-MV), an outcome measure with strong psychometrics developed for autism spectrum disorder, has promise as an outcome measure to assess social communication change with FXS participants. Methods We examined the BOSCC-MV via central coders in this multi-site-trial to assess its appropriateness for FXS. Eighteen minimally verbal males ages 3–12 years were enrolled and assessed on two consecutive days and 7 participants completed a third visit 6 months later. We examined test-retest reliability, inter-rater reliability, and both convergent and divergent validity with standard clinical measures including the Autism Diagnostic and Observation Schedule-2, Vineland 3, Social Responsiveness Scale, and the Aberrant Behavior Checklist. Results The BOSCC-MV in FXS demonstrated strong inter-rater and test-retest reliability, comparable to previous trials in idiopathic ASD. Strong convergent validity was found with Autism Diagnostic Observation Schedule-2 and Vineland-3. Divergent validity was demonstrated between BOSCC-MV and unrelated measures. Conclusions The BOSCC-MV shows promise as a FXS social communication outcome measure, warranting further large-scale evaluation.
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Affiliation(s)
- Rebecca Shaffer
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH, 45229, USA.
| | - Angela John Thurman
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, MIND Institute, University of California Davis Health, Sacramento, CA, USA
| | - Lucienne Ronco
- Fulcrum Therapeutics, Cambridge, MA, USA.,Deep Genomics Therapeutics, Toronto, ON, Canada
| | - Diego Cadavid
- Fulcrum Therapeutics, Cambridge, MA, USA.,University of Massachusetts Medical School, Worcester, MA, USA
| | | | - So Hyun Kim
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
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West MJ, Copland DA, Arnott WL, Nelson NL, Angwin AJ. Effects of emotional prosody on novel word learning in relation to autism-like traits. MOTIVATION AND EMOTION 2017. [DOI: 10.1007/s11031-017-9642-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Thurman AJ, McDuffie A, Hagerman RJ, Josol CK, Abbeduto L. Language Skills of Males with Fragile X Syndrome or Nonsyndromic Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:728-743. [PMID: 28074353 DOI: 10.1007/s10803-016-3003-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Despite the similarities observed between the fragile X syndrome (FXS) and autism spectrum disorder (ASD) phenotypes, few studies have compared their behavioral profiles outside of ASD symptomatology. In the present study, we sought to compare lexical and grammatical abilities in these two conditions. Comparisons of language abilities in both of these conditions are particularly interesting because both conditions are characterized by difficulties navigating social interactions. Results suggest that although both FXS and ASD are associated with language difficulties, there are important differences between the two conditions in terms of the language profiles observed and the factors influencing language when considering children of similar developmental levels. Theoretical implications are discussed.
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Affiliation(s)
- Angela John Thurman
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA.
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA.
| | - Andrea McDuffie
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA
| | - Randi J Hagerman
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Pediatrics, University of California Davis, Davis, USA
| | - Cynde K Josol
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA
| | - Leonard Abbeduto
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Davis, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, USA
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Niu M, Han Y, Dy ABC, Du J, Jin H, Qin J, Zhang J, Li Q, Hagerman RJ. Autism Symptoms in Fragile X Syndrome. J Child Neurol 2017; 32:903-909. [PMID: 28617074 DOI: 10.1177/0883073817712875] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fragile X syndrome (FXS) is recognized as the most common genetic cause of intellectual disability and autism spectrum disorder (ASD). Although symptoms of ASD are frequently observed in patients with FXS, researchers have not yet clearly determined whether the symptoms in patients with FXS differ from the symptoms in patients without ASD or nonsyndromic ASD. Behavioral similarities and differences between FXS and ASD are important to improve our understanding of the causes and correlations of ASD with FXS. Based on the evidence presented in this review, individuals with FXS and comorbid ASD have more severe behavioral problems than individuals with FXS alone. However, patients with FXS and comorbid ASD exhibit less severe impairments in the social and communication symptoms than patients with nonsyndromic ASD. Individuals with FXS also present with anxiety and seizures in addition to comorbid ASD symptoms, and differences in these conditions are noted in patients with FXS and ASD. This review also discusses the role of fragile X mental retardation 1 protein (FMRP) in FXS and ASD phenotypes.
