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Shetty RM, Pashine A, Shetty S, Mishra H, Walia T, Shetty SR, Desai V, Thosar N. Minor physical anomalies including palatal rugae pattern and palatal dimensions in children with sickle cell disease: A cross-sectional analytical study. Heliyon 2024; 10:e24363. [PMID: 38312689 PMCID: PMC10834466 DOI: 10.1016/j.heliyon.2024.e24363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 02/06/2024] Open
Abstract
Background Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10-18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm-5 mm), and fragmentary rugae (<3 mm). The shape of each primary palatal rugae was identified and categorized as curved, wavy, straight, circular and non-specific. Linear and angular measurements of the palatal rugae patterns and palatal dimensions (width, height, area) were measured and recorded. Results The total number of palatal rugae and fragmentary rugae was lesser in Group SCD than in Group C (p < 0.05). The depth of the palate was significantly increased, whereas the area of the palate significantly decreased in Group SCD. Conclusions The children with SCD showed distinctive palatal rugae patterns and dimensions when compared with normal healthy children that can be attributed as potential MPAs for sickle cell disease. Children with SCD had an under-developed palatal rugae pattern with a deep, narrow and small palate when compared to healthy children.The dimensions of the palatal rugae pattern in SCD showed reduced distance between the incisive papilla and the first and last rugae, indicating a further decrease in the anteroposterior dimensions of the palate. These findings may aid in the early diagnosis and prevention of malocclusion in children with SCD by appropriate interceptive orthodontic treatment.
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Affiliation(s)
- Raghavendra M Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed-to-be-University), Sawangi (Meghe), Wardha, Maharastra, India
| | - Aditi Pashine
- Associate Dentist, MyDentist, Hungerford, United Kingdom
| | - Sunaina Shetty
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hrishikesh Mishra
- Research Division, Sickle Cell Institute Chhattisgarh, Raipur, India
| | - Tarun Walia
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Vijay Desai
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Nilima Thosar
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed-to-be-University), Sawangi (Meghe), Wardha, Maharastra, India
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Al-Beltagi M. Pre-autism: What a paediatrician should know about early diagnosis of autism. World J Clin Pediatr 2023; 12:273-294. [PMID: 38178935 PMCID: PMC10762597 DOI: 10.5409/wjcp.v12.i5.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/07/2023] [Accepted: 09/25/2023] [Indexed: 12/08/2023] Open
Abstract
Autism, also known as an autism spectrum disorder, is a complex neurodevelopmental disorder usually diagnosed in the first three years of a child's life. A range of symptoms characterizes it and can be diagnosed at any age, including adolescence and adulthood. However, early diagnosis is crucial for effective management, prognosis, and care. Unfortunately, there are no established fetal, prenatal, or newborn screening programs for autism, making early detection difficult. This review aims to shed light on the early detection of autism prenatally, natally, and early in life, during a stage we call as "pre-autism" when typical symptoms are not yet apparent. Some fetal, neonatal, and infant biomarkers may predict an increased risk of autism in the coming baby. By developing a biomarker array, we can create an objective diagnostic tool to diagnose and rank the severity of autism for each patient. These biomarkers could be genetic, immunological, hormonal, metabolic, amino acids, acute phase reactants, neonatal brainstem function biophysical activity, behavioral profile, body measurements, or radiological markers. However, every biomarker has its accuracy and limitations. Several factors can make early detection of autism a real challenge. To improve early detection, we need to overcome various challenges, such as raising community awareness of early signs of autism, improving access to diagnostic tools, reducing the stigma attached to the diagnosis of autism, and addressing various culturally sensitive concepts related to the disorder.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama 26671, Manama, Bahrain
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3
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Muskens JB, Ester WA, Klip H, Zinkstok J, van Dongen-Boomsma M, Staal WG. Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01587-w. [PMID: 37656290 DOI: 10.1007/s10578-023-01587-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6-18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.
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Affiliation(s)
- Jet B Muskens
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands.
