Autism spectrum disorder

Autism spectrum disorder: difficulties in diagnosis and microRNA biomarkers

We performed a PubMed search for microRNAs in autism spectrum disorder that could serve as diagnostic biomarkers in patients and selected 17 articles published from January 2008 to December 2023, of which 4 studies were performed with whole blood, 4 with blood plasma, 5 with blood serum, 1 with serum neural cell adhesion molecule L1-captured extracellular vesicles, 1 with blood cells, and 2 with peripheral blood mononuclear cells. Most of the studies involved children and the study cohorts were largely males. Many of the studies had performed microRNA sequencing or quantitative polymerase chain reaction assays to measure microRNA expression. Only five studies had used real-time polymerase chain reaction assay to validate microRNA expression in autism spectrum disorder subjects compared to controls. The microRNAs that were validated in these studies may be considered as potential candidate biomarkers for autism spectrum disorder and include miR-500a-5p, -197-5p, -424-5p, -664a-3p, -365a-3p, -619-5p, -664a-3p, -3135a, -328-3p, and -500a-5p in blood plasma and miR-151a-3p, -181b-5p, -320a, -328, -433, -489, -572, -663a, -101-3p, -106b-5p, -19b-3p, -195-5p, and -130a-3p in blood serum of children, and miR-15b-5p and -6126 in whole blood of adults. Several important limitations were identified in the studies reviewed, and need to be taken into account in future studies. Further studies are warranted with children and adults having different levels of autism spectrum disorder severity and consideration should be given to using animal models of autism spectrum disorder to investigate the effects of suppressing or overexpressing specific microRNAs as a novel therapy.

Intranasal delivery of extracellular vesicles: A promising new approach for treating neurological and respiratory disorders

BACKGROUND

Extracellular vesicles (EVs) are membrane vesicles secreted by all types of cells, including bacteria, animals, and plants. These vesicles contain proteins, nucleic acids, and lipids from their parent cells and can transfer these components between cells. EVs have attracted attention for their potential use in diagnosis and therapy due to their natural properties, such as low immunogenicity, high biocompatibility, and ability to cross the blood-brain barrier. They can also be engineered to carry therapeutic molecules. EVs can be delivered via various routes. The intranasal route is particularly advantageous for delivering them to the central nervous system, making it a promising approach for treating neurological disorders.

SCOPE OF REVIEW

This review delves into the promising potential of intranasally administered EVs-based therapies for various medical conditions, with a particular focus on those affecting the brain and central nervous system. Additionally, the potential use of these therapies for pulmonary conditions, cancer, and allergies is examined, offering a hopeful outlook for the future of medical treatments.

MAJOR CONCLUSIONS

The intranasal administration of EVs offers significant advantages over other delivery methods. By directly delivering EVs to the brain, specifically targeting areas that have been injured, this administration proves to be highly efficient and effective, providing reassurance about the progress in medical treatments. Intranasal delivery is not limited to brain-related conditions. It can also benefit other organs like the lungs and stimulate a mucosal immune response against various pathogens due to the highly vascularized nature of the nasal cavity and airways. Moreover, it has the added benefit of minimizing toxicity to non-targeted organs and allows the EVs to remain longer in the body. As a result, there is a growing emphasis on conducting clinical trials for intranasal administration of EVs, particularly in treating respiratory tract pathologies such as coronavirus disease.

Understanding rare variant contributions to autism: lessons from dystrophin-deficient model

Duchenne and Becker Muscular Dystrophy are dystrophinopathies with a prevalence of 1:5000-6000 males, caused by pathogenic variants in DMD. These conditions are often accompanied by neurodevelopmental disorders (NDDs) like autism (ASD; ~20%) and intellectual disability (ID; ~30%). However, their low penetrance in dystrophinopathies suggests additional contributing factors. In our study, 83 individuals with dystrophinopathies were clinically evaluated and categorized based on ASD (36 individuals), ID risk (12 individuals), or controls (35 individuals). Exome sequencing analysis revealed an enrichment of risk de novo variants (DNVs) in ASD-DMD individuals (adjusted p value = 0.0356), with the number of DNVs correlating with paternal age (p value = 0.0133). Additionally, DMD-ASD individuals showed a higher average of rare risk variants (RRVs) compared to DMD-Controls (adjusted p value = 0.0285). Gene ontology analysis revealed an enrichment of extracellular matrix-related genes, especially collagens, and Ehlers-Danlos syndrome genes in ASD-DMD and DMD-ID groups. These findings support an oligogenic model for ASD in dystrophinopathies, highlighting the importance of investigating homogenized samples to elucidate ASD's genetic architecture.

Altered odor perception in Dlgap2 mutant mice, a mouse model of autism spectrum disorder

Olfactory dysfunction has been observed in patients with Autism Spectrum Disorder (ASD). A microdeletion at the 8p23 terminal regions of chromosome 8p23 was identified in a Taiwanese patient with ASD, suggesting a potential association with mutations in the DLGAP2 gene. DLGAP2 is expressed in the olfactory bulb in rodents. The current study investigated olfactory phenotypes of Dlgap2 mutant mice. The results indicated that odor detection capabilities were comparable between wild-type (WT) and Dlgap2 mutant mice. However, homozygous mutant (Homo) mice showed less interest in sniffing odors of banana and almond but greater sniffing activity in response to bedding from unfamiliar cages. Notably, exposure to banana odor elicited significant c-fos expression in most olfaction-related brain regions of WT mice, while Homo mice did not show much increase in c-fos levels in major olfactory areas, which may correlate with their diminished sniffing behavior. Bedding stimuli induced pronounced c-fos expression in WT brains and some olfaction-related regions, including the olfactory bulb, amygdala, hypothalamus, and medial prefrontal cortex, in Homo mice. These mutants may still process olfactory signals from the bedding through a relatively narrow channel, which might elicit their interest, leading to increased sniffing behaviors that may compensate for their olfactory deficits. The DLGAP2 protein was absent in the olfactory bulb of Homo mice, and the levels of PSD95 and CaMKIIβ were also affected, indicating alterations in synaptic transmission and signaling within the olfactory system. This study evaluated olfactory perception in a mouse model of ASD, which may advance diagnostic and therapeutic strategies.

SINEUP RNA rescues molecular phenotypes associated with CHD8 suppression in autism spectrum disorder model systems

Loss-of-function mutations in the chromodomain helicase DNA-binding 8 (CHD8) gene are strongly associated with autism spectrum disorders (ASDs). Indeed, the reduction of CHD8 causes transcriptional, epigenetic, and cellular phenotypic changes correlated to disease, which can be monitored in assessing new therapeutic approaches. SINEUPs are a functional class of natural and synthetic antisense long non-coding RNAs able to stimulate the translation of sense target mRNA, with no effect on transcription. Here, we employed synthetic SINEUP-CHD8 targeting the first and third AUG of the CHD8 coding sequence to efficiently stimulate endogenous CHD8 protein production. SINEUP-CHD8 were effective in cells with reduced levels of the target protein and in patient-derived fibroblasts with CHD8 mutations. Functionally, SINEUP-CHD8 were able to revert molecular phenotypes associated with CHD8 suppression, i.e., genome-wide transcriptional dysregulation, and the reduction of H3K36me3 levels. Strikingly, in chd8-morpholino-treated and ENU mutant zebrafish embryos, SINEUP-chd8 injection confirmed the ability of SINEUP RNA to rescue the chd8-suppression-induced macrocephaly phenotype and neuronal hyperproliferation. Thus, SINEUP-CHD8 molecule(s) represent a proof-of-concept toward the development of an RNA-based therapy for neurodevelopmental syndromes with implications for, and beyond ASD, and relevant to genetic disorders caused by protein haploinsufficiency.

Motor developmental delay in preschoolers with autism spectrum disorders in China and its association with core symptoms and maternal risk factors: a multi-center survey

BACKGROUND

Motor disturbance, as a related symptom of autism spectrum disorders (ASD), has not received the attention it deserves. We aimed to investigate the different degrees of motor developmental delay and influencing factors in Chinese preschool children with ASD, in order to enhance people's awareness of motor developmental delay in ASD children.

METHODS

We recruited 1,256 ASD children aged 2-6 years from the China Multi-Center Preschool Autism Project (CMPAP). We investigated the overall status of neurodevelopment in preschool children with ASD through the Revised Children Neuropsychological and Behavior Scale (CNBS-R2016) and the Gesell Developmental Scale (GDS). The multivariate ordered logistic regression model was used to analyze the relationship between different degrees of motor developmental delay and demographic, core symptoms of ASD, and maternal risk factors, which were evaluated using the questionnaires, the Childhood Autism Rating Scale (CARS) and the Social Responsiveness Scale-Second Edition (SRS-2).

