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Ibrahim K, Iturmendi-Sabater I, Vasishth M, Barron DS, Guardavaccaro M, Funaro MC, Holmes A, McCarthy G, Eickhoff SB, Sukhodolsky DG. Neural circuit disruptions of eye gaze processing in autism spectrum disorder and schizophrenia: An activation likelihood estimation meta-analysis. Schizophr Res 2024; 264:298-313. [PMID: 38215566 PMCID: PMC10922721 DOI: 10.1016/j.schres.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/07/2023] [Accepted: 12/05/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Impairment in social cognition, particularly eye gaze processing, is a shared feature common to autism spectrum disorder (ASD) and schizophrenia. However, it is unclear if a convergent neural mechanism also underlies gaze dysfunction in these conditions. The present study examined whether this shared eye gaze phenotype is reflected in a profile of convergent neurobiological dysfunction in ASD and schizophrenia. METHODS Activation likelihood estimation (ALE) meta-analyses were conducted on peak voxel coordinates across the whole brain to identify spatial convergence. Functional coactivation with regions emerging as significant was assessed using meta-analytic connectivity modeling. Functional decoding was also conducted. RESULTS Fifty-six experiments (n = 30 with schizophrenia and n = 26 with ASD) from 36 articles met inclusion criteria, which comprised 354 participants with ASD, 275 with schizophrenia and 613 healthy controls (1242 participants in total). In ASD, aberrant activation was found in the left amygdala relative to unaffected controls during gaze processing. In schizophrenia, aberrant activation was found in the right inferior frontal gyrus and supplementary motor area. Across ASD and schizophrenia, aberrant activation was found in the right inferior frontal gyrus and right fusiform gyrus during gaze processing. Functional decoding mapped the left amygdala to domains related to emotion processing and cognition, the right inferior frontal gyrus to cognition and perception, and the right fusiform gyrus to visual perception, spatial cognition, and emotion perception. These regions also showed meta-analytic connectivity to frontoparietal and frontotemporal circuitry. CONCLUSION Alterations in frontoparietal and frontotemporal circuitry emerged as neural markers of gaze impairments in ASD and schizophrenia. These findings have implications for advancing transdiagnostic biomarkers to inform targeted treatments for ASD and schizophrenia.
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Affiliation(s)
- Karim Ibrahim
- Yale University School of Medicine, Child Study Center, United States of America.
| | | | - Maya Vasishth
- Yale University School of Medicine, Child Study Center, United States of America
| | - Daniel S Barron
- Brigham and Women's Hospital, Department of Psychiatry, Anesthesiology and Pain Medicine, United States of America; Harvard Medical School, Department of Psychiatry, United States of America
| | | | - Melissa C Funaro
- Yale University, Harvey Cushing/John Hay Whitney Medical Library, United States of America
| | - Avram Holmes
- Yale University, Department of Psychology, United States of America; Yale University, Department of Psychiatry, United States of America; Yale University, Wu Tsai Institute, United States of America
| | - Gregory McCarthy
- Yale University, Department of Psychology, United States of America; Yale University, Wu Tsai Institute, United States of America
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Denis G Sukhodolsky
- Yale University School of Medicine, Child Study Center, United States of America
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Ong LT, Fan SWD. Morphological and Functional Changes of Cerebral Cortex in Autism Spectrum Disorder. INNOVATIONS IN CLINICAL NEUROSCIENCE 2023; 20:40-47. [PMID: 38193097 PMCID: PMC10773605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by early-onset impairments in socialization, communication, repetitive behaviors, and restricted interests. ASD exhibits considerable heterogeneity, with clinical presentations varying across individuals and age groups. The pathophysiology of ASD is hypothesized to be due to abnormal brain development influenced by a combination of genetic and environmental factors. One of the most consistent morphological parameters for assessing the abnormal brain structures in patients with ASD is cortical thickness. Studies have shown changes in the cortical thickness within the frontal, temporal, parietal, and occipital lobes of individuals with ASD. These changes in cortical thickness often correspond to specific clinical features observed in individuals with ASD. Furthermore, the aberrant brain anatomical features and cortical thickness alterations may lead to abnormal brain connectivity and synaptic structure. Additionally, ASD is associated with cortical hyperplasia in early childhood, followed by a cortical plateau and subsequent decline in later stages of development. However, research in this area has yielded contradictory findings regarding the cortical thickness across various brain regions in ASD.
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Affiliation(s)
- Leong Tung Ong
- Both authors are with Faculty of Medicine, University of Malaya in Kuala Lumpur, Malaysia
| | - Si Wei David Fan
- Both authors are with Faculty of Medicine, University of Malaya in Kuala Lumpur, Malaysia
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Jayashankar A, Aziz-Zadeh L. Disgust Processing and Potential Relationships with Behaviors in Autism. Curr Psychiatry Rep 2023; 25:465-478. [PMID: 37672122 PMCID: PMC10627949 DOI: 10.1007/s11920-023-01445-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE OF REVIEW While there are reports of differences in emotion processing in autism, it is less understood whether the emotion of disgust, in particular, plays a significant role in these effects. Here, we review literature on potential disgust processing differences in autism and its possible associations with autistic traits. RECENT FINDINGS In autism, there is evidence for differences in physical disgust processing, pica behaviors, attention away from other's disgust facial expressions, and differences in neural activity related to disgust processing. In typically developing individuals, disgust processing is related to moral processing, but modulated by individual differences in interoception and alexithymia. Autistic individuals may experience atypical disgust, which may lead to difficulty avoiding contaminants and affect socio-emotional processing. In autism, such outcomes may lead to increased occurrences of illness, contribute to gastrointestinal issues, diminish vicarious learning of disgust expression and behaviors, and potentially contribute to differences in processes related to moral reasoning, though further research is needed.
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Affiliation(s)
- Aditya Jayashankar
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, 90089, USA.
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, 90089, USA.
| | - Lisa Aziz-Zadeh
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, 90089, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, 90089, USA
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Bemmouna D, Weiner L. Linehan's biosocial model applied to emotion dysregulation in autism: a narrative review of the literature and an illustrative case conceptualization. Front Psychiatry 2023; 14:1238116. [PMID: 37840783 PMCID: PMC10570453 DOI: 10.3389/fpsyt.2023.1238116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Emotion dysregulation (ED) is a transdiagnostic difficulty prevalent in autism spectrum condition (ASC). Importantly, recent research has suggested that ED is involved in self-harm and suicidality. Pre-existing models on the etiology of ED in ASC focus mainly on biological factors to ASC features, such as sensory sensitivities, poor flexibility, and sensitivity to change. However, although psychosocial factors seem to play a role in the emergence of ED in ASC as well (e.g., childhood maltreatment and camouflaging), there is a lack of a comprehensive model conceptualizing biosocial factors involved in ED in autistic people. Linehan's biosocial model (1993) is one of the leading etiological models of ED in borderline personality disorder (BPD). It conceptualizes ED as emerging from transactions between a pre-existing emotional vulnerability in the child and an invalidating developmental environment. Beyond its clinical relevance, Linehan's model has gathered empirical evidence supporting its pertinence in BPD and in other psychiatric disorders. Although ASC and BPD are two distinct diagnoses, because they may share ED, Linehan's biosocial model might be useful for understanding the development of ED in ASC. Hence, this article aims to provide an application and extension of Linehan's model to conceptualize ED in ASC. To do so, we conducted a narrative review of the literature on ED and its underlying factors in ASC from a developmental perspective. To investigate the pertinence of the biosocial model applied to ED in autistic people, we were interested on data on (i) ED and its behavioral correlates in ASC, in relation to the biosocial model, (ii) the potential biological and psychosocial correlates of ED in ASC and (iii) the overlapping difficulties in ASC and BPD. Finally, to assess the pertinence of the model, we applied it to the case of an autistic woman presenting with ED and suicidal behaviors. Our review and application to the case of an autistic woman suggest that ED in ASC encompasses factors related to both biological and psychosocial risk factors as conceptualized in the BPD framework, although in both domains ASC-specific factors might be involved.
