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Acosta A, Khokhlovich E, Reis H, Vyshedskiy A. Dietary Factors Impact Developmental Trajectories in Young Autistic Children. J Autism Dev Disord 2024; 54:3533-3548. [PMID: 37584768 DOI: 10.1007/s10803-023-06074-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE The purpose of this research was to investigate the impact of dietary factors on developmental trajectories in young autistic children. METHODS A gluten-free and casein-free diets, as well as six types of food (meat and eggs, vegetables, uncooked vegetables, sweets, bread, and "white soft bread that never molds") were investigated observationally for up to three years in 5,553 children 2 to 5 years of age via parent-report measures completed within a mobile application. Children had a parent-reported diagnosis of Autism Spectrum Disorder (ASD); 78% were males; the majority of participants resided in the USA. Outcome was monitored on five orthogonal subscales: Language Comprehension, Expressive Language, Sociability, Sensory Awareness, and Health, assessed by the Autism Treatment Evaluation Checklist (ATEC) (Rimland & Edelson, 1999) and Mental Synthesis Evaluation Checklist (MSEC) (Arnold & Vyshedskiy, 2022; Braverman et al., 2018). RESULTS Consumption of fast-acting carbohydrates - sweets, bread, and "white soft bread that never molds" - was associated with a significant and a consistent Health subscale score decline. On the contrary, a gluten-free diet, as well as consumption of meat, eggs, and vegetables were associated with a significant and consistent improvement in the Language Comprehension score. Consumption of meat and eggs was also associated with a significant and consistent improvement in the Sensory Awareness score. CONCLUSION The results of this study demonstrate a strong correlation between a diet and developmental trajectories and suggest possible dietary interventions for young autistic children.
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Affiliation(s)
- Alexander Acosta
- Boston University, Boston, MA, 02215, USA
- ImagiRation, Boston, MA, 02135, USA
| | | | | | - Andrey Vyshedskiy
- Boston University, Boston, MA, 02215, USA.
- ImagiRation, Boston, MA, 02135, USA.
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Hayton T, Gross A, Basson A, Olson K, Ang O, Milne N, Pool J. Psychometric measurement properties of patient-reported and observer-reported outcome measures for spinal mobilisations and manipulation on paediatric subjects with diverse medical conditions: A systematic review. J Man Manip Ther 2024; 32:234-254. [PMID: 38146749 PMCID: PMC11216239 DOI: 10.1080/10669817.2023.2281650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/02/2023] [Indexed: 12/27/2023] Open
Abstract
INTRODUCTION Reliable, valid, and responsive outcomes is foundational to address concerns about the risks and benefits of performing spinal manipulation and mobilization in pediatric populations. The aim of this systematic review was to synthesize evidence on measurement properties from cohort/case-control/cross-sectional/randomized studies on patient-reported (SQLI - Scoliosis Quality of Life Index; VAS-Visual Analog Scale; PAQLQ - Pediatric Asthma Quality of Life Questionnaire), observer-reported (Crying Diaries; ATEC - Autism Treatment Evaluation Checklist) and mixed (PedsQL - Pediatric Quality of Life Inventory) outcome measurements identified through a scoping review on manipulation and mobilization for pediatric populations with diverse medical conditions. METHOD AND ANALYSIS Electronic databases, clinicaltrial.gov and Ebsco Open Dissertations were searched up to 21 October 202221 October 2022. Two independent reviewers selected studies, extracted data, and assessed risk of bias. Qualitative synthesis was performed using COSMIN and Cochrane GRADE methodology to establish the certainty of evidence and overall rating: sufficient (+), insufficient (-), inconsistent (±), indeterminate (?). RESULTS Eighteen studies (2 SQLI for scoliosis; 1 VAS - perceived influence of exertion or movement/position on low back problems; 1 PAQLQ for asthma; 1 Crying Diaries for infantile colic; 8 ATEC for autism; 5 PedsQL for cerebral palsy/scoliosis/healthy) with 9653 participants were selected. ATEC and PedsQL had overall sufficient (+) measurement properties with moderate certainty evidence. PAQLQ had indeterminate measurement properties with moderate certainty evidence. Very low certainty of evidence identified measurement properties to be indeterminate (?) for SQLI, Crying Diaries, and VAS- perceived influence of exertion or movement/position on low back problems. CONCLUSION ATEC for autism and PedsQL for asthma may be a suitable clinical outcome assessment (COA); additional validation studies on responsiveness and the minimal important difference are needed. Other COA require further validation.
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Affiliation(s)
- Tricia Hayton
- School of Rehabilitation, McMaster University, Hamilton, Ontario, Canada
| | - Anita Gross
- School of Rehabilitation, McMaster University, Hamilton, Ontario, Canada
| | - Annalie Basson
- Faculty of Health Science, Physiotherapy Department, University of Witwatersrand, Johannesburg, South Africa
| | | | - Oliver Ang
- Integrative Health and Wellbeing Research Program, Earl E. Bakken Center for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA
| | - Nikki Milne
- International Organisation of Physical Therapists in Paediatrics, Bond University, Gold Coast, Queensland, Australia
| | - Jan Pool
- Institute of Human Movement Studies, University of Applied Sciences. Utrecht The Netherlands
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Paveenakiattikhun S, Likhitweerawong N, Sanguansermsri C. EEG findings and clinical severity and quality of life in non-epileptic patients with autism spectrum disorders. Child Neuropsychol 2024:1-11. [PMID: 38805362 DOI: 10.1080/09297049.2024.2360651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
Electroencephalogram (EEG) abnormalities could be seen in up to 60% of non-epileptic children with autism spectrum disorder (ASD). They have been used as biomarkers of ASD severity. The objective of our study is to identify EEG abnormalities in children with different degrees of ASD severity based on the Autism Treatment Evaluation Checklist (ATEC). We also want to assess the quality of life for children with ASD. All of the children underwent at least one hour of sleep-deprived EEG. Forty-five children were enrolled, of whom 42 were male. EEG abnormalities were found in 10 (22.2%) children, predominantly in the bilateral frontal areas. There were no differences in EEG findings among the mild, moderate, and severe ASD groups. The severity of ASD was associated with female sex (p-value = 0.013), ASD with attention deficit hyperactivity disorder (ADHD) (p-value = 0.032), ASD children taking medications (p-value = 0.048), and a lower Pediatric Quality of Life Inventory (PedsQL) (p-value <0.001). Social and emotional domains were the most problematic for health-related quality of life in ASD children, according to parent reports of PedsQL. Further studies with a larger sample size will help to clarify the potential associations between EEG abnormalities and the severity of ASD, as well as the impact on quality of life.
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Affiliation(s)
- Sirada Paveenakiattikhun
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand
| | - Narueporn Likhitweerawong
- Child and Development Division, Department of Pediatrics, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand
| | - Chinnuwat Sanguansermsri
- Neurology Division, Department of Pediatrics, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand
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Roszkowska P, Klimczak E, Ostrycharz E, Rączka A, Wojciechowska-Koszko I, Dybus A, Cheng YH, Yu YH, Mazgaj S, Hukowska-Szematowicz B. Small Intestinal Bacterial Overgrowth (SIBO) and Twelve Groups of Related Diseases-Current State of Knowledge. Biomedicines 2024; 12:1030. [PMID: 38790992 PMCID: PMC11117733 DOI: 10.3390/biomedicines12051030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
The human gut microbiota creates a complex microbial ecosystem, characterized by its high population density, wide diversity, and complex interactions. Any imbalance of the intestinal microbiome, whether qualitative or quantitative, may have serious consequences for human health, including small intestinal bacterial overgrowth (SIBO). SIBO is defined as an increase in the number of bacteria (103-105 CFU/mL), an alteration in the bacterial composition, or both in the small intestine. The PubMed, Science Direct, Web of Science, EMBASE, and Medline databases were searched for studies on SIBO and related diseases. These diseases were divided into 12 groups: (1) gastrointestinal disorders; (2) autoimmune disease; (3) cardiovascular system disease; (4) metabolic disease; (5) endocrine disorders; (6) nephrological disorders; (7) dermatological diseases; (8) neurological diseases (9); developmental disorders; (10) mental disorders; (11) genetic diseases; and (12) gastrointestinal cancer. The purpose of this comprehensive review is to present the current state of knowledge on the relationships between SIBO and these 12 disease groups, taking into account risk factors and the causal context. This review fills the evidence gap on SIBO and presents a biological-medical approach to the problem, clearly showing the groups and diseases having a proven relationship with SIBO, as well as indicating groups within which research should continue to be expanded.
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Affiliation(s)
- Paulina Roszkowska
- Department of Diagnostic Immunology, Pomeranian Medical University, st. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.R.); (I.W.-K.)
| | - Emilia Klimczak
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
| | - Ewa Ostrycharz
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
- Doctoral School, University of Szczecin, st. A. Mickiewicz 16, 71-412 Szczecin, Poland
- Molecular Biology and Biotechnology Center, University of Szczecin, st. Wąska 13, 71-412 Szczecin, Poland
| | - Aleksandra Rączka
- Department of Genetics, West Pomeranian University of Technology, st. Aleja Piastów 45, 70-311 Szczecin, Poland; (A.R.); (A.D.)
| | - Iwona Wojciechowska-Koszko
- Department of Diagnostic Immunology, Pomeranian Medical University, st. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.R.); (I.W.-K.)
| | - Andrzej Dybus
- Department of Genetics, West Pomeranian University of Technology, st. Aleja Piastów 45, 70-311 Szczecin, Poland; (A.R.); (A.D.)
| | - Yeong-Hsiang Cheng
- Department of Biotechnology and Animal Science, National Ilan University, Yilan 26047, Taiwan; (Y.-H.C.); (Y.-H.Y.)
| | - Yu-Hsiang Yu
- Department of Biotechnology and Animal Science, National Ilan University, Yilan 26047, Taiwan; (Y.-H.C.); (Y.-H.Y.)
| | - Szymon Mazgaj
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
| | - Beata Hukowska-Szematowicz
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
- Molecular Biology and Biotechnology Center, University of Szczecin, st. Wąska 13, 71-412 Szczecin, Poland
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Liu A, Gong C, Wang B, Sun J, Jiang Z. Non-invasive brain stimulation for patient with autism: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1147327. [PMID: 37457781 PMCID: PMC10338880 DOI: 10.3389/fpsyt.2023.1147327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To comprehensively evaluate the efficacy of non-invasive brain stimulation (NIBS) in patients with autism spectrum disorder (ASD) in randomized controlled trials (RCT), providing a reference for future research on the same topic. Methods Five databases were searched (Pubmed, Web of Science, Medline, Embase, and Cochrane library) and tracked relevant references, Meta-analysis was performed using RevMan 5.3 software. Results Twenty-two references (829 participants) were included. The results of the meta-analysis showed that NIBS had positive effects on repetitive and stereotypical behaviors, cognitive function, and executive function in autistic patients. Most of the included studies had a moderate to high risk of bias, Mainly because of the lack of blinding of subjects and assessors to treatment assignment, as well as the lack of continuous observation of treatment effects. Conclusion Available evidence supports an improvement in some aspects of NIBS in patients with ASD. However, due to the quality of the original studies and significant publication bias, this evidence must be treated with caution. Further large multicenter randomized double-blind controlled trials and appropriate follow-up observations are needed to further evaluate the specific efficacy of NIBS in patients with ASD.
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Affiliation(s)
- Annan Liu
- Jiamusi University Affiliated No.3 Hospital, Jiamusi, China
| | - Chao Gong
- Jiamusi Medical College, Jiamusi, Heilongjiang, China
| | - Bobo Wang
- Jiamusi Medical College, Jiamusi, Heilongjiang, China
| | - Jiaxing Sun
- Jiamusi Medical College, Jiamusi, Heilongjiang, China
| | - Zhimei Jiang
- Jiamusi University College of Rehabilitation Medicine, Jiamusi, Heilongjiang, China
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Repetitive transcranial magnetic stimulation modulates long-range functional connectivity in autism spectrum disorder. J Psychiatr Res 2023; 160:187-194. [PMID: 36841084 DOI: 10.1016/j.jpsychires.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 02/23/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is growingly applied in autism spectrum disorder (ASD) due to its potential therapeutic value, however, its effects on functional network configuration and the mechanism underlying clinical improvement are still unclear. In this study, we examined the alternations of functional connectivity induced by rTMS using resting-state electroencephalogram (EEG) in children with ASD. Resting-state EEG was obtained from 24 children with ASD before and after rTMS intervention and from 24 age- and gender-matched typically developing (TD) children. The rTMS intervention course consisted of five 5-s trains at 15 Hz, with 10-min inter-train intervals, on the left parietal lobe each consecutive weekday for 3 weeks (15 sessions in total). Children with ASD showed significantly hypo-connected networks and sub-optimal network properties at both global and local levels, compared with TD peers. After rTMS intervention, long-range intra- and inter-hemispheric connections were significantly promoted, especially those within the alpha band. Meanwhile, network properties at both local and global levels were greatly promoted in the delta, theta, and alpha bands. Consistent with the changes in the network connectivities and properties, the core symptoms in ASD were also relieved measured by clinical scales after treatment. The findings of this study demonstrate that high-frequency rTMS over the parietal lobe is potentially an effective strategy to improve core symptoms by enhancing long-range connectivity reorganization in ASD.