RESULTS

The proportions of delayed development in various neurodevelopmental domains was significantly imbalanced in preschool children with ASD. The proportions of gross and fine motor developmental delay were as high as 39.6% and 68.4% respectively. ASD children in different age subgroups all exhibited gross and fine motor developmental delay. The CARS and SRS-2 total scores of ASD children with mild, moderate-severe gross or fine motor developmental delay were significantly higher than those with normal motor skills development (P < 0.05). ASD children aged ≥ 5 years, or higher CARS and SRS-2 total scores, or gestational age in the 28-36+ 6 weeks were more likely to suffer from gross motor developmental delay (OR values were 5.504, 1.083, 1.846 respectively) and fine motor developmental delay (OR values were 2.216, 1.074, 1.011, 1.661 respectively).

CONCLUSION

Gross and fine motor developmental delay were difficulties that most preschool children with ASD may face, and ASD children with motor developmental delay had greater deficits in social skills. Therefore, it is necessary to continuously monitor the gross and fine motor development progress of children with ASD for facilitating early identification and individualized intervention.

Could linguistic and cognitive factors, degree of autistic traits and sex predict speech disfluencies in autistic young adults and controls?

This study aimed to evaluate the effect of linguistic complexity and individual background variables (i.e. linguistic and cognitive abilities, degree of autistic traits, and sex) on speech disfluencies in autistic young adults and controls. Thirty-two 19- to 33-year-old autistic adults and 35 controls participated in this study. The frequency of disfluencies and stuttering severity were evaluated based on a narrative speech task. Linguistic complexity was assessed by evaluating the syntactic structures of the narratives. Cognitive and linguistic abilities were assessed using the General Ability Index (GAI), Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) from the Wechsler Adult Intelligence Scale IV. Autistic traits were measured using the Autism Spectrum Quotient (AQ). Multiple-linear regression analyses (syntactic complexity, GAI, AQ, sex, and group status as predictors) showed that (a) syntactic complexity predicted total and stuttering-like disfluencies and stuttering severity, (b) GAI predicted typical disfluencies, and (c) sex predicted total, typical, and stuttering-like disfluencies. Additional correlation analyses revealed negative association between PRI and disfluencies in the control group but not in the autistic group. No connection was found between AQ and disfluencies. It seems that while some connections between disfluencies and individual cognitive features were found, some of the possible contributing factors for greater speech disfluency might differ between autistic and typical speakers.

Exploring the neurotoxic effects of microbial metabolites: A potential link between p-Cresol and autism spectrum disorders?

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a complex etiology, including genetic and environmental factors. A growing body of evidence (preclinical and clinical studies) implicates a potential role of gut microbiome dysregulation in ASD pathophysiology. This review focuses on the microbial metabolite p-Cresol, produced by certain gut bacteria such as Clostridium, and its potential role in ASD. The review summarizes studies investigating the gut microbiome composition in ASD patients, particularly the increased abundance of Clostridium species and associated gastrointestinal symptoms. The potential neurotoxic effects of p-Cresol are explored, including its influence on neurotransmitter metabolism (especially dopamine), neuroinflammation, and brain development. The mechanistic findings from the preclinical studies of p-Cresol's induction of ASD-like behaviors and its impact on the dopaminergic system are discussed. Literature studies indicated increased levels of p-Cresol in the urine of patients with ASD. This increasing evidence suggests that p-Cresol may serve as a crucial biomarker for understanding the relationship between gut microbiota and ASD, opening avenues for potential diagnostic and therapeutic interventions.

Folic acid and autism: updated evidences

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that impairs communication, socialization, and behavior. The association of ASD with folic acid has been investigated due to the importance of this vitamin for neurological health. This study is an update of the publication 'Folic acid and autism: What do we know?' and aims to systematically review studies examining the relationship between folic acid and ASD. The search resulted in 2,389 studies on folic acid and ASD, which were selected by two reviewers based on their titles and abstracts. Studies meeting the inclusion criteria were fully read. The 52 included studies involved 10,429 individuals diagnosed with ASD and assessed the intake of vitamin B6, folic acid, and vitamin B12; serum levels of these vitamins, homocysteine, and methionine; therapeutic interventions using folic acid; and the association between maternal exposure to this vitamin and the risk of ASD. The evidence of insufficient folic acid intake in most individuals with ASD remains consistent in this update. No association was found between maternal exposure to folic acid and the risk of ASD in their children. Despite observed improvements in communication, socialization, and behavior in individuals with ASD following folic acid interventions, it is crucial to consider the individuality and complexity of ASD. Given the relevance of the topic, there remains a need for more high-quality research and clinical trials characterized by rigorous methodological designs.

The Assessment of Selenium, Aluminum, and Zinc in Children with Autism Spectrum Disorder

ASD is a complex condition defined by many causes, one of them being excessive concentrations of necessary and harmful chemicals in children. The serum, hair, and nails of children with ASD have lower levels of critical trace elements, according to studies. It is quite obvious that bio elements are involved in physiology and pathophysiology. Thus, this study examined trace element contents in serum samples from children with autism spectrum disorder (ASD), specifically zinc (Zn), aluminum (Al), and selenium (Se). The study also looked for links between trace element levels and autistic severity. The study included 47 children with autism spectrum disorder, and the Gilliam's Scale was used for severity. The study also included 53 healthy kids with age and gender-matched with those of ASD. For serum trace element analysis, graphite furnace atomic absorption spectrophotometry was used. The study found significant decreases in selenium and zinc concentration (OR, 5.25; CI, 1.96 ~ 14.08; p < 0.001) and increases in aluminum level (OR, 39.34; CI, 8.20 ~ 89.45; p < 0.001) in children with ASD compared to the control group. The area under the curve (AUC) values of 0.85 for Se, 0.98 for Al, and 0.7 for Zn showed high sensitivity and specificity for all parameters. Results indicate a strong positive connection between ASD and their levels of selenium (Se) and zinc (Zn) (β, 0.48; CI, 0.280 ~ 0.679; p < 0.001 and β, 0.31; CI, 0.10 ~ 0.52; p = 0.005). There is a negative correlation between ASD and aluminum (Al) (β 0.83; CI, 0.71 ~ 0.95; p < 0.001). This element may be a biomarker for autism in youngsters. High odds ratio (OR) values indicate trace element risk in autistic children.

Whole-genome sequencing analysis of Japanese autism spectrum disorder trios

AIM

Autism spectrum disorder (ASD) is a genetically and phenotypically heterogeneous neurodevelopmental disorder with a strong genetic basis. Conducting the first comprehensive whole-genome sequencing (WGS) analysis of Japanese ASD trios, this study aimed to elucidate the clinical significance of pathogenic variants and enhance the understanding of ASD pathogenesis.

METHODS

WGS was performed on 57 Japanese patients with ASD and their parents, investigating variants ranging from single-nucleotide variants to structural variants (SVs), short tandem repeats (STRs), mitochondrial variants, and polygenic risk score (PRS).

RESULTS

Potentially pathogenic variants that could explain observed phenotypes were identified in 18 patients (31.6%) overall and in 10 of 23 patients (43.5%) with comorbid intellectual developmental disorder (IDD). De novo variants in PTEN, CHD7, and HNRNPH2 were identified in patients referred for genetic counseling who exhibited previously reported phenotypes, including one patient with ASD who had profound IDD and macrocephaly with PTEN L320S. Analysis of the AlphaFold3 protein structure indicated potential inhibition of intramolecular interactions within PTEN. SV analysis identified deletions in ARHGAP11B and TMLHE. A pathogenic de novo mitochondrial variant was identified in a patient with ASD who had a history of encephalitis and cognitive decline. GO enrichment analysis of genes with nonsense variants and missense variants (Missense badness, PolyPhen-2, and Constraint >1) showed associations with regulation of growth and ATP-dependent chromatin remodeler activity. No reportable results were obtained in the analysis of STR and PRS.

CONCLUSION

Characterizing the comprehensive genetic architecture and phenotypes of ASD is a fundamental step towards unraveling its complex biology.

Orthodontic aligner therapy outcomes in children with autism spectrum disorder

BACKGROUND

Children with autism spectrum disorder (ASD) face unique challenges in oral care. Aligner therapy offers a promising alternative to conventional approaches for this patient group.

AIM

To evaluate orthodontic aligner therapy outcomes in children with ASD using the Peer Assessment Rating (PAR) Index and the Index of Complexity, Outcome, and Need (ICON), and to investigate whether concomitant disorders affect ICON, PAR scores, and treatment duration.

