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McKenney EE, Richards JK, Day TC, Brunwasser SM, Cucchiara CL, Kofner B, McDonald RG, Gillespie-Lynch K, Lamm J, Kang E, Lerner MD, Gotham KO. Satisfaction with social connectedness is associated with depression and anxiety symptoms in neurodiverse first-semester college students. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1972-1984. [PMID: 38380636 PMCID: PMC11303119 DOI: 10.1177/13623613231216879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
LAY ABSTRACT How satisfied people feel with their social connections and support is related to mental health outcomes for many different types of people. People may feel less socially connected at some times in their life-like when they start college. Feeling disconnected from others could lead to depression or anxiety. The transition to college may be especially difficult for autistic students as they are more likely to have difficulties adjusting socially. In our study, we asked 263 college students to answer questions about their emotions and social satisfaction twice per week during their first semester of college. We found that students who reported being less satisfied with their social connectedness (either at the beginning or throughout the semester) tended to express more symptoms of depression and anxiety. This relationship between social satisfaction and anxiety was even stronger for people who had a strong desire for social interaction (i.e. were more socially motivated). Students with more autistic traits tended to report more mood concerns, and they also reported being less satisfied with friendships at the beginning of the semester. This information may help to support ongoing efforts to better address mental health in autistic college students by encouraging efforts to improve social satisfaction.
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Novak P, Systrom DM, Marciano SP, Knief A, Felsenstein D, Giannetti MP, Hamilton MJ, Nicoloro-SantaBarbara J, Saco TV, Castells M, Farhad K, Pilgrim DM, Mullally WJ. Mismatch between subjective and objective dysautonomia. Sci Rep 2024; 14:2513. [PMID: 38291116 PMCID: PMC10828385 DOI: 10.1038/s41598-024-52368-x] [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: 08/08/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
Autonomic symptom questionnaires are frequently used to assess dysautonomia. It is unknown whether subjective dysautonomia obtained from autonomic questionnaires correlates with objective dysautonomia measured by quantitative autonomic testing. The objective of our study was to determine correlations between subjective and objective measures of dysautonomia. This was a retrospective cross-sectional study conducted at Brigham and Women's Faulkner Hospital Autonomic Laboratory between 2017 and 2023 evaluating the patients who completed autonomic testing. Analyses included validated autonomic questionnaires [Survey of Autonomic Symptoms (SAS), Composite Autonomic Symptom Score 31 (Compass-31)] and standardized autonomic tests (Valsalva maneuver, deep breathing, sudomotor, and tilt test). The autonomic testing results were graded by a Quantitative scale for grading of cardiovascular reflexes, sudomotor tests and skin biopsies (QASAT), and Composite Autonomic Severity Score (CASS). Autonomic testing, QASAT, CASS, and SAS were obtained in 2627 patients, and Compass-31 in 564 patients. The correlation was strong between subjective instruments (SAS vs. Compass-31, r = 0.74, p < 0.001) and between objective instruments (QASAT vs. CASS, r = 0.81, p < 0.001). There were no correlations between SAS and QASAT nor between Compass-31 and CASS. There continued to be no correlations between subjective and objective instruments for selected diagnoses (post-acute sequelae of COVID-19, n = 61; postural tachycardia syndrome, 211; peripheral autonomic neuropathy, 463; myalgic encephalomyelitis/chronic fatigue syndrome, 95; preload failure, 120; post-treatment Lyme disease syndrome, 163; hypermobile Ehlers-Danlos syndrome, 213; neurogenic orthostatic hypotension, 86; diabetes type II, 71, mast cell activation syndrome, 172; hereditary alpha tryptasemia, 45). The lack of correlation between subjective and objective instruments highlights the limitations of the commonly used questionnaires with some patients overestimating and some underestimating true autonomic deficit. The diagnosis-independent subjective-objective mismatch further signifies the unmet need for reliable screening surveys. Patients who overestimate the symptom burden may represent a population with idiosyncratic autonomic-like symptomatology, which needs further study. At this time, the use of autonomic questionnaires as a replacement of autonomic testing cannot be recommended.
