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Johnson E, van Zijl K, Kuyler A. Pain communication in children with autism spectrum disorder: A scoping review. PAEDIATRIC & NEONATAL PAIN 2023; 5:127-141. [PMID: 38149220 PMCID: PMC10749405 DOI: 10.1002/pne2.12115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 12/28/2023]
Abstract
Children with autism spectrum disorder (ASD) experience social interaction and communication challenges and often display repetitive, restricted patterns of behavior, activities, and interests. The concept of pain is regarded as one of the most complex human stressors due to its subjective and personal nature and the influences of multiple internal and external factors. Due to the complexity of this disorder, it remains concerning how children with ASD communicate their pain and how observers (i.e., parents, carers, and health care practitioners) respond to these children's pain communication. This scoping review aimed to identify how children with ASD communicate or express their pain. Ten studies met the inclusion criteria for further data extraction. Through reflexive thematic analysis, two main themes were identified: verbal and nonverbal responses used by children with ASD to communicate their pain that could influence pain assessment and management strategies. This review highlighted that children with ASD utilized various verbal and nonverbal methods to communicate their pain experiences and that these methods differed compared to children without disabilities. Furthermore, this review emphasizes the importance of holistic pain assessment strategies as well as additional pictorial support for children with ASD. This review recommends that future research should focus on understanding how the inclusion of different stakeholders in pain assessment for children with ASD, can contribute to holistic pain assessment.
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Affiliation(s)
- Ensa Johnson
- Department of Inclusive Education, College of EducationUniversity of South AfricaPretoriaSouth Africa
| | - Karen van Zijl
- School of the Arts: Visual ArtsUniversity of South AfricaPretoriaSouth Africa
| | - Ariné Kuyler
- Department of Inclusive Education, College of EducationUniversity of South AfricaPretoriaSouth Africa
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2
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Olde Heuvel F, Ouali Alami N, Aousji O, Pogatzki-Zahn E, Zahn PK, Wilhelm H, Deshpande D, Khatamsaz E, Catanese A, Woelfle S, Schön M, Jain S, Grabrucker S, Ludolph AC, Verpelli C, Michaelis J, Boeckers TM, Roselli F. Shank2 identifies a subset of glycinergic neurons involved in altered nociception in an autism model. Mol Autism 2023; 14:21. [PMID: 37316943 DOI: 10.1186/s13229-023-00552-7] [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: 10/27/2022] [Accepted: 05/26/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Autism Spectrum Disorders (ASD) patients experience disturbed nociception in the form of either hyposensitivity to pain or allodynia. A substantial amount of processing of somatosensory and nociceptive stimulus takes place in the dorsal spinal cord. However, many of these circuits are not very well understood in the context of nociceptive processing in ASD. METHODS We have used a Shank2-/- mouse model, which displays a set of phenotypes reminiscent of ASD, and performed behavioural and microscopic analysis to investigate the role of dorsal horn circuitry in nociceptive processing of ASD. RESULTS We determined that Shank2-/- mice display increased sensitivity to formalin pain and thermal preference, but a sensory specific mechanical allodynia. We demonstrate that high levels of Shank2 expression identifies a subpopulation of neurons in murine and human dorsal spinal cord, composed mainly by glycinergic interneurons and that loss of Shank2 causes the decrease in NMDAR in excitatory synapses on these inhibitory interneurons. In fact, in the subacute phase of the formalin test, glycinergic interneurons are strongly activated in wild type (WT) mice but not in Shank2-/- mice. Consequently, nociception projection neurons in laminae I are activated in larger numbers in Shank2-/- mice. LIMITATIONS Our investigation is limited to male mice, in agreement with the higher representation of ASD in males; therefore, caution should be applied to extrapolate the findings to females. Furthermore, ASD is characterized by extensive genetic diversity and therefore the findings related to Shank2 mutant mice may not necessarily apply to patients with different gene mutations. Since nociceptive phenotypes in ASD range between hyper- and hypo-sensitivity, diverse mutations may affect the circuit in opposite ways. CONCLUSION Our findings prove that Shank2 expression identifies a new subset of inhibitory interneurons involved in reducing the transmission of nociceptive stimuli and whose unchecked activation is associated with pain hypersensitivity. We provide evidence that dysfunction in spinal cord pain processing may contribute to the nociceptive phenotypes in ASD.
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Affiliation(s)
| | - Najwa Ouali Alami
- Department of Neurology, Ulm University, Ulm, Germany
- International PhD Program, Ulm University, Ulm, Germany
| | | | - Esther Pogatzki-Zahn
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - Peter K Zahn
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
- Clinic for Anesthesiology, Intensive Care and Pain Medicine, University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - Hanna Wilhelm
- Department of Neurology, Ulm University, Ulm, Germany
| | | | | | - Alberto Catanese
- Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Sarah Woelfle
- Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Michael Schön
- Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Sanjay Jain
- Department of Internal Medicine (Renal), Pathology and Immunology, Washington University School of Medicine, St. Louis, USA
| | | | - Albert C Ludolph
- Department of Neurology, Ulm University, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Chiara Verpelli
- Institute of Neuroscience, National Science Council, Milan, Italy
| | | | - Tobias M Boeckers
- Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany.
- Department of Anatomy and Cell Biology, Ulm University, Albert-Einstein Allee 11, 89081, Ulm, Germany.
| | - Francesco Roselli
- Department of Neurology, Ulm University, Ulm, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany.
- Center for Biomedical Research (ZBF), Helmholtzstraße 8/2, 89081, Ulm, Germany.
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3
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Hoffman T, Bar-Shalita T, Granovsky Y, Gal E, Kalingel-Levi M, Dori Y, Buxbaum C, Yarovinsky N, Weissman-Fogel I. Indifference or hypersensitivity? Solving the riddle of the pain profile in individuals with autism. Pain 2023; 164:791-803. [PMID: 36730631 DOI: 10.1097/j.pain.0000000000002767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Excitatory-inhibitory (E/I) imbalance is a mechanism that underlies autism spectrum disorder, but it is not systematically tested for pain processing. We hypothesized that the pain modulation profile (PMP) in autistic individuals is characterized by less efficient inhibitory processes together with a facilitative state, indicative of a pronociceptive PMP. Fifty-two adults diagnosed with autism and 52 healthy subjects, age matched and sex matched, underwent quantitative sensory testing to assess the function of the (1) pain facilitatory responses to phasic, repetitive, and tonic heat pain stimuli and (2) pain inhibitory processes of habituation and conditioned pain modulation. Anxiety, pain catastrophizing, sensory, and pain sensitivity were self-reported. The autistic group reported significantly higher pain ratings of suprathreshold single ( P = 0.001), repetitive (46°C- P = 0.018; 49°C- P = 0.003; 52°C- P < 0.001), and tonic ( P = 0.013) heat stimuli that were cross correlated ( r = 0.48-0.83; P < 0.001) and associated with sensitivity to daily life pain situations ( r = 0.39-0.45; P < 0.005) but not with psychological distress levels. Hypersensitivity to experimental pain was attributed to greater autism severity and sensory hypersensitivity to daily stimuli. Subjects with autism efficiently inhibited phasic but not tonic heat stimuli during conditioned pain modulation. In conclusion, in line with the E/I imbalance mechanism, autism is associated with a pronociceptive PMP expressed by hypersensitivity to daily stimuli and experimental pain and less-efficient inhibition of tonic pain. The latter is an experimental pain model resembling clinical pain. These results challenge the widely held belief that individuals with autism are indifferent to pain and should raise caregivers' awareness of pain sensitivity in autism.
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Affiliation(s)
- Tseela Hoffman
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Yelena Granovsky
- Department of Neurology, Rambam Health Care Center, Haifa, Israel
- Laboratory of Clinical Neurophysiology, Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Eynat Gal
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Merry Kalingel-Levi
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Yael Dori
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Chen Buxbaum
- Department of Neurology, Rambam Health Care Center, Haifa, Israel
| | - Natalya Yarovinsky
- Department of Cognitive Neurology, Rambam Health Care Center, Haifa, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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4
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Yasuda Y, Matsumoto J, Miura K, Hasegawa N, Hashimoto R. Genetics of autism spectrum disorders and future direction. J Hum Genet 2023; 68:193-197. [PMID: 36038624 DOI: 10.1038/s10038-022-01076-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/23/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022]
Abstract
Autism spectrum disorders (ASDs) have been increasing in prevalence. ASD is a complex human genetic disorder with high heredity and involves interactions between genes and the environment. A significant inheritance pattern in ASD involves a rare genetic mutation; common copy number variants refer to duplication or deletion of stretches of chromosomal loci or protein-disrupting single-nucleotide variants. Haploinsufficiency is one of the more common single-gene causes of ASD, explaining at least 0.5% of cases. Epigenetic mechanisms, such as DNA methylation, act at an interface of genetic and environmental risk and protective factors. Advances in genome-wide sequencing have broadened the view of the human methylome and have revealed the organization of the human genome into large-scale methylation domains with a footprint over neurologically important genes involved in embryonic development. Psychiatric disorders, including ASD, are expected to be diagnosed based on their genetically regulated pathophysiology and to be linked to their treatment.
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Affiliation(s)
- Yuka Yasuda
- Life Grow Blliliant Mental Clinic, Medical Corporation Foster, Osaka, Japan.
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
| | - Junya Matsumoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Naomi Hasegawa
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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5
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Atypical Response to Affective Touch in Children with Autism: Multi-Parametric Exploration of the Autonomic System. J Clin Med 2022; 11:jcm11237146. [PMID: 36498717 PMCID: PMC9737198 DOI: 10.3390/jcm11237146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
This study aimed at evaluating the autonomic response to pleasant affective touch in children with Autism Spectrum Disorders (ASD) and age-matched typically developing (TD) peers, thanks to multiple autonomic nervous system (ANS) parameters and by contrasting CT (C-tactile fibers) high- vs. low-density territory stimulations. We measured pupil diameter, skin conductance, and heart rate during gentle stroking of two skin territories (CT high- and low-density, respectively, forearm and palm of the hand) in thirty 6-12-year-old TD children and twenty ASD children. TD children showed an increase in pupil diameter and skin conductance associated with a heart rate deceleration in response to tactile stimulations at the two locations. Only the pupil was influenced by the stimulated location, with a later dilation peak following CT low-density territory stimulation. Globally, ASD children exhibited reduced autonomic responses, as well as different ANS baseline values compared to TD children. These atypical ANS responses to pleasant touch in ASD children were not specific to CT-fiber stimulation. Overall, these results point towards both basal autonomic dysregulation and lower tactile autonomic evoked responses in ASD, possibly reflecting lower arousal and related to social disengagement.
