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Agar G, Oliver C, Spiller J, Richards C. The developmental trajectory of sleep in children with Smith-Magenis syndrome compared to typically developing peers: a 3-year follow-up study. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad034. [PMID: 37810798 PMCID: PMC10559836 DOI: 10.1093/sleepadvances/zpad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/15/2023] [Indexed: 10/10/2023]
Abstract
Study Objectives To determine the trajectory of: (i) objective sleep parameters and (ii) caregiver-reported sleep questionnaire scores over 3 years in children with Smith-Magenis syndrome (SMS) compared to age-matched typically developing (TD) controls. We also aimed to (iii) describe individual profiles of change in sleep parameters over time. Methods Week-long, overnight actigraphy and questionnaire data from 13 children with SMS and 13 age-matched TD children were collected at Time 1 and Time 2 (3 years later). Independent samples t-tests, paired samples t-tests, and Bayesian analyses were used to compare sleep parameters and sleep questionnaire scores between groups at each time point and compare data within groups to assess change over time. Results Sleep parameters were consistently more disrupted in the SMS group than the TD group, with significantly reduced sleep efficiency, increased wake after sleep onset and earlier get up times at both time points. This was mirrored in the questionnaire data, with children with SMS evidencing higher scores for overall sleep disturbance, night waking, and daytime sleepiness. While TD sleep parameters demonstrated expected developmental changes over 3 years, in the SMS group sleep parameters and variability between and within children remained largely stable. However, some children with SMS showed substantial variation in sleep parameters over time. Questionnaire scores remained stable over 3 years in both groups. Conclusions Overall, sleep disturbance appears to be a stable feature of SMS, indicative of a divergent sleep trajectory compared to TD peers. Proactive intervention approaches should be considered for poor sleep in SMS.
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Affiliation(s)
- Georgie Agar
- School of Psychology, Aston University, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Jayne Spiller
- School of Psychology, University of Birmingham, Birmingham, UK
- School of Psychology and Vision Sciences, University of Leicester, Leicester, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK
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Zigler CK, Lucas N, McFatrich M, Gordon KL, Jones HN, Berent A, Panagoulias J, Evans P, Reeve BB. Exploring Communication Ability in Individuals With Angelman Syndrome: Findings From Qualitative Interviews With Caregivers. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:185-203. [PMID: 37104863 DOI: 10.1352/1944-7558-128.3.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/23/2022] [Indexed: 05/25/2023]
Abstract
Communication deficits have a substantial impact on quality of life for individuals with Angelman syndrome (AS) and their families, but limited qualitative work exists to support the necessary content of measures aiming to assess communication for these individuals. Following best practices for concept elicitation studies, we conducted individual qualitative interviews with caregivers and clinicians to elicit meaningful aspects of communication for individuals with AS. Caregivers were able to discuss their child's specific communication behaviors within a large number of expressive, receptive, and pragmatic functions via numerous symbolic and non-symbolic modalities. These results aligned well with published literature on communication in AS and will be used to inform the design of a novel caregiver-reported measure. Future studies on communication in individuals with AS should focus on gathering quantitative data from large samples of diverse caregivers, which would allow for estimations of the frequency of specific behaviors across the population.
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Affiliation(s)
- Christina K Zigler
- Christina K. Zigler, Nicole Lucas, and Molly McFatrich, Duke University School of Medicine
| | - Nicole Lucas
- Christina K. Zigler, Nicole Lucas, and Molly McFatrich, Duke University School of Medicine
| | - Molly McFatrich
- Christina K. Zigler, Nicole Lucas, and Molly McFatrich, Duke University School of Medicine
| | | | | | - Allyson Berent
- Allyson Berent, Jennifer Panagoulias, and Paula Evans, The Foundation for Angelman Syndrome Therapceutis (FAST)
| | - Jennifer Panagoulias
- Allyson Berent, Jennifer Panagoulias, and Paula Evans, The Foundation for Angelman Syndrome Therapceutis (FAST)
| | - Paula Evans
- Allyson Berent, Jennifer Panagoulias, and Paula Evans, The Foundation for Angelman Syndrome Therapceutis (FAST)
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Galli J, Loi E, Dusi L, Pasini N, Rossi A, Scaglioni V, Mauri L, Fazzi E. Oculocutaneous albinism: the neurological, behavioral, and neuro-ophthalmological perspective. Eur J Pediatr 2023:10.1007/s00431-023-04938-w. [PMID: 37009951 PMCID: PMC10257606 DOI: 10.1007/s00431-023-04938-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Oculocutaneous albinism (OCA) is a group of rare, genetic disorders caused by absent/reduced melanin biosynthesis. The aim of this study was to explore the neurovisual, cognitive, adaptive, and behavioral profile of children affected by OCA, also evaluating any possible effect of the visual acuity deficit on the clinical profile and genotype-phenotype correlations. Eighteen children (9 males, mean age 84 months ± 41; range 18-181 months) with a molecular confirmed diagnosis of OCA were enrolled in the study. We collected data on clinical history, neurodevelopmental profile, neurological and neurovisual examination, and cognitive, adaptive, and emotional/behavioral functioning. A global neurodevelopmental impairment was detected in 56% of the children, without evolving into an intellectual disability. All the patients showed signs and symptoms of visual impairment. Low adaptive functioning was observed in 3 cases (17%). A risk for internalizing behavioral problems was documented in 6 cases (33%), for externalizing problems in 2 (11%), and for both in 5 (28%). Twelve children (67%) showed one or more autistic-like features. Correlation analyses revealed significant associations between the visual acuity level and performance intelligence quotient (p = 0.001), processing speed index (p = 0.021), Vineland total score (p = 0.020), Vineland communication (p = 0.020), and socialization (p = 0.037) domains. No significant correlations were found between genotype and phenotype. CONCLUSION Children with OCA may present a global neurodevelopmental delay that seems to improve with age and emotional/behavioral difficulties, along with the well-known visual impairment. An early neuropsychiatric evaluation and habilitative training are recommended to improve vision-related performance, neurodevelopment, and any psychological difficulties. WHAT IS KNOWN • Children with oculocutaneous albinism show dermatological and ophthalmological problems. • An early visual impairment may have negative implications on motor, emotional, and cognitive processes that would allow the child to organize his or her experiences. WHAT IS NEW • In addition to a variable combination of ocular signs and symptoms, children with oculocutaneous albinism may present an early neurodevelopmental delay and emotional/behavioral difficulties. • An early visual treatment is recommended to improve vision-related performance, neurodevelopment, and any psychological difficulties.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Laura Dusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vera Scaglioni
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lucia Mauri
- Medical Genetics Unit, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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4
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Social attention and social-emotional modulation of attention in Angelman syndrome: an eye-tracking study. Sci Rep 2023; 13:3375. [PMID: 36854878 PMCID: PMC9975183 DOI: 10.1038/s41598-023-30199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/17/2023] [Indexed: 03/02/2023] Open
Abstract
Individuals with Angelman syndrome (AS) present with severe intellectual disability alongside a social phenotype characterised by social communication difficulties and an increased drive for social engagement. As the social phenotype in this condition is poorly understood, we examined patterns of social attention and social modulation of attention in AS. Twenty-four individuals with AS and twenty-one young children with similar mental age were shown videos featuring unfamiliar actors who performed simple actions across two conditions: a playful condition, in which the actor showed positive facial emotions, and a neutral condition, in which the actor showed a neutral facial expression. During the passive observation of the videos, participants' proportion of time spent watching the two areas of interest (faces and actions) was examined using eye-tracking technology. We found that the playful condition elicited increased proportion of fixations duration to the actor's face compared to the neutral condition similarly across groups. Additionally, the proportion of fixations duration to the action area was similar across groups in the two conditions. However, children with AS looked towards the actor's face for a shorter duration compared to the comparison group across conditions. This pattern of similarities and differences provides novel insight on the complex social phenotype of children with AS.