DESIGN

Two calibrated observers assessed digital dental casts and intraoral pictures of 37 children with ASD before (T0) and after (T1) their treatment. At T0, the participants' average age was 12.9 years (SD = 1.68); at T1, post-therapy, the average age was 14.9 years (SD = 1.51). All participants underwent orthodontic aligner therapy. Statistical methods employed in this study included descriptive analysis, Wilcoxon tests, and univariate linear regression.

RESULTS

Posttreatment, median ICON scores decreased significantly from 74 to 14, and median PAR scores from 36 to 8 (p < .0001), demonstrating "excellent to substantial" improvement in 89.2% (n = 33) of the children. Comorbidities, present in 62% of patients, did not significantly affect treatment duration (22.6 ± 11.02 months).

CONCLUSION

Children with ASD significantly benefit from orthodontic aligner therapy, emphasizing the need for tailored orthodontic care.

The Transition to Adulthood: A Qualitative Study of Autism Spectrum Disorder From Military and Veteran Parents and Military-Dependent Young Adults

INTRODUCTION

Given the unique experiences of military service members and their families, military-dependent young adults (18-25 years old) with autism spectrum disorder (ASD) and their military or veteran families experience unique barriers to accessing quality mental health care during the transition to adulthood. In fact, developing services to address ASD challenges for military families is a burgeoning area of interest for the department of defense. However, there is a limited knowledge on the specific needs of military families as the young adult's transition outside of high school and lose supports.

MATERIALS AND METHODS

The present study conducted 3 focus groups with 16 military and veteran parents, and 3 focus groups with 10 military-dependent young adults to evaluate the needs of military-dependent young adults (17-25 years old) with ASD and military/veteran parents with a young adult with ASD.

RESULTS

Parents reported several key topics, including barriers to services (e.g., permanent change of station, recently moving to a state and lacking awareness of the available resources), defining adulthood in terms working in a cohesive family structure, and therapy recommendations for parents and young adults with ASD transitioning to adulthood. Young adults provided key information, including describing experiences with having a parent in the military, difficulty accessing services during the transition to adulthood, and recommendations on therapy for military-dependent young adults with ASD.

CONCLUSION

Military and veteran families with autistic dependents lack access to important mental-health resources. When developing programs for military families and military-dependent autistic young adults, mental health providers should consider the frequent relocations, lack of access to important transition resources, and common military values. The presence of advocates at military bases should be encouraged to help military families navigate autism services in their local community.

Altered monocyte subpopulations and their association with autism spectrum disorder risk in children

OBJECTIVE

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication, restricted interests, and repetitive behaviors. Emerging evidence suggests a link between immune dysregulation and ASD. This study investigates alterations in monocyte subpopulations and cytokine production in children with ASD and their potential associations with ASD risk and severity.

METHODS

Initially, the immune status of peripheral blood mononuclear cells was assessed in cohort-I of 96 typically developing (TD) children and 92 children diagnosed with ASD using flow cytometry. Subsequently, the secretion of cytokines IL-6 and IL-10 by monocytes was evaluated following stimulation with a leukocyte activation mixture and intracellular protein staining technique in cohort-II.

RESULTS

Children with ASD exhibited significantly higher levels of total monocytes, classical monocytes (CD14hi/CD16-), and non-classical monocytes (CD14low/CD16+) compared to TD children (p < 0.001). Elevated levels of classical monocytes (β: 0.395; 95 %CI: 0.260-0.530; p < 0.001) and non-classical monocytes (β: 0.629; 95 %CI: 0.516-0.742; p < 0.001) were significantly associated with ASD after adjusting for age, sex and body mass index. Furthermore, increased production of IL-6 by monocytes was observed in children with ASD (p = 0.001). Logistic regression analysis revealed that classical monocytes (OR: 1.104; 95 %CI: 1.062-1.147; p < 0.001), non-classical monocytes (OR: 2.913; 95 %CI: 2.130-3.986; p < 0.001) and IL-6 production by monocytes (OR: 1.306; 95 %CI: 1.096-1.557; p = 0.003) are risk factors for ASD. Spearman correlation analysis revealed a negative correlation between classical monocyte levels and adaptive behavior developmental quotient (DQ) (r = - 0.377; p = 0.001), fine motor DQ (r = - 0.329; p = 0.003) and personal-social DQ (r = - 0.247; p = 0.029) in children with ASD.

CONCLUSION

Elevated classical and non-classical monocytes are potential risk factors for ASD and may influence neurodevelopmental outcomes. Further research is needed to elucidate the precise mechanisms and therapeutic implications.

Parsing the heterogeneity of brain structure and function in male children with autism spectrum disorder: a multimodal MRI study

Autism spectrum disorder (ASD) is a neurodevelopmental condition with high structural and functional heterogeneity. Multimodal fusion of structural and functional magnetic resonance imaging (MRI) allows better integration of ASD features from multiple perspectives. This study aimed to uncover the potential ASD subtypes by fusing the features of brain structure and function. An unsupervised learning method, similarity network fusion (SNF), was used. Resting-state functional MRI and structural MRI from the Autism Brain Imaging Data Exchange database of 207 male children were included in this study (105 ASD; 102 healthy controls (HC)). Gray matter volume (GMV) and amplitude of low-frequency fluctuation (ALFF) were utilized to represent structural and functional features separately. Structural and functional distance networks were constructed and fused by SNF. Then spectral clustering was carried out on the fused network. At last, the multivariate support vector regression analysis was used to investigate the relationship between the multimodal alterations and symptom severity of ASD subtypes. Two ASD subtypes were identified. Compared to HC, the two ASD subtypes demonstrated opposite GMV changes and distinct ALFF alterations. Furthermore, the alterations of ALFF predicted the severity of social communication impairments in ASD subtype 1. However, no significant associations were found between the multimodal alterations and symptoms in ASD subtype 2. These findings demonstrate the existence of heterogeneity with distinct structural and functional patterns in ASD and highlight the crucial role of combining multimodal features in investigating the neural mechanism underlying ASD.

Latest clinical frontiers related to autism diagnostic strategies

The diagnosis of autism is currently based on the developmental history, direct observation of behavior, and reported symptoms, supplemented by rating scales/interviews/structured observational evaluations-which is influenced by the clinician's knowledge and experience-with no established diagnostic biomarkers. A growing body of research has been conducted over the past decades to improve diagnostic accuracy. Here, we provide an overview of the current diagnostic assessment process as well as of recent and ongoing developments to support diagnosis in terms of genetic evaluation, telemedicine, digital technologies, use of machine learning/artificial intelligence, and research on candidate diagnostic biomarkers. Genetic testing can meaningfully contribute to the assessment process, but caution is required when interpreting negative results, and more work is needed to strengthen the transferability of genetic information into clinical practice. Digital diagnostic and machine-learning-based analyses are emerging as promising approaches, but larger and more robust studies are needed. To date, there are no available diagnostic biomarkers. Moving forward, international collaborations may help develop multimodal datasets to identify biomarkers, ensure reproducibility, and support clinical translation.

Research trends of inflammation in autism spectrum disorders: a bibliometric analysis

Background

Inflammation has been recognized as a significant factor in the pathophysiology of autism spectrum disorders (ASD), which have garnered increasing scholarly attention over the past few decades. This study aims to explore research trends related to inflammation and ASD through bibliometric analysis.

Method

A comprehensive literature search was conducted in the Web of Science Core Collection (WoSCC) on August 28, 2024. This study was restricted to literature published in English. The bibliometric analysis utilized VOSviewer, CiteSpace, and the R package "bibliometrix" to visualize collaborations, keyword co-occurrences, and emerging research trends.

Results

A total of 1,752 articles addressing inflammation and ASD were published, demonstrating a consistent upward trend in research output. The United States emerged as the country with the highest volume of publications. Saleh A. Bakheet was identified as the most prolific authors, significantly contributing to the literature with 54 publications. The University of California System was recognized as the most productive institution in this area of study. The journal of Brain Behavior and Immunity was noted as a prominent venue for publication in this field, exhibiting high citation metrics that reflect its considerable influence. The keyword "children" was the most frequently occurring term, with other significant terms including "oxidative stress" and "brain." The keyword burst analysis revealed notable periods of increased research focus on topics such as "inflammatory bowel disease," "cytokine production," "neurodevelopmental disorders," and "microbiota."

Conclusion

This bibliometric analysis highlights the growing scholarly attention devoted to the relationship between inflammation and ASD. Significant contributions and emerging trends emphasize the pivotal role of neuroinflammation in ASD, indicating a necessity for further exploration in this domain.