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Xu XJ, Lang JD, Yang J, Long B, Liu XD, Zeng XF, Tian G, You X. Differences of gut microbiota and behavioral symptoms between two subgroups of autistic children based on γδT cells-derived IFN-γ Levels: A preliminary study. Front Immunol 2023; 14:1100816. [PMID: 36875075 PMCID: PMC9975759 DOI: 10.3389/fimmu.2023.1100816] [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: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Background Autism Spectrum Disorders (ASD) are defined as a group of pervasive neurodevelopmental disorders, and the heterogeneity in the symptomology and etiology of ASD has long been recognized. Altered immune function and gut microbiota have been found in ASD populations. Immune dysfunction has been hypothesized to involve in the pathophysiology of a subtype of ASD. Methods A cohort of 105 ASD children were recruited and grouped based on IFN-γ levels derived from ex vivo stimulated γδT cells. Fecal samples were collected and analyzed with a metagenomic approach. Comparison of autistic symptoms and gut microbiota composition was made between subgroups. Enriched KEGG orthologues markers and pathogen-host interactions based on metagenome were also analyzed to reveal the differences in functional features. Results The autistic behavioral symptoms were more severe for children in the IFN-γ-high group, especially in the body and object use, social and self-help, and expressive language performance domains. LEfSe analysis of gut microbiota revealed an overrepresentation of Selenomonadales, Negatiyicutes, Veillonellaceae and Verrucomicrobiaceae and underrepresentation of Bacteroides xylanisolvens and Bifidobacterium longum in children with higher IFN-γ level. Decreased metabolism function of carbohydrate, amino acid and lipid in gut microbiota were found in the IFN-γ-high group. Additional functional profiles analyses revealed significant differences in the abundances of genes encoding carbohydrate-active enzymes between the two groups. And enriched phenotypes related to infection and gastroenteritis and underrepresentation of one gut-brain module associated with histamine degradation were also found in the IFN-γ-High group. Results of multivariate analyses revealed relatively good separation between the two groups. Conclusions Levels of IFN-γ derived from γδT cell could serve as one of the potential candidate biomarkers to subtype ASD individuals to reduce the heterogeneity associated with ASD and produce subgroups which are more likely to share a more similar phenotype and etiology. A better understanding of the associations among immune function, gut microbiota composition and metabolism abnormalities in ASD would facilitate the development of individualized biomedical treatment for this complex neurodevelopmental disorder.
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Affiliation(s)
- Xin-Jie Xu
- Medical Science Research Center, Research Center for Translational Medicine, Department of Scientific Research, Peking Union Medical College Hospital, Beijing, China.,Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji-Dong Lang
- Precision Medicine Center, Geneis Beijing Co., Ltd., Beijing, China
| | - Jun Yang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Long
- Medical Science Research Center, Research Center for Translational Medicine, Department of Scientific Research, Peking Union Medical College Hospital, Beijing, China
| | - Xu-Dong Liu
- Medical Science Research Center, Research Center for Translational Medicine, Department of Scientific Research, Peking Union Medical College Hospital, Beijing, China
| | - Xiao-Feng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Geng Tian
- Precision Medicine Center, Geneis Beijing Co., Ltd., Beijing, China
| | - Xin You
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.,Autism Special Fund, Peking Union Medical Foundation, Beijing, China
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Ji SI, Park H, Yoon SA, Hong SB. A Validation Study of the CARS-2 Compared With the ADOS-2 in the Diagnosis of Autism Spectrum Disorder: A Suggestion for Cutoff Scores. Soa Chongsonyon Chongsin Uihak 2023; 34:45-50. [PMID: 36636493 PMCID: PMC9816003 DOI: 10.5765/jkacap.220027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 01/05/2023] Open
Abstract
Objectives This study examined the validity of the Childhood Autism Rating Scale, Second Edition (CARS-2) compared with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in identifying autism spectrum disorder (ASD). Methods A total of 237 children were tested using both the CARS-2 and ADOS-2. We examined the correlation using Pearson's correlation analysis. In addition, we used a receiver operating characteristic graph to determine the optimal standard version of the CARS-2 (CARS2-ST) cutoff score for ASD diagnosis using the ADOS-2. Results The concurrent validity of the CARS2-ST was demonstrated by a significant correlation with the ADOS-2 (r=0.864, p<0.001). The optimal CARS2-ST cutoff scores were 30 and 28.5 for identifying autism and autism spectrum, respectively, based on the ADOS-2. Conclusion We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.
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Affiliation(s)
- Seong-In Ji
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hyungseo Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Sun Ah Yoon
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Soon-Beom Hong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea,Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea,Address for correspondence: Soon-Beom Hong, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-4208, Fax: +82-2-747-2471, E-mail:
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Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T. Show Me What You Have Inside-The Complex Interplay between SIBO and Multiple Medical Conditions-A Systematic Review. Nutrients 2022; 15:nu15010090. [PMID: 36615748 PMCID: PMC9824151 DOI: 10.3390/nu15010090] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
The microbiota, as a complex of microorganisms in a particular ecosystem, is part of the wider term-microbiome, which is defined as the set of all genetic content in the microbial community. Imbalanced gut microbiota has a great impact on the homeostasis of the organism. Dysbiosis, as a disturbance in bacterial balance, might trigger or exacerbate the course of different pathologies. Small intestinal bacterial overgrowth (SIBO) is a disorder characterized by differences in quantity, quality, and location of the small intestine microbiota. SIBO underlies symptoms associated with functional gastrointestinal disorders (FGD) as well as may alter the presentation of chronic diseases such as heart failure, diabetes, etc. In recent years there has been growing interest in the influence of SIBO and its impact on the whole human body as well as individual systems. Therefore, we aimed to investigate the co-existence of SIBO with different medical conditions. The PubMed database was searched up to July 2022 and we found 580 original studies; inclusion and exclusion criteria let us identify 112 eligible articles, which are quoted in this paper. The present SIBO diagnostic methods could be divided into two groups-invasive, the gold standard-small intestine aspirate culture, and non-invasive, breath tests (BT). Over the years scientists have explored SIBO and its associations with other diseases. Its role has been confirmed not only in gastroenterology but also in cardiology, endocrinology, neurology, rheumatology, and nephrology. Antibiotic therapy could reduce SIBO occurrence resulting not only in the relief of FGD symptoms but also manifestations of comorbid diseases. Although more research is needed, the link between SIBO and other diseases is an important pathway for scientists to follow.
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Affiliation(s)
- Natalia Sroka
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Białystok, 15-276 Białystok, Poland
- Correspondence:
| | - Alicja Rydzewska-Rosołowska
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Białystok, 15-276 Białystok, Poland
| | - Katarzyna Kakareko
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Białystok, 15-276 Białystok, Poland
| | - Mariusz Rosołowski
- Department of Internal Medicine and Hypertension, Medical University of Białystok, 15-540 Białystok, Poland
| | - Irena Głowińska
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Białystok, 15-276 Białystok, Poland
| | - Tomasz Hryszko
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Białystok, 15-276 Białystok, Poland
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Rinaldi A, Martins MCM, Maioli M, Rinaldi S, Fontani V. REAC Noninvasive Neurobiological Stimulation in Autism Spectrum Disorder for Alleviating Stress Impact. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:244-251. [PMID: 36213521 PMCID: PMC9525921 DOI: 10.1007/s41252-022-00293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 05/05/2023]
Abstract
Objectives Autism spectrum disorder (ASD) symptoms can become more evident because of different factors. Among these, depression, anxiety, and stress play an important role. Additionally, several studies have revealed the impact of the COVID-19 pandemic on participants with ASD. In previous studies, two noninvasive neurobiological stimulation treatments with radio electric asymmetric conveyer (REAC) technology, called neuropostural optimization (NPO) and neuropsychophysical optimization (NPPO), were shown to be effective in improving the subjective response to environmental stressors in the general population and in ASD population. Based on the proven efficacy of REAC NPO and NPPOs treatments in alleviating anxiety, stress, and depression, the purpose of this study is to verify how these treatments can reduce the severity of ASD symptoms expression, which is aggravated by depression, anxiety, and stress. The treatments' effects were perceived by caregivers and assessed by the Autism Treatment Evaluation Checklist (ATEC). Methods This study involved 46 children with a previous diagnosis of ASD made using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. The participants received one session of NPO treatment and one NPPOs treatment cycle of 18 sessions, administered within approximately 3 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of the REAC treatments. ATEC allows to evaluate four clusters (speech or language communication; sociability; sensory or cognitive awareness; and health/physical/behavior) through a numerical scale that measures increasing levels of ASD severity. Results The comparison between the scores of the ATEC administered pre- and post-REAC treatments highlighted an improvement of ASD symptoms in each of the four clusters of ATEC. Conclusions The results confirm the usefulness of REAC treatments to optimize the individual response to environmental stressors and reduce the symptomatic expression and deficits present in ASD.
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Affiliation(s)
- Arianna Rinaldi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
| | - Márcia C. Marins Martins
- International Scientific Society of Neuro Psycho Physical Optimization With REAC Technology, Brazilian Branch, São Paulo, Brazil
| | - Margherita Maioli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Rinaldi
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
- Research Department, Rinaldi Fontani Foundation, Florence, Italy
| | - Vania Fontani
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
- Research Department, Rinaldi Fontani Foundation, Florence, Italy
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11
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Liu SY, Wang X, Chen Q, Chen JJ, Jin CK, Zhan XL, Guo CH, Li XH, Lin LZ, Jing J. The validity and reliability of the simplified Chinese version of the Social Communication Questionnaire. Autism Res 2022; 15:1732-1741. [PMID: 35403828 DOI: 10.1002/aur.2726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/28/2022] [Accepted: 04/03/2022] [Indexed: 12/27/2022]
Abstract
This study aims to validate the simplified Chinese version of the Social Communication Questionnaire (SCQ) in children aged 2-12 years from both general and clinical populations. We recruited 819 Chinese children in this study, including 505 typically developing (TD) children, 202 children with autism spectrum disorder (ASD) and 112 children with non-ASD neurodevelopmental disorders. All the children's parents completed the simplified Chinese version of the SCQ and all children with ASD were additionally assessed for intelligence and the Childhood Autism Rating Scale to confirm their diagnosis. We have developed a 40-item, 4-factor structure of SCQ with two domains (social communication and social interaction; and restricted, repetitive, and stereotyped patterns of behavior), which showed adequate goodness of fit (comparative fit index [CFI] = 0.96, Tucker-Lewis index [TLI] = 0.95, standardized root mean squared residual [SRMR] = 0.07, root mean square error of approximation [RMSEA] = 0.05), with good internal consistency (Cronbach's alpha = 0.92). We have provided different cut-offs to distinguish ASD cases from TD children (11 for children under 4 years [sensitivity: 0.96, specificity: 0.95], 12 for children 4 years and above [sensitivity: 0.93, specificity: 0.98]) or children with other neurodevelopmental disorders (14 [sensitivity: 0.85, specificity: 0.88]). Through this large sample validation, we confirmed that the simplified Chinese version of the SCQ could be used for children aged 2-12 years with relatively good psychometric properties. LAY SUMMARY: We aimed to develop the simplified Chinese version of the Social Communication Questionnaire (SCQ) for Chinese children aged 2-12 years as a screening tool to identified potential risk of autism spectrum disorder (ASD). We have developed a 40-item, 4-factor structure of SCQ with two domains, which showed adequate goodness of fit and good psychometric properties. We also provided different cut-offs to identify ASD cases in general or clinical populations.
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Affiliation(s)
- Si-Yu Liu
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xin Wang
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiang Chen
- Department of Child Psychological Health, Zhuhai Women and Children's Hospital, Zhuhai, Guangdong, China
| | - Jia-Jie Chen
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cheng-Kai Jin
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiao-Ling Zhan
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cui-Hua Guo
- Child Health Care Institute, Dongguan Children's Hospital, Dongguan, Guangdong, China
| | - Xiu-Hong Li
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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12
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Geier DA, Geier MR. A Longitudinal Cohort Study of Precocious Puberty and Autism Spectrum Disorder. Horm Res Paediatr 2022; 94:219-228. [PMID: 34425572 DOI: 10.1159/000519141] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Autism spectrum disorder (ASD) is defined by persistent deficits in communication, socialization, and stereotypic behaviors. It was previously hypothesized that hormone dysfunction is a frequent occurrence among children diagnosed with an ASD. OBJECTIVES A hypothesis-testing epidemiological study examined the relationship between precocious puberty (PP) (a known disorder of childhood sex hormone dysfunction) and ASD diagnoses. METHODS The Independent Healthcare Research Database is composed of de-identified linked eligibility and claims health-care records prospectively generated from the Florida Medicaid system. A cohort of 101,736 children eligible for Florida Medicaid from 1990 to 2009 and continuously eligible with ≥10 outpatient office visits during the 120-month period following birth were examined using SAS and StatsDirect software. There were 1,593 children (15,738 person-years) in the ASD diagnosed cohort utilizing the Diagnostic and Statistical Manual of Mental Disorders, 4th revision criteria (the International Code for Disease, 9th revision [ICD-9] codes: 299.00 or 299.80) and 100,143 children (996,835 person-years) in the undiagnosed cohort. RESULTS The incidence rate of PP (ICD-9 code: 259.1) was examined using Cox proportional hazards ratio (HR) and frequency models. PP per 10,000 person-years in the ASD cohort (43.2) relative to the undiagnosed cohort (13.7) was significantly increased in frequency modeling (risk ratio = 3.15, p < 0.0001) and Cox proportional HR modeling (adjusted HR = 4.64, p < 0.0001). Further analyses revealed the incidence rate of PP diagnosed after 3 years of age was significantly increased (adjusted HR = 5.16, p < 0.0001) in the ASD cohort relative to the undiagnosed cohort but not for the incidence rate of PP diagnosed before 3 years (adjusted HR = 1.57, p = 0.44). CONCLUSION This hypothesis-testing study provides strong evidence of an increased incidence rate of PP among children diagnosed with an ASD.