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Sadhwani A, Wheeler A, Gwaltney A, Peters SU, Barbieri-Welge RL, Horowitz LT, Noll LM, Hundley RJ, Bird LM, Tan WH. Developmental Skills of Individuals with Angelman Syndrome Assessed Using the Bayley-III. J Autism Dev Disord 2023; 53:720-737. [PMID: 33517526 PMCID: PMC8322148 DOI: 10.1007/s10803-020-04861-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2020] [Indexed: 12/27/2022]
Abstract
We describe the development of 236 children with Angelman syndrome (AS) using the Bayley Scales of Infant and Toddler Development, Third Edition. Multilevel linear mixed modeling approaches were used to explore differences between molecular subtypes and over time. Individuals with AS continue to make slow gains in development through at least age 12 years of age at about 1-2 months/year based on age equivalent score and 1-16 growth score points/year depending on molecular subtype and domain. Children with a deletion have lower scores at baseline and slower rate of gaining skills while children with UBE3A variant subtype demonstrated higher scores as well as greater rates of skill attainment in all domains. The developmental profiles of UPD and ImpD were similar.
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Affiliation(s)
- Anjali Sadhwani
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, 02115, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Anne Wheeler
- RTI International, Research Triangle Park, NC, USA
| | | | - Sarika U. Peters
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rene L. Barbieri-Welge
- Developmental Evaluation Clinic, Rady Children’s Hospital - San Diego, San Diego, CA, USA
| | | | - Lisa M. Noll
- Psychology Service, Texas Children’s Hospital, Houston, TX, USA,Baylor College of Medicine, Houston, TX, USA
| | - Rachel J. Hundley
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lynne M. Bird
- Division of Dysmorphology/Genetics, Rady Children’s Hospital - San Diego, San Diego, CA, USA,Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | - Wen-Hann Tan
- Harvard Medical School, Boston, MA, USA,Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA
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Galli J, Loi E, Strobio C, Micheletti S, Martelli P, Merabet LB, Pasini N, Semeraro F, Fazzi E. Neurovisual profile in children affected by Angelman syndrome. Brain Dev 2023; 45:117-125. [PMID: 36344336 DOI: 10.1016/j.braindev.2022.10.003] [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] [Received: 06/09/2022] [Revised: 09/09/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Angelman syndrome (AS) is a rare neurogenetic disorder caused by altered expression of the maternal copy of the UBE3A gene. Together with motor, cognitive, and speech impairment, ophthalmological findings including strabismus, and ocular fundus hypopigmentation characterize the clinical phenotype. The aim of this study was to detail the neurovisual profile of children affected by AS and to explore any possible genotype-phenotype correlations. METHODS Thirty-seven children (23 females, mean age 102.8 ± 54.4 months, age range 22 to 251 months) with molecular confirmed diagnosis of AS were enrolled in the study. All underwent a comprehensive video-recorded neurovisual evaluation including the assessment of ophthalmological aspects, oculomotor functions, and basic visual abilities. RESULTS All children had visual impairments mainly characterized by refractive errors, ocular fundus changes, strabismus, discontinuous/jerky smooth pursuit and altered saccadic movements, and/or reduced visual acuity. Comparing the neurovisual profiles between the deletion and non-deletion genetic subgroups, we found a significant statistical correlation between genotype and ocular fundus hypopigmentation (p = 0.03), discontinuous smooth pursuit (p < 0.05), and contrast sensitivity abnormalities (p < 0.01) being more frequent in the deletion subgroup. CONCLUSIONS Subjects affected by AS present a wide spectrum of neurovisual impairments that lead to a clinical profile consistent with cerebral visual impairment (CVI). Moreover, subjects with a chromosome deletion show a more severe visual phenotype with respect to ocular fundus changes, smooth pursuit movements, and contrast sensitivity. Early detection of these impaired visual functions may help promote the introduction of neurovisual habilitative programs which can improve children's visual, neuromotor, and cognitive outcomes.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Caterina Strobio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Paola Martelli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Italy
| | - Francesco Semeraro
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Italy; University of Brescia, Eye Clinic, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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Key AP, Roth S, Jones D, Hunt-Hawkins H. Typical and atypical neural mechanisms support spoken word processing in Angelman syndrome. BRAIN AND LANGUAGE 2023; 236:105215. [PMID: 36502770 PMCID: PMC9839587 DOI: 10.1016/j.bandl.2022.105215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/11/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Angelman syndrome (AS) is known to affect expressive and receptive communication abilities. This study examined individual differences in neural mechanisms underlying speech processing in children with AS (n = 24, M age = 10.01 years) and typical development (n = 30, M age = 10.82 years) using auditory event-related potentials during passive listening to common English words and novel pseudowords. A group of adults with AS (n = 7, M = 31.78 years) provided data about the upper developmental range. The typically developing group demonstrated the expected more negative amplitudes in response to words than pseudowords within 250-500 ms after stimulus onset at the left temporal scalp region. Children and adults with AS exhibited a similar left-lateralized pattern of word-pseudoword differentiation at temporal and parietal regions, but not the midline parietal memory response for known words observed in the typically developing group, suggesting typical-like word-pseudoword differentiation along with possible alterations in the automatic recall of word meaning. These results have important implications for understanding receptive and expressive communication processes in AS and support the use of auditory neural responses for characterizing individual differences in neurodevelopmental disorders with limited speech.
