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Chokron S, Dutton GN. From vision to cognition: potential contributions of cerebral visual impairment to neurodevelopmental disorders. J Neural Transm (Vienna) 2023; 130:409-424. [PMID: 36547695 DOI: 10.1007/s00702-022-02572-8] [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] [Received: 08/16/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
Vision has a crucial role to play in human development and functioning. It is, therefore, not surprising that vision plays a fundamental role in the development of the child. As a consequence, an alteration in visual function is, therefore, likely to hinder the child's development. Although ocular disorders are well known, diagnosed and taken into account, cerebral visual impairments (CVI) resulting from post-chiasmatic damage are largely underdiagnosed. However, among the disorders resulting from an episode of perinatal asphyxia and/or associated with prematurity, or neonatal hypoglycaemia, CVIs are prominent. In this article, we focus on the role of the possible effects of CVI on a child's learning abilities, leading to major difficulty in disentangling the consequences of CVI from other neurodevelopmental disorders (NDD) such as dyslexia, dyscalculia, dysgraphia, attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD) and autism spectrum disorders (ASD). Although we focus here on the possible overlap between children with CVI and children with other NDD, De Witt et al. (Wit et al. Ear Hear 39:1-19, 2018) have raised exactly the same question regarding children with auditory processing disorders (the equivalent of CVI in the auditory modality). We underline how motor, social and cognitive development as well as academic success can be impaired by CVI and raise the question of the need for systematic evaluation for disorders of vision, visual perception and cognition in all children presenting with a NDD and/or previously born under adverse neurological conditions.
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Affiliation(s)
- Sylvie Chokron
- INCC, CNRS, UMR8002, Université de Paris-Cité, Paris, France.
- Institut de Neuropsychologie, Neurovision et Neurocognition, Hôpital-Fondation A. de Rothschild, Paris, France.
| | - Gordon N Dutton
- Department of Vision Science, Glasgow Caledonian University, Glasgow, UK
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Chokron S, Kovarski K, Dutton GN. Cortical Visual Impairments and Learning Disabilities. Front Hum Neurosci 2021; 15:713316. [PMID: 34720906 PMCID: PMC8548846 DOI: 10.3389/fnhum.2021.713316] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/08/2021] [Indexed: 11/13/2022] Open
Abstract
Medical advances in neonatology have improved the survival rate of premature infants, as well as children who are born under difficult neurological conditions. As a result, the prevalence of cerebral dysfunctions, whether minimal or more severe, is increasing in all industrialized countries and in some developing nations. Whereas in the past, ophthalmological diseases were considered principally responsible for severe visual impairment, today, all recent epidemiological studies show that the primary cause of blindness and severe visual impairment in children in industrialized countries is now neurological, with lesions acquired around the time of birth currently comprising the commonest contributor. The resulting cortical or cerebral visual impairments (CVIs) have long been ignored, or have been confused either with other ophthalmological disorders causing low vision, or with a range of learning disabilities. We present here the deleterious consequences that CVI can have upon learning and social interaction, and how these can be given behavioral labels without the underlying visual causes being considered. We discuss the need to train and inform clinicians in the identification and diagnosis of CVI, and how to distinguish the diagnosis of CVI from amongst other visual disorders, including the specific learning disorders. This is important because the range of approaches needed to enhance the development of children with CVI is specific to each child's unique visual needs, making incorrect labeling or diagnosis potentially detrimental to affected children because these needs are not met.
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Affiliation(s)
- Sylvie Chokron
- Hôpital Fondation Adolphe de Rothschild, Paris, France
- INCC UMR 8002, CNRS, Université de Paris, Paris, France
| | - Klara Kovarski
- Hôpital Fondation Adolphe de Rothschild, Paris, France
- INCC UMR 8002, CNRS, Université de Paris, Paris, France
| | - Gordon N. Dutton
- Department of Vision Science, Glasgow Caledonian University, Glasgow, United Kingdom
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3
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Sclafani V, Del Rosso LA, Seil SK, Calonder LA, Madrid JE, Bone KJ, Sherr EH, Garner JP, Capitanio JP, Parker KJ. Early Predictors of Impaired Social Functioning in Male Rhesus Macaques (Macaca mulatta). PLoS One 2016; 11:e0165401. [PMID: 27788195 PMCID: PMC5082922 DOI: 10.1371/journal.pone.0165401] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 10/11/2016] [Indexed: 11/21/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by social cognition impairments but its basic disease mechanisms remain poorly understood. Progress has been impeded by the absence of animal models that manifest behavioral phenotypes relevant to ASD. Rhesus monkeys are an ideal model organism to address this barrier to progress. Like humans, rhesus monkeys are highly social, possess complex social cognition abilities, and exhibit pronounced individual differences in social functioning. Moreover, we have previously shown that Low-Social (LS) vs. High-Social (HS) adult male monkeys exhibit lower social motivation and poorer social skills. It is not known, however, when these social deficits first emerge. The goals of this study were to test whether juvenile LS and HS monkeys differed as infants in their ability to process social information, and whether infant social abilities predicted later social classification (i.e., LS vs. HS), in order to facilitate earlier identification of monkeys at risk for poor social outcomes. Social classification was determined for N = 25 LS and N = 25 HS male monkeys that were 1-4 years of age. As part of a colony-wide assessment, these monkeys had previously undergone, as infants, tests of face recognition memory and the ability to respond appropriately to conspecific social signals. Monkeys later identified as LS vs. HS showed impairments in recognizing familiar vs. novel faces and in the species-typical adaptive ability to gaze avert to scenes of conspecific aggression. Additionally, multivariate logistic regression using infant social ability measures perfectly predicted later social classification of all N = 50 monkeys. These findings suggest that an early capacity to process important social information may account for differences in rhesus monkeys' motivation and competence to establish and maintain social relationships later in life. Further development of this model will facilitate identification of novel biological targets for intervention to improve social outcomes in at-risk young monkeys.
