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Murray CH, Gannon BM, Winsauer PJ, Cooper ZD, Delatte MS. The Development of Cannabinoids as Therapeutic Agents in the United States. Pharmacol Rev 2024; 76:915-955. [PMID: 38849155 PMCID: PMC11331953 DOI: 10.1124/pharmrev.123.001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
Cannabis is one of the oldest and widely used substances in the world. Cannabinoids within the cannabis plant, known as phytocannabinoids, mediate cannabis' effects through interactions with the body's endogenous cannabinoid system. This endogenous system, the endocannabinoid system, has important roles in physical and mental health. These roles point to the potential to develop cannabinoids as therapeutic agents while underscoring the risks related to interfering with the endogenous system during nonmedical use. This scoping narrative review synthesizes the current evidence for both the therapeutic and adverse effects of the major (i.e., Δ9-tetrahydrocannabinol and cannabidiol) and lesser studied minor phytocannabinoids, from nonclinical to clinical research. We pay particular attention to the areas where evidence is well established, including analgesic effects after acute exposures and neurocognitive risks after acute and chronic use. In addition, drug development considerations for cannabinoids as therapeutic agents within the United States are reviewed. The proposed clinical study design considerations encourage methodological standards for greater scientific rigor and reproducibility to ultimately extend our knowledge of the risks and benefits of cannabinoids for patients and providers. SIGNIFICANCE STATEMENT: This work provides a review of prior research related to phytocannabinoids, including therapeutic potential and known risks in the context of drug development within the United States. We also provide study design considerations for future cannabinoid drug development.
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Affiliation(s)
- Conor H Murray
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Brenda M Gannon
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Peter J Winsauer
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Ziva D Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Marcus S Delatte
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
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da Rosa ALST, Bezerra OS, Rohde LA, Graeff-Martins AS. Exploring clozapine use in severe psychiatric symptoms associated with autism spectrum disorder: A scoping review. J Psychopharmacol 2024; 38:324-343. [PMID: 38576151 DOI: 10.1177/02698811241241384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND Patients with autism spectrum disorder (ASD) may experience severe psychiatric symptoms, often unresponsive to conventional pharmacological therapies, highlighting the need for more effective alternatives. AIMS This study aims to map and synthesize evidence on the use of clozapine as a therapeutic option for managing severe psychiatric symptomatology co-occurring with ASD. METHODS We conducted a scoping review on multiple sources following the JBI guidelines. The search strategy was inclusive, targeting both peer-reviewed publications and gray literature presenting empirical data on the use of clozapine therapy for patients with ASD accompanied by comorbid psychiatric symptoms. Two independent evaluators performed the selection of studies, data extraction, and critical appraisal. RESULTS The review included 46 studies, encompassing 122 ASD individuals who received clozapine therapy. The sources of evidence comprise 31 case reports, 8 case series, 6 retrospective observational studies, and 1 quasi-experimental prospective study. The tables present the findings along with a narrative summary. Clozapine treatment demonstrated benefits in four groups of severe and treatment-resistant psychiatric symptoms in ASD patients: disruptive behaviors, psychotic symptoms, catatonia, and mood symptoms. Although side effects were common, tolerability was generally satisfactory. However, severe adverse events, such as seizures, moderate neutropenia, and myocarditis, underscore the need for intensive clinical monitoring. CONCLUSIONS While clozapine shows promise as a pharmacological intervention for severe psychopathologies in ASD, more rigorous clinical studies are required to elucidate its efficacy and safety in this population. The limited robustness of the evidence calls for caution, signaling an early research stage into this topic.
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Affiliation(s)
- André Luiz Schuh Teixeira da Rosa
- Graduate Program of Psychiatry and Behavioral Sciences, Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Olivia Sorato Bezerra
- Child Neurology Unit, Department of Pediatrics, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Luis Augusto Rohde
- Graduate Program of Psychiatry and Behavioral Sciences, Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Soledade Graeff-Martins
- Graduate Program of Psychiatry and Behavioral Sciences, Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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Zhan L, Gao Y, Huang L, Zhang H, Huang G, Wang Y, Sun J, Xie Z, Li M, Jia X, Cheng L, Yu Y. Brain functional connectivity alterations of Wernicke's area in individuals with autism spectrum conditions in multi-frequency bands: A mega-analysis. Heliyon 2024; 10:e26198. [PMID: 38404781 PMCID: PMC10884452 DOI: 10.1016/j.heliyon.2024.e26198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024] Open
Abstract
Characterized by severe deficits in communication, most individuals with autism spectrum conditions (ASC) experience significant language dysfunctions, thereby impacting their overall quality of life. Wernicke's area, a classical and traditional brain region associated with language processing, plays a substantial role in the manifestation of language impairments. The current study carried out a mega-analysis to attain a comprehensive understanding of the neural mechanisms underpinning ASC, particularly in the context of language processing. The study employed the Autism Brain Image Data Exchange (ABIDE) dataset, which encompasses data from 443 typically developing (TD) individuals and 362 individuals with ASC. The objective was to detect abnormal functional connectivity (FC) between Wernicke's area and other language-related functional regions, and identify frequency-specific altered FC using Wernicke's area as the seed region in ASC. The findings revealed that increased FC in individuals with ASC has frequency-specific characteristics. Further, in the conventional frequency band (0.01-0.08 Hz), individuals with ASC exhibited increased FC between Wernicke's area and the right thalamus compared with TD individuals. In the slow-5 frequency band (0.01-0.027 Hz), increased FC values were observed in the left cerebellum Crus II and the right lenticular nucleus, pallidum. These results provide novel insights into the potential neural mechanisms underlying communication deficits in ASC from the perspective of language impairments.