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Affiliation(s)
- Alexandra P Key
- Vanderbilt Kennedy Center for Research on Human Development, Nashville, TN 37203, USA; Vanderbilt University Medical Center, Nashville, TN 37232, USA.
| | - Sydney Roth
- Vanderbilt University, Nashville, TN 37235, USA
| | - Dorita Jones
- Vanderbilt Kennedy Center for Research on Human Development, Nashville, TN 37203, USA; Vanderbilt University Medical Center, Nashville, TN 37232, USA
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Key AP, Roth S, Venker C. Spoken language comprehension in children and adults with Angelman Syndrome. JOURNAL OF COMMUNICATION DISORDERS 2022; 100:106272. [PMID: 36244082 PMCID: PMC9994640 DOI: 10.1016/j.jcomdis.2022.106272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/12/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Objective evaluation of receptive communication abilities in nonspeaking individuals using standardized behavioral measures can be complicated by co-occurring intellectual disabilities and motor difficulties. Eye tracking during listening may offer an informative complementary approach to directly evaluate receptive language skills. METHOD This study examined feasibility of eye gaze measures as an index of spoken language comprehension in nonspeaking children and adults with Angelman syndrome (AS; n = 23) using a looking-while-listening procedure. Typically developing children (n = 34) provided a reference data set. Primary caregivers of participants with AS completed standardized informant reports (MacArthur-Bates Communicative Development Inventory: Words and Gestures; Vineland Adaptive Behavior Scales-3; Aberrant Behavior Checklist-2) to characterize communicative skills and general adaptive functioning. RESULTS Gaze data in participants with AS, particularly in the individuals reported by caregivers to have larger receptive vocabularies and stronger adaptive communicative functioning, demonstrated the expected pattern of comprehension reflected by the increased probability of looks to the target images after vs. before they were named in a spoken sentence. However, processing speed (gaze reaction time) was significantly slower in participants with AS than in the typically developing group. CONCLUSIONS Gaze-based paradigms could be an informative measure of receptive communication processes in participants who are unable to complete traditional standardized behavioral assessments.
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Ascoli M, Elia M, Gasparini S, Bonanni P, Mastroianni G, Cianci V, Neri S, Pascarella A, Santangelo D, Aguglia U, Ferlazzo E. Therapeutic approach to neurological manifestations of Angelman syndrome. Expert Rev Clin Pharmacol 2022; 15:843-850. [PMID: 35917229 DOI: 10.1080/17512433.2022.2109463] [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: 11/04/2022]
Abstract
INTRODUCTION Angelman syndrome (AS) is a neurogenetic disorder due to deficient expression of the maternal copy of the UBE3A gene, which encodes ubiquitin ligase E3A protein. Severe developmental delay, seizures and other neurological disorders characterizes AS. AREAS COVERED In this review, we focus on a comprehensive therapeutic approach to the most disabling neurological manifestations of AS: epilepsy, sleep disturbances, behavioral and movement disorders. Articles were identified through PubMed and Google Scholar up to October 2021. EXPERT OPINION Evidence for the treatment of neurological manifestations in AS mainly derives from poor quality studies (case reports, small case series, expert opinions). Seizures can be polymorphic and includes atypical absences, myoclonic, generalized tonic-clonic, unilateral clonic, or atonic attacks. Sodium valproate, levetiracetam and benzodiazepines are the most commonly used anti-seizure medications. Melatonin or mirtazapine seem to improve sleep quality. Antipsychotics, antidepressants and anxiolytics have been proposed for treatment of behavioral manifestations, but no evidence-based studies are available. Non-pharmacological approach may also be useful. Mild dystonia is common but usually does not significantly impact patients' motor performances. Well-conducted clinical trials aimed to evaluate treatment of neurological complications of AS are warranted. Gene and molecular precision therapies represent a fascinating area of research in the future.
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Affiliation(s)
- Michele Ascoli
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | | | - Sara Gasparini
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Paolo Bonanni
- Epilepsy and Neurophysiology Unit, IRCCS Medea, Conegliano, Treviso, Italy
| | - Giovanni Mastroianni
- Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Vittoria Cianci
- Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Sabrina Neri
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Angelo Pascarella
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Domenico Santangelo
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Umberto Aguglia
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Edoardo Ferlazzo
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.,Regional Epilepsy Centre, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
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Petkova SP, Adhikari A, Berg EL, Fenton TA, Duis J, Silverman JL. Gait as a quantitative translational outcome measure in Angelman syndrome. Autism Res 2022; 15:821-833. [PMID: 35274462 PMCID: PMC9311146 DOI: 10.1002/aur.2697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023]
Abstract
Angelman syndrome (AS) is a genetic neurodevelopmental disorder characterized by developmental delay, lack of speech, seizures, intellectual disability, hypotonia, and motor coordination deficits. Motor abilities are an important outcome measure in AS as they comprise a broad repertoire of metrics including ataxia, hypotonia, delayed ambulation, crouched gait, and poor posture, and motor dysfunction affects nearly every individual with AS. Guided by collaborative work with AS clinicians studying gait, the goal of this study was to perform an in‐depth gait analysis using the automated treadmill assay, DigiGait. Our hypothesis is that gait presents a strong opportunity for a reliable, quantitative, and translational metric that can serve to evaluate novel pharmacological, dietary, and genetic therapies. In this study, we used an automated gait analysis system, in addition to standard motor behavioral assays, to evaluate components of motor, exploration, coordination, balance, and gait impairments across the lifespan in an AS mouse model. Our study demonstrated marked global motoric deficits in AS mice, corroborating previous reports. Uniquely, this is the first report of nuanced aberrations in quantitative spatial and temporal components of gait in AS mice compared to sex‐ and age‐matched wildtype littermates followed longitudinally using metrics that are analogous in AS individuals. Our findings contribute evidence toward the use of nuanced motor outcomes (i.e., gait) as valuable and translationally powerful metrics for therapeutic development for AS, as well as other genetic neurodevelopmental syndromes.