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Affiliation(s)
- Valentina Sclafani
- Winnicott Research Unit, University of Reading, RG6 6AL, Reading, United Kingdom
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
| | - Laura A. Del Rosso
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
| | - Shannon K. Seil
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
| | - Laura A. Calonder
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
| | - Jesus E. Madrid
- Neurosciences Program, Stanford University, Stanford, California, 94305, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, 94305, United States of America
| | - Kyle J. Bone
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
| | - Elliott H. Sherr
- Department of Neurology, University of California San Francisco, San Francisco, California, 94143, United States of America
| | - Joseph P. Garner
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, 94305, United States of America
- Department of Comparative Medicine, Stanford University, Stanford, California, 94305, United States of America
| | - John P. Capitanio
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
- Department of Psychology, University of California Davis, Davis, California, 95616, United States of America
| | - Karen J. Parker
- California National Primate Research Center, University of California Davis, Davis, California, 95616, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, 94305, United States of America
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Chokron S, Dutton GN. Impact of Cerebral Visual Impairments on Motor Skills: Implications for Developmental Coordination Disorders. Front Psychol 2016; 7:1471. [PMID: 27757087 PMCID: PMC5048540 DOI: 10.3389/fpsyg.2016.01471] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/13/2016] [Indexed: 12/16/2022] Open
Abstract
Cerebral visual impairment (CVI) has become the primary cause of visual impairment and blindness in children in industrialized countries. Its prevalence has increased sharply, due to increased survival rates of children who sustain severe neurological conditions during the perinatal period. Improved diagnosis has probably contributed to this increase. As in adults, the nature and severity of CVI in children relate to the cause, location and extent of damage to the brain. In the present paper, we define CVI and how this impacts on visual function. We then define developmental coordination disorder (DCD) and discuss the link between CVI and DCD. The neuroanatomical correlates and aetiologies of DCD are also presented in relationship with CVI as well as the consequences of perinatal asphyxia (PA) and preterm birth on the occurrence and nature of DCD and CVI. This paper underlines why there are both clinical and theoretical reasons to disentangle CVI and DCD, and to categorize the features with more precision. In order to offer the most appropriate rehabilitation, we propose a systematic and rapid evaluation of visual function in at-risk children who have survived preterm birth or PA whether or not they have been diagnosed with cerebral palsy or DCD.
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Affiliation(s)
- Sylvie Chokron
- Unité Fonctionnelle Vision and Cognition, Fondation Ophtalmologique RothschildParis, France; Laboratoire de Psychologie de la Perception, UMR 8242, Centre National de la Recherche Scientifique - Université Paris-DescartesParis, France
| | - Gordon N Dutton
- Department of Vision Science, Glasgow Caledonian University Glasgow, UK
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Mercier C, Mottron L, Belleville S. A Psychosocial Study on Restricted Interests in High Functioning Persons with Pervasive Developmental Disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016. [DOI: 10.1177/1362361300004004006] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To explore how restricted interests are perceived by individuals with pervasive developmental disorders (PDDs) and their relatives, 18 in-depth semi-structured interviews were conducted with six high-functioning individuals with PDD, their parents and/or siblings. Results revealed that restricted interests play a significant role in the person’s life that is acknowledged by most of their relatives. They provide a sense of well-being, a positive way of occupying one’s time, a source of personal validation, and an incentive for personal growth. However, these positive dimensions are counterbalanced by their negative consequences. Following the demands and the support from their environment, the participants in the study reported to have involved themselves in an active process to adapt, reduce or diversify their restricted interests. These findings on transformation of restricted interests under development and social pressure may have theoretical (for cognitive models of autism) and clinical consequences (in their use for rehabilitation).
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Bitton JY, Demos M, Elkouby K, Connolly M, Weiss SK, Donner EJ, Whiting S, Ronen GM, Bello-Espinosa L, Wirrell EC, Mohamed IS, Dooley JM, Carmant L. Does treatment have an impact on incidence and risk factors for autism spectrum disorders in children with infantile spasms? Epilepsia 2015; 56:856-63. [PMID: 25944453 DOI: 10.1111/epi.12997] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Infantile spasms (IS) are a severe form of childhood epilepsy associated with autism spectrum disorders (ASD) in up to 35% of cases. The objective of this post hoc analysis of our randomized control trial was to determine whether rapid diagnosis and treatment of IS could limit the incidence of ASD while identifying risk factors related to ASD outcome. METHODS Patients with IS were randomized in a standardized diagnostic and treatment protocol. Clinical and electroencephalogram (EEG) evaluations were completed at all eight visits over 5 years, while cognitive evaluations were administered at 0, 6, 24 and 60 months, respectively. Autism was initially screened by means of the Checklist for Autism in Toddlers (CHAT) at 24 months, and formally assessed at the 30-and 60-month follow-ups using the Autism Diagnostic Observation Schedule-Generic (ADOS-G). RESULTS Of the 69 patients included in the study, 25 could not be assessed due to severe delay or death. Eleven of the 42 patients screened with CHAT, were found to be at risk of an ASD outcome. ADOS was performed in 44 and 10 were diagnosed with ASD. The CHAT proved to correlate highly with the ADOS (80% ppv). Only patients with symptomatic IS developed ASD (p = 0.003). Earlier diagnosis or successful treatment did not correlate with a reduced rate of ASD. Other risk factors were identified such as having chronic epileptic discharges in the frontotemporal areas after disappearance of hypsarrhythmia (p = 0.005 and p = 0.007) and being of nonwhite origin (p = 0.009). SIGNIFICANCE ASD was only observed in children with sympyomatic IS. Other clinical risk factors include chronic frontotemporal epileptic activity and being of non-white origin. Early diagnosis and treatment did not prevent ASD as an outcome of IS. However, patients at risk for ASD could be identified early on and should in the future benefit from early intervention to potentially improve their long-term outcome.
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Affiliation(s)
- Jonathan Y Bitton
- Research Centre and Division of Neurology, Department of Pediatrics, Sainte-Justine Hospital (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Michelle Demos
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katia Elkouby
- Research Centre and Division of Neurology, Department of Pediatrics, Sainte-Justine Hospital (CHU Sainte-Justine), Montreal, Quebec, Canada
| | - Mary Connolly
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shelly K Weiss
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth J Donner
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sharon Whiting
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Gabriel M Ronen
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, McMaster Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada
| | - Luis Bello-Espinosa
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Elaine C Wirrell
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,Division of Child and Adolescent Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Ismail S Mohamed
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.,Division of Neurology, Department of Pediatrics, Faculty of Medicine, Izaak Walton Killam (IWK) Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joseph M Dooley
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Izaak Walton Killam (IWK) Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lionel Carmant
- Research Centre and Division of Neurology, Department of Pediatrics, Sainte-Justine Hospital (CHU Sainte-Justine), Montreal, Quebec, Canada
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Williams C, Gilchrist ID, Fraser S, McCarthy HM, Parker J, Warnes P, Young J, Hyvarinen L. Normative data for three tests of visuocognitive function in primary school children: cross-sectional study. Br J Ophthalmol 2015; 99:752-6. [PMID: 25712824 PMCID: PMC4453624 DOI: 10.1136/bjophthalmol-2014-305868] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 11/16/2014] [Indexed: 11/18/2022]
Abstract
Background/Aims There is an increasing recognition that visuocognitive difficulties occur in children with neurodevelopmental problems. We obtained normative data for the performance of primary school children using three tests of visuocognitive function that are practicable in a clinical setting. Methods We tested 214 children aged between 4 and 11 years without known developmental problems, using tests to assess (1) orientation recognition and adaptive movement (postbox task), (2) object recognition (rectangles task) and (3) spatial integration (contours task). Results 96% could do the postbox task with ease—only 4% (all aged <9 years) exhibited minor difficulties. Errors in the rectangles task decreased with age: 33% of children aged 4–5 years had major difficulties but >99% of children aged ≥6 years had no, or minor, difficulties. Median scores for the contours task improved with age, and after age 8 years, 99% could see the contour using long-range spatial integration rather than density. Conclusions These different aspects of children’s visuocognitive performance were testable in a field setting. The data provide a benchmark by which to judge performance of children with neurodevelopmental problems and may be useful in assessment with a view to providing effective supportive strategies for children whose visuocognitive skills are lower than the expectation for their age.