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Affiliation(s)
- Peter Novak
- Autonomic Laboratory, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - David M Systrom
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Sadie P Marciano
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, MA, USA
| | - Alexandra Knief
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, MA, USA
| | - Donna Felsenstein
- Harvard Medical School, Boston, MA, USA
- Department of Infectious Disease and Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew P Giannetti
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Mastocytosis Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew J Hamilton
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Mastocytosis Center, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Tara V Saco
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Mastocytosis Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Mariana Castells
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Mastocytosis Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Khosro Farhad
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - David M Pilgrim
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - William J Mullally
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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DiCriscio AS, Beiler D, Smith J, Asdell P, Dickey S, DiStefano M, Troiani V. Assessment of autonomic symptom scales in patients with neurodevelopmental diagnoses using electronic health record data. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 108:102234. [PMID: 37982012 PMCID: PMC10653282 DOI: 10.1016/j.rasd.2023.102234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Background Sleep disturbances, gastrointestinal problems, and atypical heart rate are commonly observed in patients with autism spectrum disorder (ASD) and may relate to underlying function of the autonomic nervous system (ANS). The overall objective of the current study was to quantitatively characterize features of ANS function using symptom scales and available electronic health record (EHR) data in a clinically and genetically characterized pediatric cohort. Methods We assessed features of ANS function via chart review of patient records adapted from items drawn from a clinical research questionnaire of autonomic symptoms. This procedure coded for the presence and/or absence of targeted symptoms and was completed in 3 groups of patients, including patients with a clinical neurodevelopmental diagnosis and identified genetic etiology (NPD, n=244), those with an ASD diagnosis with no known genetic cause (ASD, n=159), and age and sex matched controls (MC, n=213). Symptoms were assessed across four main categories: (1) Mood, Behavior, and Emotion; (2) Secretomotor, Sensory Integration; (3) Urinary, Gastrointestinal, and Digestion; and (4) Circulation, Thermoregulation, Circadian function, and Sleep/Wake cycles. Results Chart review scores indicate an increased rate of autonomic symptoms across all four sections in our NPD group as compared to scores with ASD and/or MC. Additionally, we note several significant relationships between individual differences in autonomic symptoms and quantitative ASD traits. Conclusion These results highlight EHR review as a potentially useful method for quantifying variance in symptoms adapted from a questionnaire or survey. Further, using this method indicates that autonomic features are more prevalent in children with genetic disorders conferring risk for ASD and other neurodevelopmental diagnoses.
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Affiliation(s)
- A S DiCriscio
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - D Beiler
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - J Smith
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Geisinger Health System, Behavioral Health, Danville, PA, United States
| | - P Asdell
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Summa Health, Ohio, United States
| | - S Dickey
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - M DiStefano
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Geisinger Health System, Precision Health Program, Danville, PA, United States
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - V Troiani
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Department of Imaging Science and Innovation, Center for Health Research, Danville, PA, United States
- Geisinger Neuroscience Institute, Danville, PA, United States
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, PA, United States
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Kong XJ, Kang J, Liu K. Probiotic and intra-nasal oxytocin combination therapy on autonomic function and gut-brain axis signaling in young children and teens with autism spectrum disorder. J Psychiatr Res 2023; 166:1-9. [PMID: 37639877 DOI: 10.1016/j.jpsychires.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 07/05/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
Autonomic dysfunction has been widely studied in individuals with autism spectral disorder (ASD); however, the autonomic response to probiotic and oxytocin (OT) combination intervention has not yet been explored. We conducted the present study that includes 35 individuals with ASD aged 3-20 years to explore autonomic responses to daily Lactobacillus plantarum probiotic supplementation and OT nasal spray treatment both alone and in combination. We identified significant improvements in autonomic indices from subjects receiving combination treatment relative to those receiving placebo. Parameters that were observed to improve following combination treatment are time domain metrics of heart rate variability (HRV), including the root mean square of successive differences between normal heartbeats (RMSSD), standard deviation of normal-to-normal R-R intervals (SDNN), and proportion of the number of pairs of adjacent NN intervals that differ by more than 50ms (pNN50, p < 0.05). Furthermore, individuals that received either probiotics or OT alone demonstrated fewer changes in RMSSD, pNN50, and SDNN. Several parameters that demonstrated significant improvements in combination therapy were found to be correlated with baseline levels of OT (LF power: r = -0.86, p = 0.024; mean HR: r = 0.89, p = 0.012). Additionally, Social Responsiveness Scale (SRS) raw total scores (mean HR, r = 0.86, p = 0.024) and Aberrant Behavior Checklist (ABC) raw total scores (mean HR r = 0.94, p = 0.017) were correlated with mean heart rate (HR) and HRV-derived parameters. These results provide further evidence of synergy of probiotic and OT combination and help us gain a better understanding of the role of the gut-brain axis in ASD phenotypes and pathogenesis.