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, Maryland, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, Maryland, USA
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13
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Zhang L, Xu Y, Li H, Li B, Duan G, Zhu C. The role of probiotics in children with autism spectrum disorders: A study protocol for a randomised controlled trial. PLoS One 2022; 17:e0263109. [PMID: 35202432 PMCID: PMC8870536 DOI: 10.1371/journal.pone.0263109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurological and developmental condition that begins in infancy or earlier and lasts through the individual’s lifetime. The aetiology and mechanisms of ASD are not yet fully understood, and current treatment comprises mainly education and rehabilitation, without significant improvement in the core symptoms. Recent studies suggest that microbiota change in children with ASD after the ingestion of probiotics may improve the balance of microbiota and thus ASD symptoms. Objective The objectives of this study are to evaluate the efficacy of probiotics on the symptoms of children with ASD and the possible mechanisms involved. Methods This is a prospective controlled trial. A total of 160 children with ASD will be stratified and allocated to placebo and probiotics groups randomised according to the severity of their ASD symptoms. The probiotics group will be given probiotics supplements orally twice a day for 3 months and the control group will be given a placebo at the same amount, in addition to the baseline therapy of education and rehabilitation. All the children will be evaluated systematically by using different scales, questionnaires before, during, and after 3 months’ treatment, as well as 3 months after discontinuation. The potential impact of probiotics on immunity and inflammation, metabolism, and metagenome will also be investigated. Discussion Our previous study showed that the abundance of intestinal flora was greatly different in children with ASD, and that Bifidobacterium was associated with the severity of ASD. In the present study, we will investigate the impact of probiotics supplementation on the symptoms of Children with ASD, with the purpose of evaluating the possible therapeutic effects of additives on ASD and of providing a reference for clinical treatment. The results will help to disclose as yet unknown relationship between probiotics and ASD. Trial registration This study has been registered with Chinese Clinical Trial Registry (ChiCTR-2000037941).
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Affiliation(s)
- Lingling Zhang
- Henan Key Laboratory of Child Brain Injury and Henan Clinical Research Center for Child Neurological Disorders, Institute of Neuroscience and The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiran Xu
- Henan Key Laboratory of Child Brain Injury and Henan Clinical Research Center for Child Neurological Disorders, Institute of Neuroscience and The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongwei Li
- Henan Key Laboratory of Child Brain Injury and Henan Clinical Research Center for Child Neurological Disorders, Institute of Neuroscience and The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bingbing Li
- Henan Key Laboratory of Child Brain Injury and Henan Clinical Research Center for Child Neurological Disorders, Institute of Neuroscience and The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guiqin Duan
- Center for Child Behavioral Development, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury and Henan Clinical Research Center for Child Neurological Disorders, Institute of Neuroscience and The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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14
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Chu JH, Bian F, Yan RY, Li YL, Cui YH, Li Y. Comparison of diagnostic validity of two autism rating scales for suspected autism in a large Chinese sample. World J Clin Cases 2022; 10:1206-1217. [PMID: 35211554 PMCID: PMC8855175 DOI: 10.12998/wjcc.v10.i4.1206] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/17/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Autism is the most common clinical developmental disorder in children. The childhood autism rating scale (CARS) and autistic autism behavior checklist (ABC) are the most commonly used assessment scales for diagnosing autism. However, the diagnostic validations and the corresponding cutoffs for CARS and ABC in individuals with suspected autism spectrum disorder (ASD) remain unclear. Furthermore, for suspected ASD in China, it remains unclear whether CARS is a better diagnostic tool than ABC. Also unclear is whether the current cutoff points for ABC and CARS are suitable for the accurate diagnosis of ASD.
AIM To investigate the diagnostic validity of CARS and ABC based on a large Chinese sample.
METHODS A total of 591 outpatient children from the ASD Unit at Beijing Children’s Hospital between June and November 2019 were identified. First, the Clancy autism behavior scale (CABS) was used to screen out suspected autism from these children. Then, each suspected ASD was evaluated by CARS and ABC. Receiver operating characteristic (ROC) curve analysis was used to compare diagnostic validations. We also calculated the area under the curve (AUC) for both CARS and ABC.
RESULTS We found that the Cronbach alpha coefficients of CARS and ABC were 0.772 and 0.426, respectively. Therefore, the reliability of the CARS was higher than that of the ABC. In addition, we found that the correlation between CARS and CABS was 0.732. Next, we performed ROC curve analysis for CARS and ABC, which yielded AUC values of 0.846 and 0.768, respectively. The cutoff value, which is associated with the maximum Youden index, is usually applied as a decision threshold. We found that the cutoff values of CARS and ABC were 34 and 67, respectively.
CONCLUSION This result indicated that CARS is superior to ABC in the Chinese population with suspected ASD.
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Affiliation(s)
- Jia-Hui Chu
- Department of Psychiatry, Beijing Children's Hospital, Beijing 100045, China
| | - Fang Bian
- Department of Psychiatry, Beijing Children's Hospital, Beijing 100045, China
| | - Rui-Ying Yan
- Department of Psychiatry, Beijing Children's Hospital, Beijing 100045, China
| | - Yan-Lin Li
- Department of Psychiatry, Beijing Children's Hospital, Beijing 100045, China
| | - Yong-Hua Cui
- Department of Psychiatry, Beijing Children's Hospital, Beijing 100045, China
| | - Ying Li
- Department of Psychiatry, Beijing Children's Hospital, Beijing 100045, China
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15
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Seng GJ, Chiu YN, Tsai WC, Lin HY, Li SC, Hsiao MN, Liu TJ, Chen HM, Shih A, Chang YC, Who Cst Team, Soong WT. Promotion and implementation effectiveness of World Health Organization's Caregiver Skills Training program in Taiwan. Front Psychiatry 2022; 13:904380. [PMID: 36117658 PMCID: PMC9470946 DOI: 10.3389/fpsyt.2022.904380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
The World Health Organization (WHO) developed the Caregiver Skills Training for Families of Children with Developmental Delays and Disabilities (CST) with support from Autism Speaks to address the resource gaps and worldwide needs for interventions for children with developmental disorders or delays, especially those with autism spectrum disorder (ASD), and their families. Evidence has indicated that parent-mediated interventions benefit both caregivers and children by strengthening caregivers' knowledge and confidence and children's social communication skills and behavioral regulation. The CST-Taiwan team began the prepilot field trial in 2017 and developed the project to serve families in various locations. This study (1) delineated the adaptations and promotion of CST-Taiwan; (2) determined the program's effectiveness in the promotional stage, in terms of caregiver and child outcomes, and (3) examined the maintenance of its effects. The materials, delivery, and facilitator training procedure of the original CST were adapted to Taiwan. The quantitative data indicated that CST-Taiwan is a promising program, it positively affected caregiver knowledge and confidence and reduced the severity of the children's autistic symptoms. The 3-month follow-up results suggested that the effects persisted. Thus, CST-Taiwan, and its promotional strategies are feasible and effective.
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Affiliation(s)
- Guan-Jye Seng
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiang-Yuan Lin
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Su-Chen Li
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Mei-Ni Hsiao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tseng-Jung Liu
- Foundation for Autistic Children and Adults in Taiwan, Taipei, Taiwan
| | - Heng-Man Chen
- Foundation for Autistic Children and Adults in Taiwan, Taipei, Taiwan.,Department of Special Education, National Taipei University of Education, Taipei, Taiwan
| | - Andy Shih
- Autism Speaks, New York City, NY, United States
| | - Ya-Chih Chang
- Department of Special Education and Counseling, California State University, Los Angeles, CA, United States
| | - Who Cst Team
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Wei-Tsuen Soong
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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16
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Jurek L, Baltazar M, Gulati S, Novakovic N, Núñez M, Oakley J, O’Hagan A. Response (minimum clinically relevant change) in ASD symptoms after an intervention according to CARS-2: consensus from an expert elicitation procedure. Eur Child Adolesc Psychiatry 2022; 31:1-10. [PMID: 33825947 PMCID: PMC8024930 DOI: 10.1007/s00787-021-01772-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
The lack of consensual measures to monitor core change in Autism Spectrum Disorder (ASD) or response to interventions leads to difficulty to prove intervention efficacy on ASD core symptoms. There are no universally accepted outcome measures developed for measuring changes in core symptoms. However, the CARS (Childhood Autism Rating Scale) is one of the outcomes recommended in the EMA Guideline on the clinical development of medicinal products for the treatment of ASD. Unfortunately, there is currently no consensus on the response definition for CARS among individuals with ASD. The aim of this elicitation process was to determine an appropriate definition of a response on the CARS2 scale for interventions in patients with Autism Spectrum Disorder (ASD). An elicitation process was conducted following the Sheffield Elicitation Framework (SHELF). Five experts in the field of ASD and two experts in expert knowledge elicitation participated in an 1-day elicitation workshop. Experts in ASD were previously trained in the SHELF elicitation process and received a dossier of scientific evidence concerning the topic. The response definition was set as the mean clinically relevant improvement averaged over all patients, levels of functioning, age groups and clinicians. Based on the scientific evidence and expert judgment, a normal probability distribution was agreed to represent the state of knowledge of this response with expected value 4.03 and standard deviation 0.664. Considering the remaining uncertainty of the estimation and the available literature, a CARS-2 improvement of 4.5 points has been defined as a threshold to conclude to a response after an intervention. A CARS-2 improvement of 4.5 points could be used to evaluate interventions' meaningfulness in indivudals. This initial finding represents an important new benchmark and may aid decision makers in evaluating the efficacy of interventions in ASD.
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Affiliation(s)
- Lucie Jurek
- Child and Adolescent Psychiatry Department, Center for Assessment and Diagnostic of Autism, Le Vinatier Hospital, Bron, France.
| | - Matias Baltazar
- Child and Adolescent Psychiatry Department, Center for Assessment and Diagnostic of Autism, Le Vinatier Hospital, Bron, France
| | - Sheffali Gulati
- Centre of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Neda Novakovic
- Day Care Centre for Children and Adolescents with Developmental Disabilities, Belgade, Serbia
| | - María Núñez
- Faculty of Psychology, Universidad Autónoma de Madrid, Campus de Cantoblanco, Madrid, Spain
| | - Jeremy Oakley
- School of Mathematics and Statistics, The University of Sheffield, Hounsfield Road, Sheffield, UK
| | - Anthony O’Hagan
- School of Mathematics and Statistics, The University of Sheffield, Hounsfield Road, Sheffield, UK
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17
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Borissov A, Bakolis I, Tekola B, Kinfe M, Ceccarelli C, Girma F, Abdurahman R, Zerihun T, Hanlon C, Hoekstra RA. Adaptation and validation of two autism-related measures of skills and quality of life in Ethiopia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1409-1422. [PMID: 34875883 PMCID: PMC9340138 DOI: 10.1177/13623613211050751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Although most children with autism and other neurodevelopmental disorders live in low- and middle-income countries, assessment tools are lacking in these settings. This study aims to culturally adapt and validate two questionnaires for use in Ethiopia: the Autism Treatment Evaluation Checklist and the Pediatric Quality of Life Inventory™ Family Impact Module. Both questionnaires were adapted to be suitable for administration in low-literate caregivers and translated using the backward translation procedure. The factor structure, reliability and validity were investigated using caregiver-reports on 300 children with neurodevelopmental disorders or physical health conditions. Confirmatory factor analysis of the Pediatric Quality of Life Inventory™ Family Impact Module data indicated an acceptable fit of the hypothesised eight-factor structure. Internal consistency was high for both measures. Test–retest reliability was excellent for the Autism Treatment Evaluation Checklist and moderate to excellent for the Pediatric Quality of Life Inventory™ Family Impact Module. Both questionnaires demonstrated adequate known-group validity, with moderate to very large effect size group differences between case and control groups. The questionnaires correlated moderately with each other. In conclusion, the Ethiopian adaptations of the Autism Treatment Evaluation Checklist and the Pediatric Quality of Life Inventory™ Family Impact Module are valid and reliable tools for use in parents of children with neurodevelopmental disorders including autism. These adapted measures may also be valuable for use in other low-income settings.