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.
| | - Wietske A Ester
- Sarr Autism Rotterdam, Youz Child and Adolescence Psychiatry, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands
- Parnassia Psychiatric Institute, Kiwistraat 30, The Hague, 2552 DH, The Netherlands
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Endegeesterstraatweg 27, Oegstgeest, 2342 AK, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - Janneke Zinkstok
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martine van Dongen-Boomsma
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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Mujeeb Rahman KK, Subashini MM. Identification of Autism in Children Using Static Facial Features and Deep Neural Networks. Brain Sci 2022; 12:brainsci12010094. [PMID: 35053837 PMCID: PMC8773918 DOI: 10.3390/brainsci12010094] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 01/27/2023] Open
Abstract
Autism spectrum disorder (ASD) is a complicated neurological developmental disorder that manifests itself in a variety of ways. The child diagnosed with ASD and their parents’ daily lives can be dramatically improved with early diagnosis and appropriate medical intervention. The applicability of static features extracted from autistic children’s face photographs as a biomarker to distinguish them from typically developing children is investigated in this study paper. We used five pre-trained CNN models: MobileNet, Xception, EfficientNetB0, EfficientNetB1, and EfficientNetB2 as feature extractors and a DNN model as a binary classifier to identify autism in children accurately. We used a publicly available dataset to train the suggested models, which consisted of face pictures of children diagnosed with autism and controls classed as autistic and non-autistic. The Xception model outperformed the others, with an AUC of 96.63%, a sensitivity of 88.46%, and an NPV of 88%. EfficientNetB0 produced a consistent prediction score of 59% for autistic and non-autistic groups with a 95% confidence level.
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Affiliation(s)
- K. K. Mujeeb Rahman
- School of Electronics Engineering, Vellore Institute of Technology, Vellore 632014, India;
- Department of Biomedical Engineering, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - M. Monica Subashini
- School of Electrical Engineering, Vellore Institute of Technology, Vellore 632014, India
- Correspondence:
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5
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Actionable and incidental neuroradiological findings in twins with neurodevelopmental disorders. Sci Rep 2020; 10:22417. [PMID: 33376247 PMCID: PMC7772336 DOI: 10.1038/s41598-020-79959-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/15/2020] [Indexed: 11/23/2022] Open
Abstract
While previous research has investigated neuroradiological findings in autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), the entire range of neurodevelopmental disorders (NDDs) has not yet been well-studied using magnetic resonance imaging (MRI). Considering the overlap among NDDs and simultaneous development of the brain and face, guided by molecular signaling, we examined the relationship of actionable and incidental (non-actionable) MRI findings and NDD diagnoses together with facial morphological variants and genetic copy number variants (CNVs). A cross-sectional study was conducted with a twin cohort 8–36 years of age (57% monozygotic, 40% dizygotic), including 372 subjects (46% with NDDs; 47% female) imaged by MRI, 280 with data for facial morphological variants, and 183 for CNVs. Fifty-one percent of participants had MRI findings. Males had a statistically significantly higher percentage of MRI findings (57.7%) compared with females (43.8%, p = 0.03). Twin zygosity was not statistically significantly correlated with incidence or severity of specific MRI findings. No statistically significant association was found between MRI findings and any NDD diagnosis or facial morphological variants; however, MRI findings were statistically significantly associated with the number of CNVs (OR 1.20, 95% CI 1.00–1.44, p = 0.05, adjusted OR for sex 1.24, 95% CI 1.03–1.50, p = 0.02). When combining the presence of MRI findings, facial morphological variants, and CNVs, statistically significant relationships were found with ASD and ADHD diagnoses (p = 0.0006 and p = 0.002, respectively). The results of this study demonstrate that the ability to identify NDDs from combined radiology, morphology, and CNV assessments may be possible. Additionally, twins do not appear to be at increased risk for neuroradiological variants.
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6
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Maniscalco L, Frédérique BB, Roccella M, Matranga D, Tripi G. A Preliminary Study on Cranio-Facial Characteristics Associated with Minor Neurological Dysfunctions (MNDs) in Children with Autism Spectrum Disorders (ASD). Brain Sci 2020; 10:brainsci10080566. [PMID: 32824853 PMCID: PMC7465923 DOI: 10.3390/brainsci10080566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background. Craniofacial anomalies and minor neurological dysfunction (MNDs) have been identified, in literature, as risk factors for neurodevelopmental disorders. They represent physical indicators of embryonic development suggesting a possible contributory role of complications during early, even pre-conceptional, phases of ontogeny in autism spectrum disorders (ASD). Limited research has been conducted about the co-occurrence of the two biomarkers in children with ASD. This study investigates the associative patterns of cranio-facial anomalies and MNDs in ASD children, and whether these neurodevelopmental markers correlate with intensity of ASD symptoms and overall functioning. Methods. Caucasian children with ASD (n = 33) were examined. Measures were based on five anthropometric cranio-facial indexes and a standardized and detailed neurological examination according to Touwen. Relationships between anthropometric z-scores, MNDs and participant characteristics (i.e., age, cognitive abilities, severity of autistic symptoms measured using the Childhood Autism Rating Scale (CARS) checklist) were assessed. Results. With respect to specific MNDs, significant positive correlations were found between Cephalic Index and Sensory deficits (p-value < 0.001), which did not correlate with CARS score. Importantly, CARS score was positively linked with Intercanthal Index (p-value < 0.001), and negatively associated with posture and muscle tone (p-value = 0.027) and Facial Index (p-value = 0.004). Conclusion. Our data show a link between a specific facial phenotype and anomalies in motor responses, suggesting early brain dysmaturation involving subcortical structures in cerebro-craniofacial development of autistic children. This research supports the concept of a “social brain functional morphology” in autism spectrum disorders.