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Hsu JW, Tsai SJ, Bai YM, Huang KL, Su TP, Chen TJ, Chen MH. Risk of exposure to prescription opioids in children and adolescents with autism spectrum disorder: A nationwide longitudinal study. Autism Res 2022; 15:2192-2199. [PMID: 36054259 DOI: 10.1002/aur.2806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 08/15/2022] [Indexed: 12/15/2022]
Abstract
Whether children and adolescents with autism spectrum disorder (ASD) are more likely to be exposed to prescription opioids than others remains unknown. The Taiwan National Health Insurance Research Database was employed, and 14,849 children and adolescents with ASD and 148,490 age- and sex-matched non-ASD controls were enrolled between 2001 and 2009 and followed up till the end of 2011. Those exposed to prescription opioids during the follow-up period were identified. Patients with ASD were more likely to be exposed to prescription opioids (hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 4.50-5.45), including intravenous or intramuscular opioids (HR: 5.80, 95% CI: 5.23-6.43) and oral or transcutaneous opioids (HR: 2.32, 95% CI: 1.87-2.89), than were non-ASD controls. Furthermore, the ASD cohort had the increased likelihood of cumulative exposure of >14 days (HR: 6.19, 95% CI: 4.91-7.79) and >30 days (HR: 7.17, 95% CI: 5.19-9.90) to prescription opioids compared with the control cohort. ASD was a risk factor for exposure to prescription opioids. Close monitoring of prescription opioid use is necessary for at-risk children and adolescents with ASD, such as those having with or chronic pain. We found that patients with ASD were more likely to be exposed to prescription opioids, including intravenous or intramuscular opioids and oral or transcutaneous opioids, than were non-ASD controls. We suggest that close monitoring of prescription opioid use is necessary for at-risk children and adolescents with ASD, such as those having with or chronic pain.
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Affiliation(s)
- Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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7
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Tordjman S. Aggressive behavior: A language to be understood. Encephale 2022; 48 Suppl 1:S4-S13. [DOI: 10.1016/j.encep.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022]
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8
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Bogdanova OV, Bogdanov VB, Pizano A, Bouvard M, Cazalets JR, Mellen N, Amestoy A. The Current View on the Paradox of Pain in Autism Spectrum Disorders. Front Psychiatry 2022; 13:910824. [PMID: 35935443 PMCID: PMC9352888 DOI: 10.3389/fpsyt.2022.910824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/17/2022] [Indexed: 01/18/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder, which affects 1 in 44 children and may cause severe disabilities. Besides socio-communicational difficulties and repetitive behaviors, ASD also presents as atypical sensorimotor function and pain reactivity. While chronic pain is a frequent co-morbidity in autism, pain management in this population is often insufficient because of difficulties in pain evaluation, worsening their prognosis and perhaps driving higher mortality rates. Previous observations have tended to oversimplify the experience of pain in autism as being insensitive to painful stimuli. Various findings in the past 15 years have challenged and complicated this dogma. However, a relatively small number of studies investigates the physiological correlates of pain reactivity in ASD. We explore the possibility that atypical pain perception in people with ASD is mediated by alterations in pain perception, transmission, expression and modulation, and through interactions between these processes. These complex interactions may account for the great variability and sometimes contradictory findings from the studies. A growing body of evidence is challenging the idea of alterations in pain processing in ASD due to a single factor, and calls for an integrative view. We propose a model of the pain cycle that includes the interplay between the molecular and neurophysiological pathways of pain processing and it conscious appraisal that may interfere with pain reactivity and coping in autism. The role of social factors in pain-induced response is also discussed. Pain assessment in clinical care is mostly based on subjective rather than objective measures. This review clarifies the strong need for a consistent methodology, and describes innovative tools to cope with the heterogeneity of pain expression in ASD, enabling individualized assessment. Multiple measures, including self-reporting, informant reporting, clinician-assessed, and purely physiological metrics may provide more consistent results. An integrative view on the regulation of the pain cycle offers a more robust framework to characterize the experience of pain in autism.
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Affiliation(s)
- Olena V. Bogdanova
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, Bordeaux, France
| | - Volodymyr B. Bogdanov
- Laboratoire EA 4136 – Handicap Activité Cognition Santé HACS, Collège Science de la Sante, Institut Universitaire des Sciences de la Réadaptation, Université de Bordeaux, Bordeaux, France
| | - Adrien Pizano
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, Bordeaux, France
- Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Bordeaux, France
| | - Manuel Bouvard
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, Bordeaux, France
- Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Bordeaux, France
| | - Jean-Rene Cazalets
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, Bordeaux, France
| | - Nicholas Mellen
- Department of Neurology, University of Louisville, Louisville, KY, United States
| | - Anouck Amestoy
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, Bordeaux, France
- Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Bordeaux, France
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9
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Wong ASK, Burns S, Woodruff E. Examining the impact of social stressor stimuli in eliciting physiological reactivity in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e060048. [PMID: 35768097 PMCID: PMC9244685 DOI: 10.1136/bmjopen-2021-060048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Stress is not experienced the same by everyone. Some individuals, such as individuals with autism spectrum disorder (ASD), are at risk of heightened sensitivity to stress responses. ASD is a neurodevelopmental disorder commonly characterised by deficits in social communication and social interaction. Among different stressor stimuli, social stressors are particularly worth our attention due to the social and communication challenges inherent in ASD. This study aims to systematically evaluate different social stressor stimuli in eliciting physiological reactivity in ASD, focusing on the children and adolescent population. METHODS AND ANALYSIS We designed a study protocol for this study and submitted it to PROSPERO for systematic review registration. Any studies with children and adolescents with ASD between the ages of 0 and 18 in clinical and community settings will be included. All types of social stressor interventions will be included. The outcome of interest will include studies with physiological activity of the participants being measured, for example, measures related to autonomic functioning, electrodermal functioning and cortisol level. The primary literature sources will be across four electronic databases: MEDLINE, Embase, PsycInfo and CINAHL in August 2021. The second source of literature will be across grey literature, including ProQuest Dissertations & Theses Global and across clinical trial registries in August 2021. Hand searching of references will be performed on the reference lists of all included studies. Two volunteers pursuing postgraduate-level studies will independently search and screen potential studies for eligibility. Finally, all references considered by hand searching will be reviewed by two researchers. The methodological quality of the research will be assessed by adopting the quality assessment used by a previous study. The assessment consists of four primary categories: descriptive validity, internal validity, external validity and statistical conclusion validity. ETHICS AND DISSEMINATION No ethical approval is required for this study. Results will be disseminated through conferences and publications in relevant peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021244039.
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Affiliation(s)
- Agnes S K Wong
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Samantha Burns
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Earl Woodruff
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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10
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Wotton JM, Peterson E, Flenniken AM, Bains RS, Veeraragavan S, Bower LR, Bubier JA, Parisien M, Bezginov A, Haselimashhadi H, Mason J, Moore MA, Stewart ME, Clary DA, Delbarre DJ, Anderson LC, D'Souza A, Goodwin LO, Harrison ME, Huang Z, Mckay M, Qu D, Santos L, Srinivasan S, Urban R, Vukobradovic I, Ward CS, Willett AM, Braun RE, Brown SD, Dickinson ME, Heaney JD, Kumar V, Lloyd KK, Mallon AM, McKerlie C, Murray SA, Nutter LM, Parkinson H, Seavitt JR, Wells S, Samaco RC, Chesler EJ, Smedley D, Diatchenko L, Baumbauer KM, Young EE, Bonin RP, Mandillo S, White JK. Identifying genetic determinants of inflammatory pain in mice using a large-scale gene-targeted screen. Pain 2022; 163:1139-1157. [PMID: 35552317 PMCID: PMC9100450 DOI: 10.1097/j.pain.0000000000002481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 02/03/2023]
Abstract
ABSTRACT Identifying the genetic determinants of pain is a scientific imperative given the magnitude of the global health burden that pain causes. Here, we report a genetic screen for nociception, performed under the auspices of the International Mouse Phenotyping Consortium. A biased set of 110 single-gene knockout mouse strains was screened for 1 or more nociception and hypersensitivity assays, including chemical nociception (formalin) and mechanical and thermal nociception (von Frey filaments and Hargreaves tests, respectively), with or without an inflammatory agent (complete Freund's adjuvant). We identified 13 single-gene knockout strains with altered nocifensive behavior in 1 or more assays. All these novel mouse models are openly available to the scientific community to study gene function. Two of the 13 genes (Gria1 and Htr3a) have been previously reported with nociception-related phenotypes in genetically engineered mouse strains and represent useful benchmarking standards. One of the 13 genes (Cnrip1) is known from human studies to play a role in pain modulation and the knockout mouse reported herein can be used to explore this function further. The remaining 10 genes (Abhd13, Alg6, BC048562, Cgnl1, Cp, Mmp16, Oxa1l, Tecpr2, Trim14, and Trim2) reveal novel pathways involved in nociception and may provide new knowledge to better understand genetic mechanisms of inflammatory pain and to serve as models for therapeutic target validation and drug development.