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Affiliation(s)
- Stela P Petkova
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, California, USA
| | - Anna Adhikari
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, California, USA
| | - Elizabeth L Berg
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, California, USA
| | - Timothy A Fenton
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, California, USA
| | - Jessica Duis
- Section of Genetics & Inherited Metabolic Disease, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anshutz Medical Campus, Aurora, Colorado, USA
| | - Jill L Silverman
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, California, USA
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11
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Duis J, Nespeca M, Summers J, Bird L, Bindels‐de Heus KG, Valstar MJ, de Wit MY, Navis C, ten Hooven‐Radstaake M, van Iperen‐Kolk BM, Ernst S, Dendrinos M, Katz T, Diaz‐Medina G, Katyayan A, Nangia S, Thibert R, Glaze D, Keary C, Pelc K, Simon N, Sadhwani A, Heussler H, Wheeler A, Woeber C, DeRamus M, Thomas A, Kertcher E, DeValk L, Kalemeris K, Arps K, Baym C, Harris N, Gorham JP, Bohnsack BL, Chambers RC, Harris S, Chambers HG, Okoniewski K, Jalazo ER, Berent A, Bacino CA, Williams C, Anderson A. A multidisciplinary approach and consensus statement to establish standards of care for Angelman syndrome. Mol Genet Genomic Med 2022; 10:e1843. [PMID: 35150089 PMCID: PMC8922964 DOI: 10.1002/mgg3.1843] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Angelman syndrome (AS) is a rare neurogenetic disorder present in approximately 1/12,000 individuals and characterized by developmental delay, cognitive impairment, motor dysfunction, seizures, gastrointestinal concerns, and abnormal electroencephalographic background. AS is caused by absent expression of the paternally imprinted gene UBE3A in the central nervous system. Disparities in the management of AS are a major problem in preparing for precision therapies and occur even in patients with access to experts and recognized clinics. AS patients receive care based on collective provider experience due to limited evidence-based literature. We present a consensus statement and comprehensive literature review that proposes a standard of care practices for the management of AS at a critical time when therapeutics to alter the natural history of the disease are on the horizon. METHODS We compiled the key recognized clinical features of AS based on consensus from a team of specialists managing patients with AS. Working groups were established to address each focus area with committees comprised of providers who manage >5 individuals. Committees developed management guidelines for their area of expertise. These were compiled into a final document to provide a framework for standardizing management. Evidence from the medical literature was also comprehensively reviewed. RESULTS Areas covered by working groups in the consensus document include genetics, developmental medicine, psychology, general health concerns, neurology (including movement disorders), sleep, psychiatry, orthopedics, ophthalmology, communication, early intervention and therapies, and caregiver health. Working groups created frameworks, including flowcharts and tables, to help with quick access for providers. Data from the literature were incorporated to ensure providers had review of experiential versus evidence-based care guidelines. CONCLUSION Standards of care in the management of AS are keys to ensure optimal care at a critical time when new disease-modifying therapies are emerging. This document is a framework for providers of all familiarity levels.
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Affiliation(s)
- Jessica Duis
- Section of Genetics & Inherited Metabolic DiseaseSection of Pediatrics, Special CareDepartment of PediatricsChildren’s Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Mark Nespeca
- Department of NeurologyRady Children’s HospitalSan DiegoCaliforniaUSA
| | - Jane Summers
- Department of PsychiatryThe Hospital for Sick ChildrenTorontoOntarioCanada
| | - Lynne Bird
- Department of PediatricsClinical Genetics / DysmorphologyUniversity of California, San DiegoRady Children’s Hospital San DiegoSan DiegoCaliforniaUSA
| | - Karen G.C.B. Bindels‐de Heus
- Department of PediatricsErasmus MC SophiaChildren’s HospitalRotterdamNetherlands,ENCORE Expertise Center for Neurodevelopmental DisordersErasmus MC University Medical CenterRotterdamThe Netherlands
| | - M. J. Valstar
- Department of PediatricsErasmus MC SophiaChildren’s HospitalRotterdamNetherlands
| | - Marie‐Claire Y. de Wit
- Department of PediatricsErasmus MC SophiaChildren’s HospitalRotterdamNetherlands,Department of Neurology and Pediatric NeurologyErasmus MCRotterdamThe Netherlands
| | - C. Navis
- Department of PediatricsErasmus MC SophiaChildren’s HospitalRotterdamNetherlands,Department of ENT (Speech & Language Pathology)Erasmus MCRotterdamThe Netherlands
| | - Maartje ten Hooven‐Radstaake
- Department of PediatricsErasmus MC SophiaChildren’s HospitalRotterdamNetherlands,ENCORE Expertise Center for Neurodevelopmental DisordersErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Bianca M. van Iperen‐Kolk
- ENCORE Expertise Center for Neurodevelopmental DisordersErasmus MC University Medical CenterRotterdamThe Netherlands,Department of Physical TherapyErasmus MCRotterdamThe Netherlands
| | - Susan Ernst
- Department of Obstetrics and GynecologyUniversity of MichiganAnn ArborMichiganUSA
| | - Melina Dendrinos
- Department of Obstetrics and GynecologyUniversity of MichiganAnn ArborMichiganUSA
| | - Terry Katz
- Developmental PediatricsDepartment of PediatricsChildren’s Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Gloria Diaz‐Medina
- Division of Neurology and Developmental PediatricsDepartment of PediatricsBaylor College of MedicineHoustonTexasUSA,NeurologyTexas Children's HospitalHoustonTexasUSA
| | - Akshat Katyayan
- Division of Neurology and Developmental PediatricsDepartment of PediatricsBaylor College of MedicineHoustonTexasUSA,NeurologyTexas Children's HospitalHoustonTexasUSA
| | - Srishti Nangia
- Department of PediatricsDivision of Child NeurologyWeill Cornell MedicineNew York‐Presbyterian HospitalNew YorkNew YorkUSA
| | - Ronald Thibert
- Angelman Syndrome ProgramLurie Center for AutismMassachusetts General Hospital for ChildrenBostonMassachusettsUSA
| | - Daniel Glaze
- Division of Neurology and Developmental PediatricsDepartment of PediatricsBaylor College of MedicineHoustonTexasUSA,NeurologyTexas Children's HospitalHoustonTexasUSA
| | - Christopher Keary
- Angelman Syndrome ProgramLurie Center for AutismMassachusetts General Hospital for ChildrenBostonMassachusettsUSA
| | - Karine Pelc
- Department of NeurologyHôpital Universitaire des Enfants Reine FabiolaUniversité Libre de Bruxelles (ULB)BrusselsBelgium
| | - Nicole Simon
- Department of PsychiatryBoston Children’s HospitalBostonMAUSA
| | - Anjali Sadhwani
- Department of PsychiatryBoston Children’s HospitalBostonMAUSA
| | - Helen Heussler
- UQ Child Health Research CentreFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Anne Wheeler
- Center for Newborn ScreeningRTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | - Caroline Woeber
- Audiology, Speech & Learning ServicesChildren’s Hospital ColoradoAuroraColoradoUSA
| | - Margaret DeRamus
- Department of PsychiatryCarolina Institute for Developmental DisabilitiesUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Amy Thomas
- New York League for Early Learning William O'connor SchoolNew YorkNew YorkUSA
| | | | - Lauren DeValk
- Occupational TherapyChildren’s Hospital ColoradoAuroraColoradoUSA
| | - Kristen Kalemeris
- Department of Pediatric RehabilitationMonroe Carell Jr. Children's Hospital at VanderbiltNashvilleTennesseeUSA
| | - Kara Arps
- Department of Physical TherapyChildren’s Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Carol Baym
- Physical TherapyChildren’s Hospital ColoradoAuroraColoradoUSA
| | - Nicole Harris