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Affiliation(s)
- Doha Bemmouna
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, France
| | - Luisa Weiner
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, France
- Département de Psychiatrie Adulte, Hôpitaux Universitaires de Strasbourg, Strasbourg, Alsace, France
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Cai RY, Love A, Robinson A, Gibbs V. The Inter-Relationship of Emotion Regulation, Self-Compassion, and Mental Health in Autistic Adults. AUTISM IN ADULTHOOD 2023; 5:335-342. [PMID: 37663445 PMCID: PMC10468559 DOI: 10.1089/aut.2022.0068] [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] [Indexed: 01/31/2023]
Abstract
Background Emotion regulation is one of the key factors that influence mental health outcomes in autistic and nonautistic populations. Recent research has also identified self-compassion as a negative correlate of depression and positive correlate of psychological well-being in autistic adults. Empirical evidence from the general population supports the notion that being kind and compassionate toward oneself during stressful and difficult moments can help with one's ability to regulate negative emotions, which then has flow-on effects on mental health outcomes. However, the inter-relationship between self-compassion, emotion regulation, and mental health has not been examined in autistic samples. Therefore, the aim of this study was to determine if emotion regulation mediates the relationship between self-compassion and anxiety or depression in a sample of autistic adults. Methods Participants were 153 adults (meanage = 35.70, standard deviationage = 12.62) who had either self-reported a clinical diagnosis of autism spectrum disorder or self-identified as autistic. They completed an online survey capturing self-compassion, emotion regulation, anxiety, and depression. We hypothesized that emotion regulation would mediate the relationship between self-compassion and anxiety or depression, and self-compassion would not mediate the relationship between emotion regulation and anxiety or depression. Results As predicted, only emotion regulation mediated the relationship between self-compassion and mental health outcomes. Self-compassion did not mediate the relationship between emotion regulation and mental health outcomes. Conclusion This study provides preliminary evidence for the role that self-compassion plays in improving emotion regulation and mental health in autistic adults. If this mechanism of emotion regulation mediating the relationship between self-compassion and mental health is consistently found in future studies, then it would be helpful for future research to examine the clinical benefits of including a self-compassion component in emotion regulation interventions to improve mental health outcomes of autistic adults.
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Affiliation(s)
- Ru Ying Cai
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
- School of Psychological Sciences, Monash University, Clayton, Australia
| | - Abigail Love
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
| | - Ainslie Robinson
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
| | - Vicki Gibbs
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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6
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Antezana L, Coffman MC, DiCriscio AS, Richey JA. Effects of nonsocial and circumscribed interest images on neural mechanisms of emotion regulation in autistic adults. Front Behav Neurosci 2022; 16:1057736. [PMID: 36570705 PMCID: PMC9771392 DOI: 10.3389/fnbeh.2022.1057736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Emotion dysregulation is commonly reported among autistic individuals. Prior work investigating the neurofunctional mechanisms of emotion regulation (ER) in autistic adults has illustrated alterations in dorsolateral prefrontal cortex (dlPFC) activity, as well as concurrent atypical patterns of activation in subcortical regions related to affect during cognitive reappraisal of social images. Whereas most research examining ER in autism has focused on regulation of negative emotions, the effects of regulating positive emotions has been generally understudied. This is surprising given the relevance of positive motivational states to understanding circumscribed interests (CI) in autism. Methods Accordingly, the purpose of this study was to use fMRI with simultaneous eye-tracking and pupillometry to investigate the neural mechanisms of ER during passive viewing and cognitive reappraisal of a standardized set of nonsocial images and personalized (self-selected) CI images. Results The autistic group demonstrated comparatively reduced modulation of posterior cingulate cortex (PCC) activation during cognitive reappraisal of CI images compared to viewing of CI, although no eye-tracking/pupillometry differences emerged between-groups. Further, the autistic group demonstrated increased PCC connectivity with left lateral occipital and right supramarginal areas when engaging in cognitive reappraisal vs. viewing CI. Discussion In autistic adults, CI may be differentially modulated via PCC. Considering the documented role of the PCC as a core hub of the default mode network, we further postulate that ER of CI could potentially be related to self-referential cognition.
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Affiliation(s)
- Ligia Antezana
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Marika C. Coffman
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States
| | | | - John A. Richey
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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7
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Makris G, Agorastos A, Chrousos GP, Pervanidou P. Stress System Activation in Children and Adolescents With Autism Spectrum Disorder. Front Neurosci 2022; 15:756628. [PMID: 35095389 PMCID: PMC8793840 DOI: 10.3389/fnins.2021.756628] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
The mission of the human stress system is the maintenance of homeostasis in the presence of real or perceived, acute or chronic stressors. The hypothalamic–pituitary–adrenal (HPA) axis and the autonomic nervous system (ANS) are the stress system-related neuroendocrine pathways. There is abundant evidence that children and adolescents with autism spectrum disorder (ASD) may exhibit atypical function within the HPA axis and the ANS both at the resting state and during the presence of social and/or non-social stressors. The aim of this review is to provide an up-to-date summary of the findings regarding stress system alterations in children and adolescents with ASD. We focus on the variations of stress hormones circadian rhythms, specifically cortisol and alpha-amylase (i.e., a surrogate index of epinephrine/norepinephrine secretion), and on the alterations of stress system responsivity to different stressors. Also, we present imaging and immunological findings that have been associated with stress system dysregulation in children and adolescents with ASD. Finally, we review the pivotal role of HPA axis-ANS coordination, the developmental trajectory of the stress system in ASD, and the possible role of early life stress in the dysregulation of the stress system demonstrated in children and adolescents with ASD. This synthesis will hopefully provide researchers with a foundation for an integrated approach to future research into stress system variations in children and adolescents with ASD.
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Affiliation(s)
- Gerasimos Makris
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- *Correspondence: Gerasimos Makris,
| | - Agorastos Agorastos
- Department of Psychiatry II, Division of Neurosciences, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George P. Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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8
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Chernikova MA, Flores GD, Kilroy E, Labus JS, Mayer EA, Aziz-Zadeh L. The Brain-Gut-Microbiome System: Pathways and Implications for Autism Spectrum Disorder. Nutrients 2021; 13:nu13124497. [PMID: 34960049 PMCID: PMC8704412 DOI: 10.3390/nu13124497] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 12/13/2022] Open
Abstract
Gastrointestinal dysfunction is one of the most prevalent physiological symptoms of autism spectrum disorder (ASD). A growing body of largely preclinical research suggests that dysbiotic gut microbiota may modulate brain function and social behavior, yet little is known about the mechanisms that underlie these relationships and how they may influence the pathogenesis or severity of ASD. While various genetic and environmental risk factors have been implicated in ASD, this review aims to provide an overview of studies elucidating the mechanisms by which gut microbiota, associated metabolites, and the brain interact to influence behavior and ASD development, in at least a subgroup of individuals with gastrointestinal problems. Specifically, we review the brain-gut-microbiome system and discuss findings from current animal and human studies as they relate to social-behavioral and neurological impairments in ASD, microbiota-targeted therapies (i.e., probiotics, fecal microbiota transplantation) in ASD, and how microbiota may influence the brain at molecular, structural, and functional levels, with a particular interest in social and emotion-related brain networks. A deeper understanding of microbiome-brain-behavior interactions has the potential to inform new therapies aimed at modulating this system and alleviating both behavioral and physiological symptomatology in individuals with ASD.
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Affiliation(s)
- Michelle A. Chernikova
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90033, USA; (M.A.C.); (G.D.F.); (E.K.)
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA 90089, USA
- Psychology Department, Loyola Marymount University, Los Angeles, CA 90045, USA
| | - Genesis D. Flores
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90033, USA; (M.A.C.); (G.D.F.); (E.K.)
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA 90089, USA
- Psychology Department, California State Polytechnic University, Pomona, CA 91768, USA
| | - Emily Kilroy
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90033, USA; (M.A.C.); (G.D.F.); (E.K.)
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA 90089, USA
| | - Jennifer S. Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California Los Angeles, Los Angeles, CA 90095, USA;
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, CA 90095, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Gonda (Goldschmied) Neuroscience and Genetics Research Center, Brain Research Institute UCLA, Los Angeles, CA 90095, USA
| | - Emeran A. Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California Los Angeles, Los Angeles, CA 90095, USA;
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, CA 90095, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Correspondence: (E.A.M.); (L.A.-Z.)
| | - Lisa Aziz-Zadeh
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90033, USA; (M.A.C.); (G.D.F.); (E.K.)
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA 90089, USA
- Correspondence: (E.A.M.); (L.A.-Z.)
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9
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Kanlayaprasit S, Thongkorn S, Panjabud P, Jindatip D, Hu VW, Kikkawa T, Osumi N, Sarachana T. Autism-Related Transcription Factors Underlying the Sex-Specific Effects of Prenatal Bisphenol A Exposure on Transcriptome-Interactome Profiles in the Offspring Prefrontal Cortex. Int J Mol Sci 2021; 22:13201. [PMID: 34947998 PMCID: PMC8708761 DOI: 10.3390/ijms222413201] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/16/2022] Open
Abstract
Bisphenol A (BPA) is an environmental risk factor for autism spectrum disorder (ASD). BPA exposure dysregulates ASD-related genes in the hippocampus and neurological functions of offspring. However, whether prenatal BPA exposure has an impact on genes in the prefrontal cortex, another brain region highly implicated in ASD, and through what mechanisms have not been investigated. Here, we demonstrated that prenatal BPA exposure disrupts the transcriptome-interactome profiles of the prefrontal cortex of neonatal rats. Interestingly, the list of BPA-responsive genes was significantly enriched with known ASD candidate genes, as well as genes that were dysregulated in the postmortem brain tissues of ASD cases from multiple independent studies. Moreover, several differentially expressed genes in the offspring's prefrontal cortex were the targets of ASD-related transcription factors, including AR, ESR1, and RORA. The hypergeometric distribution analysis revealed that BPA may regulate the expression of such genes through these transcription factors in a sex-dependent manner. The molecular docking analysis of BPA and ASD-related transcription factors revealed novel potential targets of BPA, including RORA, SOX5, TCF4, and YY1. Our findings indicated that prenatal BPA exposure disrupts ASD-related genes in the offspring's prefrontal cortex and may increase the risk of ASD through sex-dependent molecular mechanisms, which should be investigated further.