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Affiliation(s)
| | - Emma Peterson
- The Jackson Laboratory, Bar Harbor, ME, United States
| | - Ann M. Flenniken
- The Centre for Phenogenomics, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Rasneer S. Bains
- The Mary Lyon Centre, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Surabi Veeraragavan
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | - Lynette R. Bower
- Mouse Biology Program, University of California-Davis, Davis, CA, United States
| | | | - Marc Parisien
- Department of Anesthesia, Faculty of Medicine, Faculty of Dentistry, McGill University, Genome Building, Montreal, QC, Canada
| | - Alexandr Bezginov
- The Centre for Phenogenomics, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Hamed Haselimashhadi
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, Cambridgeshire, United Kingdom
| | - Jeremy Mason
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, Cambridgeshire, United Kingdom
| | | | - Michelle E. Stewart
- The Mary Lyon Centre, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Dave A. Clary
- Mouse Biology Program, University of California-Davis, Davis, CA, United States
| | - Daniel J. Delbarre
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | | | - Abigail D'Souza
- The Centre for Phenogenomics, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | | | - Mark E. Harrison
- The Mary Lyon Centre, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Ziyue Huang
- The Centre for Phenogenomics, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Matthew Mckay
- The Jackson Laboratory, Bar Harbor, ME, United States
| | - Dawei Qu
- The Centre for Phenogenomics, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Luis Santos
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Subhiksha Srinivasan
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
| | - Rachel Urban
- The Jackson Laboratory, Bar Harbor, ME, United States
| | - Igor Vukobradovic
- The Centre for Phenogenomics, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Christopher S. Ward
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, United States
| | | | | | - Steve D.M. Brown
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Mary E. Dickinson
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, United States
| | - Jason D. Heaney
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
| | - Vivek Kumar
- The Jackson Laboratory, Bar Harbor, ME, United States
| | - K.C. Kent Lloyd
- Mouse Biology Program, University of California-Davis, Davis, CA, United States
- Department of Surgery, School of Medicine, University of California-Davis, Davis, CA, United States
| | - Ann-Marie Mallon
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Colin McKerlie
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Lauryl M.J. Nutter
- The Centre for Phenogenomics, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Helen Parkinson
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, Cambridgeshire, United Kingdom
| | - John R. Seavitt
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
| | - Sara Wells
- The Mary Lyon Centre, MRC Harwell Institute, Didcot, Oxfordshire, United Kingdom
| | - Rodney C. Samaco
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | | | - Damian Smedley
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Luda Diatchenko
- Department of Anesthesia, Faculty of Medicine, Faculty of Dentistry, McGill University, Genome Building, Montreal, QC, Canada
| | | | - Erin E. Young
- Anesthesiology, University of Kansas School of Medicine, KU Medical Center, Kansas City, KS, United States
| | - Robert P. Bonin
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Silvia Mandillo
- Institute of Biochemistry and Cell Biology-National Research Council, IBBC-CNR, Monterotondo (RM), Italy
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11
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Trudel SM, Winter EL, Fitzmaurice B, Norman G, Bray CR. Integration of physical health and sensory processing assessment for children with autism spectrum disorder in schools. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sierra M. Trudel
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Emily L. Winter
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Brenna Fitzmaurice
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Gina Norman
- Department of School Psychology University of Connecticut Storrs Connecticut USA
| | - Clark R. Bray
- Department of Mechanical Engineering University of Connecticut Storrs Connecticut USA
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12
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Zhang W, Zhuo S, Li X, Peng W. Autistic Traits and Empathy for Others' Pain Among the General Population: Test of the Mediating Effects of First-Hand Pain Sensitivity. J Autism Dev Disord 2022; 53:2006-2020. [PMID: 35217943 DOI: 10.1007/s10803-022-05471-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 12/30/2022]
Abstract
Autism spectrum disorders (ASD) are characterized by reduced pain empathy-a process that is grounded in first-hand pain perception. Because autistic traits are continuously distributed in the general population, we hypothesized that first-hand pain sensitivity would mediate the link between autistic traits and pain empathy. After controlling for alexithymia, higher autistic traits were associated with lower cognitive and emotional empathy in response to others' pain, as well as lower sensitivity to cold and heat pain (higher cold pain tolerance and lower laser heat pain-intensity ratings). Importantly, pain sensitivity fully mediated the link between autistic traits and pain empathy. These findings highlight the role of atypical first-hand pain sensitivity in the lack of pain empathy observed in people with high autistic traits or ASD.
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Affiliation(s)
- Wenyun Zhang
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China
| | - Shiwei Zhuo
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China
| | - Xiaoyun Li
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Nanhai Ave 3688, Shenzhen, 518060, Guangdong, China.
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13
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Voluntary exercise attenuates nociceptive abnormalities with no significant alterations of social interaction deficits in the BTBR mouse model of autism. Behav Brain Res 2021; 420:113727. [PMID: 34954299 DOI: 10.1016/j.bbr.2021.113727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022]
Abstract
Due to the financial burden and undesired side effects of treatment options, researchers have begun exploring alternative methods of treating autism spectrum disorder (ASD). Based on research suggesting impressive health benefits of engaging in physical activity, exercise treatment to alleviate symptoms could be a more cost effective alternative to pharmaceutical interventions. This study examined the effects of physical exercise on nociceptive responses and social interactions in an autism mouse model (BTBR T+ Itpr3tf/J). Subjects (n = 32) were separated into groups (BTBR vs B6 controls) based on the genetic strain and activity condition they were assigned. When compared to B6 controls, the BTBR mice demonstrated thermal hypoalgesia that normalized following 5 weeks of voluntary wheel running. However, exercise did not significantly attenuate social interaction deficits in BTBR mice, despite scores trending toward a positive direction. These results suggest that exercise could serve as a potential additive to other therapies for abnormal nociception in individuals with Autism Spectrum Disorder.
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14
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Tarnowska K, Gruczyńska-Sękowska E, Kowalska D, Majewska E, Kozłowska M, Winkler R. The opioid excess theory in autism spectrum disorders - is it worth investigating further? Crit Rev Food Sci Nutr 2021:1-14. [PMID: 34702104 DOI: 10.1080/10408398.2021.1996329] [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: 12/22/2022]
Abstract
Autism spectrum disorders (ASD) are defined as neurodevelopmental disorders, which are highly variable in nature and do not form a uniform picture, either in terms of symptomatology or depth of the disturbance. Diagnosis of ASD is made for children who show signs of impairment in social interaction, communication and cognitive skills. The exact cause of autism spectrum disorders has not been determined to date. Although there is no cure for ASD, a variety interventions have been proposed. The most commonly used restrictive dietary intervention is the gluten-free casein-free diet (GFCF), which is based on the opioid excess theory. This paper summarizes and discusses research on the core elements of the opioid excess theory in ASD: increased levels of opioid peptides in body fluids in ASD patients, increased intestinal permeability, altered peptidase activity and the effectiveness of GFCF diet in alleviating symptoms of ASD. Furthermore, we discuss the difficulties and their causes in conducting research with ASD patients. The assumptions of the opioid excess theory have neither been definitively confirmed nor disproved. Research in this area should continue, taking into account the highest possible quality standards and the specific needs and abilities of patients with ASD and their families.
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Affiliation(s)
- Katarzyna Tarnowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Eliza Gruczyńska-Sękowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Dorota Kowalska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Ewa Majewska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Mariola Kozłowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Renata Winkler
- Department of Organizational Behaviors, Cracow University of Economics, Cracow, Poland
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15
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Heinrichs B, Liu B, Zhang J, Meents JE, Le K, Erickson A, Hautvast P, Zhu X, Li N, Liu Y, Spehr M, Habel U, Rothermel M, Namer B, Zhang X, Lampert A, Duan G. The Potential Effect of Na v 1.8 in Autism Spectrum Disorder: Evidence From a Congenital Case With Compound Heterozygous SCN10A Mutations. Front Mol Neurosci 2021; 14:709228. [PMID: 34385907 PMCID: PMC8354588 DOI: 10.3389/fnmol.2021.709228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/07/2021] [Indexed: 12/17/2022] Open
Abstract
Apart from the most prominent symptoms in Autism spectrum disorder (ASD), namely deficits in social interaction, communication and repetitive behavior, patients often show abnormal sensory reactivity to environmental stimuli. Especially potentially painful stimuli are reported to be experienced in a different way compared to healthy persons. In our present study, we identified an ASD patient carrying compound heterozygous mutations in the voltage-gated sodium channel (VGSC) Na v 1.8, which is preferentially expressed in sensory neurons. We expressed both mutations, p.I1511M and p.R512∗, in a heterologous expression system and investigated their biophysical properties using patch-clamp recordings. The results of these experiments reveal that the p.R512∗ mutation renders the channel non-functional, while the p.I1511M mutation showed only minor effects on the channel's function. Behavioral experiments in a Na v 1.8 loss-of-function mouse model additionally revealed that Na v 1.8 may play a role in autism-like symptomatology. Our results present Na v 1.8 as a protein potentially involved in ASD pathophysiology and may therefore offer new insights into the genetic basis of this disease.
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Affiliation(s)
- Björn Heinrichs
- Institute of Physiology, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Baowen Liu
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jannis E. Meents
- Institute of Physiology, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Kim Le
- Department of Chemosensation, AG Neuromodulation, Institute for Biology II, RWTH Aachen University, Aachen, Germany
| | - Andelain Erickson
- Institute of Physiology, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Petra Hautvast
- Institute of Physiology, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Xiwen Zhu
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ningbo Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Liu
- Institute of Physiology, Uniklinik RWTH Aachen University, Aachen, Germany
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Marc Spehr
- Department of Chemosensation, Institute for Biology II, RWTH Aachen University, Aachen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Markus Rothermel
- Institute for Physiology and Cell Biology, University of Veterinary Medicine, Foundation, Hanover, Germany
| | - Barbara Namer
- Research Group Neurosciences of the Interdisciplinary Center for Clinical Research (IZKF), Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Xianwei Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Angelika Lampert
- Institute of Physiology, Uniklinik RWTH Aachen University, Aachen, Germany
| | - Guangyou Duan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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16
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La Montanara P, Hervera A, Baltussen LL, Hutson TH, Palmisano I, De Virgiliis F, Kong G, Chadwick J, Gao Y, Bartus K, Majid QA, Gorgoraptis N, Wong K, Downs J, Pizzorusso T, Ultanir SK, Leonard H, Yu H, Millar DS, Istvan N, Mazarakis ND, Di Giovanni S. Cyclin-dependent-like kinase 5 is required for pain signaling in human sensory neurons and mouse models. Sci Transl Med 2021; 12:12/551/eaax4846. [PMID: 32641489 DOI: 10.1126/scitranslmed.aax4846] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 12/10/2019] [Accepted: 04/05/2020] [Indexed: 12/19/2022]
Abstract
Cyclin-dependent-like kinase 5 (CDKL5) gene mutations lead to an X-linked disorder that is characterized by infantile epileptic encephalopathy, developmental delay, and hypotonia. However, we found that a substantial percentage of these patients also report a previously unrecognized anamnestic deficiency in pain perception. Consistent with a role in nociception, we found that CDKL5 is expressed selectively in nociceptive dorsal root ganglia (DRG) neurons in mice and in induced pluripotent stem cell (iPS)-derived human nociceptors. CDKL5-deficient mice display defective epidermal innervation, and conditional deletion of CDKL5 in DRG sensory neurons impairs nociception, phenocopying CDKL5 deficiency disorder in patients. Mechanistically, CDKL5 interacts with calcium/calmodulin-dependent protein kinase II α (CaMKIIα) to control outgrowth and transient receptor potential cation channel subfamily V member 1 (TRPV1)-dependent signaling, which are disrupted in both CDKL5 mutant murine DRG and human iPS-derived nociceptors. Together, these findings unveil a previously unrecognized role for CDKL5 in nociception, proposing an original regulatory mechanism for pain perception with implications for future therapeutics in CDKL5 deficiency disorder.