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Affiliation(s)
- Linlin Zhan
- School of Western Studies, Heilongjiang University, Harbin, China
| | - Yanyan Gao
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Lina Huang
- Department of Radiology, Changshu No. 2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Hongqiang Zhang
- Department of Radiology, Changshu No. 2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Guofeng Huang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Yadan Wang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Jiawei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Zhou Xie
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Mengting Li
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Xize Jia
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Lulu Cheng
- School of Foreign Studies, China University of Petroleum (East China), Qingdao, China
- Shanghai Center for Research in English Language Education, Shanghai International Studies University, Shanghai, China
| | - Yang Yu
- Psychiatry Department, The Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
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Salloum-Asfar S, Zawia N, Abdulla SA. Retracing our steps: A review on autism research in children, its limitation and impending pharmacological interventions. Pharmacol Ther 2024; 253:108564. [PMID: 38008401 DOI: 10.1016/j.pharmthera.2023.108564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by three core impairments: impaired communication, impaired reciprocal social interaction, and restricted, repetitive, and stereotypical behavior patterns. Spectrum refers to the heterogeneity of presentation, severity of symptoms, and medical comorbidities associated with ASD. Among the most common underlying medical conditions are attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, epilepsy, digestive disorders, metabolic disorders, and immune disorders. At present, in the absence of an objective and accurate diagnosis of ASD, such as a blood test, pharmacological management remains a challenge. There are no approved medications to treat the core symptoms of the disorder and behavioral interventions are typically used as first line treatment. Additionally, psychotropic drugs with different mechanisms of action have been approved to reduce associated symptoms and comorbidities, including aripiprazole, risperidone, and haloperidol for irritability and aggression, methylphenidate, atomoxetine, clonidine, and guanfacine for ADHD, and melatonin for sleep disturbances. The purpose of this review is to emphasize that it is imperative to develop objective, personalized diagnostic kits in order to tailor and individualize treatment strategies, as well as to describe the current pharmacological management options available in clinical practice and new prospects that may be helpful in managing ASD's core symptoms.
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Affiliation(s)
- Salam Salloum-Asfar
- Neurological Disorders Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar.
| | - Nasser Zawia
- Neurological Disorders Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Sara A Abdulla
- Neurological Disorders Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar.
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Baumer NT, Capone G. Psychopharmacological treatments in Down syndrome and autism spectrum disorder: State of the research and practical considerations. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2023; 193:e32069. [PMID: 37870763 DOI: 10.1002/ajmg.c.32069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/20/2023] [Accepted: 09/30/2023] [Indexed: 10/24/2023]
Abstract
Individuals with Down syndrome (DS) or Autism Spectrum Disorder (ASD), and especially those with both DS and co-occurring ASD (DS + ASD) commonly display behavioral and psychiatric symptoms that can impact quality of life and places increased burden on caregivers. While the mainstay of treatment in DS and ASD is focused on educational and behavioral therapies, pharmacological treatments can be used to reduce symptom burden. There is a paucity of evidence and limited clinical trials in DS and DS + ASD. Some scientific evidence is available, primarily in open label studies and case series that can guide treatment choices. Additionally, clinical decisions are often extrapolated from evidence and experience from those with ASD, or intellectual disability in those without DS. This article reviews current research in pharmacological treatment in DS, ASD, and DS + ASD, reviews co-occurring neurodevelopmental and mental health diagnoses in individuals with DS + ASD across the lifespan, and describes practical approaches to psychopharmacological management.