- Physical TherapyChildren’s Hospital ColoradoAuroraColoradoUSA
| | - John P. Gorham
- Department of Ophthalmology and Visual SciencesUniversity of MichiganAnn ArboMichiganUSA
| | - Brenda L. Bohnsack
- Division of OphthalmologyDepartment of OphthalmologyAnn & Robert H. Lurie Children’s Hospital of ChicagoNorthwestern University Feinberg School of MedicineAnn ArboMichiganUSA
| | - Reid C. Chambers
- Department of Orthopedic Surgery Nationwide Children’s HospitalColumbusOhioUSA
| | - Sarah Harris
- Division of Neurology and Developmental PediatricsDepartment of PediatricsBaylor College of MedicineHoustonTexasUSA,NeurologyTexas Children's HospitalHoustonTexasUSA
| | - Henry G. Chambers
- Orthopedic SurgerySan Diego Department of Pediatric OrthopedicsUniversity of CaliforniaRady Children’s HospitalSan DiegoCaliforniaUSA
| | - Katherine Okoniewski
- Center for Newborn ScreeningRTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | | | - Allyson Berent
- Foundation for Angelman Syndrome TherapeuticsChicagoIllinoisUSA
| | - Carlos A. Bacino
- Department of Molecular and Human GeneticsBaylor College of MedicineHoustonTexasUSA
| | - Charles Williams
- Raymond C. Philips UnitDivision of Genetics and MetabolismDepartment of PediatricsUniversity of FloridaGainesvilleFloridaUSA
| | - Anne Anderson
- Division of Neurology and Developmental PediatricsDepartment of PediatricsBaylor College of MedicineHoustonTexasUSA,NeurologyTexas Children's HospitalHoustonTexasUSA
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12
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Lubbers K, Stijl EM, Dierckx B, Hagenaar DA, Ten Hoopen LW, Legerstee JS, de Nijs PFA, Rietman AB, Greaves-Lord K, Hillegers MHJ, Dieleman GC, Mous SE. Autism Symptoms in Children and Young Adults With Fragile X Syndrome, Angelman Syndrome, Tuberous Sclerosis Complex, and Neurofibromatosis Type 1: A Cross-Syndrome Comparison. Front Psychiatry 2022; 13:852208. [PMID: 35651825 PMCID: PMC9149157 DOI: 10.3389/fpsyt.2022.852208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/26/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The etiology of autism spectrum disorder (ASD) remains unclear, due to genetic heterogeneity and heterogeneity in symptoms across individuals. This study compares ASD symptomatology between monogenetic syndromes with a high ASD prevalence, in order to reveal syndrome specific vulnerabilities and to clarify how genetic variations affect ASD symptom presentation. METHODS We assessed ASD symptom severity in children and young adults (aged 0-28 years) with Fragile X Syndrome (FXS, n = 60), Angelman Syndrome (AS, n = 91), Neurofibromatosis Type 1 (NF1, n = 279) and Tuberous Sclerosis Complex (TSC, n = 110), using the Autism Diagnostic Observation Schedule and Social Responsiveness Scale. Assessments were part of routine clinical care at the ENCORE expertise center in Rotterdam, the Netherlands. First, we compared the syndrome groups on the ASD classification prevalence and ASD severity scores. Then, we compared individuals in our syndrome groups with an ASD classification to a non-syndromic ASD group (nsASD, n = 335), on both ASD severity scores and ASD symptom profiles. Severity scores were compared using MANCOVAs with IQ and gender as covariates. RESULTS Overall, ASD severity scores were highest for the FXS group and lowest for the NF1 group. Compared to nsASD, individuals with an ASD classification in our syndrome groups showed less problems on the instruments' social domains. We found a relative strength in the AS group on the social cognition, communication and motivation domains and a relative challenge in creativity; a relative strength of the NF1 group on the restricted interests and repetitive behavior scale; and a relative challenge in the FXS and TSC groups on the restricted interests and repetitive behavior domain. CONCLUSION The syndrome-specific strengths and challenges we found provide a frame of reference to evaluate an individual's symptoms relative to the larger syndromic population and to guide treatment decisions. Our findings support the need for personalized care and a dimensional, symptom-based diagnostic approach, in contrast to a dichotomous ASD diagnosis used as a prerequisite for access to healthcare services. Similarities in ASD symptom profiles between AS and FXS, and between NF1 and TSC may reflect similarities in their neurobiology. Deep phenotyping studies are required to link neurobiological markers to ASD symptomatology.
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Affiliation(s)
- Kyra Lubbers
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eefje M Stijl
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bram Dierckx
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Doesjka A Hagenaar
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of General Paediatrics, Erasmus MC, Rotterdam, Netherlands
| | - Leontine W Ten Hoopen
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jeroen S Legerstee
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Pieter F A de Nijs
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - André B Rietman
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Kirstin Greaves-Lord
- Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Clinical Psychology and Experimental Psychopathology Unit, Department of Psychology, Rijksuniversiteit Groningen, Groningen, Netherlands.,Yulius Mental Health, Dordrecht, Netherlands.,Jonx Autism Team Northern-Netherlands, Lentis Mental Health, Groningen, Netherlands
| | - Manon H J Hillegers
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Gwendolyn C Dieleman
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sabine E Mous
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
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13
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Li S, Ma Y, Wang T, Jin H, Du X, Wang Y. Epilepsy and Molecular Phenotype Affect the Neurodevelopment of Pediatric Angelman Syndrome Patients in China. Front Psychiatry 2022; 13:886028. [PMID: 35573374 PMCID: PMC9096167 DOI: 10.3389/fpsyt.2022.886028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study investigated the mental development of children with Angelman syndrome (AS) in China and evaluated the relationship between neurodevelopment and molecular subtype, age, epilepsy, and sex using the Chinese version of the Griffith Mental Development Scale (GMDS-C) to provide detailed baseline data regarding neurodevelopment with AS in China. METHODS Participants were recruited from the AS Natural History Study. The GMDS-C was used to evaluate all participants' mental age and developmental quotients. The general quotient (GQ) and quotients of five subscales (sports, personal-social, auditory language, eye-hand coordination, and comprehensive performance) were calculated. RESULTS A total of 119 children (average age: 42.12 months; range, 7.5-95.5 months) with a genetic diagnosis of AS were enrolled. The median GQ score of the GMDS was 29.6 points (95% confidence interval, 28.6-33.25). The children had relatively good locomotor and personal-social skills but poor language skills. Overall, 89% (106/119) had mental ages younger than 24 months for all five subscales. The non-deletion group (i.e., without deletion in chromosome 15q11-13) had higher GQs and locomotor, personal-social, and performance subscale quotients. The GQ was significantly different among the three age subgroups and significantly correlated with age. Compared with the non-epilepsy group, the epilepsy group had lower GQs and lower quotients for the locomotor, personal-social, speech, language, and eye-hand coordination subscales. CONCLUSION Children with AS in China experience severe neurodevelopmental deterioration. In addition to age, molecular subtypes and the onset of seizures may also correlate with these patients' intellectual development. The GMDS-C is an accurate tool that can assess the clinical characteristics of AS. The data of this study can be used as baseline data for clinical trials performed to evaluate drug development or other AS treatment development.