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Affiliation(s)
- Paolo La Montanara
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK.
| | - Arnau Hervera
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK.,Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Department of Cell Biology, Physiology and Immunology, Faculty of Biology & Institute of Neuroscience, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Lucas L Baltussen
- Kinases and Brain Development Laboratory, Francis Crick Institute, London NW1 1AT, UK
| | - Thomas H Hutson
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK
| | - Ilaria Palmisano
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK
| | - Francesco De Virgiliis
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK
| | - Guiping Kong
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK
| | - Jessica Chadwick
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK
| | - Yunan Gao
- Gene Therapy, Centre for Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Katalin Bartus
- Wolfson Centre for Age-Related Diseases, King's College London, Guy's Campus, London Bridge, London SE1 1UL, UK
| | - Qasim A Majid
- National Heart and Lung Institute, Imperial College London, London W12 0NN, UK
| | - Nikos Gorgoraptis
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK
| | - Kingsley Wong
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Jenny Downs
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Tommaso Pizzorusso
- Institute of Neuroscience, National Research Council (CNR), I-56124 Pisa, Italy.,Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, I-50135 Florence, Italy
| | - Sila K Ultanir
- Gene Therapy, Centre for Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Helen Leonard
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Hongwei Yu
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - David S Millar
- Institute of Cancer and Genetics, Cardiff University, Cardiff F14 4ED, UK
| | - Nagy Istvan
- Nociception, Section of Anesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London W12 0NN, UK
| | - Nicholas D Mazarakis
- Gene Therapy, Centre for Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Simone Di Giovanni
- Department of Brain Sciences, Division of Neuroscience, Imperial College London, London W12 0NN, UK.
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17
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Ruelle-Le Glaunec L, Inquimbert P, Hugel S, Schlichter R, Bossu JL. [Nociception pain and autism]. Med Sci (Paris) 2021; 37:141-151. [PMID: 33591257 DOI: 10.1051/medsci/2020280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Autistic subjects frequently display sensory anomalies. Those regarding nociception and its potential outcome, pain, are of crucial interest. Indeed, because of numerous comorbidities, autistic subjects are more often exposed to painful situation. Despite being often considered as less sensitive, experimental studies evaluating this point are failing to reach consensus. Using animal model can help reduce variability and bring, regarding autism, an overview of potential alterations of the nociceptive system at the cellular and molecular level.
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Affiliation(s)
- Lucien Ruelle-Le Glaunec
- CNRS, 5 rue Blaise-Pascal, 67000 Strasbourg, France - Université de Strasbourg, Institut des neurosciences cellulaires et intégratives, UPR 3212, 8 allée du Général Rouvillois, F-67000 Strasbourg, France
| | - Perrine Inquimbert
- CNRS, 5 rue Blaise-Pascal, 67000 Strasbourg, France - Université de Strasbourg, Institut des neurosciences cellulaires et intégratives, UPR 3212, 8 allée du Général Rouvillois, F-67000 Strasbourg, France
| | | | - Rémy Schlichter
- CNRS, 5 rue Blaise-Pascal, 67000 Strasbourg, France - Université de Strasbourg, Institut des neurosciences cellulaires et intégratives, UPR 3212, 8 allée du Général Rouvillois, F-67000 Strasbourg, France
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18
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Zinchuk MS, Avedisova AS, Voinova NI, Kustov GV, Pashnin EV, Gulyaeva NV, Guekht AB. [Pain perception and nonsuicidal self-injurious behavior]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 120:144-152. [PMID: 33459555 DOI: 10.17116/jnevro2020120121144] [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: 11/17/2022]
Abstract
This review focuses on studies of pain threshold and tolerance in individuals with nonsuicidal self-injurious (NSSI) behavior. The data on methods of pain sensitivity studies are presented, with issues in animal modeling of NSSI discussed separately. The results of neuroimaging studies on pain sensitivity in individuals with NSSI are described, along with contribution of genetic factors, psychological variables, and disturbances in opioid and hypothalamic-pituitary-adrenal systems. A critical methodological analysis of the studies on pain sensitivity in individuals with NSSI was performed.
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Affiliation(s)
- M S Zinchuk
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - A S Avedisova
- Scientific and Practical Psychoneurological Center, Moscow, Russia.,Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - N I Voinova
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - G V Kustov
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - E V Pashnin
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - N V Gulyaeva
- Scientific and Practical Psychoneurological Center, Moscow, Russia.,Institute of Higher Nervous Activity and Neurophysiology of RAS, Moscow, Russia
| | - A B Guekht
- Scientific and Practical Psychoneurological Center, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
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19
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Vuattoux D, Colomer-Lahiguera S, Fernandez PA, Jequier Gygax M, Choucair ML, Beck-Popovic M, Diezi M, Manificat S, Latifyan S, Ramelet AS, Eicher M, Chabane N, Renella R. Cancer Care of Children, Adolescents and Adults With Autism Spectrum Disorders: Key Information and Strategies for Oncology Teams. Front Oncol 2021; 10:595734. [PMID: 33552969 PMCID: PMC7856416 DOI: 10.3389/fonc.2020.595734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
Delivering optimal cancer care to children, adolescents and adults with ASD has recently become a healthcare priority and represents a major challenge for all providers involved. In this review, and after consideration of the available evidence, we concisely deliver key information on this heterogenous group of neurodevelopmental disorders, as well as recommendations and concrete tools for the enhanced oncological care of this vulnerable population of patients.
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Affiliation(s)
- Delphine Vuattoux
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Sara Colomer-Lahiguera
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre-Alain Fernandez
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Marine Jequier Gygax
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie-Louise Choucair
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Maja Beck-Popovic
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuel Diezi
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Sabine Manificat
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Sofiya Latifyan
- Division of Medical Oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Nadia Chabane
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Raffaele Renella
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
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20
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Abnormalities in pain sensitivity among individuals with autism spectrum disorder: Evidence from meta-analysis. ACTA PSYCHOLOGICA SINICA 2021. [DOI: 10.3724/sp.j.1041.2021.00613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Emerson ND, Bursch B. Communicating with Youth about Pain: Developmental Considerations. CHILDREN-BASEL 2020; 7:children7100184. [PMID: 33076255 PMCID: PMC7602494 DOI: 10.3390/children7100184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pain experiences can negatively impact children and adolescents, leading to trauma symptoms and nonadherence to important health behaviors. Developmentally-tailored communication strategies may mitigate this risk. METHODS This article reviews cognitive and linguistic developmental factors, within the familial and cultural context, that are important to consider when communicating with youth about acute, procedural, and/or chronic pain. RESULTS Youth undergoing acute or procedural pain benefit from pain education, truthful information about the procedure, and advance preparation. The use of analogies may be particularly helpful for patient understanding of chronic pain development, maintenance, and treatment. Youth with developmental disabilities may express pain differently than their normative peers, requiring adaptation of communication strategies. CONCLUSION Developmentally-tailored pain communication is an important tool for caregivers and healthcare providers that may foster adaptive functioning in youth who experience pain.
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22
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Autism and Migraine: An Unexplored Association? Brain Sci 2020; 10:brainsci10090615. [PMID: 32899972 PMCID: PMC7565535 DOI: 10.3390/brainsci10090615] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
Autism spectrum disorder is characterized by neurological, psychiatric and medical comorbidities—some conditions co-occur so frequently that comorbidity in autism is the rule rather than the exception. The most common autism co-occurring conditions are intellectual disability, language disorders, attention-deficit hyperactivity disorder, epilepsy, gastrointestinal problems, sleep disorders, anxiety, depression, obsessive-compulsive disorder, psychotic disorders, oppositional defiant disorder, and eating disorders. They are well known and studied. Migraine is the most common brain disease in the world, but surprisingly only a few studies investigate the comorbidity between autism and migraine. The aim of this narrative review is to explore the literature reports about the comorbidity between autism and migraine and to investigate the common neurotransmitter, immune, anatomical and genetic abnormalities at the base of these two conditions.
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23
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Selvey P, Stypulkowski K, Waisbren S. Surgical management of the patient living with autism. Surg Open Sci 2020; 1:90-96. [PMID: 32754699 PMCID: PMC7391914 DOI: 10.1016/j.sopen.2019.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/26/2022] Open
Abstract
Background Although 1 in 59 children currently born are diagnosed with autism spectrum disorder (ASD), little is known on how to best manage those patients who require surgical intervention. The purpose of this study is to (1) investigate the best care strategies for surgical patients living with autism spectrum disorder (2) provide recommendations on how to apply those strategies to clinical practice. Methods A literature review was conducted to investigate the best clinical practices for optimizing surgical care for individuals living with autism spectrum disorder. Relevant articles were selected and examined, and individual references from those articles were manually searched using Ovid Medline and Google Scholar. Results The wide spectrum of symptoms associated with autism spectrum disorder pose unique challenges for surgical management. Early coordination with the patient and family optimizes the development of an effective care plan. Strategies include identifying triggers for anxiety as well as soothing mechanisms, performing surgery in the morning, completing preoperative paperwork prior to surgery, choosing appropriate analgesia and anxiolytics, and fast resumption of normal routines. Based on these findings a surgical checklist was created to aid in treating the patient with autism spectrum disorder. The checklist provides insight into navigating the surgical experience and emphasizes planning surgical interventions to most effectively fit individual patient needs. Conclusion The surgical treatment of those living with autism spectrum disorder poses unique challenges for the health care team. The widespread adoption of such individualized approaches encompassing pre/intra/post-operative will become more important as these children grow into adults with increased needs for surgical services. Early coordination optimizes development of an effective care plan. Identifying triggers for anxiety as well as soothing mechanisms can be helpful. Performing surgery first in the morning decreases deviation from normal routines. Completing preoperative paperwork prior to surgery reduces surgical day work. Choosing appropriate analgesia and anxiolytics assists in surgical interventions.