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Grants
- FRB65_hea(80)_175_37_05 Fundamental Fund, Chulalongkorn University
- AHS-CU 61004 Faculty of Allied Health Sciences Research Fund, Chulalongkorn University
- GRU 6300437001-1 Ratchadapisek Somphot Fund for Supporting Research Unit, Chulalongkorn University
- GRU_64_033_37_004 Ratchadapisek Somphot Fund for Supporting Research Unit, Chulalongkorn University
- The 100th Anniversary Chulalongkorn University Fund for Doctoral Scholarship, Graduate School, Chulalongkorn University
- The Overseas Research Experience Scholarship for Graduate Students from Graduate School, Chulalongkorn University
- PHD/0029/2561 The Royal Golden Jubilee Ph.D. Programme Scholarship, Thailand Research Fund and National Research Council of Thailand
- National Research Council of Thailand (NRCT)
- GCUGR1125623067D-67 The 90th Anniversary Chulalongkorn University Fund (Ratchadaphiseksomphot Endowment Fund), Graduate School, Chulalongkorn University
- GCUGR1125632108D-108 The 90th Anniversary Chulalongkorn University Fund (Ratchadaphiseksomphot Endowment Fund), Graduate School, Chulalongkorn University
- 2073011 Chulalongkorn University Laboratory Animal Center (CULAC) Grant
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Affiliation(s)
- Songphon Kanlayaprasit
- The Ph.D. Program in Clinical Biochemistry and Molecular Medicine, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (S.K.); (S.T.); (P.P.)
| | - Surangrat Thongkorn
- The Ph.D. Program in Clinical Biochemistry and Molecular Medicine, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (S.K.); (S.T.); (P.P.)
| | - Pawinee Panjabud
- The Ph.D. Program in Clinical Biochemistry and Molecular Medicine, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (S.K.); (S.T.); (P.P.)
| | - Depicha Jindatip
- Systems Neuroscience of Autism and PSychiatric Disorders (SYNAPS) Research Unit, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Valerie W. Hu
- Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20052, USA;
| | - Takako Kikkawa
- Department of Developmental Neuroscience, United Centers for Advanced Research and Translational Medicine (ART), Tohoku University Graduate School of Medicine, Sendai 980-8577, Miyagi, Japan; (T.K.); (N.O.)
| | - Noriko Osumi
- Department of Developmental Neuroscience, United Centers for Advanced Research and Translational Medicine (ART), Tohoku University Graduate School of Medicine, Sendai 980-8577, Miyagi, Japan; (T.K.); (N.O.)
| | - Tewarit Sarachana
- Systems Neuroscience of Autism and PSychiatric Disorders (SYNAPS) Research Unit, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
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10
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Ibrahim K, Soorya LV, Halpern DB, Gorenstein M, Siper PM, Wang AT. Social cognitive skills groups increase medial prefrontal cortex activity in children with autism spectrum disorder. Autism Res 2021; 14:2495-2511. [PMID: 34486810 DOI: 10.1002/aur.2603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/25/2021] [Accepted: 08/09/2021] [Indexed: 12/21/2022]
Abstract
Few studies have examined the neural mechanisms of change following social skills interventions for children with autism spectrum disorder (ASD). This study examined the neural effects of social cognitive skills groups during functional MRI (fMRI) tasks of irony comprehension and eye gaze processing in school-aged children with ASD. Verbally fluent children (ages 8-11) were randomized to social cognitive skills groups or facilitated play comparison groups. Behavioral assessments and fMRI scans were obtained at baseline and endpoint (12 weeks). During fMRI, children completed two separate tasks to engage social cognition circuitry: comprehension of potentially ironic scenarios (n = 34) and viewing emotionally expressive faces with direct or averted gaze (n = 24). Whole-brain analyses were conducted to examine neural changes following treatment. Regression analyses were also conducted to explore the relationship between neural and behavioral changes. When comparing the two groups directly, the social cognitive skills group showed greater increases in activity in the medial prefrontal cortex (mPFC), implicated in theory of mind, relative to the comparison group for both irony comprehension and gaze processing tasks. Increased mPFC activity during the irony task was associated with improvement in social functioning on the Social Responsiveness Scale across both groups. Findings indicate that social cognitive skills interventions may increase activity in regions associated with social cognition and mentalizing abilities. LAY SUMMARY: Social skills groups are a common intervention for school-aged children with ASD. However, few studies have examined the neural response to social skills groups in school-aged children with ASD. Here, we report on a study evaluating neural outcomes from an empirically supported social cognitive skills training curriculum using fMRI. This study seeks to understand the effects of targeting emotion recognition and theory of mind on the brain circuitry involved in social cognition in verbally fluent children ages 8-11. Results indicate increased neural activity in the mPFC, a region considered to be a central hub of the "social brain," in children randomized to social cognitive skills groups relative to a comparison group that received a high-quality, child-directed play approach. In addition, increased activation in the mPFC during an irony comprehension task was associated with gains in social functioning across both groups from pre- to post-treatment. This is the first fMRI study of social skills treatment outcomes following a randomized trial with an active treatment condition in school-aged children with ASD.
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Affiliation(s)
- Karim Ibrahim
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Latha V Soorya
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Rush Medical College, Rush University, Chicago, Illinois, USA
| | - Danielle B Halpern
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Gorenstein
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paige M Siper
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - A Ting Wang
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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11
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Tesfaye R, Wright N, Zaidman-Zait A, Bedford R, Zwaigenbaum L, Kerns CM, Duku E, Mirenda P, Bennett T, Georgiades S, Smith IM, Vaillancourt T, Pickles A, Szatmari P, Elsabbagh M. 'Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism'. Sleep 2021; 44:6275587. [PMID: 33987680 DOI: 10.1093/sleep/zsab122] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF difficulties in ASD are exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. A subsample (n=217) from the Pathways in ASD longitudinal study was analyzed. The Children's Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (Mean=3.5years). Metacognition (MI) and Behavioral Regulation (BRI) indices, on the Teacher Behavior Rating Inventory of Executive Functioning, were used to measure cognitive and affective components of EF respectively at four time-points (7.8-11.8years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (Mean=6.7years). Sleep traits had different age-related impacts on behavioral regulation, but not metacognition. Longer sleep onset at 3.5 years was associated with a worsening BRI difficulties slope (b=2.07, p<0.04), but conversely associated with lower BRI difficulties at 7.7 years (b=-4.14, p=0.04). A longer sleep onset at 6.7 years was related to higher BRI difficulties at 7.7 years (b=7.78, p<0.01). Longer sleep duration at 6.7 years was associated with higher BRI difficulties at age 7.7 (b=3.15, p=0.01), but subscale analyses revealed shorter sleep duration at age 6.7 was linked to a worsening inhibition slope (b=-0.60, p=0.01). Sleep onset is a robust early correlate of behavior regulation in children with ASD, whereas sleep duration is a later childhood correlate.
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Affiliation(s)
- Rackeb Tesfaye
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Canada
| | - Nicola Wright
- King's College London, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anat Zaidman-Zait
- Tel Aviv University, Department of Educational Sciences, Tel Aviv, Israel
| | - Rachael Bedford
- King's College London, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,University of Bath, Department of Psychology, Bath, UK
| | | | - Connor M Kerns
- University of British Columbia, Department of Psychology, Vancouver, Canada
| | - Eric Duku
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Pat Mirenda
- University of British Columbia, Education and Counseling Psychology, Vancouver, Canada
| | - Teresa Bennett
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Stelios Georgiades
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Isabel M Smith
- Dalhousie University, IWK Health Centre, Pediatrics, Halifax, Canada
| | | | - Andrew Pickles
- King's College London, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- University of Toronto, Department of Psychiatry, Toronto, Canada.,Centre for Addiction and Mental Health, Child and Youth Mental Health, Toronto, Canada.,SickKids Department of Psychiatry, child and adolescent psychiatry, Toronto, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Canada
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12
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Morová M, Kršková L. Autistic-like traits in laboratory rodents exposed to phthalic acid esters during early development - an animal model of autism? Physiol Res 2021; 70:345-361. [PMID: 33982578 DOI: 10.33549/physiolres.934570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Phthalates are chemical substances that are widely used to provide flexibility and durability to plastic materials. They leach from products in which they are mixed and reach living organisms. Results from experimental studies suggest that exposure to phthalates can have a negative impact on an individual's neuronal system and behavior. In this regard, exposure during early ontogenesis seems to be particularly dangerous due to the extensive growth and development of body structures and functions. Disruption during this critical time can result in alterations of behavior and the emergence of neurodevelopmental disorders, such as autism spectrum disorder (ASD). Various animal models have been used to elucidate the pathogenesis of this disease. They are fundamental for research, and although the translation of results to humans is difficult, new animal models are being developed. The aim of this review is to summarize laboratory rodent studies in which early developmental phthalate exposure resulted in brain alterations and autistic-like behavioral traits. We also discuss the possibility of using early developmental phthalate exposure in rodents to create a new animal model of autism.