Effects of gastrointestinal symptoms on the efficacy of washed microbiota transplantation in patients with autism

Objective

Washed microbiota transplantation (WMT) has emerged as a promising therapeutic strategy for autism spectrum disorder (ASD), though the factors that influence its efficacy remain poorly understood. This study explores the impact of gastrointestinal (GI) symptoms on the effectiveness of WMT in ASD.

Methods

Clinical data encompassing ASD symptoms, GI disturbances, and sleep disorders were collected from patients with ASD undergoing WMT. The therapeutic impact of WMT and the contributing factors to its efficacy were assessed.

Results

WMT significantly reduced scores on the Aberrant Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Sleep Disturbance Scale for Children (SDSC), alongside a significant reduction in the incidence of constipation, abnormal stool forms, and diarrhea (all p < 0.05). After six courses of WMT, substantial reductions were observed in ABC, CARS, and SDSC scores, with increased treatment courses correlating with greater improvement (p < 0.05). Multiple linear regression analysis revealed that WMT efficacy was enhanced in patients with pre-existing GI symptoms (diarrhea: β = 0.119, p < 0.001; abnormal stool form: β = 0.201, p < 0.001) and those receiving a higher number of treatment courses (β = 0.116, p < 0.001). Additionally, the analysis indicated that treatment outcomes were more favorable in patients who had not undergone adjunct interventions (β = -0.041, p = 0.002), had a longer disease duration (β = 0.168, p = 0.007), and exhibited more severe disease symptoms (β = 0.125, p < 0.001).

Conclusion

WMT significantly alleviates both ASD and GI symptoms, along with sleep disturbances, in affected individuals. Six treatment courses resulted in notable improvement, with increased course numbers further improving therapeutic outcomes. Furthermore, pre-treatment GI symptoms, such as diarrhea and abnormal stool forms, may influence the effectiveness of WMT. Notably, patients who did not receive additional interventions, had a prolonged disease duration, and presented with more severe symptoms experienced markedly improved treatment responses.

The Ambiguous Role of Growth Factors in Autism: What Do We Really Know?

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with multifactorial origins, including the potential involvement of neurotrophins and growth factors. These molecules, which are crucial for neuronal survival, synaptic plasticity, and brain development, have been implicated in ASD pathophysiology. Altered levels of neurotrophins such as NGF, BDNF, NT3, and NT4, as well as growth factors like IGF1, VEGF, and FGF, have been associated with cognitive deficits, sensory processing abnormalities, and behavioral issues in ASD patients. However, the literature presents conflicting results, often due to differences in research methodologies, sample sizes, patient populations, and diagnostic criteria. Despite these inconsistencies, the potential of neurotrophins and growth factors as biomarkers and therapeutic targets for ASD remains promising. Future research with standardized methodologies, larger cohorts, and a clearer understanding of genetic influences is needed to further elucidate their roles in ASD diagnosis and treatment.

Effects of sulforaphane on ABC and SRS scales in patients with autism spectrum disorder: a meta-analysis

Autism spectrum disorder (ASD) has become an increasingly prominent global health issue. Sulforaphane is a phytochemical with multiple functions that target many of the same biochemical and molecular pathways (biomarkers) associated with ASD. This study aimed to conduct a meta-analysis based on sulforaphane's effect on Aberrant Behavior Checklist (ABC) and Social Responsiveness Scale (SRS) in patients with ASD. We conducted comprehensive searches in the PubMed, Medline, Cochrane, EMBASE, and Web of Science databases from their inception. The modified Cochrane risk of bias tool was used to check the risk of bias of the included studies. Review Manager 5.3 software was used to conduct this meta-analysis. The results of this meta-analysis showed that sulforaphane significantly improved irritability and hyperactivity symptoms, suggesting that sulforaphane has the potential for the combined treatment of autism. Additional studies are needed to confirm and explore the effect of sulforaphane.

Brain functional differences during irony comprehension in adolescents with ASD

Irony comprehension is challenging for both individuals with ASD and poor comprehenders (PCs). We aimed to examine the common and specific mechanisms underlying irony comprehension difficulty in the two populations. Both adolescents with ASD and PC showed lower performance in irony comprehension than an age-matched typical control group (TD). The ASD group also showed deficits in theory of mind (ToM), while the PC group showed impairments in structural language skills. In the brain, the ASD group showed reduced brain activation in the left inferior frontal gyrus (IFG) compared to both the TD and the PC group, suggesting ASD-specific differences, which was further found to be correlated with ToM deficits in ASD. Both the TD and the PC group showed greater activation for the ironic than the literal condition in the bilateral medial prefrontal cortex (mPFC), but the ASD group did not, suggesting ASD-specific difference in irony comprehension. The PC group showed reduced activation in the right cuneus compared to the TD, which was correlated with the language comprehension score, suggesting different mechanisms than ASD. Our findings provide insights about the neurocognitive mechanisms underlying impaired irony comprehension in ASD and PC.

Dynamic and static brain functional abnormalities in autism patients at different developmental stages

To date, most studies on autism spectrum disorder (ASD) have focused on specific age ranges, while the mechanisms underlying the entire developmental process of autism patients remain unclear. The aim of this study was to investigate the alterations in brain function in autistic individuals at different developmental stages by resting-state functional MRI (rs-fMRI). We obtained rs-fMRI data from 173 ASD and 178 typical development (TD) individuals in Autism Brain Imaging Data Exchange, spanning child, adolescent, and adult groups. We characterized local brain activity using the amplitude of low-frequency fluctuations (ALFFs), regional homogeneity (ReHo), dynamic ALFF (dALFF), and dynamic ReHo (dReHo) metrics. Pearson correlation analyses were conducted on relationships between Autism Diagnostic Observation Schedule scores and activity measures in abnormal brain regions. We found abnormal ALFF values in the medial and lateral orbitofrontal gyrus and right insula cortex with ASD compared with the TD group. In addition, compared with adolescents with ASD, we found that adults with ASD exhibited an increase in dReHo values in the posterior lateral frontal lobe. We also found that changes in ALFF were associated with the severity of autism. We found abnormal activity in multiple brain regions in individuals with autism and correlated it with clinical characteristics. Our results may provide some help for further exploring the age-related neurobiological mechanisms of ASD patients.

Neuroimmunometabolism: how metabolism orchestrates immune response in healthy and diseased brain

Neuroimmunometabolism describes how neuroimmune cells, such as microglia, adapt their intracellular metabolic pathways to alter their immune functions in the central nervous system (CNS). Emerging evidence indicates that neurons also orchestrate the microglia-mediated immune response through neuro-immune cross talk, perhaps through metabolic signaling. However, little is known about how the brain's metabolic microenvironment and microglial intracellular metabolism orchestrate the neuroimmune response in healthy and diseased brains. This review addresses the balance of immunometabolic substrates in healthy and diseased brains, their metabolism by brain-resident microglia, and the potential impact of metabolic dysregulation of these substrates on the neuroimmune response and pathophysiology of psychiatric disorders. This review also suggests metabolic reprogramming of microglia as a preventive strategy for the management of neuroinflammation-related brain disorders, including psychiatric diseases.

An ALE meta-analysis of the neural evidence of facial emotion processing in autism

OBJECTIVE

Facial emotion recognition is central to successful social interaction. People with autism spectrum disorder (ASD) have difficulties in this area. However, neuroimaging evidence on facial emotion processing in ASD has been diverse. This study aims to identify common and consistent brain activity patterns during facial emotion processing in autism.

METHODS

Following PRISMA guidelines, 22 fMRI studies (539 ASD, 502 typically developing participants (TD) were included.

RESULTS

Both groups showed significant activation in the right fusiform gyrus (FG) and left fusiform face area (FFA). In addition, TD participants showed increased left amygdala activity. Compared to TD, ASD individuals had increased activation in the right cerebellum lobule VI and left secondary visual cortex. Age-based subgroup analysis showed that ASD children showed increased activity in bilateral FG, and ASD adults and TD children in the right FG. Finally, adults from both groups had increased activity in the right FG in the within-group and conjunction analyses.

CONCLUSIONS

These results suggest that ASD and TD engage core face processing areas similarly while TD may use core and an extended social brain network. Findings of this study underscore the role of fusiform face area in facial emotion processing along with more insights into the neural processing of facial emotions.

Challenges for neurodiverse children in acute medical hospitals and opportunities for the new National Children's Hospital to be 'neurodiversity-friendly'

Neurodiversity refers to the variation in human cognitive, sensory, and communication experiences and reframes deficits as differences. Rates and duration of hospitalisation in neurodiverse children are higher compared to their neurotypical peers. Despite increased admissions, paediatric medical hospitals are poorly equipped to adequately support their unique cognitive, sensory, behavioural, and communication needs, which can have negative impacts on the experiences of patients, families, and staff. The literature supports several innovative and inclusive strategies, which present exciting opportunities for Ireland's new National Children's Hospital (NCH) to become a 'neurodiversity-friendly paediatric hospital'.

