1
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Safwi SR. Autism spectrum disorder in the US: Have we done enough? Psychiatry Res 2023; 330:115595. [PMID: 37984282 DOI: 10.1016/j.psychres.2023.115595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023]
Abstract
Autism spectrum disorders (ASD) are a collection of neurodevelopmental disabilities, defined by the presence of social, behavioral and communication deficits, that are typically recognized during the first three years of life. Autism has emerged as a significant public health concern, yet there are no answers to its increasing rates. Recent data from the Autism and Developmental Disability Monitoring (ADDM) Network reported that 1 in every 36 (2.8 %) 8-year-old children were found to have autism in 2020. The current research attempts to identify the major challenges around autism care across the US such as: Inconsistent diagnosis and referral leading to delayed start of service, unequal availability of trained licensed Applied Behavioral Analysis (ABA) therapist, Inconsistent implementation of ABA interventions at various settings, Lack of support, education services and vocational opportunities for children transitioning into adulthood. This article also proposes and discusses possible strategies for mitigating those challenges.
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Affiliation(s)
- Sadia Rehman Safwi
- Department of Chronic Disease Epidemiology, Yale School Of Public Health, 60 College St, New Haven, CT 06510, USA.
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2
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Hoare E, Reyes J, Olive L, Willmott C, Steer E, Berk M, Hall K. Neurodiversity in elite sport: a systematic scoping review. BMJ Open Sport Exerc Med 2023; 9:e001575. [PMID: 37342788 PMCID: PMC10277550 DOI: 10.1136/bmjsem-2023-001575] [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] [Accepted: 05/24/2023] [Indexed: 06/23/2023] Open
Abstract
The objective of this systematic scoping review is to understand the extent and scope of evidence regarding neurodiversity in elite sport. This systematic scoping review considered epidemiological studies, com mentary and viewpoints papers, systematic review and meta-analyses, and any intervention or clinical treatment, management and practice studies in relation to neurodiversity in elite sport. Case studies and grey literature were ineligible for review. Neurodivergence included neurodevelopmental disorders such as autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and specific learning disorders. Elite sport was defined as Olympic, Paralympic, national, international, professional and semiprofessional sport. The final 23 studies included in this review comprised 10 observational studies, 4 systematic/narrative reviews, 6 commentary/position statements and 3 qualitative studies. The literature reflected a major focus on ADHD as a risk factor for concussion and prognosis for postconcussion recovery. Further, there was a focus on the medical management of ADHD, regarding adherence to sporting antidoping regulations. One study focused on the experience of autism in athletes in elite sport settings through qualitative interviews. One study focused on anxiety disorders in elite athletes, with ADHD emerging as a major risk factor. There is a strong rationale for future research to build on the evidence for neurodiversity in elite sport to foster supportive and inclusive elite sporting environments.
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Affiliation(s)
- Erin Hoare
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Australian Football League, Melbourne, Victoria, Australia
| | - Jonathan Reyes
- Australian Football League, Melbourne, Victoria, Australia
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, VIC, Australia
| | - Lisa Olive
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre of Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Willmott
- Australian Football League, Melbourne, Victoria, Australia
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, VIC, Australia
| | - Emma Steer
- Clinical and Educational and Developmental Psychologist, Melbourne, Victoria, Australia
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre of Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Kate Hall
- Australian Football League, Melbourne, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
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3
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Crawshaw D. Should We Continue to Tell Autistic People that Their Brains are Different? Psychol Rep 2023:332941231174391. [PMID: 37147123 DOI: 10.1177/00332941231174391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Autism is often considered to reflect categorically 'different brains'. Neuropsychological research on autism spectrum disorder (ASD) however, has struggled to define this difference, or derive clear-cut boundaries between autism and non-autism. Consequently, restructuring or disbanding the ASD diagnosis is becoming increasingly advocated within research. Nonetheless, autism now exists as a salient social construction, of which 'difference' is a key facet. Clinical and educational professionals must influence this cautiously, as changes to autism's social construction may counterproductively affect the quality of life of autistic people. This paper therefore reviews ASD's value as both neuropsychological and social constructs. Although lacking neuropsychological validity, the autism label may be beneficial for autistic self-identity, reduction of stigma, and administering support. Whilst a shift away from case-control ASD research is warranted, lay notions of 'different brains' may be preserved.