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Affiliation(s)
- Cathy Williams
- School of Social and Community Medicine, University of Bristol, Bristol, Avon, UK Bristol Eye Hospital, University Hospitals of Bristol Foundation NHS Trust, Bristol, Avon, UK
| | - Iain D Gilchrist
- School of Experimental Psychology, University of Bristol, Bristol, Avon, UK
| | - Sue Fraser
- Bristol Eye Hospital, University Hospitals of Bristol Foundation NHS Trust, Bristol, Avon, UK
| | - H M McCarthy
- Bristol Eye Hospital, University Hospitals of Bristol Foundation NHS Trust, Bristol, Avon, UK
| | - Julie Parker
- Bristol Eye Hospital, University Hospitals of Bristol Foundation NHS Trust, Bristol, Avon, UK
| | - Penny Warnes
- Bristol Eye Hospital, University Hospitals of Bristol Foundation NHS Trust, Bristol, Avon, UK
| | - Jill Young
- Emerson's Green Primary School, Bristol City Council, Bristol, Avon, UK
| | - Lea Hyvarinen
- Rehabilitation Sciences, TU Dortmund University, Dortmund, Germany
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Zürcher NR, Bhanot A, McDougle CJ, Hooker JM. A systematic review of molecular imaging (PET and SPECT) in autism spectrum disorder: current state and future research opportunities. Neurosci Biobehav Rev 2015; 52:56-73. [PMID: 25684726 DOI: 10.1016/j.neubiorev.2015.02.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 10/24/2022]
Abstract
Non-invasive positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are techniques used to quantify molecular interactions, biological processes and protein concentration and distribution. In the central nervous system, these molecular imaging techniques can provide critical insights into neurotransmitter receptors and their occupancy by neurotransmitters or drugs. In recent years, there has been an increase in the number of studies that have investigated neurotransmitters in autism spectrum disorder (ASD), while earlier studies mostly focused on cerebral blood flow and glucose metabolism. The underlying and contributing mechanisms of ASD are largely undetermined and ASD diagnosis relies on the behavioral phenotype. Discovery of biochemical endophenotypes would represent a milestone in autism research that could potentially lead to ASD subtype stratification and the development of novel therapeutic drugs. This review characterizes the prior use of molecular imaging by PET and SPECT in ASD, addresses methodological challenges and highlights areas of future opportunity for contributions from molecular imaging to understand ASD pathophysiology.
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Affiliation(s)
- Nicole R Zürcher
- A.A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Harvard, Boston, MA, USA
| | - Anisha Bhanot
- A.A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Christopher J McDougle
- Lurie Center for Autism, Department of Pediatrics, MassGeneral Hospital for Children, Lexington, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jacob M Hooker
- A.A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Harvard, Boston, MA, USA.
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Khorrami A, Tehrani-Doost M, Esteky H. Comparison between Face and Object Processing in Youths with Autism Spectrum Disorder: An event related potentials study. IRANIAN JOURNAL OF PSYCHIATRY 2013; 8:179-87. [PMID: 25628712 PMCID: PMC4281653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Incapability in face perception and recognition is one of the main issues in autism spectrum disorders (ASD). Event related potential (ERP) studies have revealed controversial insights on autistic brain responses to faces and objects. The current investigation examined the ERP components of young children with ASD compared to a typically developing (TD) group when looking at the upright and inverted images of faces and cars. METHODS Fourteen children and adolescents aged between 9 and 17 diagnosed as having ASD were compared with 18 age- gender matched normally developing individuals. All participants' ERPs were recorded while they were seeing the images of human faces and objects in both upright and inverted positions. The ERP components including N170 (latency and amplitude) were compared between the two groups in two conditions of upright and inverted using the repeated measure analysis method. RESULTS The processing speed for upright faces was faster than the inverted faces in the TD group; however, the difference was not significant. A significant difference was observed in terms of N170 latency between the two groups for different stimulus categories such as objects and faces(p<0.05). Moreover, inverted vs. upright stimuli in both groups elicited a greater response in terms of N170 amplitude in both groups, and this effect was significantly prominent in the right hemisphere (p<0.05). The N170 amplitude turned out to be greater for the inverted vs. upright stimuli irrespective of the stimuli type and group. CONCLUSION These data suggest youths with ASD have difficulty processing information, particularly in face perception regardless of the stimuli orientation.
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Affiliation(s)
| | - Mehdi Tehrani-Doost
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran,Department of Psychiatry, Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Esteky
- School of Cognitive Sciences, IPM, Tehran, Iran,Research Center for Brain and Cognitive Sciences, School of Medicine, Shaheed Beheshti University, Tehran, Iran,Neuroscience Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Early processing of emotional faces in children with autism: An event-related potential study. J Exp Child Psychol 2011; 109:430-44. [PMID: 21458825 DOI: 10.1016/j.jecp.2011.02.001] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 02/03/2011] [Accepted: 02/03/2011] [Indexed: 11/21/2022]
Abstract
Social deficits are one of the most striking manifestations of autism spectrum disorders (ASDs). Among these social deficits, the recognition and understanding of emotional facial expressions has been widely reported to be affected in ASDs. We investigated emotional face processing in children with and without autism using event-related potentials (ERPs). High-functioning children with autism (n=15, mean age=10.5±3.3 years) completed an implicit emotional task while visual ERPs were recorded. Two groups of typically developing children (chronological age-matched and verbal equivalent age-matched [both ns=15, mean age=7.7±3.8 years]) also participated in this study. The early ERP responses to faces (P1 and N170) were delayed, and the P1 was smaller in children with autism than in typically developing children of the same chronological age, revealing that the first stages of emotional face processing are affected in autism. However, when matched by verbal equivalent age, only P1 amplitude remained affected in autism. Our results suggest that the emotional and facial processing difficulties in autism could start from atypicalities in visual perceptual processes involving rapid feedback to primary visual areas and subsequent holistic processing.