Cellular mechanisms of early brain overgrowth in autistic children: elevated levels of GPX4 and resistance to ferroptosis

Autistic individuals with disproportionate megalencephaly (ASD-DM), characterized by enlarged brains relative to body height, have higher rates of intellectual disability and face more severe cognitive challenges than autistic children with average brain sizes. The cellular and molecular mechanisms underlying this neurophenotype remain poorly understood. To investigate these mechanisms, we generated human induced pluripotent stem cells from non-autistic typically developing children and autistic children with and without disproportionate megalencephaly. We assessed these children longitudinally from ages two to twelve years using magnetic resonance imaging and comprehensive cognitive and medical evaluations. We show that neural progenitor cells (NPCs) derived from ASD-DM children exhibit increased rates of cell survival and suppressed cell death, accompanied by heightened oxidative stress and ferrous iron accumulation. Despite these stressors, ASD-DM NPCs actively suppress apoptosis and ferroptosis by regulating proteins such as caspase-3 (CASP3), poly(ADP-ribose) polymerase 1 (PARP1), and glutathione peroxidase 4 (GPX4). Cellular ferroptotic signatures are further supported by elevated expression of selenocysteine genes, including GPX4 , in the blood of ASD-DM children and their mothers, suggesting potential hereditary or environmental influences. Furthermore, we show that peripheral expression of GPX4 and other selenocysteine genes correlate with cognitive outcomes (IQ). These findings underscore the role of ferroptosis in autism, pointing to potential diagnostic biomarkers and targets for intervention.

Systematic review and meta-analysis: relative age in attention-deficit/ hyperactivity disorder and autism spectrum disorder

Youngest students in their class, with birthdates just before the school entry cut-off date, are overrepresented among children receiving an Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis or medication for this. This is known as the relative age effect. This systematic review and meta-analysis summarises the evidence on the influence of relative age on ADHD symptoms, diagnosis and medication prescribing. As no review to date has investigated the association with autism spectrum disorder (ASD) diagnosis, this is also examined. Following prospective registration with PROSPERO, we conducted a systematic review according to the PRISMA guidelines. We searched seven databases: Medline, Embase, PsycInfo, Web of Science Core Collection, ERIC, Psychology and Behavioural Sciences Collection, and Cochrane Library. Additional references were identified from manual search of retrieved reviews. We performed a meta-analysis of quantitative data. Thirty-two studies were included, thirty-one investigated ADHD and two ASD. Younger relative age was associated with ADHD diagnosis and medication, with relative risks of 1.38 (1.36-1.52 95% CI) and 1.28 (1.21-1.36 95% CI) respectively. However, risk estimates exhibited high heterogeneity. A relative age effect was observed for teacher ratings of ADHD symptoms but not for parent ratings. With regard to ASD, the youngest children in their school year were more likely to be diagnosed with ASD. This review confirms a relative age effect for ADHD diagnosis and prescribed ADHD medication and suggests that differences in teacher and parent ratings might contribute to this. Further research is needed on the possible association with ASD.

[Pain assessment for children and adolescents with autism spectrum disorders (ASD): A systematic review]

OBJECTIVE

Pain in children and adolescents with autism spectrum disorders remains underdiagnosed due to their inherent communication difficulties. The goal of this review is to identify the most suitable methods for assessing pain in this population and for evaluating the specific perceptions of, or behavioural reactions to, pain whilst considering disorder severity and specifiers (with or without accompanying intellectual impairment, with or without accompanying language impairment).

METHOD

A systematic review and analysis of the international literature was conducted.

RESULTS

Fourteen studies were selected. No difference was found in pain-related behaviours based on the age or gender of children or adolescents with autism. Three studies showed pain-related behaviours in autism spectrum disorders to be similar to control groups. Other studies showed specific behavioural responses in autism spectrum disorders with a longer physiological and behavioural recovery time associated with an episode of acute pain in this population. Similarly, the three studies that focused on sensory perceptions of pain all showed differences in the autism spectrum disorders population compared to control groups. In hospital or daily life contexts, studies essentially showed idiosyncratic expressions, hypervigilance, motor agitation, negative emotional reactions, or vocalizations. Regarding the association of autism severity with hyposensitivity to pain, the results remain unclear even when language disorders or intellectual disabilities are also present (in conjunction with autism). The Non-Communicative Children Pain Checklist and its translation into French and Italian showed good internal validity and was used by almost half of the studies in hetero-assessment, mostly by parents. Studies recommend the inclusion of parents in the assessment in order to optimise the evaluation process. Similarly, analysis of parent/child/caregiver interviews from the studies highlights the importance of personalizing pain assessment of children and adolescents, taking into account subject-specific characteristics, pathology, and context.

CONCLUSION

An integrative and personalized approach to pain assessment appears to be the most appropriate for enhancing the understanding and detection of pain in individuals with autism spectrum disorders. This approach aligns well with a care setting where a nominated professional with a good expertise in autism is responsible for pain assessment. Given the complexity of identifying pain in individuals with autism, further qualitative studies, in conjunction with new pain exploration technologies, are considered necessary as well as a more extensive categorization of the population studies.

Psychogenetic Features of Heredity and Pathology

ABSTRACT

The purpose of this study is to provide an in-depth examination of the complex aspects of hereditary and pathological conditions arising based on psychogenetic factors, in particular, the disclosure of elements that determine the causes of their appearance. The following methods were used in the study: analytical, typological approaches, and generalization. It was found that genetic inheritance plays a significant role in the occurrence of autism spectrum disorders, bipolar disorder, schizophrenia, and other pathologies. The study revealed that the presence of a hereditary predisposition significantly increases the risk of developing these disorders in offspring. Genetic variations can affect various aspects of mental functioning and the molecular processes underlying these disorders. However, the important role of environmental factors in interaction with genetics has also been revealed. As part of this study, a plan was developed for a psychotherapist to work with parents raising a child with a mental disorder.

A scoping review of the motor impairments in autism spectrum disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder mainly defined by impairments in communication and socialization. Although motor symptoms are not typically considered central to the disease, their high frequency and early onset have been recurrently reported in the literature. Therefore, this scoping review provides a broad description of these motor impairments across all ages, as well as a discussion of their relevance and relation to other clinical aspects of ASD. The scientific search was carried out in Scopus, Pubmed, Embase, and Web of Science databases. Nineteen studies were selected after applying the eligibility criteria. The studies analyzed 784 participants diagnosed with ASD compared to 540 controls. Motor function was assessed by means of varied kinds of scales and questionnaires. The main motor domains evaluated included features of fine and gross motor skills, manual dexterity, coordination/motor control/praxis, balance, running speed/agility, strength, gait, whole-body movements, aiming and catching (ball skills), and repetitive movements. Motor impairments are consistently observed in ASD from the first years of life, persisting into adulthood. It includes a significant deficit in performance of manual, posture, strength, and gait behavior/skills. The deficits described in ASD comprised impairments in fine and gross motor skills, lower balance, lower cadence, and greater variation of gait control, as well as weakness among other features that leads this population to move in an adaptive way affecting their interactions in real life.

Adipose tissue may not be a major player in the inflammatory pathogenesis of Autism Spectrum Disorder

Purpose

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder increasingly recognized for its strong association with chronic inflammation. Adipose tissue functions as an endocrine organ and can secrete inflammatory cytokines to mediate inflammation. However, its involvement in ASD-related inflammation remains unclear. The present study aimed to clarify the role of adipose tissue in inducing inflammatory responses associated with ASD.

Methods

A total of 36 children with ASD and 18 unrelated healthy controls, aged 2-14.5 years, were enrolled in the study. The up-regulated differentially expressed genes from the GSE18123 dataset were subjected to gene ontology (GO) enrichment analysis to explore ASD-associated pathways. Plasma cytokines and adipokines levels were quantified using Milliplex MAP immunoaffinity technology. The BTBR T + Itprtf/J (BTBR) mice that are known for their core ASD behavioral traits and inflammatory phenotypes were employed as an animal ASD model to verify the key clinical findings.

Results

GO enrichment analyses revealed immune dysfunction in ASD. Symptom analysis showed that the recruited individuals had typical autistic symptoms. Plasma analysis showed no significant difference in adipokines levels, including adiponectin, leptin, resistin, adipsin, and lipocalin-2, between the ASD and control groups. However, markedly elevated levels of IL-6, IL-8, and tumor necrosis factor (TNF-α) were detected in children with ASD, suggesting that the inflammatory state is independent of adipokines. Similar results were also observed in BTBR autistic mice. Notably, levels of insulin, which are closely related to the exertion of adipokines function, also showed no significant changes.