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Affiliation(s)
- Daniel Crawshaw
- School of Psychology, University of Nottingham, University Park, Nottingham, UK
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4
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Cleary M, West S, Mclean L. From 'Refrigerator Mothers' to Empowered Advocates: The Evolution of the Autism Parent. Issues Ment Health Nurs 2023; 44:64-70. [PMID: 36049183 DOI: 10.1080/01612840.2022.2115594] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A historical perspective offers a chance to reflect on unfolding narratives. The emergence of the diagnosis of autism attracted some positions of blame for "refrigerator mothers". With ensuing neuroscience and developmental research and more nuanced biopsychosocial models, this gave way to notions of strong neurological contributions to the disorder and the positive role of parents supporting the regulation of their child. The notion of co-regulation then emerges with collective agency by parents to offer advocacy and support for those with ASD and their parents and an important role in educating society around the needs and value of those with ASD.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Loyola Mclean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW, Australia.,Royal North Shore Hospital, Sydney, NSW, Australia.,Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, NSW, Australia.,Western Clinical School, The University of Sydney, Camperdown, NSW, Australia
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5
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Tang B, Levine M, Adamek JH, Wodka EL, Caffo BS, Ewen JB. Evaluating causal psychological models: A study of language theories of autism using a large sample. Front Psychol 2023; 14:1060525. [PMID: 36910768 PMCID: PMC9998497 DOI: 10.3389/fpsyg.2023.1060525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
We used a large convenience sample (n = 22,223) from the Simons Powering Autism Research (SPARK) dataset to evaluate causal, explanatory theories of core autism symptoms. In particular, the data-items collected supported the testing of theories that posited altered language abilities as cause of social withdrawal, as well as alternative theories that competed with these language theories. Our results using this large dataset converge with the evolution of the field in the decades since these theories were first proposed, namely supporting primary social withdrawal (in some cases of autism) as a cause of altered language development, rather than vice versa. To accomplish the above empiric goals, we used a highly theory-constrained approach, one which differs from current data-driven modeling trends but is coherent with a very recent resurgence in theory-driven psychology. In addition to careful explication and formalization of theoretical accounts, we propose three principles for future work of this type: specification, quantification, and integration. Specification refers to constraining models with pre-existing data, from both outside and within autism research, with more elaborate models and more veridical measures, and with longitudinal data collection. Quantification refers to using continuous measures of both psychological causes and effects, as well as weighted graphs. This approach avoids "universality and uniqueness" tests that hold that a single cognitive difference could be responsible for a heterogeneous and complex behavioral phenotype. Integration of multiple explanatory paths within a single model helps the field examine for multiple contributors to a single behavioral feature or to multiple behavioral features. It also allows integration of explanatory theories across multiple current-day diagnoses and as well as typical development.
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Affiliation(s)
- Bohao Tang
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Jack H Adamek
- Kennedy Krieger Institute, Baltimore, MD, United States
| | - Ericka L Wodka
- Kennedy Krieger Institute, Baltimore, MD, United States.,School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Brian S Caffo
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Joshua B Ewen
- Kennedy Krieger Institute, Baltimore, MD, United States.,School of Medicine, Johns Hopkins University, Baltimore, MD, United States.,Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, United States
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6
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Nomura T. Interneuron Dysfunction and Inhibitory Deficits in Autism and Fragile X Syndrome. Cells 2021; 10:cells10102610. [PMID: 34685590 PMCID: PMC8534049 DOI: 10.3390/cells10102610] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 01/18/2023] Open
Abstract
The alteration of excitatory–inhibitory (E–I) balance has been implicated in various neurological and psychiatric diseases, including autism spectrum disorder (ASD). Fragile X syndrome (FXS) is a single-gene disorder that is the most common known cause of ASD. Understanding the molecular and physiological features of FXS is thought to enhance our knowledge of the pathophysiology of ASD. Accumulated evidence implicates deficits in the inhibitory circuits in FXS that tips E–I balance toward excitation. Deficits in interneurons, the main source of an inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), have been reported in FXS, including a reduced number of cells, reduction in intrinsic cellular excitability, or weaker synaptic connectivity. Manipulating the interneuron activity ameliorated the symptoms in the FXS mouse model, which makes it reasonable to conceptualize FXS as an interneuronopathy. While it is still poorly understood how the developmental profiles of the inhibitory circuit go awry in FXS, recent works have uncovered several developmental alterations in the functional properties of interneurons. Correcting disrupted E–I balance by potentiating the inhibitory circuit by targeting interneurons may have a therapeutic potential in FXS. I will review the recent evidence about the inhibitory alterations and interneuron dysfunction in ASD and FXS and will discuss the future directions of this field.