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Amiet C, Gourfinkel-An I, Consoli A, Périsse D, Cohen D. [Epilepsy and autism: a complex issue]. Arch Pediatr 2011; 17:650-1. [PMID: 20654825 DOI: 10.1016/s0929-693x(10)70043-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Amiet
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Université Paris 6, Laboratoire Psychologie et Neurosciences Cognitives, CNRS UMR 8189, France.
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Lippé S, Bulteau C, Dorfmuller G, Audren F, Delalande O, Jambaqué I. Cognitive outcome of parietooccipital resection in children with epilepsy. Epilepsia 2010; 51:2047-57. [DOI: 10.1111/j.1528-1167.2010.02651.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Périsse D, Amiet C, Consoli A, Thorel MV, Gourfinkel-An I, Bodeau N, Guinchat V, Barthélémy C, Cohen D. Risk factors of acute behavioral regression in psychiatrically hospitalized adolescents with autism. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2010; 19:100-108. [PMID: 20467546 PMCID: PMC2868556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 02/25/2010] [Indexed: 05/29/2023]
Abstract
AIM During adolescence, some individuals with autism engage in severe disruptive behaviors, such as violence, agitation, tantrums, or self-injurious behaviors. We aimed to assess risk factors associated with very acute states and regression in adolescents with autism in an inpatient population. METHOD Between 2001 and 2005, we reviewed the charts of all adolescents with autism (N=29, mean age=14.8 years, 79% male) hospitalized for severe disruptive behaviors in a psychiatric intensive care unit. We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), associated organic conditions, etiologic diagnosis of the episode, and treatments. RESULTS All patients exhibited severe autistic symptoms and intellectual disability, and two-thirds had no functional verbal language. Fifteen subjects exhibited epilepsy, including three cases in which epilepsy was unknown before the acute episode. For six (21%) of the subjects, uncontrolled seizures were considered the main cause of the disruptive behaviors. Other suspected risk factors associated with disruptive behavior disorders included adjustment disorder (N=7), lack of adequate therapeutic or educational management (N=6), depression (N=2), catatonia (N=2), and painful comorbid organic conditions (N=3). CONCLUSION Disruptive behaviors among adolescents with autism may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic diseases such as epilepsy. The management of these behavioral changes requires a multidisciplinary functional approach.
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Affiliation(s)
| | - Claire Amiet
- Department of Child and Adolescent Psychiatry
- Laboratoire Psychologie et Neurosciences Cognitives, CNRS UMR 8981, Paris, France
| | - Angèle Consoli
- Department of Child and Adolescent Psychiatry
- Laboratoire Psychologie et Neurosciences Cognitives, CNRS UMR 8981, Paris, France
| | | | - Isabelle Gourfinkel-An
- Center of Epileptology, Reference Center for Rare Epilepsies, AP-HP, Groupe Hospitalier Pitié-Salpétrière, Université Pierre et Marie Curie, Paris, France
| | | | | | | | - David Cohen
- Department of Child and Adolescent Psychiatry
- Laboratoire Psychologie et Neurosciences Cognitives, CNRS UMR 8981, Paris, France
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Vision in autism spectrum disorders. Vision Res 2009; 49:2705-39. [PMID: 19682485 DOI: 10.1016/j.visres.2009.08.005] [Citation(s) in RCA: 505] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 08/04/2009] [Accepted: 08/04/2009] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorders (ASDs) are developmental disorders which are thought primarily to affect social functioning. However, there is now a growing body of evidence that unusual sensory processing is at least a concomitant and possibly the cause of many of the behavioural signs and symptoms of ASD. A comprehensive and critical review of the phenomenological, empirical, neuroscientific and theoretical literature pertaining to visual processing in ASD is presented, along with a brief justification of a new theory which may help to explain some of the data, and link it with other current hypotheses about the genetic and neural aetiologies of this enigmatic condition.
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Amiet C, Gourfinkel-An I, Bouzamondo A, Tordjman S, Baulac M, Lechat P, Mottron L, Cohen D. Epilepsy in autism is associated with intellectual disability and gender: evidence from a meta-analysis. Biol Psychiatry 2008; 64:577-82. [PMID: 18565495 DOI: 10.1016/j.biopsych.2008.04.030] [Citation(s) in RCA: 284] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 04/22/2008] [Accepted: 04/24/2008] [Indexed: 12/31/2022]
Abstract
BACKGROUND The association between epilepsy and autism is consistently reported, with a wide range of prevalence rates. This may be attributed to the heterogeneity of the samples with respect to age, comorbidity, sex, and intellectual disability (ID). We aimed to compare the prevalence of epilepsy 1) among autistic patients with ID versus autistic patients without ID and 2) among male versus female autistic patients. METHODS We reviewed all data available from published reports (1963-2006) on autism and epilepsy and conducted a meta-analysis of 10 and 14 studies, respectively, to assess the relative risk (RR) of epilepsy in autism according to ID and gender. The pooled groups included 2112 (627 with IQ > or = 70, 1485 with IQ < 70) and 1530 (1191 male, 339 female) patients, respectively. RESULTS There was a strong discrepancy in relative risk (RR) according to IQ, with more autistic patients with ID having epilepsy (RR = .555; 95% confidence interval [CI]: .42-.73; p < .001). The pooled prevalence of epilepsy was 21.5% in autistic subjects with ID versus 8% in autistic subjects without ID. There was a strong discrepancy in RR according to sex, favoring comorbidity of epilepsy in autistic girls (RR = .549; 95% CI: .45-.66; p < .001). The male:female ratio of autism comorbid with epilepsy was close to 2:1 whereas the male:female ratio of autism without epilepsy was 3.5:1. CONCLUSIONS The results of this meta-analysis indicate that risk for epilepsy in autism is a function of ID severity and distinguishes autism associated with epilepsy as a subgroup of autism by its male-female ratio.