Conclusions

Our findings suggest that inflammation in ASD likely originates from non-adipocyte sources, implying that adipose tissue may not play a major role in inflammatory pathogenesis of ASD. Consequently, targeting adipose-related inflammation may not be an effective treatment approach, providing new directions for the development of targeted interventions.

Effectiveness of Intensive Linguistic Intervention in Autism Spectrum Disorder: A Case Study

Background: Autism Spectrum Disorder (ASD) is currently classified as a neurodevelopmental disorder with increasing prevalence year by year. One of the key characteristics of this population is the persistent and variable difficulty they present in the development of functional language. For this reason, most individuals with ASD are candidates for linguistic treatment, especially during the early stages of development. The aim of this study was to assess the effectiveness of an individualized and intensive oral language and communication intervention. Method: This research was conducted through a case study of a 5-year-old Spanish-speaking child diagnosed with ASD. The child's family sought intensive speech therapy to address articulation difficulties that were affecting speech intelligibility. However, a linguistic intervention program was proposed that would cover work in all areas of language. A comprehensive assessment of the child's language and communication skills was carried out by a team of five professionals. Following this, an individualized intervention was implemented for 27 h per week over a period of 4 weeks. After this period, the child's linguistic skills were reassessed. Results: The results show that the proposed intervention not only improved articulation skills. Conclusion: It is important to conduct a detailed analysis of each case and design individualized interventions that directly impact the effectiveness of treatments.

The neurobiological mechanisms underlying the effects of exercise interventions in autistic individuals

Autism spectrum disorder is a pervasive and heterogeneous neurodevelopmental condition characterized by social communication difficulties and rigid, repetitive behaviors. Owing to the complex pathogenesis of autism, effective drugs for treating its core features are lacking. Nonpharmacological approaches, including education, social-communication, behavioral and psychological methods, and exercise interventions, play important roles in supporting the needs of autistic individuals. The advantages of exercise intervention, such as its low cost, easy implementation, and high acceptance, have garnered increasing attention. Exercise interventions can effectively improve the core features and co-occurring conditions of autism, but the underlying neurobiological mechanisms are unclear. Abnormal changes in the gut microbiome, neuroinflammation, neurogenesis, and synaptic plasticity may individually or interactively be responsible for atypical brain structure and connectivity, leading to specific autistic experiences and characteristics. Interestingly, exercise can affect these biological processes and reshape brain network connections, which may explain how exercise alleviates core features and co-occurring conditions in autistic individuals. In this review, we describe the definition, diagnostic approach, epidemiology, and current support strategies for autism; highlight the benefits of exercise interventions; and call for individualized programs for different subtypes of autistic individuals. Finally, the possible neurobiological mechanisms by which exercise improves autistic features are comprehensively summarized to inform the development of optimal exercise interventions and specific targets to meet the needs of autistic individuals.

Abnormal resting-state brain network dynamics in toddlers with autism spectrum disorder

Emerging evidence suggests aberrant functional connectivity (FC) of brain networks in children, adolescents, and adults with autism spectrum disorder (ASD). However, little is known about alterations of dynamic FC in toddlers with ASD. The aim of this study was to investigate the characteristics of brain network dynamics in ASD toddlers. We analyzed resting-state functional magnetic resonance imaging data of 41 ASD and 23 typically-developing (TD) toddlers aged 15-45 months using leading eigenvector dynamics analysis. The between-group differences in the temporal properties of state were evaluated, followed by correlation analysis of these differences with autistic factors in ASD. Compared with TD subjects, ASD toddlers had a lower occurrence rate and mean dwell time in the global state. The mean dwell time of this state was negatively correlated with the body and object use of the autism behavior checklist (ABC) score. The ASD group presented a higher occurrence probability in the state related to the visual network, and the dwell time of this state was positively correlated with the relationship building of the ABC score. Moreover, the occurrence probability of the state related to the dorsal attention network and default mode network was positively correlated with the body and object use of the ABC score. Our findings indicate that there are differences in the developmental patterns of large-scale brain functional networks in ASD toddlers, which may contribute to the early identification of ASD and provide meaningful insights into its potential neural mechanisms.

Novel TBR1 c.1303C>T Variant Led to Diagnosis of Intellectual Developmental Disorder with Autism and Speech Delay: Application of Comprehensive Family-Based Whole-Genome Analysis

BACKGROUND

Intellectual developmental disorder with autism and speech delay (IDDAS) is a rare and complex neurological disorder characterized by the presence of both intellectual and speech impairment and features of autism spectrum disorder (ASD). The prevalence of IDDAS is unknown but genetically, it is caused by heterozygous variants in the TBR1 gene.

METHODS

A 7-year-old female with autistic features and delayed speech development was presented with unaffected parents. Trio-joint analysis was conducted on whole-genome sequencing (WGS) data from the proband and unaffected parents. A phenotype-driven analysis was conducted to investigate variants related to the patient's clinical presentation. A zygosity-focused analysis was performed to investigate de novo and compound heterozygote variants related to the etiology.

RESULTS

The joint-genome analysis identified a novel NM_006593.4(TBR1):c.1303C>T p.Gln435* nonsense variant in the proband. The de novo analysis confirmed the absence of the variant in the parents. No additional causative variants were identified in genes associated with the proband's phenotype.

CONCLUSIONS

This is the first report of the NM_006593.4(TBR1):c.1303C>T variant in a patient with IDDAS. This study presents the clinical features of the patient and highlights details of trio-WGS analysis in the molecular diagnosis of this complex disease. Sharing these details is important, as they contribute to the understanding of the spectrum of this rare syndrome.

Autism screening tool validation for toddlers and young children: advantages and limitations

BACKGROUND

Early identification is crucial for children with autism. However, many children are diagnosed later due to the lack of specific assessment tools in primary care settings. The study aims to evaluate the effectiveness of the STAT in screening autism across different age groups while assessing its advantages and limitations.

METHODS

In total, 434 children aged 14-48 months visiting autism clinics from March to December 2021 were included. Subjects were grouped by age (14-23, 24-36, and 37-48 months) and categorized based on clinical evaluations and STAT results.

RESULTS

In the age groups of 14-23 and 24-36 months, STAT results demonstrated high sensitivity and specificity compared to DSM-5 diagnoses and exhibited better consistency with ADOS-2 results. However, its performance was weaker in the 37-48 months group. False-negative results were associated with less pronounced autistic traits and higher developmental quotients.

CONCLUSION

STAT presents as a promising level 2 screening tool for early autism identification in China, but its accuracy diminishes in older children with less pronounced autistic traits. These findings emphasize the need for comprehensive assessment strategies for autism diagnosis across different age groups and varying levels of support needs.

IMPACT

This study evaluates the effectiveness of the Screening Tool for Autism in Toddlers (STAT) for early screening of autism across different age groups. It highlights STAT's effectiveness in younger age groups but emphasizes its limitations with older children and those with less pronounced autistic traits. The findings supplement existing literature by providing insights into STAT's utility in diverse populations. The impact lies in guiding clinical practice to improve the identification of autistic characteristics, particularly in resource-limited settings, potentially enhancing early support and outcomes for autistic children.

Characterization of gut microbiota on gender and age groups bias in Thai patients with autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication and interaction problems. The prevalence of ASD is increasing globally, with a higher ratio of males to females. Gastrointestinal symptoms are common in individuals with ASD, and gut microbiota has been implicated in the disorder's development. This study aimed to investigate the gut microbiota alteration in Thai individuals with ASD compared to healthy controls using 16S rRNA gene sequencing. The influence of gender and age on gut microbiota composition and function was also examined. A total of 65 ASD individuals and 30 neurotypical (NT) individuals were included in the analysis. The results revealed notable differences in gut microbiota composition between the ASD and NT groups, with variations observed in microbial richness and the presence of enriched microbial taxa. These differences were influenced by both gender and age. Fusobacteriota, Fusobacteriaceae, and Fusobacterium were found to be enriched in individuals with ASD. Furthermore, the study identified gender-related taxa, such as Bacteroides plebeius, enriched in ASD females. Age-related taxa, including Veillonella, known to be associated with poor oral hygiene, were also observed in ASD children. The analysis of differentially abundant pathways highlighted the enrichment of various metabolic pathways in individuals with ASD, including those related to endocrine-disrupting chemicals. These findings underscore the importance of considering gender and age when studying gut microbiota in ASD. They provide valuable insights into the potential role of gut microbiota dysbiosis in ASD pathogenesis and highlight the influence of environmental factors.