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Affiliation(s)
| | | | | | | | | | | | | | - Tigist Zerihun
- St. Paul's Hospital Millennium Medical College, Ethiopia
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18
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Borland RL, Cameron LA, Tonge BJ, Gray KM. Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:399-420. [PMID: 34796601 DOI: 10.1111/jar.12961] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well-being of children and adolescents with intellectual disability. METHOD Five databases were searched systematically (ERIC, MEDLINE, PsycINFO, SportDISCUS and SCOPUS), up to 28 February 2021. Thirty-two studies met criteria for inclusion. RESULTS Studies in this review included case studies (n = 15), treatment trials (n = 14), cross sectional studies (n = 2) and a cohort study (n = 1). Evidence was positive, though high risk of bias in treatment trials (7 of 14 rated high) meant generalisability of results was limited. CONCLUSIONS The available evidence suggests a positive relationship between physical activity and improved behaviour and emotional problems, mental health and psychosocial well-being; however, more robust randomised controlled trials are required to confirm this.
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Affiliation(s)
- Ross L Borland
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Lauren A Cameron
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
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19
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Leung JYL, Mackenzie L, Dickson C. Outcomes of assistance dog placement in the home for individuals with autism spectrum disorder and their families: A pilot study. Aust Occup Ther J 2021; 69:50-63. [PMID: 34498767 DOI: 10.1111/1440-1630.12768] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/22/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Evidence indicates that assistance dogs placed in the home are effective in supporting individuals with Autism Spectrum Disorder (ASD) by increasing social and community participation and promoting quality of life. This study aimed to examine the outcomes of assistance dog placement on quality of life, independence, and participation of families including individuals with ASD placed with an assistance dog compared to families on the waiting list for an autism assistance dog and to evaluate the feasibility of the design for future studies. METHODS A cross-sectional comparative study was conducted. The Adaptive Behaviour Analysis System, Social Responsiveness Scale, Autism Treatment Evaluation Checklist, Canadian Occupational Performance Measure, and Autism Family Experience Questionnaire were used to evaluate adaptive skills, behaviour, social difficulties, daily functioning, and family quality of life. RESULTS Six families who had an autism assistance dog placed with them, and 12 families who were on the waiting list were recruited using purposeful sampling. The pilot data found no significant differences between the two groups. However, trends were observed which suggested that assistance dogs can increase desired social behaviours, decrease ASD severity, and improve family wellbeing. For families with an assistance dog, more positive outcomes were observed for families who were partnered with an assistance dog for longer. Parents (and sometimes individuals with ASD) were able to complete and return the outcome measures via mail to collect the outcome data for the study. CONCLUSION These study findings add to the developing evidence about the use of assistance dogs with this population. A larger sample size may have allowed for significant associations to be detected. The methods used were feasible to be applied in a larger study. These results may assist health professionals advocate for funding for assistance dog placement to individuals with ASD and their families.
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Affiliation(s)
- Joyce Yan-Lok Leung
- Faculty of Medicine and Health, Susan Wakil Building, The University of Sydney, Sydney, New South Wales, Australia
| | - Lynette Mackenzie
- Faculty of Medicine and Health, Susan Wakil Building, The University of Sydney, Sydney, New South Wales, Australia
| | - Claire Dickson
- Occupational Therapy, Assistance Dogs Australia, Engadine, New South Wales, Australia
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20
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Fridberg E, Khokhlovich E, Vyshedskiy A. Watching Videos and Television Is Related to a Lower Development of Complex Language Comprehension in Young Children with Autism. Healthcare (Basel) 2021; 9:423. [PMID: 33917303 PMCID: PMC8067341 DOI: 10.3390/healthcare9040423] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 01/10/2023] Open
Abstract
The effect of passive video and television watching duration on 2- to 5-year-old children with autism was investigated in the largest and the longest observational study to date. Parents assessed the development of 3227 children quarterly for three years. Longer video and television watching were associated with better development of expressive language but significantly impeded development of complex language comprehension. On an annualized basis, low TV users (low quartile: 40 min or less of videos and television per day) improved their language comprehension 1.4 times faster than high TV users (high quartile: 2 h or more of videos and television per day). This difference was statistically significant. At the same time, high TV users improved their expressive language 1.3 times faster than low TV users. This difference was not statistically significant. No effect of video and television watching duration on sociability, cognition, or health was detected.
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Affiliation(s)
- Elisabeth Fridberg
- Biology Department, Boston University, Boston, MA 02215, USA;
- ImagiRation, Boston, MA 02135, USA
| | | | - Andrey Vyshedskiy
- Biology Department, Boston University, Boston, MA 02215, USA;
- ImagiRation, Boston, MA 02135, USA
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21
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Abdel-Rahman EA, Zaky EA, Aboulsaoud M, Elhossiny RM, Youssef WY, Mahmoud AM, Ali SS. Autism spectrum disorder (ASD)-associated mitochondrial deficits are revealed in children's platelets but unimproved by hyperbaric oxygen therapy. Free Radic Res 2021; 55:26-40. [PMID: 33402007 DOI: 10.1080/10715762.2020.1856376] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mitochondrial and immune dysfunctions are often implicated in the aetiology of autism spectrum disorder (ASD). Here, we studied for the first time the relationship between ASD severity measures and mitochondrial respiratory rates in freshly isolated platelets as well as the activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) in isolated neutrophils. We also verified the impact of hyperbaric oxygen therapy (HBOT) on mitochondrial and immune functions as well as on ASD severity measures. Blood samples were collected from three age-matched male groups (Control (Norm-N), autistic (Aut-N), and autistic + HBOT (Aut-H); N = 10 per group). Using high resolution respirometry, we found that routine basal respiration, complex I- and complex I + II-dependent oxidative phosphorylation rate were significantly impaired in Aut-N platelets. Similarly, deficits in immune response of neutrophils were evidenced through lower rates of oxygen consumption and reactive oxygen species (ROS) production by phagocytic NOX. ASD-related behavioural outcomes were found to moderately correlate with platelets' mitochondrial bioenergetic parameters as well as with NOX-mediated activity in neutrophils. HBOT was not able to improve mitochondrial dysfunctions or to counteract ASD-related behavioral deficits. Although HBOT improved one measure of the immune response; namely, NOX-mediated superoxide burst, this was not associated with significant changes in trends of recurrent infections between groups. Taken together, our data suggest that ASD-associated mitochondria and immune deficits are detectable in platelets and neutrophils. We also found no evidence that HBOT confers any significant improvement of ASD-associated physiological or behavioural phenotypes.
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Affiliation(s)
- Engy A Abdel-Rahman
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt.,Basic Research Department, Children's Cancer Hospital, Cairo, Egypt.,Department of Pharmacology, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Eman A Zaky
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Aboulsaoud
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Reham M Elhossiny
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Walaa Y Youssef
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ali M Mahmoud
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Sameh S Ali
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt.,Basic Research Department, Children's Cancer Hospital, Cairo, Egypt
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22
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Grechanyi S, Suf El-Zhil L, Ivanov D, Pozdnyakova O, Sergeev A, Atamanova E, Pozdnyakov A. Proton magnetic resonance spectroscopy in children with atypical autism comorbid with psychomotor disinhibition syndrome. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:12-18. [DOI: 10.17116/jnevro202112111212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Sener EF, Onal MG, Dal F, Nalbantoglu U, Ozkul Y, Canatan H, Oztop DB. Novel alterations of CC2D1A as a candidate gene in a Turkish sample of patients with autism spectrum disorder. Int J Neurosci 2020; 132:1072-1079. [PMID: 33287601 DOI: 10.1080/00207454.2020.1860968] [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: 10/22/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder with large genetic background, but identification of pathogenic variants has proceeded slowly because hundreds of loci are involved in this complex disorder. CC2D1A gene firstly associated with the intellectual disability (ID) in a family with a large deletion. We aimed to contribute to the literature by sequencing this gene and by this way we report novel CC2D1A variations in patients with ASD. METHODS Forty families who have a child with a diagnosis of ASD were enrolled to the study. DNA samples were obtained from each family member. Bidirectional CC2D1A gene sequencing was performed with CEQ Cycle Sequencing Kit, and the products were analyzed on the Beckman CEQ 8000. All of the genetic analysis was conducted in Erciyes University Genome and Stem Cell Center (GENKOK). RESULTS According to the sequencing results, we defined new alterations in this gene with two SNPs in exon 15 and 19 (rs747172992 and rs1364074600) in our patients. We found a pathogenic variant in one patient. This variant was located in the acceptor region. Six of the variants were missense mutations. Additionally, six different benign variants were detected in 30 patients; however, they were not associated with ASD. Two patients carried multiple rare variants. CONCLUSION In vitro and in vivo functional analysis with this gene will help to understand its contribution to ASD pathogenesis. Future studies may help to elucidate the underlying biological mechanisms of these variants leading to the autism phenotype.
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Affiliation(s)
- Elif Funda Sener
- Medical Faculty Department of Medical Biology, Erciyes University, Kayseri, Turkey.,Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
| | - Muge Gulcihan Onal
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey.,Erciyes University Halil Bayraktar Vocational School of Health College, Kayseri, Turkey
| | - Fatma Dal
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
| | - Ufuk Nalbantoglu
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey.,Faculty of Engineering, Department of Computer Engineering, Erciyes University, Kayseri, Turkey
| | - Yusuf Ozkul
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey.,Medical Faculty Department of Medical Genetics, Erciyes University, Kayseri, Turkey
| | - Halit Canatan
- Medical Faculty Department of Medical Biology, Erciyes University, Kayseri, Turkey
| | - Didem Behice Oztop
- Faculty of Medicine, Department of Child Psychiatry, Ankara University, Ankara, Turkey
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24
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Vyshedskiy A, Khokhlovich E, Dunn R, Faisman A, Elgart J, Lokshina L, Gankin Y, Ostrovsky S, deTorres L, Edelson SM, Ilyinskii PO. Novel Prefrontal Synthesis Intervention Improves Language in Children with Autism. Healthcare (Basel) 2020; 8:healthcare8040566. [PMID: 33339269 PMCID: PMC7765988 DOI: 10.3390/healthcare8040566] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/03/2022] Open
Abstract
Prefrontal synthesis (PFS) is defined as the ability to juxtapose mental visuospatial objects at will. Paralysis of PFS may be responsible for the lack of comprehension of spatial prepositions, semantically-reversible sentences, and recursive sentences observed in 30 to 40% of individuals with autism spectrum disorder (ASD). In this report we present data from a three-year-long clinical trial of 6454 ASD children age 2 to 12 years, which were administered a PFS-targeting intervention. Tablet-based verbal and nonverbal exercises emphasizing mental-juxtaposition-of-objects were organized into an application called Mental Imagery Therapy for Autism (MITA). The test group included participants who completed more than one thousand exercises and made no more than one error per exercise. The control group was selected from the rest of participants by a matching procedure. Each test group participant was matched to the control group participant by age, gender, expressive language, receptive language, sociability, cognitive awareness, and health score at first evaluation using propensity score analysis. The test group showed a 2.2-fold improvement in receptive language score vs. control group (p < 0.0001) and a 1.4-fold improvement in expressive language (p = 0.0144). No statistically significant change was detected in other subscales not targeted by the exercises. These findings show that language acquisition improves after training PFS and that a further investigation of the PFS-targeting intervention in a randomized controlled study is warranted.
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Affiliation(s)
- Andrey Vyshedskiy
- Biology Department, Boston University, Boston, MA 02215, USA
- ImagiRation, Boston, MA 02135, USA; (R.D.); (J.E.); (L.L.); (S.O.); (L.d.)
- Correspondence: ; Tel.: +1-(617)-433-7724
| | | | - Rita Dunn
- ImagiRation, Boston, MA 02135, USA; (R.D.); (J.E.); (L.L.); (S.O.); (L.d.)
| | | | - Jonah Elgart
- ImagiRation, Boston, MA 02135, USA; (R.D.); (J.E.); (L.L.); (S.O.); (L.d.)
| | - Lisa Lokshina
- ImagiRation, Boston, MA 02135, USA; (R.D.); (J.E.); (L.L.); (S.O.); (L.d.)
| | | | - Simone Ostrovsky
- ImagiRation, Boston, MA 02135, USA; (R.D.); (J.E.); (L.L.); (S.O.); (L.d.)
| | - Lauren deTorres
- ImagiRation, Boston, MA 02135, USA; (R.D.); (J.E.); (L.L.); (S.O.); (L.d.)
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25
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Abd-Allah NA, Ibrahim OM, Elmalt HA, Shehata MA, Hamed RA, Elsaadouni NM, Hawary B. Thioredoxin level and inflammatory markers in children with autism spectrum disorders. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00021-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Autism Spectrum Disorders (ASD) are a group of neurodevelopmental disabilities with unknown etiology. Recent studies suggest the contribution of immune dysfunction and oxidative stress in its pathophysiology. The present study aimed to investigate the serum level of thioredoxin (Trx), as a marker of oxidative stress and some inflammatory cytokines, and to evaluate their role in children with ASD.