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Affiliation(s)
- Claire Amiet
- Department of Child and Adolescent Psychiatry, Assistance Publique-Hospitaux de Paris, Groupe Hospitalier Pitié-Salpétrière, Université Pierre et Marie Curie, Paris, France
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16
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Disturbed holistic processing in autism spectrum disorders verified by two cognitive tasks requiring perception of complex visual stimuli. Psychiatry Res 2008; 159:330-8. [PMID: 18417223 DOI: 10.1016/j.psychres.2005.08.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2004] [Accepted: 08/17/2005] [Indexed: 11/22/2022]
Abstract
Central coherence is a key concept in research on autism spectrum disorders (ASD). It refers to the process in which diverse information is integrated and higher meaning is constructed in context. A malfunction in this process could result in abnormal attention to partial information in preference to the whole. To verify this hypothesis, we studied the performance of two visual tasks by 10 patients with autistic disorder or Asperger's disorder and by 26 (experiment 1) or 25 (experiment 2) normal subjects. In experiment 1, the subjects memorized pictures, some pictures with a change related to the main theme (D1) and others with a change not related to the main theme (D2); then the same pictures were randomly presented to the subjects who were asked to find the change. In experiment 2, the subjects were presented pictures of a normal (N) or a Thatcherized (T) face arranged side by side inversely (I) or uprightly (U) and to judge them as the same or different. In experiment 1, ASD subjects exhibited significantly lower rates of correct responses in D1 but not in D2. In experiment 2, ASD subjects exhibited significantly longer response times in NT-U but not in TN-I. These results showed a deficit in holistic processing, which is consistent with weak central coherence in ASD.
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Billard C, Jambaqué I. L’essor de la neuropsychologie de l’enfant. Rev Neurol (Paris) 2008; 164 Suppl 3:S108-13. [DOI: 10.1016/s0035-3787(08)73300-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Silva ANS, Andrade VM, Oliveira HA. [Neuropsychological assessment in patients with temporal lobe epilepsy]. ARQUIVOS DE NEURO-PSIQUIATRIA 2008; 65:492-7. [PMID: 17665022 DOI: 10.1590/s0004-282x2007000300025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 03/08/2007] [Indexed: 11/22/2022]
Abstract
We investigated the patient cognition with temporal lobe epilepsy that presented or no mesial injury in magnetic resonance exam. We used classics and ecological neuropsychological tests to indicate possible functional alterations, and to compare results between ecological and traditional instruments. Thirty-four people match in age and study year were separate in three groups: 12 patients with mesial injury; 12 without injury and 10 health people. We used for functional evaluation: Wechsler adult intelligence and memory scales subtests, verbal fluency and Rivermead behavior memory test. The patients with injuries presented low cognitive performance when compared with control groups in various tasks: attentional span, memory, speech, daily problems resolution, while the patients without injury showed more compensated with mild attentional alterations. Both traditional memory tests and ecological memory tests were efficient to describe the cognitive profile of patients with epilepsy.
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Affiliation(s)
- Alisson N S Silva
- Departamento de Psicologia, Hospital Universitário da Universidade Federal de Sergipe, Aracaju SE, Brasil
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Foong J, Flugel D. Psychiatric outcome of surgery for temporal lobe epilepsy and presurgical considerations. Epilepsy Res 2007; 75:84-96. [PMID: 17600682 DOI: 10.1016/j.eplepsyres.2007.05.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2006] [Revised: 03/14/2007] [Accepted: 05/14/2007] [Indexed: 10/23/2022]
Abstract
In recent years, surgery has become a treatment option for some patients with intractable epilepsy, particularly those with temporal lobe epilepsy. Psychiatric disturbances may complicate the postsurgical outcome in some patients and de novo psychiatric symptoms have been reported. In many but not all epilepsy surgical centres, a psychiatric assessment is included as part of the presurgical evaluation of potential candidates for surgery. This review indicates that affective disorders, namely, depression and anxiety, and psychosis are the most frequently reported postsurgical psychiatric disturbances. Whilst there are no absolute psychiatric contraindications to surgery, certain pre-existing psychiatric conditions may need careful consideration as there may be a risk of postsurgical psychiatric complications. Routine pre- and postsurgical psychiatric evaluations in patients undergoing epilepsy surgery are recommended. Clinicians involved in the care of surgical candidates should be aware of the possible psychiatric complications following surgery and ensure that the psychiatric risks are discussed with the patient and family.
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Affiliation(s)
- J Foong
- Department of Neuropsychiatry, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
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20
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Chilosi AM, Brovedani P, Moscatelli M, Bonanni P, Guerrini R. Neuropsychological Findings in Idiopathic Occipital Lobe Epilepsies. Epilepsia 2006; 47 Suppl 2:76-8. [PMID: 17105468 DOI: 10.1111/j.1528-1167.2006.00696.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE We reviewed the clinical charts of 22 patients (mean age 12 years) with idiopathic occipital lobe epilepsies (IOLE) to verify the presence of visuoperceptual difficulties. METHODS All 22 patients underwent a standard neuropsychiatric examination and had a sleep electroencephalogram (EEG). Eleven had normal development and adequate scholastic achievements, so no formal testing was performed. Psychological assessment was carried out in the remaining 11 patients who had been referred because of learning and behavioral difficulties. RESULTS AND CONCLUSIONS IQ was in the average/low-average range in most patients, with a cognitive profile characterized by relatively better verbal than performance abilities (8/11). There was a high incidence of scholastic disabilities (7/11); psychiatric disorders in the form of anxiety and depressive disorders were also frequent (6/11). In the six patients who had neuropsychological assessment with specific visuoperceptual testing, a deficit in facial discrimination was found in four patients, associated with a line orientation deficit in three. Although preliminary, and based on a tertiary-care clinical sample, these data suggest that children with IOLE, are at risk for lower intellectual performance, poor scholastic achievement and psychiatric disorders, as well as for specific deficits in the visuoperceptual domain, probably due to dysfunction of the occipitotemporal circuitries most often involved in seizure spread in epilepsies originating in the posterior brain.
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Affiliation(s)
- Anna Maria Chilosi
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, University of Pisa, Pisa, Italy.
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21
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Brunsdon R, Coltheart M, Nickels L, Joy P. Developmental prosopagnosia: A case analysis and treatment study. Cogn Neuropsychol 2006; 23:822-40. [DOI: 10.1080/02643290500441841] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Harrison J, Hare DJ. Brief Report: Assessment of Sensory Abnormalities in People with Autistic Spectrum Disorders. J Autism Dev Disord 2004; 34:727-30. [PMID: 15679192 DOI: 10.1007/s10803-004-5293-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sensory functioning has long been considered crucial in the life of people with autistic spectrum disorders (ASD) (Gillberg, C., & Coleman, M. (1992). The Biology of Autistic Syndromes (2nd ed.). London: Mac Keith press.) However, much of the research is methodologically flawed and based on child populations and adults' retrospective accounts (O'Neill, M.C 1995). Sensory-perceptual abnormalities in autism. Psychological Perspectives in Autism-Conference Proceedings 1995 (pp. 55-61). Autism Research Unit, University of Sundarland). Such sensory dysfunction may contribute to poor person/environment fit and subsequent challenging behaviour. This paper presents an assessment tool developed to explore the sensory functioning of adults with ASD.