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Affiliation(s)
- Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics-BIND-University of Palermo, 90127 Palermo, Italy;
| | | | - Michele Roccella
- Department of Psychological Sciences, Pedagogical and Education, University of Palermo, 90128 Palermo, Italy;
| | - Domenica Matranga
- Department Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza, “G. D’Alessandro”-PROMISE-University of Palermo, 90127 Palermo, Italy;
| | - Gabriele Tripi
- Department Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza, “G. D’Alessandro”-PROMISE-University of Palermo, 90127 Palermo, Italy;
- Department of Childhood Psychiatry for Neurodevelopmentals Disorders, Centre Hospitalier du Chinonais, 37500 Saint-Benoît-la-Forêt, France
- Correspondence:
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7
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Mukherjee SB, Neelam, Kapoor S, Sharma S. Identification of Essential, Equivocal and Complex Autism by the Autism Dysmorphology Measure: An Observational Study. J Autism Dev Disord 2020; 51:1550-1561. [PMID: 32767173 DOI: 10.1007/s10803-020-04641-x] [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: 10/23/2022]
Abstract
The Autism Dysmorphology Measure is designed for non-expert clinicians. It uses an algorithm to assess 12 body regions and categorizes Autism on the number of dysmorphic regions identified; Essential (≤ 3), Equivocal (4-5) or Complex (≥ 6). We evaluated 200 Indian children with Autism (mean age 3.7 years) in a hospital-based cross-sectional study and compared inter-group profiles. We found 31% Essential, 49% Equivocal and 20% Complex Autism. On comparing results with existing literature, it appeared that genetic ancestry and age significantly influenced dysmorphism and hence categorization. No significant differences were observed between complex and essential autism in epilepsy, severity of autism or development, as reported earlier. These shortcomings make the present tool unsuitable for use in young Indian children with Autism.
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Affiliation(s)
- Sharmila B Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India. .,Kalawati Saran Children's Hospital, Pediatric Office, Room 118, First floor, Bangla Sahib Marg, New Delhi, 110001, India.
| | - Neelam
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Seema Kapoor
- Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
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8
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Tian LH, Wiggins LD, Schieve LA, Yeargin-Allsopp M, Dietz P, Aylsworth AS, Elias ER, Hoover-Fong JE, Meeks NJL, Souders MC, Tsai ACH, Zackai EH, Alexander AA, Dowling NF, Shapira SK. Mapping the Relationship between Dysmorphology and Cognitive, Behavioral, and Developmental Outcomes in Children with Autism Spectrum Disorder. Autism Res 2020; 13:1227-1238. [PMID: 32567802 DOI: 10.1002/aur.2314] [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: 12/20/2019] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 11/06/2022]
Abstract
Previous studies investigating the association between dysmorphology and cognitive, behavioral, and developmental outcomes among individuals with autism spectrum disorder (ASD) have been limited by the binary classification of dysmorphology and lack of comparison groups. We assessed the association using a continuous measure of dysmorphology severity (DS) in preschool children aged 2-5 years (322 with ASD and intellectual disability [ID], 188 with ASD without ID, and 371 without ASD from the general population [POP]). In bivariate analyses, an inverse association between DS and expressive language, receptive language, fine motor, and visual reception skills was observed in children with ASD and ID. An inverse association of DS with fine motor and visual reception skills, but not expressive language and receptive language, was found in children with ASD without ID. No associations were observed in POP children. These results persisted after exclusion of children with known genetic syndromes or major morphologic anomalies. Quantile regression models showed that the inverse relationships remained significant after adjustment for sex, race/ethnicity, maternal education, family income, study site, and preterm birth. DS was not associated with autistic traits or autism symptom severity, behaviors, or regression among children with ASD with or without ID. Thus, DS was associated with a global impairment of cognitive functioning in children with ASD and ID, but only with fine motor and visual reception deficits in children with ASD without ID. A better understanding is needed for mechanisms that explain the association between DS and cognitive impairment in children with different disorders. Autism Res 2020, 13: 1227-1238. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We examined whether having more dysmorphic features (DFs) was related to developmental problems among children with autism spectrum disorder (ASD) with or without intellectual disability (ID), and children without ASD from the general population (POP). Children with ASD and ID had more language, movement, and learning issues as the number of DFs increased. Children with ASD without ID had more movement and learning issues as the number of DFs increased. These relationships were not observed in the POP group. Implications are discussed.