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Affiliation(s)
- Xue-Jun Kong
- Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Jiayi Kang
- Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA, USA
| | - Kevin Liu
- Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA, USA
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O'Reilly C, Oruganti SDR, Tilwani D, Bradshaw J. Model-Driven Analysis of ECG Using Reinforcement Learning. Bioengineering (Basel) 2023; 10:696. [PMID: 37370627 DOI: 10.3390/bioengineering10060696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/20/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Modeling is essential to better understand the generative mechanisms responsible for experimental observations gathered from complex systems. In this work, we are using such an approach to analyze the electrocardiogram (ECG). We present a systematic framework to decompose ECG signals into sums of overlapping lognormal components. We use reinforcement learning to train a deep neural network to estimate the modeling parameters from an ECG recorded in babies from 1 to 24 months of age. We demonstrate this model-driven approach by showing how the extracted parameters vary with age. From the 751,510 PQRST complexes modeled, 82.7% provided a signal-to-noise ratio that was sufficient for further analysis (>5 dB). After correction for multiple tests, 10 of the 24 modeling parameters exhibited statistical significance below the 0.01 threshold, with absolute Kendall rank correlation coefficients in the [0.27, 0.51] range. These results confirm that this model-driven approach can capture sensitive ECG parameters. Due to its physiological interpretability, this approach can provide a window into latent variables which are important for understanding the heart-beating process and its control by the autonomous nervous system.
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Affiliation(s)
- Christian O'Reilly
- Artificial Intelligence Institute of South Carolina, Columbia, SC 29208, USA
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC 29208, USA
- Carolina Autism and Neurodevelopment Research Center, University of South Carolina, Columbia, SC 29208, USA
- Institute for Mind and Brain, University of South Carolina, Columbia, SC 29208, USA
| | - Sai Durga Rithvik Oruganti
- Artificial Intelligence Institute of South Carolina, Columbia, SC 29208, USA
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC 29208, USA
| | - Deepa Tilwani
- Artificial Intelligence Institute of South Carolina, Columbia, SC 29208, USA
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC 29208, USA
- Carolina Autism and Neurodevelopment Research Center, University of South Carolina, Columbia, SC 29208, USA
- Institute for Mind and Brain, University of South Carolina, Columbia, SC 29208, USA
| | - Jessica Bradshaw
- Carolina Autism and Neurodevelopment Research Center, University of South Carolina, Columbia, SC 29208, USA
- Institute for Mind and Brain, University of South Carolina, Columbia, SC 29208, USA
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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6
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Taylor EC, Livingston LA, Clutterbuck RA, Callan MJ, Shah P. Psychological strengths and well-being: Strengths use predicts quality of life, well-being and mental health in autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613221146440. [PMID: 36639858 PMCID: PMC10375006 DOI: 10.1177/13623613221146440] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
LAY ABSTRACT It is often suggested that supporting autistic people to identify and use their strengths will lead to positive outcomes. However, little research has explored if this is true. To date, no research has explored whether autistic people already have knowledge of and use their strengths, nor whether increased strengths knowledge and use is linked to good outcomes, such as a better quality of life, well-being and improved mental health. Comparing large samples of autistic and non-autistic people, this study tested these unanswered questions. We found that autistic and non-autistic people reported similar strengths, but autistic people reported less knowledge and use of their strengths compared to non-autistic people. Importantly however, autistic people who reported using their strengths often had better quality of life, well-being and mental health than autistic people who reported using their strengths less frequently. We, therefore, propose that supporting autistic people to use their strengths more often may be a valuable way to boost well-being in this population.
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7
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Rinaldi A, Martins MCM, Maioli M, Rinaldi S, Fontani V. REAC Noninvasive Neurobiological Stimulation in Autism Spectrum Disorder for Alleviating Stress Impact. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:244-251. [PMID: 36213521 PMCID: PMC9525921 DOI: 10.1007/s41252-022-00293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 05/05/2023]
Abstract
Objectives Autism spectrum disorder (ASD) symptoms can become more evident because of different factors. Among these, depression, anxiety, and stress play an important role. Additionally, several studies have revealed the impact of the COVID-19 pandemic on participants with ASD. In previous studies, two noninvasive neurobiological stimulation treatments with radio electric asymmetric conveyer (REAC) technology, called neuropostural optimization (NPO) and neuropsychophysical optimization (NPPO), were shown to be effective in improving the subjective response to environmental stressors in the general population and in ASD population. Based on the proven efficacy of REAC NPO and NPPOs treatments in alleviating anxiety, stress, and depression, the purpose of this study is to verify how these treatments can reduce the severity of ASD symptoms expression, which is aggravated by depression, anxiety, and stress. The treatments' effects were perceived by caregivers and assessed by the Autism Treatment Evaluation Checklist (ATEC). Methods This study involved 46 children with a previous diagnosis of ASD made using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. The participants received one session of NPO treatment and one NPPOs treatment cycle of 18 sessions, administered within approximately 3 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of the REAC treatments. ATEC allows to evaluate four clusters (speech or language communication; sociability; sensory or cognitive awareness; and health/physical/behavior) through a numerical scale that measures increasing levels of ASD severity. Results The comparison between the scores of the ATEC administered pre- and post-REAC treatments highlighted an improvement of ASD symptoms in each of the four clusters of ATEC. Conclusions The results confirm the usefulness of REAC treatments to optimize the individual response to environmental stressors and reduce the symptomatic expression and deficits present in ASD.