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Affiliation(s)
- Toshihiro Nomura
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Abstract
PURPOSE OF REVIEW Genetic mutations in animals advance our understanding of disease mechanisms and treatments of neurodevelopmental disorders. Research with mutant mouse models is being extended to nonhuman primates whose brain development is closer to that of humans. This review summaries advances in mouse and nonhuman primate models. RECENT FINDINGS Mutant mouse models recapitulate key symptoms in neurodevelopmental disorders. However, successful phenotypic reversal of symptoms in mouse models has not been replicated in human studies; this failure may be because of differences in the structure and physiology of the brain between rodents and humans. Rett syndrome MECP2 models and Phelan-McDermid syndrome where reduced expression of SH3 and multiple ankyrin repeat domains 3 (SHANK3) models have been introduced in nonhuman primates and are underway in other neurodevelopmental disorders. SUMMARY Mutant mouse models in neurogenetic disorders continued to be pursued along with gene-edited and cell-based models in nonhuman primates. Established ethical guidelines are being followed and infrastructure being established to facilitate dissemination of primate transgenic models as they become available.
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Affiliation(s)
- James C Harris
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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8
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Oberman LM, Kaufmann WE. Autism Spectrum Disorder Versus Autism Spectrum Disorders: Terminology, Concepts, and Clinical Practice. Front Psychiatry 2020; 11:484. [PMID: 32636765 PMCID: PMC7317665 DOI: 10.3389/fpsyt.2020.00484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 05/12/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lindsay M Oberman
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, United States
| | - Walter E Kaufmann
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, United States
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9
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Mottron L. Autism spectrum disorder. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:127-136. [PMID: 32977873 DOI: 10.1016/b978-0-444-64148-9.00010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Autism is a frequent, precocious behavioral constellation of social and communicative atypicalities associated with apparently restricted interests and repetitive behavior and paired with an uneven ability profile. Its definition has constantly broadened in the past 75 years, introducing phenotypes increasingly distant from its initial description, heterogeneous in intelligence and speech level, and associated conditions. When it is unassociated with other conditions, its origin is mostly genetic, transmissible, and favored by frequent polymorphisms with small effects present in the general population. Identified de novo rare mutations with large deleterious effects produce phenotypes only loosely related to nonsyndromic autism. Autism is associated with brain reorganization at multiple levels, and with a variant of typical information processing, i.e., the way humans perceive, memorize, manipulate, and attribute emotional value to available information. Its phenotype evolves over the span of life, with an overall reduction of autistic signs, but it still requires some level of support. There is no treatment for this condition; however, it is compatible with high levels of integration into society.
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Affiliation(s)
- Laurent Mottron
- Department of Psychiatry and Addictology, University of Montreal, Montreal, QC, Canada.
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10
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Affiliation(s)
- James C Harris
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of History of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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11
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Thurm A, Farmer C, Salzman E, Lord C, Bishop S. State of the Field: Differentiating Intellectual Disability From Autism Spectrum Disorder. Front Psychiatry 2019; 10:526. [PMID: 31417436 PMCID: PMC6683759 DOI: 10.3389/fpsyt.2019.00526] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/03/2019] [Indexed: 01/08/2023] Open
Abstract
The topic of this special issue on secondary versus idiopathic autism allows for discussion of how different groups may come to manifest autism spectrum disorder (ASD) or ASD-like symptoms despite important etiological differences. A related issue is that, because many of the social communication deficits that define ASD represent a failure to acquire developmentally expected skills, these same deficits would be expected to occur to some extent in all individuals with intellectual disability (ID). Thus, regardless of etiology, ASD symptoms may appear across groups of individuals with vastly different profiles of underlying deficits and strengths. In this focused review, we consider the impact of ID on the diagnosis of ASD. We discuss behavioral distinctions between ID and ASD, in light of the diagnostic criterion mandating that ASD should not be diagnosed if symptoms are accounted for by ID or general developmental delay. We review the evolution of the autism diagnosis and ASD diagnostic tools to understand how this distinction has been conceptualized previously. We then consider ways that operationalized criteria may be beneficial for making the clinical distinction between ID with and without ASD. Finally, we consider the impact of the blurred diagnostic boundaries between ID and ASD on the study of secondary versus idiopathic ASD. Especially pertinent to this discussion are findings that a diagnosis of ID in the context of an ASD diagnosis may be one of the strongest indicators that an associated condition or specific etiological factor is present (i.e., secondary autism).