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Affiliation(s)
- Shuang Li
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Yu Ma
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Tianqi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Huimin Jin
- Shanghai YangZhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghia, China
| | - Xiaonan Du
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
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14
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Agbolade O, Nazri A, Yaakob R, Ghani AA, Cheah YK. Investigation of age-related facial variation among Angelman syndrome patients. Sci Rep 2021; 11:20767. [PMID: 34675349 PMCID: PMC8531312 DOI: 10.1038/s41598-021-99944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/19/2021] [Indexed: 11/09/2022] Open
Abstract
Angelman syndrome (AS) is one of the common genetic disorders that could emerge either from a 15q11-q13 deletion or paternal uniparental disomy (UPD) or imprinting or UBE3A mutations. AS comes with various behavioral and phenotypic variability, but the acquisition of subjects for experiment and automating the landmarking process to characterize facial morphology for Angelman syndrome variation investigation are common challenges. By automatically detecting and annotating subject faces, we collected 83 landmarks and 10 anthropometric linear distances were measured from 17 selected anatomical landmarks to account for shape variability. Statistical analyses were performed on the extracted data to investigate facial variation in each age group. There is a correspondence in the results achieved by relative warp (RW) of the principal component (PC) and the thin-plate spline (TPS) interpolation. The group is highly discriminated and the pattern of shape variability is higher in children than other groups when judged by the anthropometric measurement and principal component.
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Affiliation(s)
- Olalekan Agbolade
- Department of Computer Science, Faculty of Computer Science and IT, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia
| | - Azree Nazri
- Department of Computer Science, Faculty of Computer Science and IT, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia.
| | - Razali Yaakob
- Department of Computer Science, Faculty of Computer Science and IT, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia
| | - Abdul Azim Ghani
- Department of Software Engineering, Faculty of Computer Science and IT, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia
| | - Yoke Kqueen Cheah
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia
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15
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Bush L, Scott MN. Neuropsychological and ASD phenotypes in rare genetic syndromes: A critical review of the literature. Clin Neuropsychol 2021; 36:993-1027. [PMID: 34569897 DOI: 10.1080/13854046.2021.1980111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by core deficits in social communication and restricted and repetitive behaviors and interests. Recent advances in clinical genetics have improved our understanding of genetic syndromes associated with ASD, which has helped clarify distinct etiologies of ASD and document syndrome-specific profiles of neurocognitive strengths and weaknesses. Pediatric neuropsychologists have the potential to be impactful members of the care team for children with genetic syndromes and their families. METHOD We provide a critical review of the current literature related to the neuropsychological profiles of children with four genetic syndromes associated with ASD, including Tuberous Sclerosis Complex (TSC), fragile X syndrome (FXS), 22q11.2 deletion syndrome, and Angelman syndrome. Recommendations for assessment, intervention, and future directions are provided. RESULTS There is vast heterogeneity in terms of the cognitive, language, and developmental abilities of these populations. The within- and across-syndrome variability characteristic of genetic syndromes should be carefully considered during clinical evaluations, including possible measurement limitations, presence of intellectual disability, and important qualitative differences in the ASD-phenotypes across groups. CONCLUSIONS Individuals with genetic disorders pose challenging diagnostic and assessment questions. Pediatric neuropsychologists with expertise in neurodevelopmental processes are well suited to address these questions and identify profiles of neurocognitive strengths and weaknesses, tailor individualized recommendations, and provide diagnostic clarification.
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Affiliation(s)
- Lauren Bush
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Megan N Scott
- The Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA
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16
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Yang L, Shu X, Mao S, Wang Y, Du X, Zou C. Genotype-Phenotype Correlations in Angelman Syndrome. Genes (Basel) 2021; 12:987. [PMID: 34203304 PMCID: PMC8304328 DOI: 10.3390/genes12070987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/12/2022] Open
Abstract
Angelman syndrome (AS) is a rare neurodevelopmental disease that is caused by the loss of function of the maternal copy of ubiquitin-protein ligase E3A (UBE3A) on the chromosome 15q11-13 region. AS is characterized by global developmental delay, severe intellectual disability, lack of speech, happy disposition, ataxia, epilepsy, and distinct behavioral profile. There are four molecular mechanisms of etiology: maternal deletion of chromosome 15q11-q13, paternal uniparental disomy of chromosome 15q11-q13, imprinting defects, and maternally inherited UBE3A mutations. Different genetic types may show different phenotypes in performance, seizure, behavior, sleep, and other aspects. AS caused by maternal deletion of 15q11-13 appears to have worse development, cognitive skills, albinism, ataxia, and more autistic features than those of other genotypes. Children with a UBE3A mutation have less severe phenotypes and a nearly normal development quotient. In this review, we proposed to review genotype-phenotype correlations based on different genotypes. Understanding the pathophysiology of the different genotypes and the genotype-phenotype correlations will offer an opportunity for individualized treatment and genetic counseling. Genotype-phenotype correlations based on larger data should be carried out for identifying new treatment modalities.
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Affiliation(s)
- Lili Yang
- Department of Genetics and Metabolism, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China;
| | - Xiaoli Shu
- Department of Laboratory Center, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China;
| | - Shujiong Mao
- Division of Neonatology, Department of Pediatrics, Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China;
| | - Yi Wang
- Department of Neurology, Children’s Hospital of Fudan University, Shanghai 201102, China; (Y.W.); (X.D.)
| | - Xiaonan Du
- Department of Neurology, Children’s Hospital of Fudan University, Shanghai 201102, China; (Y.W.); (X.D.)
| | - Chaochun Zou
- Department of Endocrinology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
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17
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Willgoss T, Cassater D, Connor S, Krishnan ML, Miller MT, Dias-Barbosa C, Phillips D, McCormack J, Bird LM, Burdine RD, Claridge S, Bichell TJ. Measuring What Matters to Individuals with Angelman Syndrome and Their Families: Development of a Patient-Centered Disease Concept Model. Child Psychiatry Hum Dev 2021; 52:654-668. [PMID: 32880036 PMCID: PMC8238699 DOI: 10.1007/s10578-020-01051-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Angelman syndrome (AS) is a complex, heterogeneous, and life-long neurodevelopmental disorder. Despite the considerable impact on individuals and caregivers, no disease-modifying treatments are available. To support holistic clinical management and the development of AS-specific outcome measures for clinical studies, we conducted primary and secondary research identifying the impact of symptoms on individuals with AS and their unmet need. This qualitative research adopted a rigorous step-wise approach, aggregating information from published literature, then evaluating it via disease concept elicitation interviews with clinical experts and caregivers. We found that the AS-defining concepts most relevant for treatment included: impaired expressive communication, seizures, maladaptive behavior, cognitive impairment, motor function difficulties, sleep disturbance, and limited self-care abilities. We highlight the relevance of age in experiencing these key AS concepts, and the difference between the perceptions of clinicians and caregivers towards the syndrome. Finally, we outline the impact of AS on individuals, caregivers, and families.