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Affiliation(s)
- Arianna Rinaldi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
| | - Márcia C. Marins Martins
- International Scientific Society of Neuro Psycho Physical Optimization With REAC Technology, Brazilian Branch, São Paulo, Brazil
| | - Margherita Maioli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Rinaldi
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
- Research Department, Rinaldi Fontani Foundation, Florence, Italy
| | - Vania Fontani
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
- Research Department, Rinaldi Fontani Foundation, Florence, Italy
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8
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Barbier A, Chen JH, Huizinga JD. Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory. Front Psychiatry 2022; 13:830234. [PMID: 35370829 PMCID: PMC8964964 DOI: 10.3389/fpsyt.2022.830234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
The quest to understand the pathophysiology of autism spectrum disorder (ASD) has led to extensive literature that purports to provide evidence for autonomic dysfunction based on heart rate and heart rate variability (HRV), in particular respiratory sinus arrhythmia (RSA), a measure of parasympathetic functioning. Many studies conclude that autism is associated with vagal withdrawal and sympathetic hyperactivation based on HRV and electrodermal analyses. We will argue that a critical analysis of the data leads to the hypothesis that autonomic nervous system dysfunction is not a dominant feature of autism. Most children with ASD have normal parasympathetic baseline values and normal autonomic responses to social stimuli. The existing HRV and electrodermal data cannot lead to the conclusion of an over-excitation of the sympathetic nervous system. A small subgroup of ASD children in experimental settings has relatively low RSA values and relatively high heart rates. The data suggest that this is likely associated with a relatively high level of anxiety during study conditions, associated with co-morbidities such as constipation, or due to the use of psychoactive medication. Many studies interpret their data to conform with a preferred hypothesis of autonomic dysfunction as a trait of autism, related to the polyvagal theory, but the HRV evidence is to the contrary. HRV analysis may identify children with ASD having autonomic dysfunction due to co-morbidities.
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Affiliation(s)
- Ashley Barbier
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ji-Hong Chen
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jan D Huizinga
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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9
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Whiteley P, Marlow B, Kapoor RR, Blagojevic-Stokic N, Sala R. Autoimmune Encephalitis and Autism Spectrum Disorder. Front Psychiatry 2021; 12:775017. [PMID: 34975576 PMCID: PMC8718789 DOI: 10.3389/fpsyt.2021.775017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
The concept of "acquired autism" refers to the hypothesis that amongst the massive heterogeneity that encompasses autism spectrum disorder (ASD) there may be several phenotypes that are neither syndromic nor innate. Strong and consistent evidence has linked exposure to various pharmacological and infective agents with an elevated risk of a diagnosis of ASD including maternal valproate use, rubella and herpes encephalitis. Autoimmune encephalitis (AE) describes a group of conditions characterised by the body's immune system mounting an attack on healthy brain cells causing brain inflammation. The resultant cognitive, psychiatric and neurological symptoms that follow AE have also included ASD or autism-like traits and states. We review the current literature on AE and ASD. Drawing also on associated literature on autoimmune psychosis (AP) and preliminary evidence of a psychosis-linked subtype of ASD, we conclude that AE may either act as a potentially causative agent for ASD, and/or produce symptoms that could easily be mistaken for or misdiagnosed as autism. Further studies are required to discern the connection between AE and autism. Where autism is accompanied by regression and atypical onset patterns, it may be prudent to investigate whether a differential diagnosis of AE would be more appropriate.