Results
Concentrations of Trx, IL-1β, IL-8, and TNF-α were significantly higher in children with ASD compared with matched controls. There were no association between cytokine levels and the severity of clinical manifestations, according to CARS classification of severity.
Conclusion
The present study provides support for the idea that physiological abnormalities, such as oxidative stress and immune dysfunction, may contribute in the pathophysiology of ASD.
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26
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Longitudinal Epidemiological Study of Autism Subgroups Using Autism Treatment Evaluation Checklist (ATEC) Score. J Autism Dev Disord 2020; 50:1497-1508. [PMID: 30062397 PMCID: PMC7211200 DOI: 10.1007/s10803-018-3699-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Here we report the results of the subgroup analyses of an observational cohort of children whose parents completed the Autism Treatment Evaluation Checklist (ATEC) over the period of several years. A linear mixed effects model was used to evaluate longitudinal changes in ATEC scores within different patient subgroups. All groups decreased their mean ATEC score over time indicating improvement of symptoms, however there were significant differences between the groups. Younger children improved more than the older children. Children with milder ASD improved more than children with more severe ASD in the Communication subscale. There was no difference in improvement between females vs. males. One surprising finding was that children from developed English-speaking countries improved less than children from non-English-speaking countries.
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27
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Dawson-Squibb JJ, de Vries PJ. A comparative feasibility study of two parent education and training programmes for autism spectrum disorder in a low-resource South African setting. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2269-2284. [PMID: 32720806 DOI: 10.1177/1362361320942988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT After a diagnosis of autism, it is an important first step to give families information about autism and skills to help them support their child. These interventions are called Parent Education and Training programmes. Little is known about these programmes or if they can make a difference to families, particularly in countries with few autism resources. In this study, we compared two Parent Education and Training programmes in South Africa. EarlyBird/EarlyBird Plus was developed in the United Kingdom, and Autism Cares in South Africa. We wanted to know if parents found the programmes useful, and if any changes were required. We collected information from parents through questionnaires and interviews before and after the group. We also asked a panel of experts (including parents) to compare the programmes. In total, 18 parents attended the EarlyBird/EarlyBird Plus group and 11 attended the Autism Cares group. Parents found both programmes helpful and made suggestions for improvements. Parents showed less stress, more knowledge of autism, and saw improvements in their children. The expert panel rated EarlyBird/EarlyBird Plus as better because it was more supportive of parents and was seen as easier to run in the country. Our study showed that Parent Education and Training programmes are important, but that researchers must study not only the outcomes but also the implementation needs of these programmes.
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Affiliation(s)
- John-Joe Dawson-Squibb
- Centre for Autism Research in Africa (CARA), Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
| | - Petrus J de Vries
- Centre for Autism Research in Africa (CARA), Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
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28
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González-Domenech PJ, Díaz Atienza F, García Pablos C, Fernández Soto ML, Martínez-Ortega JM, Gutiérrez-Rojas L. Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial. J Autism Dev Disord 2020; 50:935-948. [PMID: 31813108 DOI: 10.1007/s10803-019-04333-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6 months and a GFCF diet for another 6 months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets.
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Affiliation(s)
- Pablo José González-Domenech
- Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain
| | - Francisco Díaz Atienza
- Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain
| | - Carlos García Pablos
- Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain
| | | | | | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain. .,Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain. .,CTS-549 Research Group, Institute of Neuroscience, Granada, Spain.
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29
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Hadoush H, Nazzal M, Almasri NA, Khalil H, Alafeef M. Therapeutic Effects of Bilateral Anodal Transcranial Direct Current Stimulation on Prefrontal and Motor Cortical Areas in Children with Autism Spectrum Disorders: A Pilot Study. Autism Res 2020; 13:828-836. [PMID: 32149480 DOI: 10.1002/aur.2290] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/12/2019] [Accepted: 02/13/2020] [Indexed: 12/28/2022]
Abstract
Dysfunctional frontal cortical areas associated with clinical features are observed in children with autism spectrum disorder (ASD). This study attempted to identify any potential therapeutic effects of bilateral anodal transcranial direct current stimulation (tDCS) applied over the left and right prefrontal and motor areas on the clinical characteristics of children with ASD. Fifty children with confirmed ASD medical diagnoses were divided equally and randomly into a tDCS treatment group and a control group. The tDCS treatment group underwent 10 sessions (20-min durations, five per week) of bilateral anodal tDCS stimulation applied simultaneously over the left and right prefrontal and motor areas, whereas the control group underwent the same procedures but with the use of sham tDCS stimulation. Total scores and sub-scores of autism treatment evaluation checklist (ATEC) (language and communication; sociability; sensory awareness; and behavioral, health, and physical conditions) were measured before and after the tDCS treatment sessions of both groups. There were significant decreases in total ATEC scores (P = 0.014), sociability sub-scores (P = 0.021), and behavioral, health, and physical condition sub-scores (P = 0.011) in the tDCS treatment group. No significant changes were observed in total ATEC scores and sub-scores in the control group. In conclusion, compared to the control group, bilateral anodal tDCS showed potential therapeutic effects on children with ASD in terms of improvements in sociability, behavior, health, and physical conditions with no reported side effects. Autism Res 2020, 13: 828-836. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Dysfunctional frontal cortical areas are associated with clinical features in children with autism spectrum disorder (ASD). Transcranial direct current stimulation (tDCS) is found to be a safe, noninvasive method to stimulate cortical regions and thus have therapeutic effects on children with ASD. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Hikmat Hadoush
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences at Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Nazzal
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences at Jordan University of Science and Technology, Irbid, Jordan
| | - Nihad A Almasri
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences at Jordan University of Science and Technology, Irbid, Jordan
| | - Maha Alafeef
- Department of Biomedical Engineering, Jordan University of Science and Technology, Irbid, Jordan
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30
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Fu L, Weng J, Feng M, Xiao X, Xiao T, Fu J, Qiu N, Li C, Da Y, Ke X. Predictors of Change in Play-Based Communication and Behavior Intervention for High-Risk ASD: The Role of Mother-Child Dyadic Synchrony. Front Pediatr 2020; 8:581893. [PMID: 33344381 PMCID: PMC7738436 DOI: 10.3389/fped.2020.581893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Interindividual variability is important in the evolution of adaptative profiles of children with ASD having benefited from an early intervention make up for deficits in communication, language and social interactions. Therefore, this paper aimed to determine the nature of factors influencing the efficacy variability of a particular intervention technique i.e., "Play-based communication and behavior intervention" (PCBI). Methods: The participants comprised 70 13-30-month-old toddlers with ASD enrolled in PCBI for 12 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of PCBI. Video recordings of 5 min of free-play before and after PCBI were used to examine behaviors of mothers and children and parent-child dyadic synchrony. Hierarchical multiple regression analyses and machine learning algorithms were performed to explore the effect of these potential predictors (mothers' factors, children's factors and videotaped mother-child interaction) of intervention efficacy. Results: The hierarchical regression analysis and the machine learning algorithms indicated that parenting stress, level of completion of training at home and mother-child dyadic synchrony were crucial factors in predicting and monitoring the efficacy of PCBI. Conclusions: In summary, the findings suggest that PCBI could be particularly beneficial to children with ASD who show a good performance in the mother-child dyadic synchrony evaluation. A better dyadic mother-child synchrony could enhance the PCBI efficacy through adapted emotional and behavioral responses of the mother and the child and has a beneficial influence on the child's psychological development.
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Affiliation(s)
- Linyan Fu
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jiao Weng
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Three Hospital of Longyan, Longyan, China
| | - Min Feng
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Xiang Xiao
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Ting Xiao
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Junli Fu
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Nana Qiu
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Chunyan Li
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yun Da
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Xiaoyan Ke
- Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
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31
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Saniee S, Pouretemad HR, Zardkhaneh SA. Developing set-shifting improvement tasks (SSIT) for children with high-functioning autism. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1207-1220. [PMID: 31267604 DOI: 10.1111/jir.12633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 12/08/2018] [Accepted: 04/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) experience set-shifting deficit as a part of executive function, which can lead to cognitive and behavioural flexibility deficits and/or restricted behaviours. Despite the increasing body of research on this cognitive deficit, set-shifting training has not been exclusively studied in ASD. AIMS In this study, a training condition [set-shifting improvement tasks (SSIT)] was developed to improve set-shifting ability; afterwards, the possible effects of these tasks were investigated. METHODS AND PROCEDURES With the aim of improving set-shifting ability in children with autism, a training program (SSIT), involving a computer game (Tatka, a puzzle game produced by our research team) with some home-based tasks (for generalisation purposes), was developed. Then, in a quasi-experimental design, the effects of SSIT tasks were studied on children (n = 13, 5-7 years old) with high-functioning autism. Outcome measures (pre-training, post-training and a 6-week follow-up) were assessed using Modified Wisconsin Card Sorting Test, Bender-Gestalt Test and Behavioural Flexibility Rating Scale. RESULTS AND OUTCOMES A significant change was observed in both cognitive (Bender Gestalt, ηp2=0.84 ; WCST; =p20.87 ) and behavioural flexibilities ( ηp2=0.79 ) and also in repetitive behaviours ( ηp2=0.45 ). Furthermore, the result remained stable to some extent for about 1 month after the training condition. CONCLUSIONS AND IMPLICATIONS Developing the SSIT is just an initial step in the major target of creating cognitive rehabilitation tools to be used by clinicians and parents for children diagnosed with ASD and should be understood as a supplement, rather than an alternative, to the main treatments such as applied behaviour analysis. Future research with larger samples are needed to confirm whether this intervention is effective for children with ASD.
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Affiliation(s)
- S Saniee
- Department of Cognitive Psychology, Shahid Beheshti University, Tehran, Iran
| | - H R Pouretemad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - S A Zardkhaneh
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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32
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Riordan NH, Hincapié ML, Morales I, Fernández G, Allen N, Leu C, Madrigal M, Paz Rodríguez J, Novarro N. Allogeneic Human Umbilical Cord Mesenchymal Stem Cells for the Treatment of Autism Spectrum Disorder in Children: Safety Profile and Effect on Cytokine Levels. Stem Cells Transl Med 2019; 8:1008-1016. [PMID: 31187597 PMCID: PMC6766688 DOI: 10.1002/sctm.19-0010] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/10/2019] [Indexed: 12/14/2022] Open
Abstract
Individuals with autism spectrum disorder (ASD) suffer from developmental disabilities that impact communication, behavior, and social interaction. Immune dysregulation and inflammation have been linked to children with ASD, the latter manifesting in serum levels of macrophage‐derived chemokine (MDC) and thymus, and activation‐regulated chemokine (TARC). Mesenchymal stem cells derived from umbilical cord tissue (UC‐MSCs) have immune‐modulatory and anti‐inflammatory properties, and have been safely used to treat a variety of conditions. This study investigated the safety and efficacy of UC‐MSCs administered to children diagnosed with ASD. Efficacy was evaluated with the Autism Treatment Evaluation Checklist (ATEC) and the Childhood Autism Rating Scale (CARS), and with measurements of MDC and TARC serum levels. Twenty subjects received a dose of 36 million intravenous UC‐MSCs every 12 weeks (four times over a 9‐month period), and were followed up at 3 and 12 months after treatment completion. Adverse events related to treatment were mild or moderate and short in duration. The CARS and ATEC scores of eight subjects decreased over the course of treatment, placing them in a lower ASD symptom category when compared with baseline. MDC and TARC inflammatory cytokine levels also decreased for five of these eight subjects. The mean MDC, TARC, ATEC, and CARS values attained their lowest levels 3 months after the last administration. UC‐MSC administration in children with ASD was therefore determined to be safe. Although some signals of efficacy were observed in a small group of children, possible links between inflammation levels and ASD symptoms should be further investigated. stem cells translational medicine2019;8:1008–1016
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Affiliation(s)
- Neil H Riordan
- MediStem Panama, Inc., City of Knowledge, Clayton, Republic of Panama.,Stem Cell Institute, Panama, Republic of Panama
| | | | - Isabela Morales
- MediStem Panama, Inc., City of Knowledge, Clayton, Republic of Panama
| | | | - Nicole Allen
- MediStem Panama, Inc., City of Knowledge, Clayton, Republic of Panama
| | - Cindy Leu
- Stem Cell Institute, Panama, Republic of Panama
| | | | | | - Nelson Novarro
- Pacífica Salud, Hospital Punta Pacífica, Panama, Republic of Panama
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33
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Yang Y, Wang H, Xue Q, Huang Z, Wang Y. High-Frequency Repetitive Transcranial Magnetic Stimulation Applied to the Parietal Cortex for Low-Functioning Children With Autism Spectrum Disorder: A Case Series. Front Psychiatry 2019; 10:293. [PMID: 31143132 PMCID: PMC6520602 DOI: 10.3389/fpsyt.2019.00293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/15/2019] [Indexed: 02/02/2023] Open
Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique to stimulate specific areas of cortical dysfunction in several neuropsychiatric diseases; however, it is not known whether high-frequency rTMS (HF-rTMS) over the left inferior parietal lobule, in low functioning children with autism spectrum disorder (ASD), improves core symptoms. Method: Eleven low-functioning children with ASD completed two separate HF-rTMS treatment courses, 6 weeks apart. Each treatment course involved five 5-s trains at 20 Hz, with 10-min inter-train intervals, on left inferior parietal lobule each consecutive weekday for a 3-week period (15 treatments per course). Subjects were assessed at five time points: immediately before and after the first HF-rTMS course, immediately before and after the second HF-rTMS course, and 6 weeks after the second rTMS treatment course. Treatment effectiveness was evaluated using the Verbal Behavior Assessment Scale (VerBAS) and Autism Treatment Evaluation Checklist (ATEC). The latter test consists of four subtest scales: Language, Sociability, Sensory, and Behavior. In addition, daily treatment logbooks completed by parents were considered as one of the outcome measures. Results: Participants showed a significant reduction in language- and social-related symptoms measured by ATEC from pretreatment to the 6-week follow-up after the second treatment course. Moreover, some possible improvements in imitation and cognition were reported by caregivers. Conclusions: Our findings suggest that HF-rTMS over the left parietal cortex might improve core deficits in low-functioning children with ASD.
