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Debbaut E, Steyaert J, El Bakkali M. Autism spectrum disorder profiles in RASopathies: A systematic review. Mol Genet Genomic Med 2024; 12:e2428. [PMID: 38581124 PMCID: PMC10997847 DOI: 10.1002/mgg3.2428] [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: 09/22/2023] [Revised: 03/10/2024] [Accepted: 03/19/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND RASopathies are associated with an increased risk of autism spectrum disorder (ASD). For neurofibromatosis type 1 (NF1) there is ample evidence for this increased risk, while for other RASopathies this association has been studied less. No specific ASD profile has been delineated so far for RASopathies or a specific RASopathy individually. METHODS We conducted a systematic review to investigate whether a specific RASopathy is associated with a specific ASD profile, or if RASopathies altogether have a distinct ASD profile compared to idiopathic ASD (iASD). We searched PubMed, Web of Science, and Open Grey for data about ASD features in RASopathies and potential modifiers. RESULTS We included 41 articles on ASD features in NF1, Noonan syndrome (NS), Costello syndrome (CS), and cardio-facio-cutaneous syndrome (CFC). Individuals with NF1, NS, CS, and CFC on average have higher ASD symptomatology than healthy controls and unaffected siblings, though less than people with iASD. There is insufficient evidence for a distinct ASD phenotype in RASopathies compared to iASD or when RASopathies are compared with each other. We identified several potentially modifying factors of ASD symptoms in RASopathies. CONCLUSIONS Our systematic review found no convincing evidence for a specific ASD profile in RASopathies compared to iASD, or in a specific RASopathy compared to other RASopathies. However, we identified important limitations in the research literature which may also account for this result. These limitations are discussed and recommendations for future research are formulated.
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Affiliation(s)
- Edward Debbaut
- Center for Developmental Psychiatry, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Leuven Autism Research (LAuRes)KU LeuvenLeuvenBelgium
| | - Jean Steyaert
- Center for Developmental Psychiatry, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Leuven Autism Research (LAuRes)KU LeuvenLeuvenBelgium
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Daniels N, Moerkerke M, Steyaert J, Bamps A, Debbaut E, Prinsen J, Tang T, Van der Donck S, Boets B, Alaerts K. Effects of multiple-dose intranasal oxytocin administration on social responsiveness in children with autism: a randomized, placebo-controlled trial. Mol Autism 2023; 14:16. [PMID: 37081454 PMCID: PMC10117268 DOI: 10.1186/s13229-023-00546-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Intranasal administration of oxytocin is increasingly explored as a new approach to facilitate social development and reduce disability associated with a diagnosis of autism spectrum disorder (ASD). The efficacy of multiple-dose oxytocin administration in children with ASD is, however, not well established. METHODS A double-blind, randomized, placebo-controlled trial with parallel design explored the effects of a 4-week intranasal oxytocin administration (12 IU, twice daily) on parent-rated social responsiveness (Social Responsiveness Scale: SRS-2) in pre-pubertal school-aged children (aged 8-12 years, 61 boys, 16 girls). Secondary outcomes included a questionnaire-based assessment of repetitive behaviors, anxiety, and attachment. Effects of oxytocin were assessed immediately after the administration period and at a follow-up, 4 weeks after the last administration. The double-blind phase was followed by a 4-week single-blind phase during which all participants received intranasal oxytocin. RESULTS In the double-blind phase, both the oxytocin and placebo group displayed significant pre-to-post-improvements in social responsiveness and secondary questionnaires, but improvements were not specific to the intranasal oxytocin. Notably, in the single-blind phase, participants who were first allocated to intranasal placebo and later changed to intranasal oxytocin displayed a significant improvement in social responsiveness, over and above the placebo-induced improvements noted in the first phase. Participants receiving oxytocin in the first phase also showed a significant further improvement upon receiving a second course of oxytocin, but only at the 4-week follow-up. Further, exploratory moderator analyses indicated that children who received psychosocial trainings (3 or more sessions per month) along with oxytocin administration displayed a more pronounced improvement in social responsiveness. LIMITATIONS Future studies using larger cohorts and more explicitly controlled concurrent psychosocial trainings are warranted to further explore the preliminary moderator effects, also including understudied populations within the autism spectrum, such as children with co-occurring intellectual disabilities. CONCLUSIONS Four weeks of oxytocin administration did not induce treatment-specific improvements in social responsiveness in school-aged children with ASD. Future studies are warranted to further explore the clinical efficacy of oxytocin administration paired with targeted psychosocial trainings that stimulate socio-communicative behaviors. Trial registration The trial was registered with the European Clinical Trial Registry (EudraCT 2018-000769-35) on June 7th, 2018 ( https://www.clinicaltrialsregister.eu/ctr-search/trial/2018-000769-35/BE ).
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Affiliation(s)
- Nicky Daniels
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Box 1501, 3001, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Matthijs Moerkerke
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jean Steyaert
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Child Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Annelies Bamps
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Child Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Edward Debbaut
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Child Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Jellina Prinsen
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Box 1501, 3001, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Tiffany Tang
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Stephanie Van der Donck
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Bart Boets
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Kaat Alaerts
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Box 1501, 3001, Leuven, Belgium.
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.
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Gross AM, Plotkin SR, Widemann BC. Neurofibromatosis Clinical Trials-REiNS Collaboration 2020 Recommendations: Looking Back and Moving Ahead. Neurology 2021; 97:S1-S3. [PMID: 34230201 DOI: 10.1212/wnl.0000000000012429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/19/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Andrea M Gross
- From the Pediatric Oncology Branch (A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston.
| | - Scott R Plotkin
- From the Pediatric Oncology Branch (A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Brigitte C Widemann
- From the Pediatric Oncology Branch (A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
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