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Affiliation(s)
- Lin H Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patricia Dietz
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Arthur S Aylsworth
- Department of Pediatrics and Genetics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Ellen R Elias
- Department of Pediatrics and Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Julie E Hoover-Fong
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Naomi J L Meeks
- Department of Pediatrics and Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Margaret C Souders
- Clinical Genetics Center, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anne C-H Tsai
- Department of Pediatrics and Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Elaine H Zackai
- Clinical Genetics Center, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Aimee A Alexander
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicole F Dowling
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stuart K Shapira
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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9
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Myers L, Anderlid BM, Nordgren A, Lundin K, Kuja-Halkola R, Tammimies K, Bölte S. Clinical versus automated assessments of morphological variants in twins with and without neurodevelopmental disorders. Am J Med Genet A 2020; 182:1177-1189. [PMID: 32162839 DOI: 10.1002/ajmg.a.61545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/05/2019] [Accepted: 02/14/2020] [Indexed: 12/28/2022]
Abstract
Physical examinations are recommended as part of a comprehensive evaluation for individuals with neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder. These examinations should include assessment for morphological variants. Previous studies have shown an increase in morphological variants in individuals with NDDs, particularly ASD, and that these variants may be present in greater amounts in individuals with genetic alterations. Unfortunately, assessment for morphological variants can be subjective and time-consuming, and require a high degree of clinical expertise. Therefore, objective, automated methods of morphological assessment are desirable. This study compared the use of Face2Gene, an automated tool to explore facial morphological variants, to clinical consensus assessment, using a cohort of N = 290 twins enriched for NDDs (n = 135 with NDD diagnoses). Agreement between automated and clinical assessments were satisfactory to complete (78.3-100%). In our twin sample, individuals with NDDs did not have greater numbers of facial morphological variants when compared to those with typical development, nor when controlling for shared genetic and environmental factors within twin pairs. Common facial morphological variants in those with and without NDDs were similar and included thick upper lip vermilion, abnormality of the nasal tip, long face, and upslanted palpebral fissure. We conclude that although facial morphological variants can be assessed reliably in NDDs with automated tools like Face2Gene, clinical utility is limited when just exploring the facial region. Therefore, currently, automated assessments may best complement, rather than replace, in-person clinical assessments.
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Affiliation(s)
- Lynnea Myers
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Britt-Marie Anderlid
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Ann Nordgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Karl Lundin
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kristiina Tammimies
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden.,Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia
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10
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Tripi G, Roux S, Matranga D, Maniscalco L, Glorioso P, Bonnet-Brilhault F, Roccella M. Cranio-Facial Characteristics in Children with Autism Spectrum Disorders (ASD). J Clin Med 2019; 8:jcm8050641. [PMID: 31075935 PMCID: PMC6571684 DOI: 10.3390/jcm8050641] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/01/2019] [Accepted: 05/07/2019] [Indexed: 12/03/2022] Open
Abstract
Background: Cranio-facial anomalies frequently occur in neurodevelopmental disorders because both face and brain are derived from neuroectoderm. The identification of differences in the facial phenotype of children with Autism Spectrum Disorders (ASD) may reflect alterations in embryologic brain development in children with ASD. Methods: we evaluated 33 caucasian children with ASD using a 2D computerized photogrammetry. Anthropometric euclidean measurements and landmarks located on the soft tissue of the face and head, were based on five cranio-facial indexes. Relationships between anthropometric z-scores and participant characteristics (i.e., age, Global IQ, severity of autistic symptoms measured using the CARS checklist) were assessed. Results: Cephalic index z-score differed significantly from 0 in our ASD group (p = 0.019). Moreover, a significant negative correlation was found between Facial Index z-score and CARS score (p = 0.003); conversely, a positive correlation was found between Interchantal Index z-score and CARS score (p = 0.028). Conclusion: our measurements shows a dolichocephalic head shape which is not correlated with autism severity. Importantly, two craniofacial markers were significantly correlated with autism severity: increased orbital hyperthelorism and decrease of height of the facial midline. These data support previous findings of craniofacial anomalies in autism spectrum disorder suggesting an “ASD facial phenotype” that could be used to improve ASD diagnoses.
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Affiliation(s)
- Gabriele Tripi
- Department Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro"-PROMISE-University of Palermo, 90127 Palermo, Italy.