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Affiliation(s)
- Paige Selvey
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States
| | - Katie Stypulkowski
- University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80918, United States
| | - Steven Waisbren
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.,Minneapolis VA Health Care System, 1 Veterans Drive Ste 2J, Minneapolis, MN 55417, United States
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Thiruvengadam M, Venkidasamy B, Thirupathi P, Chung IM, Subramanian U. β-Casomorphin: A complete health perspective. Food Chem 2020; 337:127765. [PMID: 32799161 DOI: 10.1016/j.foodchem.2020.127765] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 07/19/2020] [Accepted: 08/02/2020] [Indexed: 12/20/2022]
Abstract
β-Casomorphin-7 (BCM-7) is a heptapeptide dietary molecule derived from the digestion of the β-casein of dairy and dairy products. In this review, we have covered the extensive details about BCM and its derived peptides out of the gastrointestinal and enzymatic digestion of milk and milk products, its structure and properties, and its immunological aspects related to human health among infants and adults of both genders. We have left judgment about BCM's pros and cons to the reader by describing the details in a cyclopedic perspective. In addition, a section on the possible ways to detect BCMs from their sources using proteomics, genome-based techniques, such as PCR and aptamers, and other analytical techniques equip the reader to get an idea about the details of the diagnostics available and possible applications in future. Overall, this review will provide information to the end-users of milk and milk products to enable them to make their own decisions about BCMs.
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Affiliation(s)
- Muthu Thiruvengadam
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Republic of Korea
| | - Baskar Venkidasamy
- Department of Biotechnology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Prabhu Thirupathi
- Translational Research Platform for Veterinary Biologicals, Tamil Nadu Veterinary and Animal Sciences University, Madhavaram Milk Colony, Chennai 600051, Tamil Nadu, India
| | - Ill-Min Chung
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Republic of Korea
| | - Umadevi Subramanian
- Translational Research Platform for Veterinary Biologicals, Tamil Nadu Veterinary and Animal Sciences University, Madhavaram Milk Colony, Chennai 600051, Tamil Nadu, India.
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Guinchat V, Vlamynck E, Diaz L, Chambon C, Pouzenc J, Cravero C, Baeza-Velasco C, Hamonet C, Xavier J, Cohen D. Compressive Garments in Individuals with Autism and Severe Proprioceptive Dysfunction: A Retrospective Exploratory Case Series. CHILDREN-BASEL 2020; 7:children7070077. [PMID: 32668622 PMCID: PMC7401870 DOI: 10.3390/children7070077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/03/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: Compression garments (CGs) are an adjuvant treatment for generalized joint hypermobility (GJH), including the Ehlers-Danlos syndrome/hypermobility types. The effects of CGs are likely to be related to better proprioceptive control. We aimed to explore the use of CGs in individuals with autism and severe proprioceptive dysfunction (SPD), including individuals with GJH, to control posture and challenging behaviors. (2) Methods: We retrospectively described 14 patients with autism and SPD, including seven with comorbid GJH, who were hospitalized for major challenging behaviors with remaining behavioral symptomatology after the implementation of multidisciplinary approaches, including medication, treatment of organic comorbidities, and behavioral restructuring. Each patient received a CG to wear for at least 1 h (but most often longer) per day for six weeks. We assessed challenging behaviors in these participants with the Aberrant Behavior Checklist (ABC), sensory integration with the Dunn questionnaire, and postural sway and motor performance using a self-designed motricity path at baseline, two weeks, and six weeks. (3) Results: We observed a significant effect on most ABC rating scores at two weeks, which persisted at six weeks (total score, p = 0.004; irritability, p = 0.007; hyperactivity, p = 0.001; lethargy, p = 0.001). Postural control in dorsal and profile positions was significantly improved between before and after wearing the CGs (p = 0.006 and 0.007, respectively). Motor performance was also significantly improved. However, we did not observe a significant change in Dunn sensory scores. During the six-week duration, the treatment was generally well-tolerated. A comorbid GJH diagnosis was not associated with a better outcome. (4) Conclusions: CGs appear to be a promising adjuvant treatment for both behavioral and postural impairments in individuals with autism and SPD.
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Affiliation(s)
- Vincent Guinchat
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
- Psychiatric Section of Mental Development, Psychiatric University Clinic, Lausanne University Hospital (CHUV), Prilly, 1011 Lausanne, Switzerland
| | | | - Lautaro Diaz
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
- Psychiatric Section of Mental Development, Psychiatric University Clinic, Lausanne University Hospital (CHUV), Prilly, 1011 Lausanne, Switzerland
| | - Coralie Chambon
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
| | - Justine Pouzenc
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
| | - Cora Cravero
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
- Interdepartmental Mobile Unit for Complex Situations in Autism, Elan Retrouvé Foundation, 75009 Paris, France
| | - Carolina Baeza-Velasco
- Laboratory of Psychopathology and Health Processes (EA 4057), Université Paris Descartes, Sorbonne Paris Cité, 92100 Boulogne-Billancourt, France;
- INSERM U1061, Neuropsychiatry: Epidemiological and Clinical Research, Department of Emergency Psychiatry and Acute Care, CHU de Montpellier, 34295 Montpellier, France
| | - Claude Hamonet
- Department of Physical Reeducation, University Paris-Est Créteil, 94000 Créteil, France;
| | - Jean Xavier
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
- Department of Child and Adolescent Psychiatry, Henri Laborit Hospital Centre, 86000 Poitiers, France
- CNRS UMR 7295, Cognitive Learning Research Centre, Poitiers University, 86073 Poitiers, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, 75006 Paris, France; (V.G.); (L.D.); (C.C.); (J.P.); (C.C.); (J.X.)
- CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne Université, 75006 Paris, France
- Correspondence: ; Tel.: +33-(0)1-4216-2351
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Palese A, Conforto L, Meloni F, Bordei V, Domenighini A, Bulfone E, Grassetti L, Gonella S. Assessing pain in children with autism spectrum disorders: findings from a preliminary validation study. Scand J Caring Sci 2020; 35:457-467. [PMID: 32311779 DOI: 10.1111/scs.12857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/15/2020] [Accepted: 03/20/2020] [Indexed: 11/29/2022]
Abstract
AIMS Assessing pain in children with autism spectrum disorders (ASDs) can be extremely challenging, since many cannot self-report pain. This study aims to test the validity of the Non-Communicating Children's Pain Checklist - Revised (NCCPC-R) in identifying pain in children and adolescents affected by ASDs. MATERIALS AND METHODS A two-phase validation study based on (a) the translation and cultural adaptation of the NCCPC-R to Italian and to ASD-specific needs and context; and (b) the validation of a modified, 32-item version of the NCCPC-R. In all, 141 carers of children aged 6-16 years with ASDs were asked to recall an in-pain episode and a not-in-pain episode of their child and to rate on a 3-point scale (0 = not at all, 3 = very often) each behaviour included in the tool. Internal consistency (Cronbach's α), explorative and confirmative factorial structure, as well as concurrent and discriminant validity, were all assessed. RESULTS Confirmatory factor analysis established the revised version of the NCCPC-R for children with ASDs (named = NCCPC-RASD ), formed from 10 of the original 30 items categorised into three factors ('Changing in mood', 'Increasing in tension' and 'Alerting reaction') to have an acceptable level of reliability. The tool was internally consistent (α = 0.741 during in-pain episodes, α = 0.790 during not-in-pain episodes) and was able to discriminate between in-pain episodes (13.36 out of 40; CI 95% 12.34-14.39) and not-in-pain episodes (7.84 out of 40; CI 95% 6.86-8.82, p < 0.001). CONCLUSIONS These results provide preliminary evidence that the 10-item version of the NCCPC-RASD is a reliable and valid tool for assessing pain in children with ASD.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Sciences, University of Udine, Udine, Italy
| | | | - Francesca Meloni
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Valeria Bordei
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Alessia Domenighini
- Responsible of Programmes offered at the ProgettoautismoFVG Onlus, Feletto Umberto, Italy
| | | | - Luca Grassetti
- Department of Economics and Statistics, University of Udine, Udine, Italy
| | - Silvia Gonella
- Department of Medical Science, AOU Città della Salute e della Scienza di Torino, Torino, Italy
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Marotta R, Risoleo MC, Messina G, Parisi L, Carotenuto M, Vetri L, Roccella M. The Neurochemistry of Autism. Brain Sci 2020; 10:E163. [PMID: 32182969 PMCID: PMC7139720 DOI: 10.3390/brainsci10030163] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Abstract
Autism spectrum disorder (ASD) refers to complex neurobehavioral and neurodevelopmental conditions characterized by impaired social interaction and communication, restricted and repetitive patterns of behavior or interests, and altered sensory processing. Environmental, immunological, genetic, and epigenetic factors are implicated in the pathophysiology of autism and provoke the occurrence of neuroanatomical and neurochemical events relatively early in the development of the central nervous system. Many neurochemical pathways are involved in determining ASD; however, how these complex networks interact and cause the onset of the core symptoms of autism remains unclear. Further studies on neurochemical alterations in autism are necessary to clarify the early neurodevelopmental variations behind the enormous heterogeneity of autism spectrum disorder, and therefore lead to new approaches for the treatment and prevention of autism. In this review, we aim to delineate the state-of-the-art main research findings about the neurochemical alterations in autism etiology, and focuses on gamma aminobutyric acid (GABA) and glutamate, serotonin, dopamine, N-acetyl aspartate, oxytocin and arginine-vasopressin, melatonin, vitamin D, orexin, endogenous opioids, and acetylcholine. We also aim to suggest a possible related therapeutic approach that could improve the quality of ASD interventions. Over one hundred references were collected through electronic database searching in Medline and EMBASE (Ovid), Scopus (Elsevier), ERIC (Proquest), PubMed, and the Web of Science (ISI).