The Role of Nutrition, Oxidative Stress, and Trace Elements in the Pathophysiology of Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and interaction, alongside repetitive behaviors, and atypical sensory-motor patterns. The growing prevalence of ASD has driven substantial advancements in research aimed at understanding its etiology, preventing its onset, and mitigating its impact. This ongoing effort necessitates continuous updates to the body of knowledge and the identification of previously unexplored factors. The present study addresses this need by examining the roles of nutrition, oxidative stress, and trace elements in the pathophysiology of ASD. In this review, an overview is provided of the key dietary recommendations for individuals with ASD, including gluten-free and casein-free (GFCF) diets, ketogenic diets (KDs), and other nutritional interventions. Furthermore, it explores the involvement of oxidative stress in ASD and highlights the significance of trace elements in maintaining neuropsychiatric health. The impact of these factors on molecular and cellular mechanisms was discussed, alongside therapeutic strategies and their efficacy in managing ASD.

Reliably quantifying the severity of social symptoms in children with autism using ASDSpeech

Several studies have demonstrated that the severity of social communication problems, a core symptom of Autism Spectrum Disorder (ASD), is correlated with specific speech characteristics of ASD individuals. This suggests that it may be possible to develop speech analysis algorithms that can quantify ASD symptom severity from speech recordings in a direct and objective manner. Here we demonstrate the utility of a new open-source AI algorithm, ASDSpeech, which can analyze speech recordings of ASD children and reliably quantify their social communication difficulties across multiple developmental timepoints. The algorithm was trained and tested on the largest ASD speech dataset available to date, which contained 99,193 vocalizations from 197 ASD children recorded in 258 Autism Diagnostic Observation Schedule, Second edition (ADOS-2) assessments. ASDSpeech was trained with acoustic and conversational features extracted from the speech recordings of 136 children, who participated in a single ADOS-2 assessment, and tested with independent recordings of 61 additional children who completed two ADOS-2 assessments, separated by 1-2 years. Estimated total ADOS-2 scores in the test set were significantly correlated with actual scores when examining either the first (r(59) = 0.544, P < 0.0001) or second (r(59) = 0.605, P < 0.0001) assessment. Separate estimation of social communication and restricted and repetitive behavior symptoms revealed that ASDSpeech was particularly accurate at estimating social communication symptoms (i.e., ADOS-2 social affect scores). These results demonstrate the potential utility of ASDSpeech for enhancing basic and clinical ASD research as well as clinical management. We openly share both algorithm and speech feature dataset for use and further development by the community.

The association between preterm delivery and autism spectrum disorder in childhood: A retrospective cohort study

BACKGROUND

Prematurity complications are a leading cause of mortality and morbidity in offspring, including adverse neurodevelopmental outcomes. The association between preterm birth (PTB) and autism spectrum disorder (ASD) remains debated.

OBJECTIVE

To investigate the association between PTB and ASD diagnosis during childhood.

METHODS

This cohort study analyzed data from community clinics and a tertiary hospital, encompassing deliveries from 2005 to 2017. ASD incidence was compared across gestational age categories: extremely preterm (<28 weeks), very preterm (28-32 weeks), moderate to late preterm (32-37 weeks), and term (≥37 weeks). Additional comparisons were made between all preterm (<37 weeks) and term deliveries (≥37 weeks). Cumulative ASD incidence was assessed using Kaplan-Meier survival curves and a Cox proportional hazards model adjusted for potential confounders.

RESULTS

Among 114 975 pregnancies, 0.3% delivered at <28 weeks, 0.6% at 28-32 weeks, and 6% at 32-37 weeks, with 6.9% preterm deliveries overall. Univariable analysis revealed a significant association between PTB and ASD (1.6% for <28 weeks vs 0.3% for 28-32 weeks vs 0.8% for 32-37 weeks vs 0.7% for term, P = 0.036). Crude ASD incidence was 0.8% (odds ratio [OR] 1.21, 95% confidence interval [CI] 0.93-1.56, P = 0.15). However, adjusted results showed no significant association: adjusted hazard ratio = 0.74 (95% CI 0.24-2.34, P = 0.61) for <28 weeks, 0.99 (95% CI 0.24-3.99, P = 0.98) for 28-32 weeks, and 1.07 (95% CI 0.81-1.43, P = 0.63) for 32-37 weeks. Kaplan-Meier analysis showed similar cumulative ASD incidence across groups (P = 0.855).

CONCLUSION

This retrospective cohort study found no significant association between PTB and childhood ASD diagnosis.

Identification of Bacterial Lipopolysaccharide-Associated Genes and Molecular Subtypes in Autism Spectrum Disorder

Background

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition marked by diverse symptoms affecting social interaction, communication, and behavior. This research aims to explore bacterial lipopolysaccharide (LPS)- and immune-related (BLI) molecular subgroups in ASD to enhance understanding of the disorder.

Methods

We analyzed 89 control samples and 157 ASD samples from the GEO database, identifying BLI signatures using least absolute shrinkage and selection operator regression (LASSO) and logistic regression machine learning algorithms. A nomogram prediction model was developed based on these signatures, and we performed Gene Set Enrichment Analysis (GSEA), Gene Set Variation Analysis (GSVA), and immune cell infiltration analysis to assess the impact of BLI subtypes and their underlying mechanisms.

Results

Our findings revealed 17 differentially expressed BLI genes in children with ASD, with BLNK, MAPK8, PRKCQ, and TNFSF12 identified as potential biomarkers. The nomogram demonstrated high diagnostic accuracy for ASD. We delineated two distinct molecular subtypes (Cluster 1 and Cluster 2), with GSVA indicating that Cluster 2 showed upregulation of immune- and inflammation-related pathways. This cluster exhibited increased levels of antimicrobial agents, chemokines, cytokines, and TNF family cytokines, alongside activation of bacterial lipoprotein-related pathways. A significant correlation was found between these pathways and distinct immune cell subtypes, suggesting a potential mechanism for neuroinflammation and immune cell infiltration in ASD.

Conclusion

Our research highlights the role of BLI-associated genes in the immune responses of individuals with ASD, indicating their contribution to the disorder's typification. The interplay between bacterial components, genetic predisposition, and immune dysregulation offers new insights for understanding ASD and developing personalized interventions.

Prob-sparse self-attention extraction of time-aligned dynamic functional connectivity for ASD diagnosis

Dynamic functional connectivity (DFC) has shown promise in the diagnosis of Autism Spectrum Disorder (ASD). However, extracting highly discriminative information from the complex DFC matrix remains a challenging task. In this paper, we propose an ASD classification framework PSA-FCN which is based on time-aligned DFC and Prob-Sparse Self-Attention to address this problem. Specifically, we introduce Prob-Sparse Self-Attention to selectively extract global features, and use self-attention distillation as a transition at each layer to capture local patterns and reduce dimensionality. Additionally, we construct a time-aligned DFC matrix to mitigate the time sensitivity of DFC and extend the dataset, thereby alleviating model overfitting. Our model is evaluated on fMRI data from the ABIDE NYU site, and the experimental results demonstrate that the model outperforms other methods in the paper with a classification accuracy of 81.8 %. Additionally, our research findings reveal significant variability in the DFC connections of brain regions of ASD patients, including Cuneus (CUN), Lingual gyrus (LING), Superior occipital gyrus (SOG), Posterior cingulate gyrus (PCG), and Precuneus (PCUN), which is consistent with prior research. In summary, our proposed PSA framework shows potential in ASD diagnosis as well as automatic discovery of critical ASD-related biomarkers.

EEG Abnormalities and Phenotypic Correlates in Preschoolers with Autism Spectrum Disorder: A Single-Center Study

Background: The literature suggests the existence of an association between autism spectrum disorders (ASDs) and subclinical electroencephalographic abnormalities (SEAs), which show a heterogeneous prevalence rate (12.5-60.7%) within the pediatric ASD population. The aim of this study was to investigate the EEG findings in a cohort of ASD preschoolers and their correlation with the phenotypic characteristics. Methods: We retrospectively reviewed data on 141 ASD preschoolers evaluated in a tertiary care university hospital over the period 2008-2018. All participants underwent at least one standard polygraphic electroencephalogram (EEG) and a clinical multidisciplinary assessment with standardized instruments. Results: 77 patients (55%) showed SEAs, which were mainly represented by epileptiform discharges (p < 0.00001), especially focal and multifocal (p = 0.010). Abnormal EEG (p = 0.035) and epileptiform discharges (p = 0.014) were associated with seizure onset and were predominant in sleep (p < 0.00001). Patients with abnormal tracing (p = 0.031) and slow abnormalities (p < 0.001) were significantly younger. ASD severity was not found to be correlated with EEG results, which showed a potential, albeit non-significant, association with some psychometric parameters. Very similar results were found when patients were divided according to sex. Conclusions: EEG abnormalities appear to correlate more with ASD internalizing, externalizing and emotional comorbidities, rather than with ASD core symptoms; larger samples are needed to further investigate this association.