- Childhood Psychiatric Service for Neurodevelopmentals Disorders, Centre Hospitalier du Chinonais, 37500 Saint-Benoît-la-Forêt, France.
| | - Sylvie Roux
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France.
| | - Domenica Matranga
- Department Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro"-PROMISE-University of Palermo, 90127 Palermo, Italy.
| | - Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics-BIND-University of Palermo, 90127 Palermo, Italy.
| | - Pasqualino Glorioso
- Childhood Psychiatric Service for Neurodevelopmentals Disorders, Centre Hospitalier du Chinonais, 37500 Saint-Benoît-la-Forêt, France.
| | | | - Michele Roccella
- Department of Psychological Sciences, Pedagogical and Education, University of Palermo, 90128 Palermo, Italy.
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11
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A Novel Approach to Dysmorphology to Enhance the Phenotypic Classification of Autism Spectrum Disorder in the Study to Explore Early Development. J Autism Dev Disord 2019; 49:2184-2202. [PMID: 30783897 DOI: 10.1007/s10803-019-03899-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The presence of multiple dysmorphic features in some children with autism spectrum disorder (ASD) might identify distinct ASD phenotypes and serve as potential markers for understanding causes and prognoses. To evaluate dysmorphology in ASD, children aged 3-6 years with ASD and non-ASD population controls (POP) from the Study to Explore Early Development were evaluated using a novel, systematic dysmorphology review approach. Separate analyses were conducted for non-Hispanic White, non-Hispanic Black, and Hispanic children. In each racial/ethnic group, ~ 17% of ASD cases were Dysmorphic compared with ~ 5% of POP controls. The ASD-POP differential was not explained by known genetic disorders or birth defects. In future epidemiologic studies, subgrouping ASD cases as Dysmorphic vs. Non-dysmorphic might help delineate risk factors for ASD.
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12
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Hertz-Picciotto I, Schmidt RJ, Walker CK, Bennett DH, Oliver M, Shedd-Wise KM, LaSalle JM, Giulivi C, Puschner B, Thomas J, Roa DL, Pessah IN, Van de Water J, Tancredi DJ, Ozonoff S. A Prospective Study of Environmental Exposures and Early Biomarkers in Autism Spectrum Disorder: Design, Protocols, and Preliminary Data from the MARBLES Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:117004. [PMID: 30465702 PMCID: PMC6371714 DOI: 10.1289/ehp535] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Until recently, environmental factors in autism spectrum disorder (ASD) were largely ignored. Over the last decade, altered risks from lifestyle, medical, chemical, and other factors have emerged through various study designs: whole population cohorts linked to diagnostic and/or exposure-related databases, large case-control studies, and smaller cohorts of children at elevated risk for ASD. OBJECTIVES This study aimed to introduce the MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) prospective study and its goals, motivate the enhanced-risk cohort design, describe protocols and main exposures of interest, and present initial descriptive results for the study population. METHODS Families having one or more previous child with ASD were contacted before or during a pregnancy, and once the woman became pregnant, were invited to enroll. Data and biological samples were collected throughout pregnancy, at birth, and until the child's third birthday. Neurodevelopment was assessed longitudinally. The study began enrolling in 2006 and is ongoing. RESULTS As of 30 June 2018, 463 pregnant mothers have enrolled. Most mothers ([Formula: see text]) were thirty years of age or over, including 7.9% who are fourty years of age or over. The sample includes 22% Hispanic and another 25% nonHispanic Black, Asian, or multiracial participants; 24% were born outside the United States. Retention is high: 84% of participants whose pregnancies did not end in miscarriage completed the study or are still currently active. Among children evaluated at 36 months of age, 24% met criteria for ASD, and another 25% were assessed as nonASD nontypical development. CONCLUSION Few environmental studies of ASD prospectively obtain early-life exposure measurements. The MARBLES study fills this gap with extensive data and specimen collection beginning in pregnancy and has achieved excellent retention in an ethnically diverse study population. The 24% familial recurrence risk is consistent with recent reported risks observed in large samples of siblings of children diagnosed with ASD. https://doi.org/10.1289/EHP535.