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Affiliation(s)
- M Morová
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava 4, Slovak Republic.
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13
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McVey AJ, Schiltz HK, Coffman M, Antezana L, Magnus B. A Preliminary Psychometric Analysis of the Difficulties with Emotion Regulation Scale (DERS) Among Autistic Adolescents and Adults: Factor Structure, Reliability, and Validity. J Autism Dev Disord 2021; 52:1169-1188. [PMID: 33886035 DOI: 10.1007/s10803-021-05018-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 12/01/2022]
Abstract
Emotion dysregulation is common among autistic people, yet few measures have received psychometric evaluation in this population. We examined the factor structure, reliability, and validity of a commonly-used measure of emotion dysregulation, the Difficulties with Emotion Regulation Scale (DERS), in a sample of 156 autistic adolescents and adults. Data were drawn from the NIH National Database for Autism Research (NDAR) and an author's existing dataset. Results demonstrated that the factor structure generally conformed to the original 6-factor model, with modifications. Reliability analyses revealed good-to-excellent internal consistencies. Validity analyses indicated that the DERS was positively associated with measures of anxiety, depression, and alexithymia. Our findings provide preliminary evidence for the utility of the DERS in a small autistic sample, with minor modifications.
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Affiliation(s)
- Alana J McVey
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada. .,Department of Psychology, Marquette University, Milwaukee, WI, USA.
| | | | - Marika Coffman
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.,Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Ligia Antezana
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Brooke Magnus
- Department of Psychology, Marquette University, Milwaukee, WI, USA.,Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, USA
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14
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Boys with autism spectrum disorder have distinct cortical folding patterns underpinning impaired self-regulation: a surface-based morphometry study. Brain Imaging Behav 2021; 14:2464-2476. [PMID: 31512098 DOI: 10.1007/s11682-019-00199-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although impaired self-regulation (dysregulation) in autism spectrum disorder (ASD) garnered increasing awareness, the neural mechanism of dysregulation in ASD are far from conclusive. To complement our previous voxel-based morphometry findings, we estimated the cortical thickness, surface area, and local gyrification index based on the surface-based morphometry from structural MRI images in 85 ASD and 65 typically developing control (TDC) boys, aged 7-17 years. Levels of dysregulation were measured by the sum of T-scores of Attention, Aggression, and Anxiety/Depression subscales on the Child Behavior Checklist. We found both ASD and TDC shared similar relationships between dysregulation and cortical folding patterns in the left superior and inferior temporal gyri and the left premotor cortex. Significant diagnosis by dysregulation interactions in cortical folding patterns were identified over the right middle frontal and right lateral orbitofrontal regions. The statistical significance of greater local gyrification index in ASD than TDC in several brain regions disappeared when the level of dysregulation was considered. The findings of shared and distinct neural correlates underpinning dysregulation between ASD and TDC may facilitate the development of targeted interventions in the future. The present work also demonstrates that inter-subject variations in self-regulation may explain some extents of ASD-associated brain morphometric differences, likely suggesting that dysregulation is one of the yardsticks for dissecting the heterogeneity of ASD.
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15
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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16
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Association of self-regulation with white matter correlates in boys with and without autism spectrum disorder. Sci Rep 2020; 10:13811. [PMID: 32796900 PMCID: PMC7429820 DOI: 10.1038/s41598-020-70836-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 07/24/2020] [Indexed: 12/27/2022] Open
Abstract
Previous studies demonstrated distinct neural correlates underpinning impaired self-regulation (dysregulation) between individuals with autism spectrum disorder (ASD) and typically developing controls (TDC). However, the impacts of dysregulation on white matter (WM) microstructural property in ASD and TDC remain unclear. Diffusion spectrum imaging was acquired in 59 ASD and 62 TDC boys. We investigated the relationship between participants’ dysregulation levels and microstructural property of 76 WM tracts in a multivariate analysis (canonical correlation analysis), across diagnostic groups. A single mode of brain-behavior co-variation was identified: participants were spread along a single axis linking diagnosis, dysregulation, diagnosis-by-dysregulation interaction, and intelligence to a specific WM property pattern. This mode corresponds to diagnosis-distinct correlates underpinning dysregulation, which showed higher generalized fractional anisotropy (GFA) associated with less dysregulation in ASD but greater dysregulation in TDC, in the tracts connecting limbic and emotion regulation systems. Moreover, higher GFA of the tracts implicated in memory, attention, sensorimotor processing, and perception associated with less dysregulation in TDC but worse dysregulation in ASD. No shared WM correlates of dysregulation between ASD and TDC were identified. Corresponding to previous studies, we demonstrated that ASD and TDC have broad distinct white matter microstructural property underpinning self-regulation.
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17
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Tymofiyeva O, Zhou VX, Lee CM, Xu D, Hess CP, Yang TT. MRI Insights Into Adolescent Neurocircuitry-A Vision for the Future. Front Hum Neurosci 2020; 14:237. [PMID: 32733218 PMCID: PMC7359264 DOI: 10.3389/fnhum.2020.00237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Adolescence is the time of onset of many psychiatric disorders. Half of pediatric patients present with comorbid psychiatric disorders that complicate both their medical and psychiatric care. Currently, diagnosis and treatment decisions are based on symptoms. The field urgently needs brain-based diagnosis and personalized care. Neuroimaging can shed light on how aberrations in brain circuits might underlie psychiatric disorders and their development in adolescents. In this perspective article, we summarize recent MRI literature that provides insights into development of psychiatric disorders in adolescents. We specifically focus on studies of brain structural and functional connectivity. Ninety-six included studies demonstrate the potential of MRI to assess psychiatrically relevant constructs, diagnose psychiatric disorders, predict their development or predict response to treatment. Limitations of the included studies are discussed, and recommendations for future research are offered. We also present a vision for the role that neuroimaging may play in pediatrics and primary care in the future: a routine neuropsychological and neuropsychiatric imaging (NPPI) protocol for adolescent patients, which would include a 30-min brain scan, a quality control and safety read of the scan, followed by computer-based calculation of the structural and functional brain network metrics that can be compared to the normative data by the pediatrician. We also perform a cost-benefit analysis to support this vision and provide a roadmap of the steps required for this vision to be implemented.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Vivian X Zhou
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Chuan-Mei Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Clinical Excellence Research Center, Stanford University, Stanford, CA, United States
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher P Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Tony T Yang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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18
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Factor RS, Swain DM, Antezana L, Muskett A, Gatto AJ, Radtke SR, Scarpa A. Teaching emotion regulation to children with autism spectrum disorder: Outcomes of the Stress and Anger Management Program (STAMP). Bull Menninger Clin 2020; 83:235-258. [PMID: 31502872 DOI: 10.1521/bumc.2019.83.3.235] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Young children with autism spectrum disorder (ASD) struggle with emotion regulation (ER), which is developmentally preceded by lability/negative affect (L/N), and their parents face unique challenges to parenting and providing assistance. The Stress and Anger Management Program (STAMP) is a cognitive-behavioral treatment designed to address ER deficits in young children with ASD through child skill-building and parent training. The current study evaluated child L/N, ER, and parental confidence outcomes in 4- to 7-year-old children with ASD (N = 23; 19 boys) and their parents randomly assigned to a treatment (n = 12) or a waitlist control group (n = 11). Child L/N decreased, regulation was not significantly changed, and parental confidence regarding the child's ability to manage anger and anxiety increased from pre- to posttreatment in the treatment group, but not in the waitlist group. Implications for future interventions that address ER in children with ASD and their parents are discussed.