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Affiliation(s)
- Manman Niu
- 1 Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ying Han
- 1 Department of Pediatrics, Peking University First Hospital, Beijing, China.,2 MIND Institute, University of California, Davis, CA, USA
| | - Angel Belle C Dy
- 2 MIND Institute, University of California, Davis, CA, USA.,3 Ateneo de Manila University - School of Medicine and Public Health, Philippines
| | - Junbao Du
- 1 Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hongfang Jin
- 1 Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jiong Qin
- 4 Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - Jing Zhang
- 1 Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Qinrui Li
- 1 Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Randi J Hagerman
- 2 MIND Institute, University of California, Davis, CA, USA.,5 Department of Pediatrics, University of California, Davis, CA, USA
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Ligsay A, Van Dijck A, Nguyen DV, Lozano R, Chen Y, Bickel ES, Hessl D, Schneider A, Angkustsiri K, Tassone F, Ceulemans B, Kooy RF, Hagerman RJ. A randomized double-blind, placebo-controlled trial of ganaxolone in children and adolescents with fragile X syndrome. J Neurodev Disord 2017; 9:26. [PMID: 28764646 PMCID: PMC5540519 DOI: 10.1186/s11689-017-9207-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 06/01/2017] [Indexed: 12/14/2022] Open
Abstract
Background Gamma-aminobutyric acid (GABA) system deficits are integral to the pathophysiologic development of fragile X syndrome (FXS). Ganaxolone, a GABAA receptor positive allosteric modulator, is hypothesized to improve symptoms such as anxiety, hyperactivity, and attention deficits in children with FXS. Methods This study was a randomized, double-blind, placebo-controlled, crossover trial of ganaxolone in children with FXS, aged 6–17 years. Results Sixty-one participants were assessed for eligibility, and 59 were randomized to the study. Fifty-five participants completed at least the first arm and were included in the intention-to-treat analysis; 51 participants completed both treatment arms. There were no statistically significant improvements observed on the primary outcome measure (Clinical Global Impression-Improvement), the key secondary outcome measure (Pediatric Anxiety Rating Scale-R), or any other secondary outcome measures in the overall study population. However, post-hoc analyses revealed positive trends in areas of anxiety, attention, and hyperactivity in participants with higher baseline anxiety and low full-scale IQ scores. No serious adverse events (AEs) occurred, although there was a significant increase in the frequency and severity of AEs related to ganaxolone compared to placebo. Conclusions While ganaxolone was found to be safe, there were no significant improvements in the outcome measures in the overall study population. However, ganaxolone in subgroups of children with FXS, including those with higher anxiety or lower cognitive abilities, might have beneficial effects. Trial registration ClinicalTrials.gov, NCT01725152
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Affiliation(s)
- Andrew Ligsay
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Anke Van Dijck
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Department of Neurology-Pediatric Neurology, University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
| | - Danh V Nguyen
- Department of Medicine, University of California, Irvine School of Medicine, Orange, California, USA.,Biostatistics Institute for Clinical and Translational Science, University of California, Irvine, California, USA
| | - Reymundo Lozano
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,Seaver Autism Center for Research and Treatment, Department of Genetics and Genomic Sciences, Psychiatry, and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Yanjun Chen
- Biostatistics Institute for Clinical and Translational Science, University of California, Irvine, California, USA
| | - Erika S Bickel
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA
| | - David Hessl
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Andrea Schneider
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Kathleen Angkustsiri
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Flora Tassone
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Berten Ceulemans
- Department of Neurology-Pediatric Neurology, University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
| | - R Frank Kooy
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Randi J Hagerman
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis Medical Center, 2825 50th Street, Sacramento, CA, 95817, USA. .,Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA.