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Affiliation(s)
- Nicole T Baumer
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - George Capone
- Department of Pediatrics, Johns Hopkins Medicine, Baltimore, Maryland, USA
- Kennedy Krieger Institute, Baltimore, Maryland, USA
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Tobe R, Zhu Y, Gleissl T, Rossomanno S, Veenstra-VanderWeele J, Smith J, Hollander E. Predictors of placebo response in three large clinical trials of the V1a receptor antagonist balovaptan in autism spectrum disorder. Neuropsychopharmacology 2023:10.1038/s41386-023-01573-9. [PMID: 37045991 PMCID: PMC10267133 DOI: 10.1038/s41386-023-01573-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
High rates of placebo response are increasingly implicated in failed autism spectrum disorder (ASD) clinical trials. Despite this, there are limited investigations of placebo response in ASD. We sought to identify baseline predictors of placebo response and quantify their influence on clinical scales of interest for three harmonized randomized clinical trials of balovaptan, a V1a receptor antagonist. We employed a two-step approach to identify predictors of placebo response on the Vineland-II two-domain composite (2DC) (primary outcome and a caregiver measure) and Clinical Global Impression (CGI) scale (secondary outcome and a clinician measure). The initial candidate predictor set of variables pertained to participant-level, site-specific, and protocol-related factors. Step 1 aimed to identify influential predictors of placebo response using Least Absolute Shrinkage and Selection Operator (LASSO) regression, while Step 2 quantified the influence of predictors via linear regression. Results were validated through statistical bootstrapping approaches with 500 replications of the analysis dataset. The pooled participant-level dataset included individuals with ASD aged 5 to 62 years (mean age 21 [SD 10]), among which 263 and 172 participants received placebo at Weeks 12 and 24, respectively. Although no influential predictors were identified for CGI, findings for Vineland-II 2DC are robust and informative. Decreased placebo response was predicted by higher baseline Vineland-II 2DC (i.e., more advanced adaptive function), longer trial duration, and European (vs United States) sites, while increased placebo response was predicted by commercial (vs academic) sites, attention deficit hyperactivity disorder and depression. Identification of these factors may be useful in anticipating and mitigating placebo response in drug development efforts in ASD and across developmental and psychiatric conditions.
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Affiliation(s)
- Russell Tobe
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
| | - Yajing Zhu
- F. Hoffmann-La Roche Ltd., Welwyn Garden City, UK
| | | | | | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Janice Smith
- F. Hoffmann-La Roche Ltd., Welwyn Garden City, UK
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences and Albert Einstein College of Medicine, New York, NY, USA
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Amadori S, Barbuti M, Perugi G. Pharmacotherapy for bipolar disorder in adults with high-functioning autism. Expert Opin Pharmacother 2022; 23:1753-1760. [PMID: 36263803 DOI: 10.1080/14656566.2022.2138332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The association between high-functioning autism (HFA) and bipolar disorder (BD) in adult subjects has been confirmed by a growing number of studies. However, identifying and treating BD in this population is a clinical challenge and requires careful assessment and adequate knowledge of both disorders. AREAS COVERED This review aims to provide a clinical presentation of mood episodes in HFA individuals, and an update on the pharmacotherapy of BD in these individuals, sharing with the reader expert opinion on the current state of the art and future perspectives. EXPERT OPINION BD has an atypical clinical presentation in HFA subjects with the possibility of diagnostic and therapeutic mistakes. Despite the absence of controlled studies, the available evidence indicates mood stabilizers, especially lithium, as the first treatment option. HFA subjects are particularly vulnerable to pharmacological side effects, such as extrapyramidal and catatonic symptoms with antipsychotics, or activation syndrome with antidepressants. Accordingly, initial titration of these drugs should be slow and their use should be limited in time. Among antipsychotics, dopamine receptor antagonists with combined serotonergic activity are preferable. Further research is needed to improve the diagnostic process and to delineate the effectiveness of different drugs for BD in HFA subjects.