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Affiliation(s)
- Rosa Marotta
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro 88100, Italy; (R.M.); (M.C.R.)
| | - Maria C. Risoleo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro 88100, Italy; (R.M.); (M.C.R.)
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli 80138, Italy;
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71100, Italy;
| | - Lucia Parisi
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, Palermo 90128, Italy; (L.P.); (M.R.)
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli 80138, Italy;
| | - Luigi Vetri
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo 90127, Italy
| | - Michele Roccella
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, Palermo 90128, Italy; (L.P.); (M.R.)
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28
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Liu J, Chen LL, Shen S, Mao J, Lopes M, Liu S, Kong X. Challenges in the Diagnosis and Management of Pain in Individuals with Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00199-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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29
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Abstract
We tested endogenous pain modulation mechanisms in adults with autism spectrum disorders (ASD). Nineteen ASD adults without intellectual disabilities were included, matched with 19 healthy volunteers on the basis of sex and chronological age. An experimental pain model was used to measure excitatory and inhibitory pain mechanisms in a single session. Statistical analyses indicated that endogenous pain modulation mechanisms in ASD group did not differ significantly from those of healthy adults. The pain scores were very disparate in ASD group with a greater range of extreme scores than in control group. Unlike schizophrenic patients, there was no systematic dysfunction of endogenous excitatory pain modulation mechanisms, but the high variability requires to be wise to interpret the results and formulate conclusion.
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30
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Guinchat V, Cravero C, Lefèvre-Utile J, Cohen D. Multidisciplinary treatment plan for challenging behaviors in neurodevelopmental disorders. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:301-321. [PMID: 32977887 DOI: 10.1016/b978-0-444-64148-9.00022-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Among symptoms that patients with neurodevelopmental disorders can exhibit, challenging behaviors (CBs) are some of the more complex to face, both for caregivers and the patients themselves. They are more frequent in individuals with severe autism spectrum disorders and intellectual disability, and during the transition period from late childhood to young adulthood. Here, we offer an overview of the therapeutic approaches proven worthy in managing CB. Topics include nonpharmacologic treatments (such as behavioral and family interventions), drug prescriptions, and specific intensive care for life-threatening situations, including inpatient stay in specialized neurobehavioral units. Then, we focus on rare, complex, and resistant clinical presentations, mainly based on the authors' clinical experience. We propose a multimodal intervention framework for these complex presentations, embracing developmental and dimensional approaches. A case presentation illustrates the proposed framework, with the aim of serving readers and health practitioners that are facing such cases.
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Affiliation(s)
- Vincent Guinchat
- Psychiatric Section of Mental Development, Psychiatric University Clinic, Lausanne University Hospital, Prilly-Lausanne, Switzerland.
| | - Cora Cravero
- Service de Psychiatrie de l'Enfant et de l'Adolescent, APHP.Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Jean Lefèvre-Utile
- Service de Psychiatrie de l'Enfant et de l'Adolescent, APHP.Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - David Cohen
- Service de Psychiatrie de l'Enfant et de l'Adolescent, APHP.Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Institut des Systèmes Intelligents et Robotiques, Sorbonne Université, Paris, France
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31
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Kirsten TB, Casarin RC, Bernardi MM, Felicio LF. Pioglitazone abolishes cognition impairments as well as BDNF and neurotensin disturbances in a rat model of autism. Biol Open 2019; 8:bio.041327. [PMID: 31036753 PMCID: PMC6550086 DOI: 10.1242/bio.041327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We have shown that exposure of rats to lipopolysaccharide (LPS) during gestation induces autistic-like behaviors in juvenile offspring and pioglitazone post treatment corrects social and communication deficits. The first objective of the present study was to evaluate the cognition of the rats, because this is also a behavioral sphere committed in autism. Second, biomarkers related to pioglitazone pathways and autism were studied to try to understand their mechanisms. We used our rat model of autism and pioglitazone was administered daily to these young offspring. T-maze spontaneous alternations tests, plasma levels of brain-derived neurotrophic factor (BDNF), beta-endorphin, neurotensin, oxytocin, and substance P were all studied. Exposure of rats to LPS during gestation induced cognitive deficits in the young offspring, elevated BDNF levels and decreased neurotensin levels. Daily postnatal pioglitazone treatment abolished cognition impairments as well as BDNF and neurotensin disturbances. Together with our previous studies, we suggest pioglitazone as a candidate for the treatment of autism, because it improved the responses of the three most typical autistic-like behaviors. BDNF and neurotensin also appeared to be related to the autistic-like behaviors and should be considered for therapeutic purposes. Summary: Exposure of rats to lipopolysaccharide during gestation induced autistic-like behaviors in the juvenile offspring. Daily postnatal pioglitazone treatment abolished cognition impairments as well as brain-derived neurotrophic factor and neurotensin disturbances.
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Affiliation(s)
- Thiago B Kirsten
- Department of Pathology, School of Veterinary Medicine, University of São Paulo, São Paulo 05508-270, Brazil .,Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, Brazil
| | - Renato C Casarin
- Graduate Program of Dentistry, Paulista University, São Paulo 04026-002, Brazil
| | - Maria M Bernardi
- Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, Brazil.,Graduate Program of Dentistry, Paulista University, São Paulo 04026-002, Brazil
| | - Luciano F Felicio
- Department of Pathology, School of Veterinary Medicine, University of São Paulo, São Paulo 05508-270, Brazil
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Whitney DG, Shapiro DN, Peterson MD, Warschausky SA. Factors associated with depression and anxiety in children with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:408-417. [PMID: 30588708 PMCID: PMC6469993 DOI: 10.1111/jir.12583] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/25/2018] [Accepted: 12/01/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND Individuals with intellectual disabilities (ID) are at increased risk for depression and anxiety disorders; however, there is a paucity of research that pertains to associative factors for these mental health disorders in this population. The objective of this investigation was to determine factors associated with depression and anxiety problems in children with ID. METHODS Children 6-17 years with ID (n = 423; 63% male) from the 2016 National Survey of Children's Health were included in this cross-sectional study. Outcome measures included depression and anxiety problems. Predictor variables included sociodemographics, ID severity, co-morbid conditions (autism spectrum disorders, epilepsy, cerebral palsy, Down syndrome and attention-deficit/hyperactivity disorder), physical factors (i.e. physical activity, sleep duration and pain) and social factors (e.g. participation in activities and bully victimisation). Multivariable logistic regression was performed to determine the association between all factors and depression and/or anxiety problems among children with ID. RESULTS The prevalence of depression and/or anxiety problems was 35.4%. After adjusting for sociodemographics, Hispanic race was associated with lower odds [odds ratio (OR), 0.3; 95% confidence interval (CI), 0.1-0.8] of depression and/or anxiety problems. After adjusting for race, co-morbid conditions, and physical and social factors, autism spectrum disorders (OR, 4.4; 95% CI, 1.1-10.1), Down syndrome (OR, 0.2; 95% CI, 0.1-0.8), attention-deficit/hyperactivity disorder (OR, 5.9; 95% CI, 2.5-14.3), pain (OR, 7.0; 95% CI, 2.9-17.1) and bully victimisation (OR 2.3; 95% CI, 1.0-5.3) were each associated with depression and/or anxiety problems. CONCLUSIONS The present study identified both treatable and modifiable, as well as unmodifiable, factors associated with depression and/or anxiety problems in children with ID.
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Affiliation(s)
- D G Whitney
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - D N Shapiro
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - M D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - S A Warschausky
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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Corbett BA, Muscatello RA, Baldinger C. Comparing stress and arousal systems in response to different social contexts in children with ASD. Biol Psychol 2019; 140:119-130. [PMID: 30557600 PMCID: PMC6471662 DOI: 10.1016/j.biopsycho.2018.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 12/28/2022]
Abstract
Response to psychological stress can vary based on the extent to which the context is perceived as stressful, especially under different social conditions. The purpose of this preliminary study was to compare physiological stress (cortisol) and regulation (respiratory sinus arrhythmia, RSA) of 10-12 year old children with autism spectrum disorder (ASD, n = 31) or typical development (TD, n = 25) when exposed to two social stress protocols. The extent to which perceived emotion (affect recognition) and anxiety (state and trait) mediate the stress response was also explored. Results revealed different patterns of stress responses dependent on the type of stressor. During a friendly social interaction, both groups generally showed an adaptive, synergistic response between cortisol and RSA. In response to social evaluation, however, the ASD group did not show correlating responses between physiological systems, which was likely due to a blunted stress response to the social evaluative stressor. The ability to recognize neutral faces mediated the relationship between diagnostic group and physiological response to social evaluation, indicating that perception of threat is essential to triggering a stress response. The current study emphasizes the need to consider the important role of social context, social perception, and perceived anxiety when examining social interaction and stress.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States.
| | | | - Charles Baldinger
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Sener EF, Taheri S, Sahin MC, Bayramov KK, Marasli MK, Zararsiz G, Mehmetbeyoglu E, Oztop DB, Canpolat M, Canatan H, Ozkul Y. Altered Global mRNA Expressions of Pain and Aggression Related Genes in the Blood of Children with Autism Spectrum Disorders. J Mol Neurosci 2018; 67:89-96. [PMID: 30519864 DOI: 10.1007/s12031-018-1213-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/11/2018] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by repetitive stereotypic behaviors, restricted interests, social withdrawal, and communication deficits. Aggression and insensitivity to pain are largely unexplained in these cases. We analyzed nine mRNA expressions of the candidate genes related to aggression and insensitivity to pain in the peripheral blood of patients with ASD. Whole blood samples were obtained from 40 autistic patients (33 boys, 7 girls) and 50 age- and sex-matched controls (37 boys and 13 girls) to isolate RNA. Gene expression was assessed by quantitative Real-Time PCR (qRT-PCR) in the Erciyes University Genome and Stem Cell Center (GENKOK). All of the gene expressions except CRHR1 and SLC6A4 were found to be statistically different between the ASD patients and controls. Gene expression also differed according to gender. Alterations in the mRNA expression patterns of the HTR1E, OPRL1, OPRM1, TACR1, PRKG1, SCN9A and DRD4 genes provide further evidence for a relevant effect of the respective candidate genes on the pathophysiology of ASD. Future studies may determine the sensitivity of these candidate markers in larger samples including further neuropsychiatric diagnosis.