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Affiliation(s)
- Reina S Factor
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia.,Virginia Tech Autism Clinic and Center for Autism Research, Blacksburg, Virginia
| | - Deanna M Swain
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia.,Virginia Tech Autism Clinic and Center for Autism Research, Blacksburg, Virginia
| | - Ligia Antezana
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia.,Virginia Tech Autism Clinic and Center for Autism Research, Blacksburg, Virginia
| | - Ashley Muskett
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia.,Virginia Tech Autism Clinic and Center for Autism Research, Blacksburg, Virginia
| | - Alyssa J Gatto
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Sarah R Radtke
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Angela Scarpa
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia.,Virginia Tech Autism Clinic and Center for Autism Research, Blacksburg, Virginia
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19
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Lin HY, Ni HC, Tseng WYI, Gau SSF. Characterizing intrinsic functional connectivity in relation to impaired self-regulation in intellectually able male youth with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1201-1216. [DOI: 10.1177/1362361319888104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While a considerable number of youth with autism spectrum disorder exhibit impaired self-regulation (dysregulation), little is known about the neural correlates of dysregulation in autism spectrum disorder. In a sample of intellectually able boys with autism spectrum disorder (further categorized as those with and without dysregulation) and typically developing boys (aged 7–17 years), we conducted a multivariate connectome-wide association study to examine the intrinsic functional connectivity with resting-state functional magnetic resonance imaging. Dysregulation was defined by the sum of Attention, Aggression, and Anxiety/Depression subscales on the Child Behavior Checklist. We identified that both categorical and dimensional neural correlates of dysregulation in youth with autism spectrum disorder involved atypical connectivity among the components of multiple brain networks, especially between those subserving sensorimotor processing and salience encoding, beyond higher-level cognitive control circuitries. Interaction within the attention network might serve as autism spectrum disorder–specific neural correlates underpinning dysregulation. Our results highlight that the inter-individual variability in dysregulation might contribute to the inconsistency in the neuroimaging literature of autism spectrum disorder. Collectively, the present findings provide evidence to suggest that dysregulation might be considered as both categorical and dimensional moderators to parse heterogeneity of autism spectrum disorder.Lay AbstractImpaired self-regulation (i.e., dysregulation in affective, behavioral, and cognitive control), is commonly present in young people with autism spectrum disorder (ASD). However, little is known about what is happening in people’s brains when self-regulation is impaired in young people with ASD. We used a technique called functional MRI (which measures brain activity by detecting changes associated with blood flow) at a resting state (when participants are not asked to do anything) to research this in intellectually able young people with ASD. We found that brains with more connections, especially between regions involved in sensorimotor processing and regions involved in the processes that enable peoples to focus their attention on the most pertinent features from the sensory environment (salience processing), were related to more impaired self-regulation in young people with and without ASD. We also found that impaired self-regulation was related to increased communication within the brain system involved in voluntary orienting attention to a sensory cue (the dorsal attention network) in young people with ASD. These results highlight how different people have different degrees of dysregulation, which has been largely overlooked in the earlier brain imaging reports on ASD. This might contribute to understanding some of the inconsistencies in the existing published literature on this topic.
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Affiliation(s)
- Hsiang-Yuan Lin
- National Taiwan University Hospital
- National Taiwan University
| | - Hsing-Chang Ni
- National Taiwan University
- Chang Gung Memorial Hospital at Linkou
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20
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Ibrahim K, Eilbott JA, Ventola P, He G, Pelphrey KA, McCarthy G, Sukhodolsky DG. Reduced Amygdala-Prefrontal Functional Connectivity in Children With Autism Spectrum Disorder and Co-occurring Disruptive Behavior. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:1031-1041. [PMID: 30979647 PMCID: PMC7173634 DOI: 10.1016/j.bpsc.2019.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Disruptive behaviors are prevalent in children with autism spectrum disorder (ASD) and often cause substantial impairments. However, the underlying neural mechanisms of disruptive behaviors remain poorly understood in ASD. In children without ASD, disruptive behavior is associated with amygdala hyperactivity and reduced connectivity with the ventrolateral prefrontal cortex (vlPFC). This study examined amygdala reactivity and connectivity in children with ASD with and without co-occurring disruptive behavior disorders. We also investigated differential contributions of externalizing behaviors and callous-unemotional traits to variance in amygdala connectivity and reactivity. METHODS This cross-sectional study involved behavioral assessments and neuroimaging in three groups of children 8 to 16 years of age: 18 children had ASD and disruptive behavior, 20 children had ASD without disruptive behavior, and 19 children were typically developing control participants matched for age, gender, and IQ. During functional magnetic resonance imaging, participants completed an emotion perception task of fearful versus calm faces. Task-specific changes in amygdala reactivity and connectivity were examined using whole-brain, psychophysiological interaction, and multiple regression analyses. RESULTS Children with ASD and disruptive behavior showed reduced amygdala-vlPFC connectivity compared with children with ASD without disruptive behavior. Externalizing behaviors and callous-unemotional traits were associated with amygdala reactivity to fearful faces in children with ASD after controlling for suppressor effects. CONCLUSIONS Reduced amygdala-vlPFC connectivity during fear processing may differentiate children with ASD and disruptive behavior from children with ASD without disruptive behavior. The presence of callous-unemotional traits may have implications for identifying differential patterns of amygdala activity associated with increased risk of aggression in ASD. These findings suggest a neural mechanism of emotion dysregulation associated with disruptive behavior in children with ASD.
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Affiliation(s)
- Karim Ibrahim
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut.
| | - Jeffrey A Eilbott
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Pamela Ventola
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - George He
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Kevin A Pelphrey
- Department of Neurology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Gregory McCarthy
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Denis G Sukhodolsky
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut.
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21
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Stack A, Lucyshyn J. Autism Spectrum Disorder and the Experience of Traumatic Events: Review of the Current Literature to Inform Modifications to a Treatment Model for Children with Autism. J Autism Dev Disord 2019; 49:1613-1625. [PMID: 30539370 DOI: 10.1007/s10803-018-3854-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children with autism incur trauma and have increased vulnerabilities for experiencing trauma. This paper summarizes the current literature in the study of trauma in typically developing children and those with autism. A treatment model for children with autism, drawing on components from cognitive behavior therapy (CBT), trauma-focused CBT, and CBT to teach emotion regulation and treat anxiety in children with autism is suggested. Components include: (a) Functional Behavior Assessment; (b) behavior plans and behavioral skills training; (c) teaching emotion regulation; (d) exposure therapy; (e) cognitive restructuring; (f) parent and child support between sessions; (g) safety plan; and (h) programming for generalization and maintenance. Future research should establish evidence-based treatment of trauma in this population by evaluating the modified treatment package.
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Affiliation(s)
- Alexia Stack
- A Block Above Behavioral Consulting, 3185 Sunnyhurst Rd., North Vancouver, BC, V7K 2G4, Canada.
| | - Joseph Lucyshyn
- Department of Educational and Counselling Psychology, Faculty of Education, University of British Columbia, 2125 Main Mall, Vancouver, BC, V6T 1Z4, Canada
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22
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Nomi JS, Molnar-Szakacs I, Uddin LQ. Insular function in autism: Update and future directions in neuroimaging and interventions. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:412-426. [PMID: 30381235 DOI: 10.1016/j.pnpbp.2018.10.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/15/2018] [Accepted: 10/26/2018] [Indexed: 12/13/2022]
Abstract
The insular cortex, hidden within the lateral sulcus of the human brain, participates in a range of cognitive, affective, and sensory functions. Autism spectrum disorder (ASD), a neurodevelopmental condition affecting all of these functional domains, has increasingly been linked with atypical activation and connectivity of the insular cortices. Here we review the latest research linking atypical insular function to a range of behaviors characteristic of ASD, with an emphasis on neuroimaging findings in the domains of social cognition and executive function. We summarize some of the recent work linking the insula to interventions in autism, including oxytocin-based pharmacological treatments and music therapy. We suggest that future directions likely to yield significant insights into insular pathology in ASD include the analysis of the dynamics of this brain region. We also conclude that more basic research is necessary on the use of oxytocin pharmacotherapy, and larger studies addressing participant heterogeneity are needed on the use of music therapy in ASD. Long-term studies are needed to ascertain sustained effects of these interventions.
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Affiliation(s)
- Jason S Nomi
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | | | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA; Canadian Institute for Advanced Research, Toronto, ON, Canada.
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23
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The role of right ventrolateral prefrontal cortex on social emotional regulation in subclinical depression: An tDCS study. ACTA PSYCHOLOGICA SINICA 2019. [DOI: 10.3724/sp.j.1041.2019.00207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Cai RY, Richdale AL, Uljarević M, Dissanayake C, Samson AC. Emotion regulation in autism spectrum disorder: Where we are and where we need to go. Autism Res 2018; 11:962-978. [PMID: 29979494 DOI: 10.1002/aur.1968] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 03/04/2018] [Accepted: 04/20/2018] [Indexed: 12/11/2022]
Abstract
Emotion dysregulation is a common issue experienced by individuals with autism spectrum disorder (ASD) and has been associated with a wide range of negative mental and physical health outcomes. This commentary highlights the role emotion dysregulation plays in ASD by first considering the literature on emotion regulation (ER) in the general population and then summarizing the ER research in ASD. Based on the evaluation of previous research findings, we conclude that individuals with ASD have more ER difficulties and consistently self-report or demonstrate a less adaptive pattern of ER strategy use. In addition, the higher prevalence of internalizing and externalizing issues seen in ASD are associated with the greater habitual use of some ER strategies and less habitual use of others. Conceptual and methodological limitations are discussed, including the use of coping measures and single-method approaches, and ASD gender distribution. We propose a set of new directions for investigating ER in ASD, incorporating knowledge from other literatures on the role of flexibility in healthy adaptation, overlaps between flexibility and executive function deficits, the adaptive value of up-regulation of positive emotions, and the importance of emotional self-awareness. Increasing our capacity for identifying the mechanisms underlying co-morbid affective disorders can ultimately inform the design of effective interventions to maximize the wellbeing of individuals with ASD. Autism Res 2018, 11: 962-978. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Research has shown that people diagnosed with autism tend to have difficulties with regulating their own emotions. This commentary article summarizes the main information from emotion regulation research conducted both in autism and in other populations. We make suggestions on how we can improve emotion regulation research in autism, with the ultimate goal being to use the learning gained from research to design effective interventions that can improve the wellbeing of people with autism.