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Affiliation(s)
- Yingxue Yang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing, China
| | - Hongxing Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing, China
| | - Qing Xue
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing, China
| | - Zhaoyang Huang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing, China
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Sener EF, Taheri S, Sahin MC, Bayramov KK, Marasli MK, Zararsiz G, Mehmetbeyoglu E, Oztop DB, Canpolat M, Canatan H, Ozkul Y. Altered Global mRNA Expressions of Pain and Aggression Related Genes in the Blood of Children with Autism Spectrum Disorders. J Mol Neurosci 2018; 67:89-96. [PMID: 30519864 DOI: 10.1007/s12031-018-1213-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/11/2018] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by repetitive stereotypic behaviors, restricted interests, social withdrawal, and communication deficits. Aggression and insensitivity to pain are largely unexplained in these cases. We analyzed nine mRNA expressions of the candidate genes related to aggression and insensitivity to pain in the peripheral blood of patients with ASD. Whole blood samples were obtained from 40 autistic patients (33 boys, 7 girls) and 50 age- and sex-matched controls (37 boys and 13 girls) to isolate RNA. Gene expression was assessed by quantitative Real-Time PCR (qRT-PCR) in the Erciyes University Genome and Stem Cell Center (GENKOK). All of the gene expressions except CRHR1 and SLC6A4 were found to be statistically different between the ASD patients and controls. Gene expression also differed according to gender. Alterations in the mRNA expression patterns of the HTR1E, OPRL1, OPRM1, TACR1, PRKG1, SCN9A and DRD4 genes provide further evidence for a relevant effect of the respective candidate genes on the pathophysiology of ASD. Future studies may determine the sensitivity of these candidate markers in larger samples including further neuropsychiatric diagnosis.
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MESH Headings
- Aggression
- Autism Spectrum Disorder/blood
- Autism Spectrum Disorder/genetics
- Autism Spectrum Disorder/physiopathology
- Biomarkers/blood
- Child, Preschool
- Cyclic GMP-Dependent Protein Kinase Type I/genetics
- Cyclic GMP-Dependent Protein Kinase Type I/metabolism
- Female
- Humans
- Male
- NAV1.7 Voltage-Gated Sodium Channel/genetics
- NAV1.7 Voltage-Gated Sodium Channel/metabolism
- Pain Perception
- RNA, Messenger/blood
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptor, Serotonin, 5-HT1A/genetics
- Receptor, Serotonin, 5-HT1A/metabolism
- Receptors, Dopamine D4/genetics
- Receptors, Dopamine D4/metabolism
- Receptors, Opioid/genetics
- Receptors, Opioid/metabolism
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Affiliation(s)
- Elif Funda Sener
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey.
- Erciyes University Genome and Stem Cell Center (GENKOK), 38039, Kayseri, Turkey.
| | - Serpil Taheri
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
- Erciyes University Genome and Stem Cell Center (GENKOK), 38039, Kayseri, Turkey
| | | | | | | | - Gokmen Zararsiz
- Department of Biostatistics, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
| | - Ecmel Mehmetbeyoglu
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
- Erciyes University Genome and Stem Cell Center (GENKOK), 38039, Kayseri, Turkey
| | - Didem Behice Oztop
- Department of Child and Adolescent Psychiatry, Ankara University Medical Faculty , Ankara, Turkey
| | - Mehmet Canpolat
- Department of Child Neurology, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Halit Canatan
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
| | - Yusuf Ozkul
- Department of Medical Genetics, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
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Oliveira TRDS, Nascimento AA, Pellicani AD, Torres GMX, Silva KD, Guedes-Granzotti RB. Speech therapy intervention in a teenager with autism spectrum disorder: a case report. REVISTA CEFAC 2018. [DOI: 10.1590/1982-021620182068518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Autism Spectrum Disorder is a neurodevelopmental disorder that affects socio-communicative and behavioral abilities. In the language aspect, there is a greater impairment at the pragmatic level and in non-verbal aspects. The objective of this study was to characterize the severity of Autism Spectrum Disorder in an adolescent, pre-and post-speech-language therapy, and describe the process of speech-language intervention using Picture Exchange Communication System allied to the principles of behavioral analysis applied to language. The Autism Treatment Evaluation Checklist with the parents was applied. Then, a therapeutic program of 14 sessions of 50 minutes was developed, one per week, and then the questionnaire was reapplied. In the course of the therapeutic process, it was possible to observe an increase in the number of figure exchanges independently, an increase in the number of vocalizations with communicative intention or functional speech, longer time of visual contact and social smile, reduction of inappropriate behaviors with a significant improvement in the Autism Treatment Evaluation Checklist score.
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Nowak K, Muzaj H, Nawrocka H, Sobaniec P. Evaluation of the effectiveness of MNRI therapy in children with autism based on the ATEC test – a preliminary report. REHABILITACJA MEDYCZNA 2018. [DOI: 10.5604/01.3001.0012.6899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Autism (ASD) is a multiform disorder of unexplored etiology. Therapeutic treatment is therefore symptomatic0 and due to the complexity and variety of symptoms, it must be individualized. Therapists reach for various methods and forms of work with an autistic patient. In this situation, there is also a need to evaluate the therapeutic procedure and the choice of methods that will help assess the effectiveness of therapy. One of the proposed activities is therapeutic modality MNRI (Masgutova Neurosensorimotor Reflex Integration), while the standard ATEC test is used to assess the effectiveness of therapy. The MNRI method deals with the functioning of basic reflexes, the movement system and its impact on the developmental and learning processes. The MNRI method is aimed at restoring normal neurosensoric development and integration of reflex patterns, motor coordination systems and skills enabling movement functioning, behavioural regulation, emotional and cognitive functions. Therapy consists in activating reflex patterns to stimulate the natural resources of the brain, the body, strengthening memory and neurosensotimotive as well as motor integration. The aim of the study was to evaluate the effectiveness of MNRI therapy in children with autism based on the ATEC test. The study involved 60 children diagnosed with autism (F84.0) according to ICD-10 criteria. The average age of patients was 10.7 years. Each participant of the project took an active part in the 11-day rehabilitation process according to the MNRI programme. The standardized ATEC test was used to assess the effectiveness of therapy. Analysis of the results of the ATEC test before and after the 11-day rehabilitation in autistic patients showed positive effects of MNRI therapy among 43.5% of the subjects. These effects included, for part I - in terms of communication, an increase was noted by 9.2%; for part II – socialization0 58.3%; part III - sensory feeling, cognitive awareness, 47.2% and in part IV - physical health, emotions, behaviour, 57.9%. MNRI therapy positively influenced the examined group of autistic patients. Particularly noticeable improvement was expressed in the reduction of self-inflicted harm (65%), reduced hypersensitivity and improvement in sound tolerance (80%), improvement of awareness of one’s own body's (60%); greater calmness, self-control (80%). The therapy is safe, painless, has no negative effects. This article is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. null
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Affiliation(s)
- Katarzyna Nowak
- Uniwersytet Medyczny w Białymstoku / Medical University of Białystok, Poland
| | - Halina Muzaj
- Wyższa Szkoła Fizjoterapii we Wrocławiu / Academy of Physiotherapy in Wrocław, Poland
| | - Halina Nawrocka
- Klinika Zdrowia w Świebodzicach / Swobodzice Health Clinic, Poland
| | - Piotr Sobaniec
- Uniwersytet Medyczny w Białymstoku / Medical University of Białystok, Poland
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Grimaldi R, Gibson GR, Vulevic J, Giallourou N, Castro-Mejía JL, Hansen LH, Leigh Gibson E, Nielsen DS, Costabile A. A prebiotic intervention study in children with autism spectrum disorders (ASDs). MICROBIOME 2018; 6:133. [PMID: 30071894 PMCID: PMC6091020 DOI: 10.1186/s40168-018-0523-3] [Citation(s) in RCA: 196] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/27/2018] [Indexed: 06/02/2023]
Abstract
BACKGROUND Different dietary approaches, such as gluten and casein free diets, or the use of probiotics and prebiotics have been suggested in autistic spectrum disorders in order to reduce gastrointestinal (GI) disturbances. GI symptoms are of particular interest in this population due to prevalence and correlation with the severity of behavioural traits. Nowadays, there is lack of strong evidence about the effect of dietary interventions on these problems, particularly prebiotics. Therefore, we assessed the impact of exclusion diets and a 6-week Bimuno® galactooligosaccharide (B-GOS®) prebiotic intervention in 30 autistic children. RESULTS The results showed that children on exclusion diets reported significantly lower scores of abdominal pain and bowel movement, as well as lower abundance of Bifidobacterium spp. and Veillonellaceae family, but higher presence of Faecalibacterium prausnitzii and Bacteroides spp. In addition, significant correlations were found between bacterial populations and faecal amino acids in this group, compared to children following an unrestricted diet. Following B-GOS® intervention, we observed improvements in anti-social behaviour, significant increase of Lachnospiraceae family, and significant changes in faecal and urine metabolites. CONCLUSIONS To our knowledge, this is the first study where the effect of exclusion diets and prebiotics has been evaluated in autism, showing potential beneficial effects. A combined dietary approach resulted in significant changes in gut microbiota composition and metabolism suggesting that multiple interventions might be more relevant for the improvement of these aspects as well as psychological traits. TRIAL REGISTRATION NCT02720900 ; registered in November 2015.
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Affiliation(s)
- Roberta Grimaldi
- Department of Food and Nutritional Sciences, University of Reading, Reading, RG66AP UK
- Clasado Research Services Ltd., Thames Valley Science Park, Reading, RG29LH UK
| | - Glenn R. Gibson
- Department of Food and Nutritional Sciences, University of Reading, Reading, RG66AP UK
| | - Jelena Vulevic
- Clasado Research Services Ltd., Thames Valley Science Park, Reading, RG29LH UK
| | - Natasa Giallourou
- Division of Computational and Systems Medicine, Imperial College London, London, SW7 2AZ UK
| | - Josué L. Castro-Mejía
- Department of Food Science, Faculty of Science, Food Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Lars H. Hansen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - E. Leigh Gibson
- Health Sciences Research Centre, Life Sciences Department, Whitelands College, University of Roehampton, London, SW15 4JD UK
| | - Dennis S. Nielsen
- Department of Food Science, Faculty of Science, Food Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Adele Costabile
- Health Sciences Research Centre, Life Sciences Department, Whitelands College, University of Roehampton, London, SW15 4JD UK
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Geier DA, Kern JK, Sykes LK, Geier MR. Mercury-associated diagnoses among children diagnosed with pervasive development disorders. Metab Brain Dis 2018; 33:949-960. [PMID: 29512044 DOI: 10.1007/s11011-018-0211-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/25/2018] [Indexed: 12/27/2022]
Abstract
Nelson and Bauman (Pediatrics 111:674-679, 2003) previously hypothesized that pervasive developmental disorder (PDD) was not associated with mercury (Hg) exposure because the medical conditions associated with Hg exposure were not associated with PDD. A hypothesis-testing longitudinal case-control study evaluated the frequency of medically diagnosed conditions previously associated with Hg poisoning, including: epilepsy, dysarthria, failure to thrive, cerebral palsy, or contact dermatitis and other eczema among children preceding their eventual PDD diagnosis (cases) compared to controls. A retrospective examination of medical records within the Vaccine Safety Datalink (VSD) was undertaken. Cases diagnosed with PDD (n = 534) were born from 1991 to 2000 and continuously enrolled until their PDD diagnosis. Controls (n = 26,367) were born from 1991 to 1993 and continuously enrolled from birth for 7.22 years. Within the first 5 years of life, cases compared to controls were significantly (p < 0.0001) more likely to be assigned a diagnosis of contact dermatitis and other eczema (odds ratio (OR) = 2.033), dysarthria (OR = 23.992), epilepsy (OR = 5.351), failure to thrive (OR = 25.3), and cerebral palsy (OR = 4.464). Similar results were observed when the data were separated by gender. Overall, the results of the present study and recently published studies provide direct evidence supporting a link in twelve of twelve categories (100%) of Hg poisoning associated symptoms as defined by Nelson and Bauman (Pediatrics 111:674-679, 2003) and symptoms observed in those with a PDD diagnosis. The results of this study support the biological plausibility of Hg poisoning to induce PDD diagnoses and rejection of the Nelson and Bauman (Pediatrics 111:674-679, 2003) hypothesis because those with a PDD diagnosis have an increased frequency of conditions previously associated with Hg poisoning.