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Affiliation(s)
- Irva Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California Davis (UC Davis), Davis, California, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California Davis (UC Davis), Davis, California, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
| | - Cheryl K Walker
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Obstetrics & Gynecology, School of Medicine, UC Davis, Davis, California, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, School of Medicine, University of California Davis (UC Davis), Davis, California, USA
| | - McKenzie Oliver
- Department of Public Health Sciences, School of Medicine, University of California Davis (UC Davis), Davis, California, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
| | - Kristine M Shedd-Wise
- Department of Public Health Sciences, School of Medicine, University of California Davis (UC Davis), Davis, California, USA
| | - Janine M LaSalle
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Molecular Biosciences, School of Veterinary Medicine, UC Davis, Davis, California, USA
| | - Cecilia Giulivi
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Medical Microbiology, School of Medicine, UC Davis, Davis, California, USA
| | - Birgit Puschner
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Medical Microbiology, School of Medicine, UC Davis, Davis, California, USA
| | - Jennifer Thomas
- Department of Public Health Sciences, School of Medicine, University of California Davis (UC Davis), Davis, California, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
| | - Dorcas L Roa
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
| | - Isaac N Pessah
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Medical Microbiology, School of Medicine, UC Davis, Davis, California, USA
| | - Judy Van de Water
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Rheumatology and Allergy, School of Medicine, UC Davis, Davis, California, USA
| | - Daniel J Tancredi
- Department of Pediatrics, School of Medicine, UC Davis, Davis, California, USA
| | - Sally Ozonoff
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, UC Davis, Davis, California, USA
- Department of Psychiatry, School of Medicine, UC Davis, Davis, California, USA
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13
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Tsai MC, Lee CT, Tsai IN, Gan ST, Liang YL, Lin SH. Minor physical anomalies in adolescents at risk for substance use and early sex. Medicine (Baltimore) 2018; 97:e11147. [PMID: 29901645 PMCID: PMC6023981 DOI: 10.1097/md.0000000000011147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Minor physical anomalies (MPAs) are associated with disruptions of fetal development. We propose that the same genetic compositions that contribute to the presence of MPAs, also predispose individuals to health-compromising behaviors, thus considering MPAs as particular endophenotypes.We developed a screening questionnaire for problematic conduct, substance abuse, and early sexual practice. A total of 108 adolescents (55 males, 50.9%) aged 11 to 19 years were recruited and further divided into case and control groups according to their answers to the questions of health behaviors mentioned above. We then measured their MPAs that included qualitative and quantitative physical features. Stepwise logistic regression and the receiver operating characteristic (ROC) analyses were used to determine the predictive values of MPAs for behavioral outcomes.The obliquity of palpebral fissure and the head MPAs were negatively associated with substance use. In the ROC analysis, the model provided an area under curve (AUC) of 0.91 with prediction indices being 0.89 for sensitivity and 0.85 for specificity. In addition, the feet MPAs and outer canthal distance were positively, whereas the obliquity of palpebral fissure and ear rotation was negatively associated with early sexual practices. The AUC for early sexual practice was 0.91 and the prediction indexes were 0.87 for sensitivity and 0.88 for specificity.Certain MPAs were associated with adolescent substance use and early sex, which suggests a neurodevelopmental etiology for behavioral outcomes.
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Affiliation(s)
- Meng-Che Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
- Department of Pediatrics
| | - Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - I-Ning Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Shu-Ting Gan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Yi-Lin Liang
- Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
- Department of Public Health, College of Medicine
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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14
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Boutrus M, Maybery MT, Alvares GA, Tan DW, Varcin KJ, Whitehouse AJO. Investigating facial phenotype in autism spectrum conditions: The importance of a hypothesis driven approach. Autism Res 2017; 10:1910-1918. [PMID: 28816000 DOI: 10.1002/aur.1824] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 04/20/2017] [Accepted: 05/23/2017] [Indexed: 11/11/2022]
Abstract
Atypical facial characteristics have been observed in many disorders associated with developmental disability. While autism spectrum conditions (ASC) have not previously been thought to be associated with a distinct facial phenotype, an emerging research literature is casting doubt on this assumption. The identification of differences in the facial phenotype of individuals with ASC may contribute to efforts to promote early identification of the condition and help elucidate etiological pathways. With the aim of identifying facial phenotypes associated with ASC, this commentary evaluated facial features purported to distinguish ASC from typical development. Although there is little consensus across the reviewed studies for the majority of facial characteristics described, preliminary evidence suggests increased facial asymmetry may be more common in ASC. There is also evidence to suggest that there are morphologically distinct subgroups within ASC that correspond with different cognitive and behavioral symptomatology. However, in light of the various inconsistencies in the reported literature, and based on an accumulating understanding of etiological pathways proposed to be associated with ASC, we propose an alternative paradigm for investigating facial phenotypes in ASC. A series of studies are outlined to demonstrate the promise of a research program that has taken a hypothesis-driven approach to examine facial phenotypes associated with increased exposure to prenatal testosterone and to ASC. Autism Res 2017, 10: 1910-1918. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This commentary reviewed studies that found differences in the facial features of individuals with autism spectrum conditions (ASC) compared to typically developing individuals. While there is little agreement between studies, there is some support for asymmetrical facial features associated with ASC, and preliminary evidence that particular facial features relate to specific patterns of cognitive and behavioral symptoms. However, in light of inconsistencies between studies and based on accumulating understanding of etiological pathways, we propose an alternative approach to investigating facial differences in ASC.