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Affiliation(s)
- Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Emma Salzman
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Catherine Lord
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Somer Bishop
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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12
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Poisson A, Favre E, Peyroux E, Nicolas A, Schlutz Bolard C, Demily C. An ambiguous psychiatric diagnosis resolved by genetic investigations. Schizophr Res 2018; 195:577-578. [PMID: 28943095 DOI: 10.1016/j.schres.2017.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A Poisson
- GénoPsy, Reference Center for Diagnosis and Management of Genetic Psychiatric Disorders, Centre Hospitalier le Vinatier and EDR-Psy Team (CNRS & Lyon 1 Claude Bernard University), Lyon, France; Université de Lyon, Université Lyon 1, Faculté de médecine et de maïeutique Lyon Sud Charles Mérieux, Lyon, France.
| | - E Favre
- GénoPsy, Reference Center for Diagnosis and Management of Genetic Psychiatric Disorders, Centre Hospitalier le Vinatier and EDR-Psy Team (CNRS & Lyon 1 Claude Bernard University), Lyon, France
| | - E Peyroux
- GénoPsy, Reference Center for Diagnosis and Management of Genetic Psychiatric Disorders, Centre Hospitalier le Vinatier and EDR-Psy Team (CNRS & Lyon 1 Claude Bernard University), Lyon, France
| | - A Nicolas
- GénoPsy, Reference Center for Diagnosis and Management of Genetic Psychiatric Disorders, Centre Hospitalier le Vinatier and EDR-Psy Team (CNRS & Lyon 1 Claude Bernard University), Lyon, France; Université de Lyon, Université Lyon 1, Faculté de médecine et de maïeutique Lyon Sud Charles Mérieux, Lyon, France
| | - C Schlutz Bolard
- HCL, Department of Genetics, Reference Center for Developmental Anomalies and Malformation Syndromes, Bron, France; GENDEV, Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR529, UCBL1, Lyon, France
| | - C Demily
- GénoPsy, Reference Center for Diagnosis and Management of Genetic Psychiatric Disorders, Centre Hospitalier le Vinatier and EDR-Psy Team (CNRS & Lyon 1 Claude Bernard University), Lyon, France; Université de Lyon, Université Lyon 1, Faculté de médecine et de maïeutique Lyon Sud Charles Mérieux, Lyon, France
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14
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Abstract
PURPOSE OF REVIEW The overlap of neuropsychiatric illness and developmental disability continues to be prominently recognized in clinical practice and in the academic literature. Theoretical and practical considerations may represent a frontier for understanding brain and behavior relationships. The purpose of this review is to explore this common relationship and report on recent literature that helps advance the larger fields of psychiatry and neurology. RECENT FINDINGS Overlap between developmental disability, epilepsy, and neuropsychiatric illness may be more common than originally thought. Excessive excitatory neurotransmitter activity may be present in epilepsy and in autism spectrum disorder. Specific seizure types may be associated with features of developmental disabilities and neuropsychiatric conditions. SUMMARY Neuropsychiatric illness is common in epilepsy and more frequent in developmental disabilities than generally recognized. Seizure foci in the temporal lobe may play a significant role. Brain connectivity and specific neurotransmitter systems are active areas of investigation. Antiepileptic drugs may improve neuropsychiatric symptoms in persons with developmental disability and epilepsy.