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Affiliation(s)
- David A Geier
- The Institute of Chronic Illnesses, Inc, 14 Redgate Ct, Silver Spring, MD, USA
| | - Janet K Kern
- The Institute of Chronic Illnesses, Inc, 14 Redgate Ct, Silver Spring, MD, USA.
- CoMeD, Inc, Silver Spring, MD, USA.
- CONEM US Autism Research Group, Allen, TX, USA.
| | | | - Mark R Geier
- The Institute of Chronic Illnesses, Inc, 14 Redgate Ct, Silver Spring, MD, USA
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Braverman J, Dunn R, Vyshedskiy A. Development of the Mental Synthesis Evaluation Checklist (MSEC): A Parent-Report Tool for Mental Synthesis Ability Assessment in Children with Language Delay. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E62. [PMID: 29783788 PMCID: PMC5977044 DOI: 10.3390/children5050062] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 12/02/2022]
Abstract
Mental synthesis is the conscious purposeful process of synthesizing novel mental images from objects stored in memory. Mental synthesis ability is essential for understanding complex syntax, spatial prepositions, and verb tenses. In typical children, the timeline of mental synthesis acquisition is highly correlated with an increasing vocabulary. Children with Autism Spectrum Disorder (ASD), on the other hand, may learn hundreds of words but never acquire mental synthesis. In these individuals, tests assessing vocabulary comprehension may fail to demonstrate the profound deficit in mental synthesis. We developed a parent-reported Mental Synthesis Evaluation Checklist (MSEC) designed to assess mental synthesis acquisition in ASD children. The psychometric quality of MSEC was tested with 3715 parents of ASD children. Internal reliability of the 20-item MSEC was good (Cronbach's alpha >0.9). MSEC exhibited adequate test⁻retest reliability; good construct validity, supported by a positive correlation with the Autism Treatment Evaluation Checklist (ATEC) Communication subscale; and good known group validity reflected by the difference in MSEC scores for children of different ASD severity levels. The MSEC questionnaire is copyright-free and can be used by researchers as a complimentary subscale for the ATEC evaluation. We hope that the addition of MSEC will make the combined assessment more sensitive to small steps in a child's development. As MSEC does not rely on productive language, it may be an especially useful tool for assessing the development of nonverbal and minimally verbal children.
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Affiliation(s)
| | - Rita Dunn
- ImagiRation LLC, Boston, MA 02215, USA.
| | - Andrey Vyshedskiy
- ImagiRation LLC, Boston, MA 02215, USA.
- Boston University, Boston, MA 02215, USA.
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Transcranial Direct Current Stimulation to the Right Temporoparietal Junction for Social Functioning in Autism Spectrum Disorder: A Case Report. J ECT 2018; 34:e10-e13. [PMID: 28825927 PMCID: PMC6495599 DOI: 10.1097/yct.0000000000000445] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES While there is evidence of improved social functioning after applying transcranial direct current stimulation (tDCS) at the right temporoparietal junction (rTPJ) in individuals who are healthy, no current studies have investigated the use of tDCS at the rTPJ to improve social functioning in individuals with autism spectrum disorder (ASD). This case investigates the use of tDCS applied to the rTPJ to target social functioning in a high-functioning adult with ASD. METHODS The authors present a case of an 18-year old patient with ASD treated successfully with tDCS; 1.5 mA of tDCS was applied once a day for 30 minutes for 8 consecutive days with the anode electrode over rTPJ (CP6 in the 10/10 electroencephalogram system) and the cathode electrode placed on the ipsilateral deltoid. Behavioral outcome was assessed using the Autism Treatment Evaluation Checklist prior to tDCS, after the final tDCS session, and at 2 months after tDCS. An additional, informal follow-up was also made 1 year after tDCS. RESULTS Autism Treatment Evaluation Checklist showed substantial improvement in social functioning from baseline to post-tDCS, which was maintained at 2 months. The patient also reported lessened feelings of anger and frustration over social disappointments. Informal follow-up 1 year after stimulation indicates that the patient continues to maintain many improvements. CONCLUSIONS Anodal tDCS to the rTPJ may represent an effective treatment for improving social functioning in ASD, with a larger clinical trial needed to validate this effect.
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Mahapatra S, Vyshedsky D, Martinez S, Kannel B, Braverman J, Edelson SM, Vyshedskiy A. Autism Treatment Evaluation Checklist (ATEC) Norms: A "Growth Chart" for ATEC Score Changes as a Function of Age. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E25. [PMID: 29462954 PMCID: PMC5835994 DOI: 10.3390/children5020025] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/29/2018] [Accepted: 02/13/2018] [Indexed: 11/17/2022]
Abstract
Most early-intervention Autism Spectrum Disorder (ASD) clinical trials are limited by the availability of psychometric technicians who assess each child's abilities before and after therapeutic intervention. If parents could administer regular psychometric evaluations of their children, then the cost of clinical trials will be reduced, enabling longer clinical trials with the larger number of participants. The Autism Treatment Evaluation Checklist (ATEC) was designed nearly two decades ago to provide such a tool, but the norms on the longitudinal changes in ATEC in the "treatment as usual" population were lacking. Here we report the norms of the observational cohort who voluntarily completed ATEC evaluations over the period of four years from 2013 to 2017.
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Affiliation(s)
| | | | | | | | | | - Stephen M Edelson
- Autism Research Institute, 4182 Adams Avenue, San Diego, CA 92116, USA.
| | - Andrey Vyshedskiy
- Boston University, One Silber Way, Boston, MA 02215, USA.
- ImagiRation LLC, 9 Michael Rd, Boston, MA 02135, USA.
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Hydrogen breath test to detect small intestinal bacterial overgrowth: a prevalence case-control study in autism. Eur Child Adolesc Psychiatry 2018; 27:233-240. [PMID: 28799094 DOI: 10.1007/s00787-017-1039-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 08/04/2017] [Indexed: 12/26/2022]
Abstract
The aim of this study is to assess the prevalence of small intestinal bacterial overgrowth (SIBO) by hydrogen breath test in patients with autism spectrum disorders (ASD) with respect to a consistent control group. From 2011 to 2013, 310 children with ASD and 1240 sex- and age-matched typical children were enrolled in this study to undergo glucose breath test. The study participants were considered to exhibit SIBO when an increase in H2 of ≥20 ppm or CH4 of ≥10 ppm with respect to the fasting value was observed up to 60 min after the ingestion of glucose. Ninety-six children with autism suffered from SIBO, giving a prevalence rate of SIBO was 31.0% (95% CI 25.8-36.1%). In contrast, 9.3% of the typical children acknowledged SIBO. The difference between groups was statistically significant (P < 0.0001). The median Autism Treatment Evaluation Checklist (ATEC) score in the children with autism and with SIBO was significantly high when compared with the children without autism and without SIBO [98 (IQR, 45-120) vs. 63 (32-94), P < 0.001]. For the autism group, the 6-GI Severity Index (6-GSI) score was found to be strongly and significantly correlated with the total ATEC score (r = 0.639, P < 0.0001). SIBO was significantly associated with worse symptoms of autism, demonstrating that children with SIBO may significantly contribute to symptoms of autism.
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Holingue C, Newill C, Lee LC, Pasricha P, Fallin MD. Gastrointestinal symptoms in autism spectrum disorder: A review of the literature on ascertainment and prevalence. Autism Res 2018; 11:24-36. [PMID: 28856868 PMCID: PMC5773354 DOI: 10.1002/aur.1854] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/07/2017] [Accepted: 08/11/2017] [Indexed: 01/29/2023]
Abstract
There is no standard approach to measuring GI symptoms in individuals with ASD, despite postulated interactions. The objectives of this study were to (a) describe the range of GI symptom ascertainment approaches in studies of ASD, (b) describe the range of prevalence estimates across studies, and (c) assess associations between ascertainment approach and prevalence estimates. Studies published from 1/1/1980 to 1/31/2017 were collected via PubMed. Eligibility included studies with at least ten individuals with ASD that measured GI symptoms or conditions. We excluded review and hypothesis papers. We extracted information on study design, GI symptom ascertainment method, demographics, and ASD diagnostic criteria. From a subset of studies, we extracted GI symptom estimates. Out of a possible 386 titles, 144 were included. The prevalence range for constipation was 4.3-45.5% (median 22%), for diarrhea was 2.3-75.6% (median 13.0%), and for any or more than one symptom was 4.2-96.8% (median 46.8%). GI symptoms differed significantly by age of individuals, primary goal of study, study design, study sample, and who reported symptoms (P < .05). Due to small sample size, we were not able to test for associations between every GI symptom and study characteristic of interest, or examine associations between GI symptoms and intellectual or verbal disability. Studies used a broad range of methods to ascertain GI symptoms in ASD. GI symptoms varied widely across these studies, with significant differences by study characteristics. Our findings highlight the need for a reliable, valid GI assessment tool to be used consistently across studies of ASD. Autism Res 2018, 11: 24-36. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY We reviewed studies having to do with autism spectrum disorder and the gastrointestinal system, dating back to 1980. We found that the median prevalence of constipation was 22.2%, diarrhea 13.0%, and any symptom 46.8%. All symptoms had a wide range of estimates across studies. GI symptoms were associated with characteristics of the study, including who measured the GI symptoms. We call for the development of a reliable and valid GI questionnaire for studies of ASD.
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Affiliation(s)
- Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Carol Newill
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Li-Ching Lee
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Pankaj Pasricha
- Johns Hopkins Center for Neurogastroenterology, Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - M. Daniele Fallin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Saad K, Abdel-Rahman AA, Elserogy YM, Al-Atram AA, El-Houfey AA, Othman HAK, Bjørklund G, Jia F, Urbina MA, Abo-Elela MGM, Ahmad FA, Abd El-Baseer KA, Ahmed AE, Abdel-Salam AM. Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder. J Child Psychol Psychiatry 2018; 59:20-29. [PMID: 27868194 DOI: 10.1111/jcpp.12652] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children. METHODS This study is a double-blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3-10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25-hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and the Autism Treatment Evaluation Checklist (ATEC). TRIAL REGISTRATION NUMBER UMIN-CTR Study Design: trial number: UMIN000020281. RESULTS Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4-month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD. CONCLUSIONS This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide-scale studies are needed to critically validate the efficacy of vitamin D in ASD.
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Affiliation(s)
- Khaled Saad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed A Abdel-Rahman
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Yasser M Elserogy
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdulrahman A Al-Atram
- Department of Psychiatry, College of Medicine, Almajmaah University, Riyadh, Saudi Arabia
| | - Amira A El-Houfey
- Department of Community Health Nursing, Assiut University, Assiut, Egypt
| | | | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Feiyong Jia
- Department of Pediatric Neurology and Neurorehabilitation, The First Hospital of Jilin University, Changchun, China
| | - Mauricio A Urbina
- Department of Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Departamento de Zoología, Facultad de Ciencias Naturales y Oceanográficas, Universidad de Concepción, Concepción, Chile
| | | | | | - Khaled A Abd El-Baseer
- Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ahmed E Ahmed
- Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ahmad M Abdel-Salam
- Department of Pharmaceutics and Industrial Pharmacy, Alazhar University, Assiut, Egypt
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El-Rashidy O, El-Baz F, El-Gendy Y, Khalaf R, Reda D, Saad K. Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metab Brain Dis 2017; 32:1935-1941. [PMID: 28808808 DOI: 10.1007/s11011-017-0088-z] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023]
Abstract
UNLABELLED Many diet regimens were studied for patients with autism spectrum disorder (ASD) over the past few years. Ketogenic diet is gaining attention due to its proven effect on neurological conditions like epilepsy in children. Forty-five children aged 3-8 years diagnosed with ASD based on DSM-5 criteria were enrolled in this study. Patients were equally divided into 3 groups, first group received ketogenic diet as modified Atkins diet (MAD), second group received gluten free casein free (GFCF) diet and the third group received balanced nutrition and served as a control group. All patients were assessed in terms of neurological examination, anthropometric measures, as well as Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Test (ATEC) scales before and 6 months after starting diet. Both diet groups showed significant improvement in ATEC and CARS scores in comparison to control group, yet ketogenic scored better results in cognition and sociability compared to GFCF diet group. Depending on the parameters measured in our study, modified Atkins diet and gluten free casein free diet regimens may safely improve autistic manifestations and could be recommended for children with ASD. At this stage, this study is a single center study with a small number of patients and a great deal of additional wide-scale prospective studies are however needed to confirm these results. TRIAL REGISTRATION NUMBER UMIN-CTR Study Design: trial Number UMIN000021433.