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Affiliation(s)
| | - Ben Marlow
- Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
- The Synapse Centre for Neurodevelopment ESNEFT, Colchester, United Kingdom
| | - Ritika R. Kapoor
- Paediatric Endocrinology, Variety Club Children's Hospital, King's College Hospital NHS Foundation Trust, London, United Kingdom
- Faculty of Medicine and Life Sciences, King's College London, London, United Kingdom
| | | | - Regina Sala
- Centre for Psychiatry, Wolfson Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, United Kingdom
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10
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Tonhajzerova I, Ondrejka I, Ferencova N, Bujnakova I, Grendar M, Olexova LB, Hrtanek I, Visnovcova Z. Alternations in the Cardiovascular Autonomic Regulation and Growth Factors in Autism. Physiol Res 2021; 70:551-561. [PMID: 34062079 DOI: 10.33549/physiolres.934662] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Autism spectrum disorder (ASD) represents a serious neurodevelopmental disorder associated with autonomic nervous system dysregulation. The aim was to study complex cardiovascular autonomic regulation using heart rate variability (HRV) and systolic blood pressure variability (SBPV) linear/non-linear analysis at rest and during orthostasis, and to assess plasma levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in autistic children. Twenty-five ASD boys and 25 age and gender-matched children at the age 7-15 years were examined. After venous blood taking, continuous ECG and blood pressure biosignals were recorded at rest and during orthostasis. Evaluated parameters: RR intervals, high- and low-frequency band of HRV spectral analysis (HF-HRV, LF-HRV), symbolic dynamics parameters 0V%, 1V%, 2LV%, 2UV%, low- and high-frequency band of SBPV (LF-SBPV, HF-SBPV), systolic, diastolic, mean blood pressure, EGF, VEGF plasma levels. RR intervals were significantly shortened and the HF-HRV, LF-SBPV, HF-SBPV parameters were significantly lower at rest, the HF-HRV and LF-SBPV remained lower during orthostasis in autistic children compared to controls (p<0.05). EGF plasma levels were significantly lower in ASD compared to controls (p=0.046). No significant differences were found in remaining parameters. Our study revealed tachycardia, cardiovagal underactivity, and blunted sympathetic vasomotor regulation at rest and during orthostasis in autistic children. Additionally, complex heart rate dynamics are similar in autistic children than controls. Furthermore, EGF was reduced in autistic children without significant correlations with any autonomic parameters. We suggest that the abnormal complex cardiovascular reflex control could contribute to understanding the pathway linking autonomic features and autism.
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Affiliation(s)
- I Tonhajzerova
- Biomedical Center Martin JFM CU, Mala Hora, Martin, Slovak Republic
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11
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Kuschner ES, Malow BA. Autism and physical health across the lifespan. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:599-602. [PMID: 33910389 DOI: 10.1177/13623613211006524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Emily S Kuschner
- The Children's Hospital of Philadelphia, USAUniversity of Pennsylvania Perelman School of Medicine, USA
| | - Beth Ann Malow
- Department of Neurology, Vanderbilt University Medical Center, USA
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12
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Bellamy R, Ring H, Watson P, Kemp A, Munn G, Clare IC. The effect of ambient sounds on decision-making and heart rate variability in autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2209-2222. [PMID: 34132124 PMCID: PMC7614480 DOI: 10.1177/13623613211014993] [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: 11/16/2022]
Abstract
LAY ABSTRACT Many autistic people report difficulties making decisions during everyday tasks, such as shopping. To examine the effect of sounds on decision-making, we developed a supermarket task where people watched a film shown from the shopper's perspective and were asked to make decisions between different products. The task was divided into three sections and participants completed each section in a different auditory environment: (1) no sounds, (2) non-social sounds (e.g. fridges humming) and (3) social sounds (e.g. people talking). Thirty-eight autistic and 37 neurotypical adults took part. We measured decision-making by examining how long it took to make a decision and how consistent people were with their decisions. We also measured heart rate variability because this biological response provides a measure of anxiety. After the supermarket shopping task, participants told us in their own words about their experiences. Autistic participants said that they found the non-social and social sound conditions more difficult than the no sound condition, and autistic participants found the social sound condition more negative than neurotypical participants. However, decision-making and heart rate variability were similar for autistic and neurotypical participants across the sound conditions, suggesting that these measures may not have been sensitive enough to reflect the experiences the autistic participants reported. Further research should consider alternative measures to explore the experiences reported by autistic people to help us understand which specific aspects of the environment autistic people are sensitive to. This, in turn, may enable more specific and evidence-based autism-friendly changes to be made.
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Affiliation(s)
| | - Howard Ring
- University of Cambridge, UK.,Cambridgeshire & Peterborough NHS Foundation Trust, UK
| | | | | | | | - Isabel Ch Clare
- University of Cambridge, UK.,Cambridgeshire & Peterborough NHS Foundation Trust, UK.,NIHR ARC East of England at Cambridgeshire & Peterborough NHS Foundation Trust, UK
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