Current virtual reality-based rehabilitation interventions in neuro-developmental disorders at developmental ages

This mini-review examines the available papers about virtual reality (VR) as a tool for the diagnosis or therapy of neurodevelopmental disorders, focusing on Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Specific Learning Disorders (SLD). Through a search on literature, we selected 62 studies published between 1998 and 2024. After exclusion criteria, our synoptic table includes 32 studies on ADHD (17 were on diagnostic evaluation and 15 were on therapeutic interventions), 2 on pure ASD, and 2 on pure SLD. These cover a total of 8,139 participants with ADHD (ages 3-19), 458 with ASD (ages 4-19), and 162 with SLD (ages 7-11). Results show that VR offers high ecological validity and enables improvements in cognitive and social skills. Specifically, in individuals with ADHD, VR showed benefits in attention and executive function, with optimal results when combined with pharmacological treatments. For ASD kids, VR proved effective in enhancing social skills and emotional regulation through personalized virtual scenarios. However, the literature on SLD remains limited, suggesting an evolving area of research. Despite limitations related to small sample sizes and technology costs, VR presents a promising outlook for clinical intervention in neuro-developmental disorders, supporting enhanced skills in a safe and controlled environment. We conclude that both immersive and non-immersive VR represents a valuable supplement to traditional therapies, allowing for personalized approaches.

Virtual environments as a novel and promising approach in (neuro)diagnosis and (neuro)therapy: a perspective on the example of autism spectrum disorder

Over the last three decades, dynamically evolving research using novel technologies, including virtual environments (VEs), has presented promising solutions for neuroscience and neuropsychology. This article explores the known and potential benefits and drawbacks of employing modern technologies for diagnosing and treating developmental disorders, exemplified by autism spectrum disorder (ASD). ASD's complex nature is ideal for illustrating the advantages and disadvantages of the digital world. While VEs' possibilities remain under-explored, they offer enhanced diagnostics and treatment options for ASD, augmenting traditional approaches. Unlike real-world obstacles primarily rooted in social challenges and overwhelming environments, these novel technologies provide unique compensatory opportunities for ASD-related deficits. From our perspective in addition to other recent work, digital technologies should be adapted to suit the specific needs of individuals with ASD.

The effectiveness of music therapy in improving behavioral symptoms among children with autism spectrum disorders: a systematic review and meta-analysis

Objectives

This comprehensive review and meta-analysis aimed to thoroughly identify the effectiveness of music therapy (MT) in improving behavioral symptoms in children with autism spectrum disorders (ASD) by analyzing the data from all relevant randomized controlled trials (RCTs) related to this field.

Methods

From inception until September 18, 2024, PubMed, Web of Science, the Cochrane Library, SinoMed, and Embase were searched. Two reviewers extracted the data separately, and any controversies between the authors' assessments were resolved by conversation or speaking with another author. The behavioral symptoms scale score before and after the intervention was taken from the included trials and used to reflect the therapeutic effect of music therapy in children with autism.

Results

2607 records across all retrieved databases were discovered, thirteen of which were included in a meta-analysis with 1160 participants. According to the meta-analysis, children with autism showed a substantial improvement in their behavior symptoms when receiving music treatment (standardized mean difference [SMD] = -0.66, 95% confidence interval [CI]: -0.93 to -0.39, p < 0.001). With I 2 = 78% and P < 0.001, we did discover a medium level of heterogeneity among the included studies.

Conclusions

MT has a positive impact on improving behavioral symptoms in children with autism. However, given the significant heterogeneity and limitations in this study, RCTs with rigorous methodological quality are still required to confirm the curative benefits of MT in autistic children precisely.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024597939.

The Impact of a Music- and Movement-Based Intervention on Motor Competence, Social Engagement, and Behavior in Children with Autism Spectrum Disorder

BACKGROUND/OBJECTIVES

The main objective of this manuscript is to evaluate the effects of training, music, and movement intervention on motor functions, social engagement, and behaviors in autistic children.

METHODS

Twenty-one children with a diagnosis of mild autism spectrum disorder (ASD), with an age range of 5-to-13 years, were divided into two groups: the experimental group (n = 10) and the control group (n = 11). All participants were examined before (T0) and after the intervention (T1) to evaluate their motor functions (Bruininks-Oseretsky Motor Performance Test (BOT-2)), maladaptive behavior (RCS (Response to Challenge Scale)), and enjoyment and engagement (PACES (Physical Activity Enjoyment Scale)).

RESULTS

Statistical analysis showed that music and movement intervention significantly improved motor functions such as balance and bilateral coordination (p < 0.0001), social engagement (p = 0.002), and adaptive behaviors (p = 0.005) in children with ASD. Our research supports the feasibility of music and movement intervention and documents the interest in participating in children with ASD.

CONCLUSIONS

This study demonstrates the benefits of movement and music interventions and can be considered a useful way to manage autism spectrum disorders in the future.

Emotion recognition deficits in children and adolescents with autism spectrum disorder: a comprehensive meta-analysis of accuracy and response time

Background

Autism spectrum disorder is a neurodevelopmental condition characterized by persistent challenges in social communication and restricted, repetitive behaviors. Emotion recognition deficits are a core feature of ASD, impairing social functioning and quality of life. This meta-analysis evaluates emotion recognition accuracy and response time in individuals with autism spectrum disorder compared to neurotypical individuals and those with other neurodevelopmental disorders.

Methods

This systematic review with a meta-analysis was conducted following PRISMA guidelines. A comprehensive literature search across PubMed, Scopus, Cochrane Library, and Web of Science identified 13 studies published between 2006 and 2024. Data on emotion recognition accuracy and response times were synthesized using standardized mean differences in random-effects models. Heterogeneity was assessed using the I 2 statistic, and sensitivity analyses were performed to ensure robustness.

Results

Individuals with ASD exhibited significantly lower overall emotion recognition accuracy compared to TD individuals (SMD = -1.29, 95% CI: -2.20 to -0.39, p < 0.01) and NDDs (SMD = -0.89, 95% CI: -1.23 to -0.55, p = 0.02). Response times were significantly prolonged in ASD compared to TD individuals (SMD = 0.50, 95% CI: 0.36-0.63, p < 0.01) but not when compared to NDDs. Emotion-specific analyses did not consistently reveal significant differences across emotions (fear, anger, happiness, sadness, disgust, surprise), with substantial heterogeneity observed across studies (I 2 > 50%).

Conclusions

This systematic review with a meta-analysis highlights significant impairments in emotion recognition accuracy and processing speed among individuals with autism spectrum disorder, particularly compared to neurotypical individuals. These findings underscore the importance of developing targeted interventions to address these deficits, which are foundational to improving social cognition and quality of life in autism spectrum disorder. Future research should prioritize standardized methodologies and explore cultural and contextual factors influencing emotion recognition abilities.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=627339, PROSPERO (CRD42024627339).

Soluble epoxide hydrolase deletion rescues behavioral and synaptic deficits by AMPK-mTOR pathway in autism animals

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social defects often accompanied with emotional comorbidities. Aberrations in synaptic function and plasticity are the core feature in the pathophysiology of ASD. Targeting soluble epoxide hydrolase (sEH) has been found to exert protection in a wide-range of pathological conditions. However, the regulation of sEH deficiency on the synaptic deficits of ASD and the underlying mechanisms remain unclear. The valproate (VPA)-treated ASD animal model with genetic sEH knockout was applied in the present study. The results showed that the sEH expression was significantly increased in the prefrontal cortex of VPA-treated animals. Although no effect was found on tail malformation and body weight loss, genetic sEH deletion alleviated social deficits, and fear learning and memory extinction in the VPA-treated mice. After a series of electrophysiological assessments, we found that the beneficial effects of sEH deletion focused on the long-term synaptic plasticity, rather than presynaptic efficiency, in the VPA-treated mice. Furthermore, we observed that the dysregulated AMPK-mTOR pathway was restored under genetic sEH deletion in VPA-treated mice. Taken together, these findings uncovered an important role of sEH deficiency in the synaptic dysfunctions of ASD mediated by AMPK-mTOR pathway, providing a novel therapeutic target for ASD.