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Affiliation(s)
- Omnia El-Rashidy
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Farida El-Baz
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yasmin El-Gendy
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Randa Khalaf
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina Reda
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Khaled Saad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
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Saad K, Zahran AM, Elsayh KI, Abdel-Rahman AA, Al-Atram AA, Hussein A, El-Gendy YG. Frequency of Dendritic Cells and Their Expression of Costimulatory Molecules in Children with Autism Spectrum Disorders. J Autism Dev Disord 2017; 47:2671-2678. [PMID: 28589497 DOI: 10.1007/s10803-017-3190-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aim of our study was to evaluate the frequencies of myeloid dendritic cells (mDCs) and plasmacytoid dendritic cells (pDCs) in children with ASD. Subjects were 32 children with ASD and 30 healthy children as controls. The numbers of mDCs and pDCs and the expression of CD86 and CD80 on the entire DCs were detected by flow cytometry. ASD children had significantly higher percentages of mDCs and pDCs when compared to controls. We found significant inverse relationships between serum 25-hydroxyvitamin D levels and the frequencies of mDCs and pDCs in autistic children. Our data suggested that DCs could play a role in the clinical course of ASD. The relationship of DCs to immune disorders in ASD remains to be determined.
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Affiliation(s)
- Khaled Saad
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
| | - Asmaa M Zahran
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Khalid I Elsayh
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Ahmed A Abdel-Rahman
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdulrahman A Al-Atram
- Department of Psychiatry, College of Medicine, Almajmaah University, Almajmaah, Kingdom of Saudi Arabia
| | - Almontaser Hussein
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Yasmin G El-Gendy
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Naviaux RK, Curtis B, Li K, Naviaux JC, Bright AT, Reiner GE, Westerfield M, Goh S, Alaynick WA, Wang L, Capparelli EV, Adams C, Sun J, Jain S, He F, Arellano DA, Mash LE, Chukoskie L, Lincoln A, Townsend J. Low-dose suramin in autism spectrum disorder: a small, phase I/II, randomized clinical trial. Ann Clin Transl Neurol 2017; 4:491-505. [PMID: 28695149 PMCID: PMC5497533 DOI: 10.1002/acn3.424] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE No drug is yet approved to treat the core symptoms of autism spectrum disorder (ASD). Low-dose suramin was effective in the maternal immune activation and Fragile X mouse models of ASD. The Suramin Autism Treatment-1 (SAT-1) trial was a double-blind, placebo-controlled, translational pilot study to examine the safety and activity of low-dose suramin in children with ASD. METHODS Ten male subjects with ASD, ages 5-14 years, were matched by age, IQ, and autism severity into five pairs, then randomized to receive a single, intravenous infusion of suramin (20 mg/kg) or saline. The primary outcomes were ADOS-2 comparison scores and Expressive One-Word Picture Vocabulary Test (EOWPVT). Secondary outcomes were the aberrant behavior checklist, autism treatment evaluation checklist, repetitive behavior questionnaire, and clinical global impression questionnaire. RESULTS Blood levels of suramin were 12 ± 1.5 μmol/L (mean ± SD) at 2 days and 1.5 ± 0.5 μmol/L after 6 weeks. The terminal half-life was 14.7 ± 0.7 days. A self-limited, asymptomatic rash was seen, but there were no serious adverse events. ADOS-2 comparison scores improved by -1.6 ± 0.55 points (n = 5; 95% CI = -2.3 to -0.9; Cohen's d = 2.9; P = 0.0028) in the suramin group and did not change in the placebo group. EOWPVT scores did not change. Secondary outcomes also showed improvements in language, social interaction, and decreased restricted or repetitive behaviors. INTERPRETATION The safety and activity of low-dose suramin showed promise as a novel approach to treatment of ASD in this small study.
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Affiliation(s)
- Robert K. Naviaux
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of MedicineUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of PediatricsUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of PathologyUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
| | - Brooke Curtis
- Alliant International University10455 Pomerado RoadSan DiegoCalifornia92131
| | - Kefeng Li
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of MedicineUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
| | - Jane C. Naviaux
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of NeurosciencesUniversity of CaliforniaSan Diego School of Medicine9500 Gilman Drive.La JollaCA92093‐0662
| | - A. Taylor Bright
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of MedicineUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
| | - Gail E. Reiner
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of NeurosciencesUniversity of CaliforniaSan Diego School of Medicine9500 Gilman Drive.La JollaCA92093‐0662
| | - Marissa Westerfield
- The Research in Autism and Development Laboratory (RAD Lab)University of California9500 Gilman DriveLa JollaCA92093‐0959
| | - Suzanne Goh
- Pediatric Neurology Therapeutics7090 Miratech DrSan DiegoCA92121
| | - William A. Alaynick
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of MedicineUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
| | - Lin Wang
- The Mitochondrial and Metabolic Disease CenterUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
- Department of MedicineUniversity of CaliforniaSan Diego School of Medicine214 Dickinson St., Bldg CTF, Rm C102San Diego92103‐8467California
| | - Edmund V. Capparelli
- Department of Pediatricsand Skaggs School of Pharmacy and Pharmaceutical SciencesUniversity of CaliforniaSan Diego School of Medicine9500 Gilman DriveLa JollaCA92093‐0657
| | - Cynthia Adams
- Clinical and Translational Research Institute (CTRI)University of CaliforniaSan DiegoLa JollaCA92037
| | - Ji Sun
- Clinical and Translational Research Institute (CTRI)University of CaliforniaSan DiegoLa JollaCA92037
| | - Sonia Jain
- Department of Family Medicine and Public HealthUniversity of CaliforniaSan DiegoLa JollaCA92093
| | - Feng He
- Department of Family Medicine and Public HealthUniversity of CaliforniaSan DiegoLa JollaCA92093
| | - Deyna A. Arellano
- Clinical and Translational Research Institute (CTRI)University of CaliforniaSan DiegoLa JollaCA92037
| | - Lisa E. Mash
- The Research in Autism and Development Laboratory (RAD Lab)University of California9500 Gilman DriveLa JollaCA92093‐0959
- Department of PsychologySan Diego State University5500 Campanile DriveSan DiegoCA92182
| | - Leanne Chukoskie
- The Research in Autism and Development Laboratory (RAD Lab)University of California9500 Gilman DriveLa JollaCA92093‐0959
- Institute for Neural ComputationUniversity of California9500 Gilman DriveLa Jolla92093‐0523
| | - Alan Lincoln
- Alliant International University10455 Pomerado RoadSan DiegoCalifornia92131
| | - Jeanne Townsend
- Department of NeurosciencesUniversity of CaliforniaSan Diego School of Medicine9500 Gilman Drive.La JollaCA92093‐0662
- The Research in Autism and Development Laboratory (RAD Lab)University of California9500 Gilman DriveLa JollaCA92093‐0959
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Geier D, Kern J, Geier M. Neonatal factors among subjects diagnosed with a pervasive developmental disorder in the US. J Matern Fetal Neonatal Med 2017; 31:1709-1714. [PMID: 28462601 DOI: 10.1080/14767058.2017.1326096] [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: 10/19/2022]
Abstract
PURPOSE Contradictory studies suggest that some neonatal factors may be associated with a pervasive developmental disorder (PDD) diagnosis, but limited data is available from longitudinal, prospective medical record assessments. MATERIALS AND METHODS The present hypothesis-testing longitudinal, case-control study evaluated birth characteristics among cases diagnosed with a PDD in comparison to controls by examining prospectively collected automated medical records within the Vaccine Safety Datalink (VSD) database. RESULTS Cases were Health Maintenance Organization (HMO)-enrolled from birth until diagnosed with International Classification of Disease, 9th revision (ICD-9) PDD (299.xx) and controls were HMO-enrolled from birth for at least 4.75 years without a PDD diagnosis. The birth characteristics examined included: gender, gestational age in weeks at birth, mean birth weight in grams, Appearance-Pulse-Grimace-Activity-Respiration (APGAR) scores at 1 minute and 5 minutes, and maternal age in years at birth. Cases had a significantly increased male/female ratio relative to controls. By contrast, mean gestational age at birth, mean birth weight, mean maternal age at birth, and mean APGAR scores at 1 minute and 5 minutes were not statistically different among cases compared to controls. CONCLUSIONS This study indicates that cases diagnosed with a PDD as compared to controls do not have significant differences in neonatal factors.
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Affiliation(s)
- David Geier
- a The Institute of Chronic Illnesses, Inc , Silver Spring , MD , USA.,b CoMeD, Inc , Silver Spring , MD , USA
| | - Janet Kern
- a The Institute of Chronic Illnesses, Inc , Silver Spring , MD , USA.,b CoMeD, Inc , Silver Spring , MD , USA.,c CONEM US Autism Research Group , Allen , TX , USA
| | - Mark Geier
- a The Institute of Chronic Illnesses, Inc , Silver Spring , MD , USA.,b CoMeD, Inc , Silver Spring , MD , USA
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Desoky T, Hassan MH, Fayed HM, Sakhr HM. Biochemical assessments of thyroid profile, serum 25-hydroxycholecalciferol and cluster of differentiation 5 expression levels among children with autism. Neuropsychiatr Dis Treat 2017; 13:2397-2403. [PMID: 28979127 PMCID: PMC5608227 DOI: 10.2147/ndt.s146152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The exact pathogenesis of autism is still unknown. Both thyroid hormones and 25(OH)D are important for brain development, in addition to CD5; all have immunomodulatory actions by which their dysregulation may have a potential role in autism pathogenesis. OBJECTIVES The objectives of this study were to assess the thyroid profile, serum 25(OH)D levels and CD5 expression levels among autistic patients and to find out the correlations between the measured biomarkers with each other on one side and with the disease severity on the other side. PATIENTS AND METHODS This cross-sectional case-control study has been conducted on 60 children with autism and 40 controls, recruited from Qena Governorate, Upper Egypt. Childhood Autism Rating Scale (CARS) score was used to assess the included patients. Biochemical assays of thyroid function in the form of free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH) and 25(OH)D were done using commercially available enzyme-linked immunosorbent assay (ELISA) kits, while CD5 expression levels were measured using flow cytometry (FCM) analysis for all the included patients and controls. RESULTS The overall measurement results show significant higher mean serum TSH levels, mean CD5 expression levels with significant lower mean serum 25(OH)D levels among autistic children when compared with the control group (p<0.05 for all). Significant negative correlations between CD5 with FT3, FT4 and 25(OH)D were observed. CARS score showed significant negative correlations with both FT3 and 25(OH)D, while it was positively correlated with CD5 in a significant manner (p<0.05 for all). CONCLUSION Elevated CD5 expression and decreased 25(OH)D stores could play a potential role in the pathogenesis of autism via their immune-modulator actions. High TSH serum levels among autistic children, although within the physiological range, reflect the presence of thyroid dysfunction among such children, which needs further assessment.
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Affiliation(s)
| | | | | | - Hala M Sakhr
- Department of Pediatrics, Qena Faculty of Medicine, Qena University Hospitals, South Valley University, Qena, Egypt
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Geier DA, Kern JK, Geier MR. A Two-Phase Case-Control Study of Autism Risk Among Children Born From the Late 1990s Through the Early 2000s in the United States. Med Sci Monit 2016; 22:5196-5202. [PMID: 28031551 PMCID: PMC5218387 DOI: 10.12659/msm.900257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background This study evaluated the hypothesis that the 1999 recommendation by the American Academy of Pediatrics (AAP) and US Public Health Service (PHS) to reduce exposure to mercury (Hg) from Thimerosal in US vaccines would be associated with a reduction in the long-term risk of being diagnosed with autism. Material/Methods A two-phase assessment utilizing a case (n=73) -control (n=11,783) study in the Vaccine Adverse Event Reporting System (VAERS) database (for hypothesis generating) and a more rigorous, independent matched case (n=40) -control (n=40) study (hypothesis testing) was undertaken. Results Analysis of the VAERS database using logistic regression revealed that the odds ratio (OR) for being an autism case in the VAERS database significantly decreased with a more recent year of vaccination in comparison to controls (OR=0.65) from 1998 to 2003. Sex-separated analyses revealed similar significant effects for males (OR=0.62) and females (OR=0.71). Analyses of the matched case-control data revealed, using the t-test statistic, that the mean date of birth among cases diagnosed with an autism spectrum disorder (ASD) (2000.5±1.2) was significantly more in the past than in controls (2001.1±1.3). Logistic regression also revealed that the OR for being diagnosed with ASD significantly decreased with a more recent date of birth in comparison to controls (OR=0.67) from 1998–2003. Conclusions This study reveals that the risk of autism during from the late1990s to early 2000s in the US significantly decreased with reductions in Hg exposure from Thimerosal-containing childhood vaccines, but future studies should examine this phenomenon in other US populations. Vaccine programs have significantly reduced the morbidity and mortality associated with infectious disease, but Thimerosal should be removed from all vaccines.
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Affiliation(s)
- David A Geier
- Department of Research, Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,Department of Research, CoMeD, Inc., 14 Redgate Court, Silver Spring, MD, USA
| | - Janet K Kern
- Department of Research, Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,Department of Research, CoMeD, Inc., 14 Redgate Court, Silver Spring, MD, USA.,Department of Research, CONEM US Autism Research Group, Allen, TX, USA
| | - Mark R Geier
- Department of Research, Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,Department of Research, CoMeD, Inc., 14 Redgate Court, Silver Spring, MD, USA
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