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Affiliation(s)
- Ru Ying Cai
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Mirko Uljarević
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Andrea C Samson
- Swiss Center for Affective Sciences, University of Geneva, Campus Biotech, Chemin des Mines 9, Geneva, 1202, Switzerland.,Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, 401 Quarry Road, Stanford, CA, 94305.,Swiss Distance Learning University, Brig, Switzerland, Überlandstrasse 12, Brig, 3900, Switzerland
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25
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Mazefsky CA, Yu L, White SW, Siegel M, Pilkonis PA. The emotion dysregulation inventory: Psychometric properties and item response theory calibration in an autism spectrum disorder sample. Autism Res 2018; 11:928-941. [PMID: 29624893 PMCID: PMC6026073 DOI: 10.1002/aur.1947] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/21/2018] [Accepted: 03/05/2018] [Indexed: 11/09/2022]
Abstract
Individuals with autism spectrum disorder (ASD) often present with prominent emotion dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS® ) to capture observable indicators of poor emotion regulation. Caregivers of 1,755 youth with ASD completed 66 candidate EDI items, and the final 30 items were selected based on classical test theory and item response theory (IRT) analyses. The analyses identified two factors: (a) Reactivity, characterized by intense, rapidly escalating, sustained, and poorly regulated negative emotional reactions, and (b) Dysphoria, characterized by anhedonia, sadness, and nervousness. The final items did not show differential item functioning (DIF) based on gender, age, intellectual ability, or verbal ability. Because the final items were calibrated using IRT, even a small number of items offers high precision, minimizing respondent burden. IRT co-calibration of the EDI with related measures demonstrated its superiority in assessing the severity of emotion dysregulation with as few as seven items. Validity of the EDI was supported by expert review, its association with related constructs (e.g., anxiety and depression symptoms, aggression), higher scores in psychiatric inpatients with ASD compared to a community ASD sample, and demonstration of test-retest stability and sensitivity to change. In sum, the EDI provides an efficient and sensitive method to measure emotion dysregulation for clinical assessment, monitoring, and research in youth with ASD of any level of cognitive or verbal ability. Autism Res 2018, 11: 928-941. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This paper describes a new measure of poor emotional control called the Emotion Dysregulation Inventory (EDI). Caregivers of 1,755 youth with ASD completed candidate items, and advanced statistical techniques were applied to identify the best final items. The EDI is unique because it captures common emotional problems in ASD and is appropriate for both nonverbal and verbal youth. It is an efficient and sensitive measure for use in clinical assessments, monitoring, and research with youth with ASD.
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Affiliation(s)
- Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Lan Yu
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Susan W White
- Department of Psychology, Virginia Tech, Blacksburg, Virginia
| | - Matthew Siegel
- Maine Medical Center Research Institute, Maine Behavioral Healthcare, Scarborough, Maine
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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26
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Uljarević M, Hedley D, Nevill R, Evans DW, Cai RY, Butter E, Mulick JA. Brief report: Poor self-regulation as a predictor of individual differences in adaptive functioning in young children with autism spectrum disorder. Autism Res 2018; 11:1157-1165. [DOI: 10.1002/aur.1953] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 03/13/2018] [Accepted: 03/18/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Mirko Uljarević
- Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of Medicine; Stanford University; Stanford California
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne Victoria Australia
| | - Darren Hedley
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne Victoria Australia
- Nationwide Children's Hospital; Columbus Ohio
| | - Rose Nevill
- The Ohio State University; Columbus Ohio
- Kennedy Krieger Institute and John Hopkins School of Medicine; Baltimore Maryland
| | | | - Ru Ying Cai
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne Victoria Australia
| | - Eric Butter
- Nationwide Children's Hospital; Columbus Ohio
- The Ohio State University; Columbus Ohio
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Vasa RA, Kreiser NL, Keefer A, Singh V, Mostofsky SH. Relationships between autism spectrum disorder and intolerance of uncertainty. Autism Res 2018; 11:636-644. [PMID: 29316350 PMCID: PMC5903967 DOI: 10.1002/aur.1916] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 11/08/2017] [Accepted: 12/06/2017] [Indexed: 12/21/2022]
Abstract
Intolerance of uncertainty (IU) is a dispositional risk factor involving maladaptive responding under conditions of uncertainty. Recent data indicate that IU is likely elevated in youth with autism spectrum disorder (ASD) and is positively correlated with anxiety. This study examined whether IU may be associated with ASD independent of anxiety. Relationships between anxiety, ASD, and IU were examined in 57 children with ASD without co-occurring intellectual disability and 32 control participants, ages 7-16 years. Hierarchal linear regressions were run to examine whether ASD variables, including emotion dysregulation, were predictive of IU when controlling for anxiety. Severity of social communication deficits, repetitive behaviors, and emotion dysregulation were each related to IU when controlling for the effects of anxiety. When these variables were entered into the regression model together, emotion dysregulation was the only significant predictor of IU. These findings suggest that IU is directly related to features of ASD possibly due to shared genetic, neurological, or psychological underpinnings. Autism Res 2018, 11: 636-644. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Youth with ASD without co-occurring intellectual disability experience high levels of intolerance of uncertainty (IU), which is related to anxiety. This study found that IU may also have a relationship with certain aspects of ASD, particularly emotion dysregulation.
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Affiliation(s)
- Roma A. Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, Maryland, 21211
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, Maryland, 21205
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, Maryland, 21287
| | - Nicole L. Kreiser
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 710, Norfolk, Virginia, 23507
| | - Amy Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, Maryland, 21211
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, Maryland, 21287
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, Maryland, 21211
| | - Stewart H. Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, Maryland, 21205
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 710, Norfolk, Virginia, 23507
- Department of Neurology, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, Maryland, 21205
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28
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He Z, Lin Y, Xia L, Liu Z, Zhang D, Elliott R. Critical role of the right VLPFC in emotional regulation of social exclusion: a tDCS study. Soc Cogn Affect Neurosci 2018; 13:357-366. [PMID: 29618116 PMCID: PMC5928413 DOI: 10.1093/scan/nsy026] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/28/2018] [Accepted: 03/18/2018] [Indexed: 11/20/2022] Open
Abstract
There is abundant evidence suggesting that the right ventrolateral prefrontal cortex (rVLPFC) plays an important role in down-regulating the emotional response to social exclusion. However, a causal relationship between rVLPFC function and explicit emotional regulation is not clear in the context of social exclusion. This study employed anodal transcranial direct current stimulation (tDCS) to activate rVLPFC while participants used emotional regulation to reappraise pictures of social exclusion. Forty-four participants were randomly assigned to an active tDCS group or a sham group. Both groups viewed social exclusion images under two conditions: in the no-reappraisal condition, participants were instructed to passively view social exclusion images; in the reappraisal condition, they reappraised the images to down-regulate negative emotional responses. Compared to sham stimulation, anodal tDCS over the rVLPFC resulted in less negative emotion ratings, and produced significantly smaller pupil diameter in the reappraisal, compared to no-reappraisal block. The tDCS also led to longer fixation durations to rejectees and shorter fixation durations to rejecters. Taken together, these findings suggest a causal role for rVLPFC in down-regulation of negative emotions produced by social exclusion. This study has implications for clinical interventions targeting emotional regulation deficits.