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Affiliation(s)
- Maryam Boutrus
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Murray T Maybery
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Diana Weiting Tan
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Kandice J Varcin
- Telethon Kids Institute, University of Western Australia, West Perth, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, West Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
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15
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Flor J, Bellando J, Lopez M, Shui A. Developmental functioning and medical Co-morbidity profile of children with complex and essential autism. Autism Res 2017; 10:1344-1352. [PMID: 28474389 DOI: 10.1002/aur.1779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/11/2017] [Accepted: 02/16/2017] [Indexed: 11/12/2022]
Abstract
Children with Autism Spectrum Disorders (ASD) may be characterized as "complex" (those with microcephaly and/or dysmorphology) or "essential" (those with neither of these two). Previous studies found subjects in the complex group exhibited lower IQ scores, poorer response to behavioral intervention, more seizures and more abnormal EEGs and brain MRIs compared to the essential group. The objective of this study was to determine if there are differences in complex versus essential subjects based on several developmental/psychological measures as well as certain medical comorbidities. This study utilized data from 1,347 individuals (2-17 years old) well-characterized subjects enrolled in Autism Treatment Network (ATN) Registry. Head circumference measurement and the Autism Dysmorphology Measure (ADM) were used by trained physicians to classify subjects as complex or essential. Significantly lower scores were seen for complex subjects in cognitive level, adaptive behavior and quality of life. Complex subjects showed significantly increased physician-documented GI symptoms and were on a higher number of medications. No significant differences in autism severity scores, behavioral ratings and parent-reported sleep problems were found. After adjusting for multiple comparisons made, adaptive scores remained significantly lower for the complex group, and the complex group used a significantly higher number of medications and had increased GI symptoms. Complex and essential autism subtypes may have distinct developmental and medical correlates and thus underlines the importance of looking for microcephaly and dysmorphology, when evaluating a child with autism. Determining this distinction in autism may have implications in prognosis, identifying medical co-morbidities, directing diagnostic evaluations and treatment interventions. Autism Res 2017, 10: 1344-1352. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Jaimie Flor
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.,Biostatistics Center, Massachusetts General Hospital
| | - Jayne Bellando
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.,Biostatistics Center, Massachusetts General Hospital
| | - Maya Lopez
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.,Biostatistics Center, Massachusetts General Hospital
| | - Amy Shui
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.,Biostatistics Center, Massachusetts General Hospital
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16
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Stray-Pedersen A, Jouanguy E, Crequer A, Bertuch AA, Brown BS, Jhangiani SN, Muzny DM, Gambin T, Sorte H, Sasa G, Metry D, Campbell J, Sockrider MM, Dishop MK, Scollard DM, Gibbs RA, Mace EM, Orange JS, Lupski JR, Casanova JL, Noroski LM. Compound heterozygous CORO1A mutations in siblings with a mucocutaneous-immunodeficiency syndrome of epidermodysplasia verruciformis-HPV, molluscum contagiosum and granulomatous tuberculoid leprosy. J Clin Immunol 2014; 34:871-90. [PMID: 25073507 PMCID: PMC4386834 DOI: 10.1007/s10875-014-0074-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 06/30/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE Coronin-1A deficiency is a recently recognized autosomal recessive primary immunodeficiency caused by mutations in CORO1A (OMIM 605000) that results in T-cell lymphopenia and is classified as T(-)B(+)NK(+)severe combined immunodeficiency (SCID). Only two other CORO1A-kindred are known to date, thus the defining characteristics are not well delineated. We identified a unique CORO1A-kindred. METHODS We captured a 10-year analysis of the immune-clinical phenotypes in two affected siblings from disease debut of age 7 years. Target-specific genetic studies were pursued but unrevealing. Telomere lengths were also assessed. Whole exome sequencing (WES) uncovered the molecular diagnosis and Western blot validated findings. RESULTS We found the compound heterozygous CORO1A variants: c.248_249delCT (p.P83RfsX10) and a novel mutation c.1077delC (p.Q360RfsX44) (NM_007074.3) in two affected non-consanguineous siblings that manifested as absent CD4CD45RA(+) (naïve) T and memory B cells, low NK cells and abnormally increased double-negative (DN) ϒδ T-cells. Distinguishing characteristics were late clinical debut with an unusual mucocutaneous syndrome of epidermodysplasia verruciformis-human papilloma virus (EV-HPV), molluscum contagiosum and oral-cutaneous herpetic ulcers; the older female sibling also had a disfiguring granulomatous tuberculoid leprosy. Both had bilateral bronchiectasis and the female died of EBV+ lymphomas at age 16 years. The younger surviving male, without malignancy, had reproducibly very short telomere lengths, not before appreciated in CORO1A mutations. CONCLUSION We reveal the third CORO1A-mutated kindred, with the immune phenotype of abnormal naïve CD4 and DN T-cells and newfound characteristics of a late/hypomorphic-like SCID of an EV-HPV mucocutaneous syndrome with also B and NK defects and shortened telomeres. Our findings contribute to the elucidation of the CORO1A-SCID-CID spectrum.