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McPartland J, Dawson G, Webb SJ, Panagiotides H, Carver LJ. Event-related brain potentials reveal anomalies in temporal processing of faces in autism spectrum disorder. J Child Psychol Psychiatry 2004; 45:1235-45. [PMID: 15335344 DOI: 10.1111/j.1469-7610.2004.00318.x] [Citation(s) in RCA: 253] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Individuals with autism exhibit impairments in face recognition, and neuroimaging studies have shown that individuals with autism exhibit abnormal patterns of brain activity during face processing. The current study examined the temporal characteristics of face processing in autism and their relation to behavior. METHOD High-density event-related brain potentials (ERPs) were recorded to images of faces, inverted faces, and objects from 9 individuals with autism spectrum disorder (15-42 years old) and 14 typical individuals (16-37 years old). RESULTS With respect to a face-sensitive ERP component (N170), individuals with autism exhibited longer N170 latencies to faces than typical individuals but comparable latencies to objects. Typical individuals exhibited longer N170 latencies to inverted as compared to upright faces, whereas individuals with autism did not show differences in N170 latency to upright versus inverted faces. Neural speed of face processing, as reflected in N170 latency, correlated with performance on a face recognition task for individuals with autism. CONCLUSIONS These data provide evidence for slowed neural speed of face processing in autism and highlight the role of speed of processing in face processing impairments in autism.
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Cohen-Gadol AA, Ozduman K, Bronen RA, Kim JH, Spencer DD. Long-term outcome after epilepsy surgery for focal cortical dysplasia. J Neurosurg 2004; 101:55-65. [PMID: 15255252 DOI: 10.3171/jns.2004.101.1.0055] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Reports of outcomes for surgical treatment of cortical dysplasia associated with epilepsy are conflicting due to the inclusion of patients with a wide range of malformations of cortical development. The authors report their experience and the long-term outcome for a subgroup of patients with the histopathological diagnosis of focal cortical dysplasia of Taylor. METHODS The records of 22 patients with focal cortical dysplasia of Taylor (15 with the balloon-cell type and seven with the nonballoon-cell type) were reviewed. There were 11 female and 11 male patients whose mean age was 26 +/- 17.6 years (mean +/- standard deviation [SD]) at surgery. The details of their epilepsy evaluation and resection were analyzed. Extent of resection was preoperatively planned using information obtained from long-term intracranial monitoring (15 patients) and/or more definitively determined by histopathologically proven clear margins during resection when feasible (12 patients). The mean duration of follow up was 6.3 +/- 5.1 years (mean +/- SD, range 0.5-15.6 years). Risk factors for epilepsy were trauma (seven patients) or meningoencephalitis (one patient); 14 patients (64%) had no obvious risk factors. The mean age at seizure onset was 9.2 years and the mean duration of their epilepsy was 16.1 +/- 9 years. In two patients there were no adverse findings on magnetic resonance (MR) imaging. In 15 patients (68%), the epileptogenic zone identified on long-term intracranial monitoring extended beyond the abnormality observed on MR images. Focal resection (lesion plus margins) was performed in 14 patients (64%), whereas eight (36%) underwent partial/tailored lobectomy. Two patients underwent multiple subpial transections in addition to partial lesionectomy because their lesions involved the sensorimotor cortex. In these two, functional MR imaging confirmed a normal functional anatomy despite the presence of the cortical dysplasia. Eleven (92%) of 12 patients who underwent resection guided by histopathologically proven clear margins and three (43%) of seven patients who underwent histopathologically proven subtotal resection have remained seizure free. Evidence of clear margins was significantly associated with an improved seizure outcome (p = 0.003). Postoperatively, expected deficits included nondisabling visual field defects, which occurred in three patients (14%), and transient sensorimotor deficits, which appeared in five (23%). Two patients had meningitis, which was successfully treated with antibiotics. Overall, 16 patients (73%) are either seizure free (13 patients), have rare nondisabling partial seizures (one patient), or had one seizure after their medication was changed (two patients). Thirteen patients (59%) have discontinued anticonvulsant medications or are being maintained on monotherapy. Of five patients (23%), two have had rare disabling seizures or significant reduction in their seizure frequency (three patients). One patient's seizures have remained the same. CONCLUSIONS Focal cortical dysplasias are a distinct subgroup of malformations of cortical development and have a favorable outcome after resection. The epileptogenic zone often extends beyond the abnormality found on neuroimaging. Resection of the epileptogenic zone guided by histopathologically proven clear margins is associated with an improved seizure outcome.
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Affiliation(s)
- Aaron A Cohen-Gadol
- Department of Neurosurgery, Yale Universityv School of Medicine, New Haven, Connecticut 55905, USA.
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25
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Jambaqué I. Contribution de la neuropsychologie développementale à l'étude des sujets à haut potentiel : une revue de questions. PSYCHOLOGIE FRANCAISE 2004. [DOI: 10.1016/j.psfr.2004.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Levitt JG, O'Neill J, Blanton RE, Smalley S, Fadale D, McCracken JT, Guthrie D, Toga AW, Alger JR. Proton magnetic resonance spectroscopic imaging of the brain in childhood autism. Biol Psychiatry 2003; 54:1355-66. [PMID: 14675799 DOI: 10.1016/s0006-3223(03)00688-7] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Autism is a developmental disorder of unknown neurologic basis. Based on prior work, we used proton magnetic resonance spectroscopic imaging ((1)H- MRSI) to investigate brain structures, including cingulate and caudate, that we hypothesized would reveal metabolic abnormalities in subjects with autism. METHODS In 22 children with autism, 5 to 16 years old, and 20 age-matched healthy control subjects, (1)H-MRSI assessed levels of N-acetyl compounds (NAA), choline compounds (Cho), and creatine plus phosphocreatine (Cr) at 272 msec echo-time and 1.5 T. RESULTS In subjects with autism compared with control subjects, Cho was 27.2% lower in left inferior anterior cingulate and 19.1% higher in the head of the right caudate nucleus; Cr was 21.1% higher in the head of the right caudate nucleus, but lower in the body of the left caudate nucleus (17.9%) and right occipital cortex (16.6%). CONCLUSIONS Results are consistent with altered membrane metabolism, altered energetic metabolism, or both in the left anterior cingulate gyrus, both caudate nuclei, and right occipital cortex in subjects with autism compared with control subjects.