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Affiliation(s)
- Salvatore Amadori
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa (PI), Italy
| | - Margherita Barbuti
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa (PI), Italy
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa (PI), Italy
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Li H, Shi B, Wang X, Cao M, Chen J, Liu S, Zhan X, Jin C, Gui Z, Jing J, Zhu Y. Associations of emotional/behavioral problems with accelerometer-measured sedentary behavior, physical activity and step counts in children with autism spectrum disorder. Front Public Health 2022; 10:981128. [PMID: 36299767 PMCID: PMC9588958 DOI: 10.3389/fpubh.2022.981128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/22/2022] [Indexed: 01/25/2023] Open
Abstract
Background The evidence for associations of emotional/behavioral status with sedentary behavior (SB), physical activity (PA) and step counts is scarce in children with autism spectrum disorder (ASD). Also, ASD-related deficiencies may affect actual levels of PA. We aimed to describe accelerometer-measured SB, PA and step counts in children with ASD, and to examine the associations of emotional/behavioral problems with SB, PA and step counts after assessing associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies. Methods A total of 93 ASD children, aged 6-9 years, were recruited from the Center for Child and Adolescent Psychology and Behavioral Development of Sun Yat-sen University in Guangzhou, China. Participants wore an accelerometer for seven consecutive days. Of the original 93, 78 participants' accelerometer-measured valid PA were obtained, and the data were shown as time spent in SB, light, moderate, moderate-to-vigorous and vigorous PA, and step counts. Participants' emotional/behavioral problems were assessed via the Strengths and Difficulties Questionnaire (SDQ), and anxiety symptoms were evaluated by the Screen for Child Anxiety Related Emotional Disorders (SCARED). ASD-associated deficiencies include restricted repetitive behaviors (Repetitive Behavior Scale-Revised), poor social competence (Social Responsiveness Scale Second Edition) and motor development restrictions (Developmental Coordination Disorder Questionnaire). Results Of the 78 participants, daily vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) averaged 15.62 and 51.95 min, respectively. After adjustment for covariates, SDQ emotional symptoms (β = -0.060, p = 0.028) were inversely associated with the average daily minutes in VPA. Meanwhile, SDQ emotional symptoms (β = -0.033, p = 0.016) were inversely associated with the average daily MVPA minutes in the crude model. After adjustment for covariates, SCARED somatic/panic (β = -0.007, p = 0.040) and generalized anxiety (β = -0.025, p = 0.014) were negatively associated with the average daily VPA minutes; SCARED total anxiety (β = -0.006, p = 0.029) was conversely associated with daily MVPA duration. After adjustment for covariates, no significant associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies were found (p > 0.05). Conclusions Accelerometer-measured SB, PA and step counts showed no associations with ASD-related deficiencies. On this basis, we further found that the emotional symptoms were inversely associated with VPA and MVPA. These results emphasize the importance of VPA and MVPA in children with ASD. The longitudinally investigations on the directionality of these associations between emotional symptoms with VPA and MVPA are needed in the future.
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Affiliation(s)
- Hailin Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bijun Shi
- Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Muqing Cao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiajie Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Siyu Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoling Zhan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chengkai Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaohuan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China,*Correspondence: Jin Jing
| | - Yanna Zhu
- Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Yanna Zhu
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Yue X, Zhang G, Li X, Shen Y, Wei W, Bai Y, Luo Y, Wei H, Li Z, Zhang X, Wang M. Brain Functional Alterations in Prepubertal Boys With Autism Spectrum Disorders. Front Hum Neurosci 2022; 16:891965. [PMID: 35664346 PMCID: PMC9160196 DOI: 10.3389/fnhum.2022.891965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives Abnormal brain function in ASD patients changes dynamically across developmental stages. However, no one has studied the brain function of prepubertal children with ASD. Prepuberty is an important stage for children’s socialization. This study aimed to investigate alterations in local spontaneous brain activity in prepubertal boys with ASD. Materials and Methods Measures of the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) acquired from resting-state functional magnetic resonance imaging (RS-fMRI) database, including 34 boys with ASD and 49 typically developing (TD) boys aged 7 to 10 years, were used to detect regional brain activity. Pearson correlation analyses were conducted on the relationship between abnormal ALFF and ReHo values and Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview-Revised (ADI-R) scores. Results In the ASD group, we found decreased ALFF in the left inferior parietal lobule (IPL) and decreased ReHo in the left lingual gyrus (LG), left superior temporal gyrus (STG), left middle occipital gyrus (MOG), and right cuneus (p < 0.05, FDR correction). There were negative correlations between ReHo values in the left LG and left STG and the ADOS social affect score and a negative correlation between ReHo values in the left STG and the calibrated severity total ADOS score. Conclusion Brain regions with functional abnormalities, including the left IPL, left LG, left STG, left MOG, and right cuneus may be crucial in the neuropathology of prepubertal boys with ASD. Furthermore, ReHo abnormalities in the left LG and left STG were correlated with sociality. These results will supplement the study of neural mechanisms in ASD at different developmental stages, and be helpful in exploring the neural mechanisms of prepubertal boys with ASD.
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Affiliation(s)
- Xipeng Yue
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Ge Zhang
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Xiaochen Li
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yu Shen
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Wei Wei
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yan Bai
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yu Luo
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Huanhuan Wei
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Ziqiang Li
- Henan Provincial People’s Hospital, Xinxiang Medical University, Xinxiang, China
| | | | - Meiyun Wang
- Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China
- *Correspondence: Meiyun Wang,
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