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Abstract
In 1943, Leo Kanner published the first systematic description of early infantile autism. He concluded that this was a neurodevelopmental disorder and that 'these children have come into the world with an innate inability to form the usual, biologically provided contact with people'. Moreover, his astute descriptions of parental behavior in his first publications were prescient and underlie later recognition of the importance of genetics. Our understanding has grown over the ensuing years with revisions in diagnostic classification, recognition of the broader autism phenotype in families, appreciation of the importance of developmental models, advances in genetic methodology, better understanding of the relationship to intellectual deficits, recognition of syndromic autism in neurogenetic sydromes, advances in neuroimaging, and advances in animal models, both mutant mouse models and transgenic non human primate models. Kanner recognized diagnostic heterogeneity and opined that the children had not read those diagnostic manuals and did not easily fall into clear cut categories. Such heterogeneity continues to confound our diagnostic efforts. Always an advocate for children, when reviewing the DSM III criteria in 1980, Kanner emphasized that no matter how well developed our criteria each child must be treated as a unique person.
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Affiliation(s)
- James Harris
- a Department of Psychiatry and Behavioral Sciences , The Johns Hopkins University School of Medicine , Baltimore , MD , USA
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16
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Bolis D, Schilbach L. Observing and participating in social interactions: Action perception and action control across the autistic spectrum. Dev Cogn Neurosci 2018; 29:168-175. [PMID: 28188104 PMCID: PMC6987847 DOI: 10.1016/j.dcn.2017.01.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/18/2016] [Accepted: 01/18/2017] [Indexed: 12/13/2022] Open
Abstract
Autism is a developmental condition, characterized by difficulties of social interaction and communication, as well as restricted interests and repetitive behaviors. Although several important conceptions have shed light on specific facets, there is still no consensus about a universal yet specific theory in terms of its underlying mechanisms. While some theories have exclusively focused on sensory aspects, others have emphasized social difficulties. However, sensory and social processes in autism might be interconnected to a higher degree than what has been traditionally thought. We propose that a mismatch in sensory abilities across individuals can lead to difficulties on a social, i.e. interpersonal level and vice versa. In this article, we, therefore, selectively review evidence indicating an interrelationship between perceptual and social difficulties in autism. Additionally, we link this body of research with studies, which investigate the mechanisms of action control in social contexts. By doing so, we highlight that autistic traits are also crucially related to differences in integration, anticipation and automatic responding to social cues, rather than a mere inability to register and learn from social cues. Importantly, such differences may only manifest themselves in sufficiently complex situations, such as real-life social interactions, where such processes are inextricably linked.
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Affiliation(s)
- Dimitris Bolis
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.
| | - Leonhard Schilbach
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany; Department of Psychiatry, Ludwig Maximilian University, Munich, Germany; Graduate School of Systemic Neuroscience (GSN), Munich, Germany.
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17
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Soorya L, Leon J, Trelles MP, Thurm A. Framework for assessing individuals with rare genetic disorders associated with profound intellectual and multiple disabilities (PIMD): the example of Phelan McDermid Syndrome. Clin Neuropsychol 2017; 32:1226-1255. [PMID: 29265961 DOI: 10.1080/13854046.2017.1413211] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Specialized strategies are needed to understand the complex neuropsychological impairments reported in individuals with profound intellectual and multiple disabilities (PIMD) associated with rare genetic disorders. METHODS This narrative review focuses on assessment of individuals with Phelan-McDermid Syndrome (PMS) as a condition commonly associated with PIMD. Published case series and prospective studies were reviewed to evaluate approaches to cognitive, language, motor/sensory, and behavioral domains. This review is framed using general principles for neuropsychological evaluation in PIMD. RESULTS Neuropsychological assessment domains and tools varied across published reports. Adaptive behavior measures, out-of-range developmental assessments, and social-communication measures were commonly used. Available findings were used to shape a recommended framework with potential to improve measurement of clinical outcomes and advance scientific discovery. CONCLUSIONS The recommended framework outlines an inter-disciplinary and multimodal neuropsychological assessment process relying on modified standardized assessments, functional assessments, and caregiver/informant reports when evaluating individuals with PIMD. Arrested development and skill variability/regression are also discussed as additional, important considerations in neuropsychological evaluation of individuals with PIMD and rare genetic disorders.