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Affiliation(s)
- Jennifer G Levitt
- Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, Los Angeles, California, USA
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27
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Manjaly ZM, Marshall JC, Stephan KE, Gurd JM, Zilles K, Fink GR. In search of the hidden: an fMRI study with implications for the study of patients with autism and with acquired brain injury. Neuroimage 2003; 19:674-83. [PMID: 12880798 DOI: 10.1016/s1053-8119(03)00095-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The Embedded Figures Task involves a search for a target hidden in a more complex visual pattern. The task has been used to study local perception and visual search in a range of normal and pathological populations. After acquired brain damage, impairment on embedded figures is strongly associated with aphasia; in the context of developmental disorder, people with autism or with Asperger's syndrome are reliably found to be better than normal controls on the task. The current study employed functional MRI with healthy volunteers to elucidate the brain regions that are specifically involved in the local search aspects of the Embedded Figures Task. We did so by analyzing the neural activations that are implicated in the task over and above those involved in an easier visual search task and in a straightforward shape recognition task. Significant activations (P < 0.05, corrected) specific in the above sense to the Embedded Figures Task were found in left inferior and left superior parietal cortex and in left ventral premotor cortex (inferior frontal gyrus). By contrast, comparing the overall effect of visual search within geometric figures to pure recognition of geometric shapes revealed more widespread activations in parietal, occipital, cerebellar, and frontal areas bilaterally. The implications of these findings for some developmental and acquired pathologies of perceptual functioning are outlined. We also relate our results to studies of local/global processing in other tasks.
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Affiliation(s)
- Zina M Manjaly
- Institut für Medizin, Forschungszentrum, Jülich, Germany
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28
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Eriksson K, Kylliäinen A, Hirvonen K, Nieminen P, Koivikko M. Visual agnosia in a child with non-lesional occipito-temporal CSWS. Brain Dev 2003; 25:262-7. [PMID: 12767457 DOI: 10.1016/s0387-7604(02)00225-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In this paper we describe a case of severe visual agnosia in a child with an electrophysiological pattern of continuous spike-wave discharges in slow sleep (CSWS) in the occipito-temporal regions. The neuropsychological spectrum related to this phenomenon is discussed. Published paediatric reports associate visual agnosia (i.e. an inability to recognize objects without impairment of visual acuity) mainly with symptomatic occipito-temporal aetiology (e.g. cortical dysplasia, vascular insults) and other neurological symptoms (e.g. autism). We describe a detailed 2 year electrophysiological and neuropsychological follow-up of an 8-year-old boy with sporadic seizures, occipito-temporal CSWS and visual agnosia. The growth and neurological development of the child had been considered as normal, neurological examination did not reveal any focal signs, visual acuity was intact and MRI was normal. First EEG and six consecutive 24 h video EEG recordings during the follow-up of 22 months showed continuous spike-and-wave activity covering over 85% of the non-REM sleep. According to structured neuropsychological tests (Wechsler Intelligence Scale for Children--Third Edition, A Developmental Neuropsychological Assessment (NEPSY), Test of Visual-Perceptual Skills, Corsi block, Hooper Visual Organization Test) the boy had normal verbal intelligence but major deficits in visual perception, especially in object recognition, impaired shape discrimination and detection, and poor copying skills. Attention and executive functions were intact. There were no difficulties in short- or long-term memory. Verbal cues and naming the objects improved visual memory. Tracing the objects with a finger or by moving the head improved object recognition. Currently the boy attends a special school with a rehabilitation plan including neuropsychological and occupational therapies. This case adds a new facet to the spectrum of neuropsychological deficits in children with CSWS. Sleep EEG should be included in the etiological studies of children with specific neuropsychological problems and detailed neuropsychological assessment is needed for diagnostic and rehabilitation purposes.
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Affiliation(s)
- Kai Eriksson
- Tampere University Hospital, Pediatric Neurology Unit and Medical School, University of Tampere, Tampere, Finland.
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Abstract
Face recognition is one of the most complex visual tasks performed by the human brain. Data from monkeys suggest that area IT may play a key role in identifying faces, and functional imaging research suggests that the human homologue of IT may be located in the medial occipitotemporal cortex, where a FFA has been located. Damage to medial occipitotemporal structures on the right or bilaterally leads to prosopagnosia, the failure to recognize facial identity. Prosopagnosia is not a single functional disorder but a family of dysfunctions, with different patients having different degrees of impairments to various perceptual and memory stages involved in face processing. Understanding the perceptual basis of this disorder and epiphenomena, such as covert recognition, is a goal of current research. Deficits in face perception also may contribute to Capgras syndrome and may be related to the impaired social development of patients with Asperger syndrome. More recently, identified deficits in face processing include the false recognition of unfamiliar faces and the impaired extraction of social information from faces, independent of the recognition of identity. Many of these prosopagnosia and other face processing deficits can be placed in the context of cognitive models of face processing stages, which are being refined continually by data from neurologic patients and functional imaging in normal subjects.
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Affiliation(s)
- Jason J Barton
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston University, Boston, MA, USA.
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Barton JJS, Cherkasova MV, Press DZ, Intriligator JM, O'Connor M. Developmental prosopagnosia: a study of three patients. Brain Cogn 2003; 51:12-30. [PMID: 12633587 DOI: 10.1016/s0278-2626(02)00516-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We studied perception in three patients with prosopagnosia of childhood onset. All had trouble with other 'within-category' judgments. All were deficient on face matching tests and severely impaired on tests of perception of the spatial relations of facial features and abstract designs, indicating a deficit in the encoding of coordinate relationships, similar to adult-onset prosopagnosia with lesions of the fusiform face area. Two had difficulty perceiving feature colour, which correlated with reduced luminance sensitivity. In contrast to adult-onset patients, saturation discrimination was spared in two and spatial resolution impaired in two. Curvature discrimination was relatively spared. Contrast sensitivity showed variable reductions at different spatial frequencies. We conclude that developmental prosopagnosia is similar to the adult-onset form in encoding deficits for the spatial arrangement of facial elements. Deficits in luminance perception and spatial resolution are more associated with defective encoding for basic object-level recognition, as shown on tests of object and spatial perception.