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Budimirovic DB, Berry-Kravis E, Erickson CA, Hall SS, Hessl D, Reiss AL, King MK, Abbeduto L, Kaufmann WE. Updated report on tools to measure outcomes of clinical trials in fragile X syndrome. J Neurodev Disord 2017; 9:14. [PMID: 28616097 PMCID: PMC5467057 DOI: 10.1186/s11689-017-9193-x] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 02/22/2017] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Fragile X syndrome (FXS) has been the neurodevelopmental disorder with the most active translation of preclinical breakthroughs into clinical trials. This process has led to a critical assessment of outcome measures, which resulted in a comprehensive review published in 2013. Nevertheless, the disappointing outcome of several recent phase III drug trials in FXS, and parallel efforts at evaluating behavioral endpoints for trials in autism spectrum disorder (ASD), has emphasized the need for re-assessing outcome measures and revising recommendations for FXS. METHODS After performing an extensive database search (PubMed, Food and Drug Administration (FDA)/National Institutes of Health (NIH)'s www.ClinicalTrials.gov, etc.) to determine progress since 2013, members of the Working Groups who published the 2013 Report evaluated the available outcome measures for FXS and related neurodevelopmental disorders using the COSMIN grading system of levels of evidence. The latter has also been applied to a British survey of endpoints for ASD. In addition, we also generated an informal classification of outcome measures for use in FXS intervention studies as instruments appropriate to detect shorter- or longer-term changes. RESULTS To date, a total of 22 double-blind controlled clinical trials in FXS have been identified through www.ClinicalTrials.gov and an extensive literature search. The vast majority of these FDA/NIH-registered clinical trials has been completed between 2008 and 2015 and has targeted the core excitatory/inhibitory imbalance present in FXS and other neurodevelopmental disorders. Limited data exist on reliability and validity for most tools used to measure cognitive, behavioral, and other problems in FXS in these trials and other studies. Overall, evidence for most tools supports a moderate tool quality grading. Data on sensitivity to treatment, currently under evaluation, could improve ratings for some cognitive and behavioral tools. Some progress has also been made at identifying promising biomarkers, mainly on blood-based and neurophysiological measures. CONCLUSION Despite the tangible progress in implementing clinical trials in FXS, the increasing data on measurement properties of endpoints, and the ongoing process of new tool development, the vast majority of outcome measures are at the moderate quality level with limited information on reliability, validity, and sensitivity to treatment. This situation is not unique to FXS, since reviews of endpoints for ASD have arrived at similar conclusions. These findings, in conjunction with the predominance of parent-based measures particularly in the behavioral domain, indicate that endpoint development in FXS needs to continue with an emphasis on more objective measures (observational, direct testing, biomarkers) that reflect meaningful improvements in quality of life. A major continuous challenge is the development of measurement tools concurrently with testing drug safety and efficacy in clinical trials.
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Affiliation(s)
- Dejan B. Budimirovic
- Departments of Psychiatry and Behavioral Sciences, Kennedy Krieger Institute and Child Psychiatry, Johns Hopkins University School of Medicine, 716 N. Broadway, Baltimore, MD 21205 USA
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences, Biochemistry, Rush University Medical Center, 1725 West Harrison, Suite 718, Chicago, IL 60612 USA
| | - Craig A. Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA
| | - Scott S. Hall
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - David Hessl
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Allan L. Reiss
- Division of Interdisciplinary Brain Sciences, Departments of Psychiatry and Behavioral Sciences, Radiology and Pediatrics, Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - Margaret K. King
- Autism & Developmental Medicine Institute, Geisinger Health System, Present address: Novartis Pharmaceuticals Corporation, US Medical, One Health Plaza, East Hanover, NJ 07936 USA
| | - Leonard Abbeduto
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, 2825 50th Street, Sacramento, CA 95817 USA
| | - Walter E. Kaufmann
- Center for Translational Research, Greenwood Genetic Center, 113 Gregor Mendel Circle, Greenwood, SC 29646 USA
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115 USA
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Thurman AJ, McDuffie A, Kover ST, Hagerman RJ, Abbeduto L. Autism Symptomatology in Boys with Fragile X Syndrome: A Cross Sectional Developmental Trajectories Comparison with Nonsyndromic Autism Spectrum Disorder. J Autism Dev Disord 2015; 45:2816-32. [PMID: 25904201 PMCID: PMC4554893 DOI: 10.1007/s10803-015-2443-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although males with fragile X syndrome (FXS) are frequently described as demonstrating autism symptomatology, there is much debate regarding whether the behavioral symptoms representing the core domains of autism are the result of the same or different underlying neurological/psychological mechanisms. The present study used a cross-sectional developmental trajectories approach to compare the profiles of autism symptomatology relative to chronological age (CA), nonverbal IQ, and expressive vocabulary ability between individuals with FXS and individuals with nonsyndromic ASD. Results suggest that the onset of autism symptoms and their developmental trajectories in males with FXS differ in important ways as a function of CA, nonverbal cognitive ability, and expressive vocabulary relative to males with nonsyndromic ASD. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Angela John Thurman
- MIND Institute, University of California Davis, 2825 50th Street, Room 2101, Sacramento, CA, 95817, USA,
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