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Affiliation(s)
- Tom Willgoss
- Roche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW, UK.
| | - Daiana Cassater
- grid.417570.00000 0004 0374 1269Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Siobhan Connor
- grid.419227.bRoche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW UK
| | - Michelle L. Krishnan
- grid.417570.00000 0004 0374 1269Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Meghan T. Miller
- grid.417570.00000 0004 0374 1269Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Dawn Phillips
- grid.410711.20000 0001 1034 1720Division of Physical Therapy, School of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Julie McCormack
- grid.423257.50000 0004 0510 2209Evidera, Patient-Centered Research, Bethesda, MD USA
| | - Lynne M. Bird
- grid.266100.30000 0001 2107 4242Department of Pediatrics, University of California San Diego, San Diego, CA USA
| | - Rebecca D. Burdine
- grid.16750.350000 0001 2097 5006Department of Molecular Biology, Princeton University, Princeton, NJ USA
| | - Sharon Claridge
- Foundation for Angelman Syndrome Research (FAST), Downers Grove, IL USA
| | - Terry Jo Bichell
- Consortium for Outcome Measures and Biomarkers for Neurodevelopmental Disorders, Nashville, TN USA
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18
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Michieletto P, Pensiero S, Diplotti L, Ronfani L, Giangreco M, Danieli A, Bonanni P. Strabismus surgery in Angelman syndrome: More than ocular alignment. PLoS One 2020; 15:e0242366. [PMID: 33186391 PMCID: PMC7665582 DOI: 10.1371/journal.pone.0242366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/01/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To report and evaluate strabismus surgery in children with Angelman syndrome, in order to optimize and standardize surgical approach. Other purposes are to understand the possible relation between ocular findings and motor ability, and between improvement in ocular alignment and changes in motor skills in this population. DESIGN Observational cross-sectional study. METHODS Medical records of pediatric patients with Angelman syndrome, who underwent strabismus surgery, were investigated. Collected data included: genotype, gender, age at the time of surgery, refractive error, pre-operative strabismus, surgical procedure, surgical outcome, gross and fine motor development assessment pre- and post-operatively. RESULTS Seventeen subjects, aged 3-15 years, were investigated. Fourteen patients were exotropic, three esotropic. Most patients presented astigmatism. Considering the exaggerated response to standard amounts of surgery and the risk of consecutive strabismus on long term follow-up reported by previous studies in children with developmental delay, a reduction of the amount of strabismus surgery was applied. Post-operatively, all patients presented with a significative reduction of the baseline deviation angle, with all esotropic patients and 7 exotropic patients (59%) achieving orthotropia. The surgical outcomes were variable according to the type and the amount of baseline strabismus, but no case presented with exaggerated surgical response. At baseline, patients showed important delays in all motor abilities, and, post-operatively, presented a significant improvement in walking and fine motor tasks. Pre- and post-operative motor abilities were negatively correlated to astigmatism, anisometropia, and amount of deviation. CONCLUSIONS According to our data, the standard nomograms for strabismus surgery may be successfully applied in subjects with Angelman syndrome and exotropia. Our data suggest that the reduction of the deviation angle improves motor skills in strabismic pediatric patients with Angelman syndrome.
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Affiliation(s)
- Paola Michieletto
- Ophthalmology Service, Scientific Institute IRCCS Eugenio Medea, Conegliano-Pieve di Soligo (TV), Italy
| | - Stefano Pensiero
- Department of Ophthalmology, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Trieste, Italy
| | - Laura Diplotti
- Department of Ophthalmology, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Trieste, Italy
- * E-mail:
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Trieste, Italy
| | - Manuela Giangreco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Trieste, Italy
| | - Alberto Danieli
- Epilepsy and Clinical Neurophysiology Unit, Scientific Institute IRCCS Eugenio Medea, Conegliano-Pieve di Soligo (TV), Italy
| | - Paolo Bonanni
- Epilepsy and Clinical Neurophysiology Unit, Scientific Institute IRCCS Eugenio Medea, Conegliano-Pieve di Soligo (TV), Italy
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19
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Micheletti S, Vivanti G, Renzetti S, Martelli P, Calza S, Fazzi E. Imitation in Angelman syndrome: the role of social engagement. Sci Rep 2020; 10:16398. [PMID: 33009450 PMCID: PMC7532435 DOI: 10.1038/s41598-020-72079-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022] Open
Abstract
Individuals with Angelman syndrome (AS) are characterized by severe cognitive impairments alongside an enhanced drive for social engagement. As knowledge on imitation skills in this population is limited, we conducted the first controlled study of imitation in AS. We examined how 23 individuals with AS and 21 typically developing young children with similar mental age imitated novel actions in response to socially or non-socially engaging models, and in response to video-recorded versus live demonstrations of novel actions. Individuals with AS imitated as frequently and as accurately as typical young children in response to live demonstrations; but they imitated less frequently and less accurately in response to video-recorded demonstrations. Further, imitation was modulated by whether the demonstrator was socially engaging or emotionally neutral in the AS group, while this modulation was not present in the comparison group. Individuals with higher mental age imitated more frequently and more accurately across groups. Imitation performance in AS appears to be more modulated by the social context compared to typical infants and young children with similar mental age, possibly reflecting an enhanced drive for social engagement. A socially engaging instructional style might facilitate imitative learning in this population.
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Affiliation(s)
- Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Giacomo Vivanti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Stefano Renzetti
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Paola Martelli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Bindels-de Heus KGCB, Mous SE, Ten Hooven-Radstaake M, van Iperen-Kolk BM, Navis C, Rietman AB, Ten Hoopen LW, Brooks AS, Elgersma Y, Moll HA, de Wit MCY. An overview of health issues and development in a large clinical cohort of children with Angelman syndrome. Am J Med Genet A 2019; 182:53-63. [PMID: 31729827 PMCID: PMC6916553 DOI: 10.1002/ajmg.a.61382] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 01/22/2023]
Abstract
This study presents a broad overview of health issues and psychomotor development of 100 children with Angelman syndrome (AS), seen at the ENCORE Expertise Center for AS in Rotterdam, the Netherlands. We aimed to further delineate the phenotype of AS, to evaluate the association of the phenotype with genotype and other determinants such as epilepsy and to get insight in possible targets for intervention. We confirmed the presence of a more severe phenotype in the 15q11.2‐q13 deletion subtype. Novel findings were an association of (early onset of) epilepsy with a negative effect on development, a high occurrence of nonconvulsive status epilepticus, a high rate of crouch gait in the older children with risk of deterioration of mobility, a relatively low occurrence of microcephaly, a higher mean weight for height in all genetic subtypes with a significant higher mean in the nondeletion children, and a high occurrence of hyperphagia across all genetic subtypes. Natural history data are needed to design future trials. With this large clinical cohort with structured prospective and multidisciplinary follow‐up, we provide unbiased data on AS to support further intervention studies to optimize outcome and quality of life of children with AS and their family.