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Affiliation(s)
- Latha Soorya
- a Department of Psychiatry , Rush University Medical Center , Chicago , IL , USA
| | - Jill Leon
- b Intramural Research Program , National Institute of Mental Health , Bethesda , MD , USA
| | - M Pilar Trelles
- c Department of Psychiatry , Icahn School of Medicine , New York , NY , USA
| | - Audrey Thurm
- b Intramural Research Program , National Institute of Mental Health , Bethesda , MD , USA
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18
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Abstract
Abstract:Currently, many scientific fields such as psychology or biomedicine face a methodological crisis concerning the reproducibility, replicability, and validity of their research. In neuroimaging, similar methodological concerns have taken hold of the field, and researchers are working frantically toward finding solutions for the methodological problems specific to neuroimaging. This article examines some ethical and legal implications of this methodological crisis in neuroimaging. With respect to ethical challenges, the article discusses the impact of flawed methods in neuroimaging research in cognitive and clinical neuroscience, particularly with respect to faulty brain-based models of human cognition, behavior, and personality. Specifically examined is whether such faulty models, when they are applied to neurological or psychiatric diseases, could put patients at risk, and whether this places special obligations on researchers using neuroimaging. In the legal domain, the actual use of neuroimaging as evidence in United States courtrooms is surveyed, followed by an examination of ways that the methodological problems may create challenges for the criminal justice system. Finally, the article reviews and promotes some promising ideas and initiatives from within the neuroimaging community for addressing the methodological problems.
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19
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Rui M, Qian J, Liu L, Cai Y, Lv H, Han J, Jia Z, Xie W. The neuronal protein Neurexin directly interacts with the Scribble-Pix complex to stimulate F-actin assembly for synaptic vesicle clustering. J Biol Chem 2017; 292:14334-14348. [PMID: 28710284 PMCID: PMC5582829 DOI: 10.1074/jbc.m117.794040] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/29/2017] [Indexed: 01/17/2023] Open
Abstract
Synaptic vesicles (SVs) form distinct pools at synaptic terminals, and this well-regulated separation is necessary for normal neurotransmission. However, how the SV cluster, in particular synaptic compartments, maintains normal neurotransmitter release remains a mystery. The presynaptic protein Neurexin (NRX) plays a significant role in synaptic architecture and function, and some evidence suggests that NRX is associated with neurological disorders, including autism spectrum disorders. However, the role of NRX in SV clustering is unclear. Here, using the neuromuscular junction at the 2-3 instar stages of Drosophila larvae as a model and biochemical imaging and electrophysiology techniques, we demonstrate that Drosophila NRX (DNRX) plays critical roles in regulating synaptic terminal clustering and release of SVs. We found that DNRX controls the terminal clustering and release of SVs by stimulating presynaptic F-actin. Furthermore, our results indicate that DNRX functions through the scaffold protein Scribble and the GEF protein DPix to activate the small GTPase Ras-related C3 Botulinum toxin substrate 1 (Rac1). We observed a direct interaction between the C-terminal PDZ-binding motif of DNRX and the PDZ domains of Scribble and that Scribble bridges DNRX to DPix, forming a DNRX-Scribble-DPix complex that activates Rac1 and subsequently stimulates presynaptic F-actin assembly and SV clustering. Taken together, our work provides important insights into the function of DNRX in regulating SV clustering, which could help inform further research into pathological neurexin-mediated mechanisms in neurological disorders such as autism.
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Affiliation(s)
- Menglong Rui
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China
| | - Jinjun Qian
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China
| | - Lijuan Liu
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China
| | - Yihan Cai
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China
| | - Huihui Lv
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China
| | - Junhai Han
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China.,the Institute of Life Sciences, the Collaborative Innovation Center for Brain Science, Southeast University, Nanjing 210096, China
| | - Zhengping Jia
- the Department of Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada, and.,the Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Wei Xie
- From Key Laboratory of Developmental Genes and Human Disease, Institute of Life Sciences, Southeast University, Nanjing 210096, China, .,the Institute of Life Sciences, the Collaborative Innovation Center for Brain Science, Southeast University, Nanjing 210096, China
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Advances in developmental neuropsychiatry: autism spectrum disorder, Cornelia De Lange syndrome, self-injurious behavior, Down syndrome, fetal alcohol spectrum disorder, and borderline intellectual functioning. Curr Opin Psychiatry 2017; 30:65-68. [PMID: 28067728 DOI: 10.1097/yco.0000000000000318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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