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Affiliation(s)
- Zhenhong He
- Department of Psychology, College of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, China.,Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, M13 9PT, UK
| | - Yiqin Lin
- Department of Psychology, College of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, China
| | - Lisheng Xia
- College of Information Engineering, Shenzhen University, Shenzhen, 518060, China
| | - Zhenli Liu
- Department of Psychology, College of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, China
| | - Dandan Zhang
- Department of Psychology, College of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, China.,Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, 518060, China
| | - Rebecca Elliott
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, M13 9PT, UK
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29
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Bennett RH, Somandepalli K, Roy AK, Di Martino A. The Neural Correlates of Emotional Lability in Children with Autism Spectrum Disorder. Brain Connect 2018; 7:281-288. [PMID: 28506079 DOI: 10.1089/brain.2016.0472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Autism spectrum disorder (ASD) is exceptionally heterogeneous in both clinical and physiopathological presentations. Clinical variability applies to ASD-specific symptoms and frequent comorbid psychopathology such as emotional lability (EL). To date, the physiopathological underpinnings of the co-occurrence of EL and ASD are unknown. As a first step, we examined within-ASD inter-individual variability of EL and its neuronal correlates using resting-state functional magnetic resonance imaging (R-fMRI). We analyzed R-fMRI data from 58 children diagnosed with ASD (5-12 years) in relation to the Conners' Parent Rating Scale EL index. We performed both an a priori amygdala region-of-interest (ROI) analysis, and a multivariate unbiased whole-brain data-driven approach. While no significant brain-behavior relationships were identified regarding amygdala intrinsic functional connectivity (iFC), multivariate whole-brain analyses revealed an extended functional circuitry centered on two regions: middle frontal gyrus (MFG) and posterior insula (PI). Follow-up parametric and nonparametric ROI-analyses of these regions revealed relationships between EL and MFG- and PI-iFC with default, salience, and visual networks suggesting that higher-order cognitive and somatosensory processes are critical for emotion regulation in ASD. We did not detect evidence of amygdala iFC underpinning EL in ASD. However, exploratory whole-brain analyses identified large-scale networks that have been previously reported abnormal in ASD. Future studies should consider EL as a potential source of neuronal heterogeneity in ASD and focus on multinetwork interactions.
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Affiliation(s)
- Randi H Bennett
- 1 Department of Psychology, Fordham University , Bronx, New York
| | - Krishna Somandepalli
- 2 Department of Child and Adolescent Psychiatry, NYU Child Study Center of the Langone Medical Center , New York, New York
| | - Amy K Roy
- 1 Department of Psychology, Fordham University , Bronx, New York
| | - Adriana Di Martino
- 2 Department of Child and Adolescent Psychiatry, NYU Child Study Center of the Langone Medical Center , New York, New York
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30
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Neural correlates of impaired self-regulation in male youths with autism spectrum disorder: A voxel-based morphometry study. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:233-241. [PMID: 29129723 DOI: 10.1016/j.pnpbp.2017.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/01/2017] [Accepted: 11/07/2017] [Indexed: 11/22/2022]
Abstract
Although recent studies revealed impaired self-regulation (dysregulation) in autism spectrum disorder (ASD), neural correlates of dysregulation and its impacts on autistic neuroanatomy remain unclear. Voxel-based morphometry was applied on structural MRI images in 81 ASD and 61 typically developing (TD) boys aged 7-17years. Dysregulation was defined by the sum of T-scores of Attention, Aggression, and Anxiety/Depression subscales in the Child Behavior Checklist>180. There were 53 and 28 boys in the ASD+Dysregulation and ASD-Dysregulation groups, respectively. First, we compared regional gray matter (GM) volume for ASD and TD. Second, we investigated regional GM volumetric differences among the ASD+Dysregulation, ASD-Dysregulation and TD groups. Lastly, shared and distinct neurostructural correlates of dysregulation were investigated in the ASD and TD groups. The ASD-TD difference on neuroanatomy no longer existed after controlling the dysregulation severity. ASD+Dysregulation had larger regional GM volumes in the right fusiform gyrus, and smaller GM volumes in the anterior prefrontal cortex than ASD-Dysregulation and TD, respectively. ASD+Dysregulation had smaller GM volumes in the left lateral occipital/superior parietal cortex than TD boys. No GM difference was identified between ASD-Dysregulation and TD. ASD and TD had a shared association between GM volumes in the orbitofrontal cortex and dysregulation levels. Our findings suggest that atypical neuroanatomy associated with ASD might partially reflect a disproportionate level of impaired self-regulation. Categorical and dimensional considerations of dysregulation should be implemented in future ASD studies.
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31
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Fink J, Pflugradt E, Stierle C, Exner C. Changing disgust through imagery rescripting and cognitive reappraisal in contamination-based obsessive-compulsive disorder. J Anxiety Disord 2018; 54:36-48. [PMID: 29421371 DOI: 10.1016/j.janxdis.2018.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 01/16/2023]
Abstract
Contamination-related obsessive-compulsive disorder (C-OCD) is characterized by strongly experienced disgust and fear, in response to potentially contaminating stimuli. Both emotions differ in their susceptibility for change by habituation and extinction, which are important processes for the success of exposure therapy. Even though the response rates for exposure therapy for C-OCD are very good, it seems promising to test additional therapeutic techniques which target disgust more directly. Therefore, imagery rescripting and cognitive reappraisal were evaluated for their potential to change levels of disgust (within-subject), in the two-session laboratory study with 30 participants, with diagnosed C-OCD, and 30 matched, healthy controls (between-subject), presented. The results show that both emotion-regulation strategies reduced disgust better than a non-intervention control task (counting fishes), across all the participants. Therefore, both strategies seem to be applicable and effective for reducing disgust, in the short term, in participants with diagnosed C-OCD. The implications of these findings for the experimental approach and for the clinical treatment of C-OCD, are discussed.
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Affiliation(s)
- Jakob Fink
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Elisa Pflugradt
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Christian Stierle
- Schön Klinik Bad Bramstedt, Birkenweg 10, 24576 Bad Bramstedt, Germany.
| | - Cornelia Exner
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
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32
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De Groot K, Van Strien JW. Self-Report and Brain Indicators of Impaired Emotion Regulation in the Broad Autism Spectrum. J Autism Dev Disord 2018; 47:2138-2152. [PMID: 28447304 PMCID: PMC5487758 DOI: 10.1007/s10803-017-3138-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Although not used as a diagnostic criterion, impaired emotion regulation is frequently observed in autism. The present study examined self-reported use of emotion regulation strategies in individuals scoring low or high on autistic traits. In addition, the late positive potential, which is sensitive to emotional arousal, was used to examine the effect of one strategy, reappraisal. Reporting more autistic traits was related to using more maladaptive and fewer adaptive emotion regulation strategies. Across both groups, no attenuation of the late positive potential during downregulation of unpleasant pictures was found, possibly because of the used valence-changing reappraisal operationalisation. Hence, although self-report indicated impaired emotion regulation in individuals high on autistic traits, electrophysiological findings could not confirm this.
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Affiliation(s)
- Kristel De Groot
- Faculty of Social Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
| | - Jan W Van Strien
- Faculty of Social Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
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33
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Brief Report: Inter-Relationship between Emotion Regulation, Intolerance of Uncertainty, Anxiety, and Depression in Youth with Autism Spectrum Disorder. J Autism Dev Disord 2017; 48:316-325. [DOI: 10.1007/s10803-017-3318-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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34
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Paula CAR, Reategui C, Costa BKDS, da Fonseca CQ, da Silva L, Morya E, Brasil FL. High-Frequency EEG Variations in Children with Autism Spectrum Disorder during Human Faces Visualization. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3591914. [PMID: 29018811 PMCID: PMC5606140 DOI: 10.1155/2017/3591914] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/27/2017] [Accepted: 07/27/2017] [Indexed: 12/13/2022]
Abstract
Autism spectrum disorder (ASD) is a neuropsychiatric disorder characterized by the impairment in the social reciprocity, interaction/language, and behavior, with stereotypes and signs of sensory function deficits. Electroencephalography (EEG) is a well-established and noninvasive tool for neurophysiological characterization and monitoring of the brain electrical activity, able to identify abnormalities related to frequency range, connectivity, and lateralization of brain functions. This research aims to evidence quantitative differences in the frequency spectrum pattern between EEG signals of children with and without ASD during visualization of human faces in three different expressions: neutral, happy, and angry. Quantitative clinical evaluations, neuropsychological evaluation, and EEG of children with and without ASD were analyzed paired by age and gender. The results showed stronger activation in higher frequencies (above 30 Hz) in frontal, central, parietal, and occipital regions in the ASD group. This pattern of activation may correlate with developmental characteristics in the children with ASD.