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Affiliation(s)
- Karen G C B Bindels-de Heus
- Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands.,ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands
| | - Sabine E Mous
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Maartje Ten Hooven-Radstaake
- Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands.,ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands
| | - Bianca M van Iperen-Kolk
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Physical Therapy, Erasmus MC, Rotterdam, The Netherlands
| | - Cindy Navis
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of ENT (Speech & Language Pathology), Erasmus MC, Rotterdam, The Netherlands
| | - André B Rietman
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Leontine W Ten Hoopen
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Alice S Brooks
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | | | - Ype Elgersma
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Henriëtte A Moll
- Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands.,ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands
| | - Marie-Claire Y de Wit
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, Rotterdam, The Netherlands.,Department of Neurology and Pediatric Neurology, Erasmus MC, Rotterdam, The Netherlands
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Pearson E, Wilde L, Heald M, Royston R, Oliver C. Communication in Angelman syndrome: a scoping review. Dev Med Child Neurol 2019; 61:1266-1274. [PMID: 31074506 DOI: 10.1111/dmcn.14257] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Abstract
AIM A scoping review was conducted to examine and evaluate empirical data on the communication profile of Angelman syndrome beyond the described dissociation between receptive language and speech. METHOD Three databases (PsycINFO, Embase, and Web of Science) were searched to retrieve articles investigating communication in Angelman syndrome. Seventeen articles investigating the broader communication profile were found; their methodology was evaluated against quality criteria. RESULTS Despite the absence of speech, individuals with Angelman syndrome have a wide repertoire of non-verbal communicative behaviours, mainly characterized by gestures, although advanced forms such as symbolic communication are used by some individuals. The use of communicative forms differs between the genetic aetiologies of Angelman syndrome; individuals with non-deletion aetiologies typically have greater communicative abilities. INTERPRETATION The broader communication profile of Angelman syndrome is characterized by diverse and multimodal abilities, including some use of symbolic forms of communication that appears atypical given the absence of speech. This is suggestive of a probable dissociation between speech and other expressive forms of communication, indicating an isolated speech production impairment. This highlights a need in this population for alternative communication and specific input from services tailored to support the nuances of the communication profile of Angelman syndrome. WHAT THIS PAPER ADDS Although absent speech is near universal, a diverse profile of other communicative abilities has been reported. Parental reporting has been predominantly used to assess the communication profile of Angelman syndrome. Literature that investigates the specificities and possible dissociations in such a communication profile is limited.
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Affiliation(s)
- Effie Pearson
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Lucy Wilde
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Mary Heald
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Rachel Royston
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
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Summers J. Using Behavioral Approaches to Assess Memory, Imitation and Motor Performance in Children with Angelman Syndrome: Results of a Pilot Study. Dev Neurorehabil 2019; 22:516-526. [PMID: 31116614 DOI: 10.1080/17518423.2019.1619857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose: This study was designed to assess memory, imitation of motor actions and motor performance by 12 children (age range 40-151 months) with Angelman syndrome (AS), a rare neurogenetic disorder associated with learning and memory impairments. Methods: Children's functioning was assessed at several time points over a 3-month period. Results: Memory and motor performance tests had acceptable test-retest and inter-rater reliability whereas the motor imitation test did not. Children were able to recall action sequences after a 24-h delay. Memory and motor performance scores were correlated with children's chronological age and raw scores on subdomains of the Vineland-II. Conclusions: These behavioral tests require further development and evaluation but may show promise to accompany standardized assessments that are currently in use with children with AS.
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Affiliation(s)
- Jane Summers
- Hospital for Sick Children , Toronto , Ontario , Canada.,Department of Psychiatry, University of Toronto , Toronto , ON , Canada
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Key AP, Jones D, Peters S, Dold C. Feasibility of using auditory event-related potentials to investigate learning and memory in nonverbal individuals with Angelman syndrome. Brain Cogn 2018; 128:73-79. [PMID: 30471990 DOI: 10.1016/j.bandc.2018.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 12/21/2022]
Abstract
The combination of intellectual, communicative, and motor deficits limit the use of standardized behavioral assessments of cognition in individuals with Angelman syndrome (AS). The current study is the first to objectively evaluate learning and memory in AS using auditory event-related potentials (ERP) during passive exposure to spoken stimuli. Fifteen nonverbal individuals with the deletion subtype of AS (age 4-45 years) completed the auditory incidental memory paradigm. Auditory ERPs were recorded in response to a sequence of unfamiliar nonwords, in which one randomly selected stimulus was repeated multiple times and the rest were presented once. Larger parietal responses within 200-500 ms for the repeated nonword compared to novel distracters were associated with caregiver reports of more adaptive communication skills. These findings demonstrate good tolerability of ERP procedures (94% success rate) and indicate that persons with AS can acquire new information following repeated auditory exposure, even in the absence of explicit memorization instructions. Strong associations between the caregiver reports of adaptive functioning and neural indices of auditory learning and memory support the utility of brain-based measures for objectively evaluating higher-order information processing in nonverbal persons with neurodevelopmental disorders.
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Affiliation(s)
- Alexandra P Key
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, United States; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, United States.
| | - Dorita Jones
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, United States
| | - Sarika Peters
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, United States; Department of Pediatrics, Vanderbilt University Medical Center, United States
| | - Caitlin Dold
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, United States
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Onnis L, Truzzi A, Ma X. Language development and disorders: Possible genes and environment interactions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 82:132-146. [PMID: 30077386 DOI: 10.1016/j.ridd.2018.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 06/22/2018] [Accepted: 06/23/2018] [Indexed: 06/08/2023]
Abstract
Language development requires both basic cognitive mechanisms for learning language and a rich social context from which learning takes off. Disruptions in learning mechanisms, processing abilities, and/or social interactions increase the risks associated with social exclusion or developmental delays. Given the complexity of language processes, a multilevel approach is proposed where both cognitive mechanisms, genetic and environmental factors need to be probed together with their possible interactions. Here we review and discuss such interplay between environment and genetic predispositions in understanding language disorders, with a particular focus on a possible endophenotype, the ability for statistical sequential learning.
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Affiliation(s)
- Luca Onnis
- Nanyang Technological University, Singapore.
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