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Affiliation(s)
- Asbjorg Stray-Pedersen
- Allergy & Immunology, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA, Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA, Department of Medical Genetics, Oslo University Hospital, Oslo, Norway, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, University Paris Descartes and Inserm, Imagine Foundation, Paris, FranceEU
| | - Amandine Crequer
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, University Paris Descartes and Inserm, Imagine Foundation, Paris, FranceEU
| | - Alison A. Bertuch
- Hematology/Oncology, Texas Children's Hospital, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Betty S. Brown
- Allergy & Immunology, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Clinical Immunology Laboratory, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital/Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Shalini N. Jhangiani
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Donna M. Muzny
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Tomasz Gambin
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Hanne Sorte
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Ghadir Sasa
- Hematology/Oncology, Texas Children's Hospital, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Denise Metry
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Department of Dermatology, Texas Children's Hospital, Houston, TX, USA
| | - Judith Campbell
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Infectious Diseases, Texas Children's Hospital, Houston, TX, USA
| | - Marianna M. Sockrider
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Pulmonary Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Megan K. Dishop
- Department of Pathology, University of Colorado, Denver, CO, USA, Department of Pathology, Texas Children's Hospital, Houston, TX
| | | | - Richard A. Gibbs
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Emily M. Mace
- Allergy & Immunology, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Center for Human Immunobiology, Texas Children's Hospital-Baylor College of Medicine, Houston, TX, USA
| | - Jordan S. Orange
- Allergy & Immunology, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA, Hematology/Oncology, Texas Children's Hospital, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Clinical Immunology Laboratory, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital/Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Center for Human Immunobiology, Texas Children's Hospital-Baylor College of Medicine, Houston, TX, USA
| | - James R. Lupski
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Human Genome Sequencing Center of Baylor College of Medicine, Houston, TX, USA
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, University Paris Descartes and Inserm, Imagine Foundation, Paris, FranceEU
| | - Lenora M. Noroski
- Allergy & Immunology, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, TX, USA, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA, Clinical Immunology Laboratory, Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital/Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Goriely A, McGrath JJ, Hultman CM, Wilkie AOM, Malaspina D. "Selfish spermatogonial selection": a novel mechanism for the association between advanced paternal age and neurodevelopmental disorders. Am J Psychiatry 2013; 170:599-608. [PMID: 23639989 PMCID: PMC4001324 DOI: 10.1176/appi.ajp.2013.12101352] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is robust evidence from epidemiological studies that the offspring of older fathers have an increased risk of neurodevelopmental disorders, such as schizophrenia and autism. The authors present a novel mechanism that may contribute to this association. Because the male germ cell undergoes many more cell divisions across the reproductive age range, copy errors taking place in the paternal germline are associated with de novo mutations in the offspring of older men. Recently it has been recognized that somatic mutations in male germ cells that modify proliferation through dysregulation of the RAS protein pathway can lead to within-testis expansion of mutant clonal lines. First identified in association with rare disorders related to paternal age (e.g., Apert syndrome, achondroplasia), this process is known as "selfish spermatogonial selection." This mechanism favors propagation of germ cells carrying pathogenic mutations, increasingly skews the mutational profile of sperm as men age, and enriches de novo mutations in the offspring of older fathers that preferentially affect specific cellular signaling pathways. This mechanism not only offers a parsimonious explanation for the association between advanced paternal age and various neurodevelopmental disorders but also provides insights into the genetic architecture (role of de novo mutations), neurobiological correlates (altered cell cycle), and some epidemiological features of these disorders. The authors outline hypotheses to test this model. Given the secular changes for delayed parenthood in most societies, this hypothesis has important public health implications.
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Affiliation(s)
- Anne Goriely
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
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