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Affiliation(s)
- Celina A. Reis Paula
- Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Rod. RN 160, Km 03, No. 3003, 59280-000 Macaiba, RN, Brazil
- Anita Garibaldi Center for Education and Research in Health, Santos Dumont Institute, Rod. RN 160, Km 02, No. 2010, 59280-970 Macaiba, RN, Brazil
| | - Camille Reategui
- Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Rod. RN 160, Km 03, No. 3003, 59280-000 Macaiba, RN, Brazil
| | - Bruna Karen de Sousa Costa
- Electrical Engineering Department, Federal University of Campina Grande (UFCG), 882 Aprígio Veloso St, 58429-900 Campina Grande, PB, Brazil
| | - Caio Queiroz da Fonseca
- Electrical Engineering Department, Federal University of Campina Grande (UFCG), 882 Aprígio Veloso St, 58429-900 Campina Grande, PB, Brazil
| | - Luana da Silva
- Electrical Engineering Department, Federal University of Santa Maria (UFSM), 1000 Roraima Av., 97105-900 Santa Maria, RS, Brazil
| | - Edgard Morya
- Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Rod. RN 160, Km 03, No. 3003, 59280-000 Macaiba, RN, Brazil
| | - Fabricio Lima Brasil
- Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Rod. RN 160, Km 03, No. 3003, 59280-000 Macaiba, RN, Brazil
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35
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Flannery JE, Giuliani NR, Flournoy JC, Pfeifer JH. Neurodevelopmental changes across adolescence in viewing and labeling dynamic peer emotions. Dev Cogn Neurosci 2017; 25:113-127. [PMID: 28262423 PMCID: PMC5764159 DOI: 10.1016/j.dcn.2017.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 12/31/2016] [Accepted: 02/04/2017] [Indexed: 11/30/2022] Open
Abstract
Dynamic peer facial stimuli recruit key regions involved in emotion processing. LPFC shows a nonlinear age trend across adolescence to labeling dynamic peer faces. MOFC/vMPFC shows a linear decrease with age to viewing dynamic peer faces. No significant age trends were observed in amygdala during viewing or labeling dynamic peer faces.
Adolescence is a sensitive period of social-affective development, characterized by biological, neurological, and social changes. The field currently conceptualizes these changes in terms of an imbalance between systems supporting reactivity and regulation, specifically nonlinear changes in reactivity networks and linear changes in regulatory networks. Previous research suggests that the labeling or reappraisal of emotion increases activity in lateral prefrontal cortex (LPFC), and decreases activity in amygdala relative to passive viewing of affective stimuli. However, past work in this area has relied heavily on paradigms using static, adult faces, as well as explicit regulation. In the current study, we assessed cross-sectional trends in neural responses to viewing and labeling dynamic peer emotional expressions in adolescent girls 10–23 years old. Our dynamic adolescent stimuli set reliably and robustly recruited key brain regions involved in emotion reactivity (medial orbital frontal cortex/ventral medial prefrontal cortex; MOFC/vMPFC, bilateral amygdala) and regulation (bilateral dorsal and ventral LPFC). However, contrary to the age-trends predicted by the dominant models in studies of risk/reward, the LPFC showed a nonlinear age trend across adolescence to labeling dynamic peer faces, whereas the MOFC/vMPFC showed a linear decrease with age to viewing dynamic peer faces. There were no significant age trends observed in the amygdala.
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Affiliation(s)
| | | | - John C Flournoy
- Department of Psychology, University of Oregon, United States
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36
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Cerebral bases of emotion regulation toward odours: A first approach. Behav Brain Res 2017; 317:37-45. [DOI: 10.1016/j.bbr.2016.09.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/05/2016] [Accepted: 09/11/2016] [Indexed: 01/29/2023]
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37
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Samson AC, Dougherty RF, Lee IA, Phillips JM, Gross JJ, Hardan AY. White matter structure in the uncinate fasciculus: Implications for socio-affective deficits in Autism Spectrum Disorder. Psychiatry Res Neuroimaging 2016; 255:66-74. [PMID: 27552717 DOI: 10.1016/j.pscychresns.2016.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 08/05/2016] [Accepted: 08/12/2016] [Indexed: 11/19/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) have social and communication deficits and difficulties regulating emotions. The brain bases of these socio-affective deficits are not yet clear, but one candidate is structural connectivity in the left uncinate fasciculus, which connects limbic temporal and frontal areas thought to be involved in socio-affective processing. In this study, we assessed white matter structure in the left and right uncinate fasciculus in 18 high-functioning individuals with ASD and 18 group-matched typically developing (TD) controls using Diffusion Tensor Imaging. To test specificity of the associations, we also examined the association between both uncinate fasciculi and restricted and repetitive behaviors. Compared to TD individuals, individuals with ASD had significantly lower fractional anisotropy (FA) in the left and right uncinate. Group status significantly moderated the association between left uncinate and socio-affective deficits, indicating that within the ASD group, FA was associated with socio-affective deficits: Individuals with ASD with lower FA in the left uncinate had significantly more social and emotion regulation deficits. There was no association with restricted and repetitive behaviors. This study provides evidence that the left uncinate may play a critical role in socio-affective skills in individuals with ASD.
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Affiliation(s)
- Andrea C Samson
- Swiss Center for Affective Sciences, Campus Biotech, University of Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland; Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA.
| | - Robert F Dougherty
- Stanford Center for Cognitive and Neurobiological Imaging, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA
| | - Ihno A Lee
- Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA
| | - Jennifer M Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA
| | - James J Gross
- Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA
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38
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Mazefsky CA. Emotion Regulation and Emotional Distress in Autism Spectrum Disorder: Foundations and Considerations for Future Research. J Autism Dev Disord 2016; 45:3405-8. [PMID: 26391886 DOI: 10.1007/s10803-015-2602-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Autism spectrum disorder (ASD) is often associated with emotional distress and psychiatric comorbidities. Atypical emotion regulation (ER) may underlie these accompanying features. This special issue of the Journal of Autism and Developmental Disorders presents a series of mechanistic and applied papers on ER and emotional experiences in ASD. Important concepts for future research are discussed, including how to conceptualize emotion dysregulation in ASD, the importance of capturing variability in emotion dysregulation in ASD studies, and the promise of intervention approaches that target ER impairments. This special issue highlights the growing emphasis on ER and emotional distress in ASD, and aims to encourage continued research in this area given the potential for this line of inquiry to lead to improved outcomes.
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Affiliation(s)
- Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Webster Hall Suite 300, Pittsburgh, PA, 15213, USA.
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39
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Richey JA, Damiano CR, Sabatino A, Rittenberg A, Petty C, Bizzell J, Voyvodic J, Heller AS, Coffman MC, Smoski M, Davidson RJ, Dichter GS. Neural Mechanisms of Emotion Regulation in Autism Spectrum Disorder. J Autism Dev Disord 2016; 45:3409-23. [PMID: 25618212 DOI: 10.1007/s10803-015-2359-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by high rates of comorbid internalizing and externalizing disorders. One mechanistic account of these comorbidities is that ASD is characterized by impaired emotion regulation (ER) that results in deficits modulating emotional responses. We assessed neural activation during cognitive reappraisal of faces in high functioning adults with ASD. Groups did not differ in looking time, pupilometry, or subjective ratings of faces during reappraisal. However, instructions to increase positive and negative emotional responses resulted in less increase in nucleus accumbens and amygdala activations (respectively) in the ASD group, and both regulation instructions resulted in less change in dorsolateral prefrontal cortex activation in the ASD group. Results suggest a potential mechanistic account of impaired ER in ASD.
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Affiliation(s)
- J Anthony Richey
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, CB# 3366, 101 Manning Drive, Chapel Hill, NC, 27599-7160, USA.,Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Cara R Damiano
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, CB# 3366, 101 Manning Drive, Chapel Hill, NC, 27599-7160, USA.,Department of Psychology, University of North Carolina at Chapel Hill, Davie Hall, Chapel Hill, NC, 27599-3270, USA
| | - Antoinette Sabatino
- Department of Psychology, University of North Carolina at Chapel Hill, Davie Hall, Chapel Hill, NC, 27599-3270, USA.,Geisinger-Autism and Developmental Medicine Institute, Lewisburg, PA, USA
| | - Alison Rittenberg
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, CB# 3366, 101 Manning Drive, Chapel Hill, NC, 27599-7160, USA
| | - Chris Petty
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA
| | - Josh Bizzell
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7160, Chapel Hill, NC, 27599-7160, USA
| | - James Voyvodic
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA
| | - Aaron S Heller
- Sackler Institute for Developmental Psychobiology, Weill Medical College of Cornell University, New York, NY, 10065, USA
| | | | - Moria Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3026, Durham, NC, 27710, USA
| | - Richard J Davidson
- Waisman Laboratory for Brain Imaging and Behavior, Center for Investigating Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Gabriel S Dichter
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, CB# 3366, 101 Manning Drive, Chapel Hill, NC, 27599-7160, USA. .,Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA. .,Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7160, Chapel Hill, NC, 27599-7160, USA. .,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3026, Durham, NC, 27710, USA. .,Department of Psychology, University of North Carolina at Chapel Hill, Davie Hall, Chapel Hill, NC, 27599-3270, USA.
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40
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Pehrs C, Samson AC, Gross JJ. The quartet theory: Implications for autism spectrum disorder: Comment on "The quartet theory of human emotions: An integrative and neurofunctional model" by S. Koelsch et al. Phys Life Rev 2015; 13:77-9. [PMID: 25912770 DOI: 10.1016/j.plrev.2015.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 04/17/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Corinna Pehrs
- Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany.
| | - Andrea C Samson
- Swiss Center for Affective Sciences, University of Geneva, Chemin des Mines 9, 1211 Geneva, Switzerland
| | - James J Gross
- Department of Psychology, Stanford University, 450 Serra Mall, Bldg 420, Stanford, CA 94305, USA
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