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Affiliation(s)
- Jason J S Barton
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
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31
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Dawson G, Carver L, Meltzoff AN, Panagiotides H, McPartland J, Webb SJ. Neural correlates of face and object recognition in young children with autism spectrum disorder, developmental delay, and typical development. Child Dev 2002; 73:700-17. [PMID: 12038546 PMCID: PMC3651041 DOI: 10.1111/1467-8624.00433] [Citation(s) in RCA: 305] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study utilized electroencephalographic recordings to examine whether young children with autism spectrum disorder (ASD) have impaired face recognition ability. High-density brain event-related potentials (ERPs) were recorded to photos of the child's mother's face versus an unfamiliar female face and photos of a favorite versus an unfamiliar toy from children with ASD, children with typical development, and children with developmental delay, all 3 to 4 years of age (N = 118). Typically developing children showed ERP amplitude differences in two components, P400 and Nc, to a familiar versus an unfamiliar face, and to a familiar versus an unfamiliar object. In contrast, children with ASD failed to show differences in ERPs to a familiar versus an unfamiliar face, but they did show P400 and Nc amplitude differences to a familiar versus an unfamiliar object. Developmentally delayed children showed significant ERP amplitude differences for the positive slow wave for both faces and objects. These data suggest that autism is associated with face recognition impairment that is manifest early in life.
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Affiliation(s)
- Geraldine Dawson
- Center on Human Development and Disability, University of Washington, Seattle 98195, USA.
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32
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Kaya M, Karasalihoğlu S, Ustün F, Gültekin A, Cermik TF, Fazlioğlu Y, Türe M, Yiğitbaşi ON, Berkarda S. The relationship between 99mTc-HMPAO brain SPECT and the scores of real life rating scale in autistic children. Brain Dev 2002; 24:77-81. [PMID: 11891096 DOI: 10.1016/s0387-7604(02)00006-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Childhood autism is a developmental disability of unknown origin with probable multiple etiologies. The purpose of this study was to compare the changes of regional cerebral blood flow (rCBF) in autistic and non-autistic controls, and to determine the relationship between rCBF on 99mTc-hexamethylpropylene amine oxime (HMPAO) brain SPECT and the scores of the Ritvo-Freeman Real Life Rating Scale (RLRS), IQ levels, and age of autistic children. Eighteen autistic children (four girls, 14 boys; mean age: 6.13 +/- 1.99 years) and 11 non-autistic controls (five girls, six boys, mean age: 6.5 +/- 3.39 years) were examined using 99mTc-HMPAO brain SPECT. All the children satisfying DSM-IV criteria for autistic disorder were taken into evaluation, and scored by the Ritvo-Freeman RLRS. IQ levels of these children were determined by Goodenough IQ test. Six cortical regions of interest (ROIs; frontal (F), parietal (P), frontotemporal (FT), temporal (T), temporo-occipital (TO), and occipital (O)) were obtained on transaxial slices for count data acquisition. The ratio of average counts in each ROI to whole-slice counts for the autistic children was correlated with the scores of Ritvo-Freeman RLRS. Hypoperfusion in rCBF in autistic children compared with the control group were identified in bilateral F, FT, T, and TO regions. We found no relationship between rCBF on 99mTc-HMPAO brain SPECT and the scores of the Ritvo-Freeman RLRS. There was a relationship between bilateral F regions perfusion on 99mTc-HMPAO brain SPECT and the age of autistic children. There was also a negative correlation between IQ levels and the scores of sensory responses, social relationship to people, and sensory-motor responses. Our results suggest that 99mTc-HMPAO brain SPECT is helpful to locate the perfusion abnormalities but no correlation is found between rCBF on 99mTc-HMPAO brain SPECT and the scores of Ritvo-Freeman RLRS.
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Affiliation(s)
- Meryem Kaya
- Department of Nuclear Medicine, Faculty of Medicine, Trakya University, Tip Fakultesi, Nukleer Tip ABD 22030, Edirne, Turkey.
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Kieffer-Renaux V, Bulteau C, Grill J, Levy-Piebois C, Couanet D, Pierre-Kahn A, Hartmann O, Kalifa C. Visual agnosia after treatment of a posterior fossa ependymoma in a 16-month-old girl. J Child Neurol 2001; 16:698-704. [PMID: 11575616 DOI: 10.1177/088307380101600917] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We present the clinical observation of a 16-month-old girl treated for a posterior fossa ependymoma who experienced severe and delayed visual dysfunction. She was initially treated by surgery and conventional chemotherapy. When she relapsed at age 3 years, the salvage treatment combined high-dose chemotherapy, second surgery, and local irradiation. At age 4 years, disturbed gait and dysarthric speech appeared rapidly, and she became unable to recognize objects and people. Computed tomography revealed bilateral calcifications in the cerebellum and temporal and occipital lobes but no relapse. The neuropsychologic evaluations revealed signs of visual agnosia and marked intellectual impairment. The role of the different treatment modalities in the pathogenesis of this unusual syndrome is discussed.
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Affiliation(s)
- V Kieffer-Renaux
- Department of Pediatrics, Gustave Roussy Institute, Villejuif, France.
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Abstract
Malformations of cortical development (MCD) are responsible for many cases of refractory epilepsy in adults and children. The results of surgical treatment are difficult to assess from the published literature. Judging from the limited number of adequately reported cases, approximately 40% of all cases of MCD treated surgically may be rendered seizure-free over a minimum 2-year follow-up period. This figure is the same for focal cortical dysplasia (FCD), the most common variety of MCD in surgical reports. In comparison with outcome for epilepsy associated with hippocampal sclerosis, this figure is low. Part of the difference may be artificial and related to limited reporting. Much of the difference is likely to relate to the complex underlying biology of MCD. Analysis of epileptogenesis in MCD has been undertaken. Different types of MCD have different sequelae. Some varieties are intrinsically epileptogenic; these include FCD and heterotopia. Although in most cases, the visualized MCD lies within the region of brain responsible for generating seizures (the epileptogenic zone), it may not constitute the entire epileptogenic zone in all cases. For polymicrogyria and schizencephaly in particular, the visualized abnormalities are probably not the most important component of the epileptogenic zone. There is evidence that the epileptogenic zone is spatially distributed and also, in some cases, temporally distributed. These findings may explain poor surgical outcome and the inadequacy of current presurgical evaluative methods. New preoperative techniques offer the opportunity of improved presurgical planning and selection of cases more likely to be rendered seizure-free by current surgical techniques. Of paramount importance is improved reporting. The establishment of a central registry may facilitate this aim. Specific recommendations are made for surgical strategies based on current experience and understanding.
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Affiliation(s)
- S M Sisodiya
- Epilepsy Research Group, Institute of Neurology, University College London, UK.
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