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MESH Headings
- Aggression
- Autism Spectrum Disorder/blood
- Autism Spectrum Disorder/genetics
- Autism Spectrum Disorder/physiopathology
- Biomarkers/blood
- Child, Preschool
- Cyclic GMP-Dependent Protein Kinase Type I/genetics
- Cyclic GMP-Dependent Protein Kinase Type I/metabolism
- Female
- Humans
- Male
- NAV1.7 Voltage-Gated Sodium Channel/genetics
- NAV1.7 Voltage-Gated Sodium Channel/metabolism
- Pain Perception
- RNA, Messenger/blood
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptor, Serotonin, 5-HT1A/genetics
- Receptor, Serotonin, 5-HT1A/metabolism
- Receptors, Dopamine D4/genetics
- Receptors, Dopamine D4/metabolism
- Receptors, Opioid/genetics
- Receptors, Opioid/metabolism
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Affiliation(s)
- Elif Funda Sener
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey.
- Erciyes University Genome and Stem Cell Center (GENKOK), 38039, Kayseri, Turkey.
| | - Serpil Taheri
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
- Erciyes University Genome and Stem Cell Center (GENKOK), 38039, Kayseri, Turkey
| | | | | | | | - Gokmen Zararsiz
- Department of Biostatistics, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
| | - Ecmel Mehmetbeyoglu
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
- Erciyes University Genome and Stem Cell Center (GENKOK), 38039, Kayseri, Turkey
| | - Didem Behice Oztop
- Department of Child and Adolescent Psychiatry, Ankara University Medical Faculty , Ankara, Turkey
| | - Mehmet Canpolat
- Department of Child Neurology, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Halit Canatan
- Department of Medical Biology, Erciyes University Medical Faculty , 38039, Kayseri, Turkey
| | - Yusuf Ozkul
- Department of Medical Genetics, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
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35
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Deon Kidd V, De Claro AMO. Preparing for Autistic Patients in Orthopaedic Surgery: Tips for a Successful Health-Care Interaction. J Bone Joint Surg Am 2018; 100:e132. [PMID: 30334893 DOI: 10.2106/jbjs.18.00252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The prevalence of autism in the United States has been climbing for the last 3 decades, and this comes at a time when the medical community is poorly equipped to address the various needs of individuals with autism spectrum disorder (ASD). Because busy orthopaedic surgery practices will invariably encounter more patients with ASD, they may want to develop pragmatic strategies and protocols that will promote a successful health-care interaction with these patients.
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Affiliation(s)
- Vasco Deon Kidd
- Orthopaedic Surgery PA Fellowship Program Director, Arrowhead Orthopaedics, Colton, California
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36
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Garcia-Villamisar D, Moore D, Garcia-Martínez M. Internalizing Symptoms Mediate the Relation Between Acute Pain and Autism in Adults. J Autism Dev Disord 2018; 49:270-278. [PMID: 30264376 DOI: 10.1007/s10803-018-3765-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research on pain in autism spectrum disorder (ASD) is in its infancy, with almost nothing known about how individual differences may predicting pain response in ASD. In the present study, 45 adults (28 male, age 22-48 years) with diagnoses of autism and intellectual delay were observed during vaccination or dental cleaning and their pain behaviours coded and measures of autism symptom severity, anxiety, depression and obsessivity taken. Our findings showed that greater autism severity predicted greater pain response which was partially mediated by anxiety and depression. These data suggest that mental health symptoms are important when considering pain response in autism. Mood must therefore be considered in future research on pain in ASD as well as clinical pain management.
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Affiliation(s)
- D Garcia-Villamisar
- Unit of Psychopathology, Department of Personality and Clinical Psychology, Complutense University of Madrid, Madrid, Spain.
- Asociación Nuevo Horizonte, 28231, Las Rozas, Madrid, Spain.
| | - D Moore
- Psychology Department, School of Natural Science and Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, UK
| | - M Garcia-Martínez
- Unit of Psychopathology, Department of Personality and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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37
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Gu X, Zhou TJ, Anagnostou E, Soorya L, Kolevzon A, Hof PR, Fan J. Heightened brain response to pain anticipation in high-functioning adults with autism spectrum disorder. Eur J Neurosci 2018; 47:592-601. [PMID: 28452081 PMCID: PMC5659957 DOI: 10.1111/ejn.13598] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder (ASD) is marked by both socio-communicative difficulties and abnormalities in sensory processing. Much of the work on sensory deficits in ASD has focused on tactile sensations and the perceptual aspects of somatosensation, such as encoding of stimulus intensity and location. Although aberrant pain processing has often been noted in clinical observations of patients with ASD, it remains largely uninvestigated. Importantly, the neural mechanism underlying higher order cognitive aspects of pain processing such as pain anticipation also remains unknown. Here we examined both pain perception and anticipation in high-functioning adults with ASD and matched healthy controls (HC) using an anticipatory pain paradigm in combination with functional magnetic resonance imaging (fMRI) and concurrent skin conductance response (SCR) recording. Participants were asked to choose a level of electrical stimulation that would feel moderately painful to them. Compared to HC group, ASD group chose a lower level of stimulation prior to fMRI. However, ASD participants showed greater activation in both rostral and dorsal anterior cingulate cortex during the anticipation of stimulation, but not during stimulation delivery. There was no significant group difference in insular activation during either pain anticipation or perception. However, activity in the left anterior insula correlated with SCR during pain anticipation. Taken together, these results suggest that ASD is marked with aberrantly higher level of sensitivity to upcoming aversive stimuli, which may reflect abnormal attentional orientation to nociceptive signals and a failure in interoceptive inference.
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Affiliation(s)
- Xiaosi Gu
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75235, USA
| | - Thomas J. Zhou
- Department of Psychology, Queens College, The City University of New York, Flushing, NY 11367, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Evdokia Anagnostou
- Bloorview Research Institute, University of Toronto, Toronto, Canada M4G 1R8
| | - Latha Soorya
- Department of Psychiatry, Rush University, Chicago, IL 60612, USA
| | - Alexander Kolevzon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Patrick R. Hof
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Flushing, NY 11367, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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38
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Riquelme I, Hatem SM, Montoya P. Reduction of Pain Sensitivity after Somatosensory Therapy in Children with Autism Spectrum Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 46:1731-1740. [DOI: 10.1007/s10802-017-0390-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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39
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Summers J, Shahrami A, Cali S, D'Mello C, Kako M, Palikucin-Reljin A, Savage M, Shaw O, Lunsky Y. Self-Injury in Autism Spectrum Disorder and Intellectual Disability: Exploring the Role of Reactivity to Pain and Sensory Input. Brain Sci 2017; 7:brainsci7110140. [PMID: 29072583 PMCID: PMC5704147 DOI: 10.3390/brainsci7110140] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/11/2017] [Accepted: 10/23/2017] [Indexed: 12/27/2022] Open
Abstract
This paper provides information about the prevalence and topography of self-injurious behavior in children and adults with autism spectrum disorder and intellectual disability. Dominant models regarding the etiology of self-injury in this population are reviewed, with a focus on the role of reactivity to pain and sensory input. Neuroimaging studies are presented and suggestions are offered for future research.
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Affiliation(s)
- Jane Summers
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Ali Shahrami
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Stefanie Cali
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Chantelle D'Mello
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Milena Kako
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | | | - Melissa Savage
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Olivia Shaw
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
| | - Yona Lunsky
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada.
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40
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Benromano T, Pick CG, Merick J, Defrin R. Physiological and Behavioral Responses to Calibrated Noxious Stimuli Among Individuals with Cerebral Palsy and Intellectual Disability. PAIN MEDICINE 2017; 18:441-453. [PMID: 27473634 DOI: 10.1093/pm/pnw155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective As individuals with intellectual disability (ID) due to cerebral palsy (CP) are at high risk of experiencing pain, measuring their pain is crucial for adequate treatment. While verbal reports are the gold standard in pain measurements, they may not be sufficient in ID. The aim was to detect behavioral/autonomic responses that may indicate the presence and intensity of pain in individuals with CP and ID, using calibrated stimuli, here for the first time. Subjects Thirteen adults with CP and ID (CPID), 15 healthy controls (HC), and 5 adults with CP with no ID (CPNID). Methods Subjects received pressure stimuli of various intensities. Self-reports (using a pyramid scale), facial expressions (retrospectively analyzed with Facial Action Coding System = FACS), and autonomic function (heart rate, heart rate variability, pulse, galvanic skin response) were analyzed. Results Self-reports and facial expressions but not the autonomic function exhibited stimulus-response relationship to pressure stimulation among all groups. The CPID group had increased pain ratings and facial expressions compared with controls. In addition, the increase in facial expressions along the increase in noxious stimulation was larger than in controls. Freezing in response to pain was frequent in CPID. Conclusions 1) Individuals with CP and ID have increased responses to pain; 2) facial expressions and self-reports, but not autonomic variables can reliably indicate their pain intensity; 3) the pyramid scale is suitable for self-report in this population. Although facial expressions may replace verbal reports, increased facial expressions at rest among these individuals may mask pain, especially at lower intensities.
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Affiliation(s)
- Tali Benromano
- Department of Anatomy and Anthropology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chaim G Pick
- Department of Anatomy and Anthropology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Israel
| | - Joav Merick
- National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services, Jerusalem and Division of Pediatrics, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ruth Defrin
- Sagol School of Neuroscience, Tel-Aviv University, Israel.,Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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41
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Martin P. Pain in Rett syndrome: peculiarities in pain processing and expression, liability to pain causing disorders and diseases, and specific aspects of pain assessment. ADVANCES IN AUTISM 2017. [DOI: 10.1108/aia-02-2017-0003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Peter Martin
- Epilepsiezentrum Kork, Seguin-Klinik, Kehl-Kork, Germany
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42
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Goldschmidt J. What Happened to Paul? Manifestation of Abnormal Pain Response for Individuals With Autism Spectrum Disorder. QUALITATIVE HEALTH RESEARCH 2017; 27:1133-1145. [PMID: 27117957 DOI: 10.1177/1049732316644415] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
During the progression of a pilot nutrition intervention designed to teach cooking skills to young adults with autism spectrum disorder (ASD), one participant-Paul-fell in the parking lot. Prior to the accident, Paul had been making significant gains in the program and had communicated in a number of ways his enthusiasm. After his accident, which resulted in broken and dislocated bones in his ankle, his demeanor was dramatically altered, program gains were lost, and staff noted the appearance of many new challenging behaviors. This article analyzes Paul's behavior in reference to the pain response in autism. For some time, it was believed that many individuals with ASD did not experience pain based on anecdotal reports of how individuals responded to injury with seeming indifference. This view has given way of late to a more nuanced understanding of how atypical sensory processing and stimulus over-selectivity spill over into pain pathways and pain amplification mechanisms. The consequence is not a reduction in pain sensation, but a different expression of pain, determined by that individual's particular communicative, cognitive, or physiological challenges. From this perspective, many of the disruptive and harmful behaviors that emerged after Paul's accident can be seen as a delayed response to the incident. This article concludes by arguing that professionals across all domains of health care need to begin to see behavior as communicative for those with ASD. This is particularly true of changes in behavior, which can be significant indicators of health care problems rather than something to be dismissed as another manifestation of the condition.
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43
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Failla MD, Moana-Filho EJ, Essick GK, Baranek GT, Rogers BP, Cascio CJ. Initially intact neural responses to pain in autism are diminished during sustained pain. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:669-683. [PMID: 28513186 DOI: 10.1177/1362361317696043] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pain assessments typically depend on self-report of the pain experience. Yet, in individuals with autism spectrum disorders, this can be an unreliable due to communication difficulties. Importantly, observations of behavioral hypo- and hyperresponsivity to pain suggest altered pain sensitivity in autism spectrum disorder. Neuroimaging may provide insight into mechanisms underlying pain behaviors. The neural pain signature reliably responds to painful stimulation and is modulated by other outside regions, affecting the pain experience. In this first functional magnetic resonance imaging study of pain in autism spectrum disorder, we investigated neural responses to pain in 15 adults with autism spectrum disorder relative to a typical comparison group (n = 16). We explored temporal and spatial properties of the neural pain signature and its modulators during sustained heat pain. The two groups had indistinguishable pain ratings and neural pain signature responses during acute pain; yet, we observed strikingly reduced neural pain signature response in autism spectrum disorder during sustained pain and after stimulus offset. The posterior cingulate cortex, a neural pain signature modulating region, mirrored this late signal reduction in autism spectrum disorder. Intact early responses, followed by diminished late responses to sustained pain, may reflect altered pain coping or evaluation in autism spectrum disorder. Evidence of a dichotomous neural response to initial versus protracted pain may clarify the coexistence of both hypo- and hyperresponsiveness to pain in autism spectrum disorder.
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Affiliation(s)
| | | | | | | | - Baxter P Rogers
- 1 Vanderbilt University, USA.,4 Vanderbilt University Institute of Imaging Science, USA
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44
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Pellissier LP, Gandía J, Laboute T, Becker JAJ, Le Merrer J. μ opioid receptor, social behaviour and autism spectrum disorder: reward matters. Br J Pharmacol 2017; 175:2750-2769. [PMID: 28369738 DOI: 10.1111/bph.13808] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/10/2017] [Accepted: 03/24/2017] [Indexed: 12/19/2022] Open
Abstract
The endogenous opioid system is well known to relieve pain and underpin the rewarding properties of most drugs of abuse. Among opioid receptors, the μ receptor mediates most of the analgesic and rewarding properties of opioids. Based on striking similarities between social distress, physical pain and opiate withdrawal, μ receptors have been proposed to play a critical role in modulating social behaviour in humans and animals. This review summarizes experimental data demonstrating such role and proposes a novel model, the μ opioid receptor balance model, to account for the contribution of μ receptors to the subtle regulation of social behaviour. Interestingly, μ receptor null mice show behavioural deficits similar to those observed in patients with autism spectrum disorder (ASD), including severe impairment in social interactions. Therefore, after a brief summary of recent evidence for blunted (social) reward processes in subjects with ASD, we review here arguments for altered μ receptor function in this pathology. This article is part of a themed section on Emerging Areas of Opioid Pharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.14/issuetoc.
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Affiliation(s)
- Lucie P Pellissier
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, Université de Tours Rabelais, IFCE, Inserm, Nouzilly, France
| | - Jorge Gandía
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, Université de Tours Rabelais, IFCE, Inserm, Nouzilly, France
| | - Thibaut Laboute
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, Université de Tours Rabelais, IFCE, Inserm, Nouzilly, France
| | - Jérôme A J Becker
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, Université de Tours Rabelais, IFCE, Inserm, Nouzilly, France
| | - Julie Le Merrer
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, Université de Tours Rabelais, IFCE, Inserm, Nouzilly, France
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45
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Attenuated contact heat-evoked potentials associated with sensory and social-emotional symptoms in individuals with autism spectrum disorder. Sci Rep 2017; 7:36887. [PMID: 28139664 PMCID: PMC5282530 DOI: 10.1038/srep36887] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/26/2016] [Indexed: 02/06/2023] Open
Abstract
Sensory disturbance is associated with socio-emotional problems in individuals with autism spectrum disorder (ASD). Most studies assess sensory symptoms by self-reports, which are largely limited by the language ability and self-awareness of the individuals. This study aims to investigate sensory disturbance by contact heat-evoked potentials (CHEP) in ASD individuals, and to examine the clinical correlates of CHEP parameters. We compared the CHEP parameters and reported pain between 31 ASD individuals (aged 20.5 ± 5.2 years) and and 22 typically-developing controls (TD, aged 21.4 ± 2.6), and correlated the CHEP parameters with self-reported sensory symptoms and attention/socio-emotional symptoms. We found that ASD individuals showed smaller P2-wave amplitudes than TD, even though they reported a similar level of pain. In TD individuals, a smaller P2-wave amplitude was related to higher scores on ‘low registration,’ ‘attention to detail,’ and ‘attention switching difficulties.’ In ASD individuals, longer N2-wave latency was related to higher scores on ‘sensory sensitivity’ and socio-emotional problems; while higher reported pain was associated with higher scores on ‘low registration,’ overall autistic severity, and longer N2-wave latency. Our findings of attenuated CHEP response in ASD, which was associated with sensory symptoms and socio-emotional problems, suggest a potential role for CHEP in studying sensory disturbances in ASD.
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46
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Wang L, Almeida LEF, Nettleton M, Khaibullina A, Albani S, Kamimura S, Nouraie M, Quezado ZMN. Altered nocifensive behavior in animal models of autism spectrum disorder: The role of the nicotinic cholinergic system. Neuropharmacology 2016; 111:323-334. [PMID: 27638450 PMCID: PMC5075237 DOI: 10.1016/j.neuropharm.2016.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/21/2016] [Accepted: 09/12/2016] [Indexed: 02/05/2023]
Abstract
Caretakers and clinicians alike have long recognized that individuals with autism spectrum disorder (ASD) can have altered sensory processing, which can contribute to its core symptoms. However, the pathobiology of sensory alterations in ASD is poorly understood. Here we examined nocifensive behavior in ASD mouse models, the BTBR T+Itpr3tf/J (BTBR) and the fragile-X mental retardation-1 knockout (Fmr1-KO) mice. We also examined the effects of nicotine on nocifensive behavior given that nicotine, a nicotinic cholinergic receptor (nAChR) agonist that has antinociceptive effects, was shown to improve social deficits and decrease repetitive behaviors in BTBR mice. Compared to respective controls, both BTBR and Fmr1-KO had hyporesponsiveness to noxious thermal stimuli and electrical stimulation of C-sensory fibers, normal responsiveness to electrical stimulation of Aβ- and Aδ-fiber, and hyperresponsiveness to visceral pain after acetic acid intraperitoneal injection. In BTBR, nicotine at lower doses increased, whereas at higher doses, it decreased hotplate latency compared to vehicle. In a significantly different effect pattern, in control mice, nicotine had antinociceptive effects to noxious heat only at the high dose. Interestingly, these nocifensive behavior alterations and differential responses to nicotine antinociceptive effects in BTBR mice were associated with significant downregulation of α3, α4, α5, α7, β2, β3, and β4 nAChR subunits in several cerebral regions both, during embryonic development and adulthood. Taken together, these findings further implicate nAChRs in behaviors alterations in the BTBR model and lend support to the hypothesis that nAChRs may be a target for treatment of behavior deficits and sensory dysfunction in ASD.
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Affiliation(s)
- Li Wang
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA
| | - Luis E F Almeida
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA
| | - Margaret Nettleton
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA
| | - Alfia Khaibullina
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA
| | - Sarah Albani
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA
| | - Sayuri Kamimura
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA
| | - Mehdi Nouraie
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Zenaide M N Quezado
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA; Center for Neuroscience Research, Children's Research Institute, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20010, USA.
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47
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Lydon S, Healy O, Reed P, Mulhern T, Hughes BM, Goodwin MS. A systematic review of physiological reactivity to stimuli in autism. Dev Neurorehabil 2016; 19:335-355. [PMID: 25356589 DOI: 10.3109/17518423.2014.971975] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The prevalence of abnormal behavioural responses to a variety of stimuli among individuals with autism has led researchers to examine whether physiological reactivity (PR) is typical in this population. This article reviewed studies assessing PR to sensory, social and emotional, and stressor stimuli in individuals with autism. METHODS Systematic searches of electronic databases identified 57 studies that met our inclusion criteria. Studies were analysed to determine: (a) participant characteristics; (b) physiological measures used; (c) PR to sensory, social and emotional or stressor stimuli; (d) the relation between PR and behavioural or psychological variables and (e) baseline physiological activity. A novel measure of methodological quality suitable for use with non-randomized, non-interventional, psychophysiological studies was also developed and applied. RESULTS Individuals with autism were found to respond differently than typically developing controls in 78.6%, 66.7% and 71.4% of sensory, social and emotional, and stressor stimulus classes, respectively. However, this extant literature is characterized by variable and inconsistent findings, which do not appear to be accounted for by varying methodological quality, making it difficult to determine what specific factors differentiate individuals with autism who present with atypical PR from those who do not. CONCLUSIONS Despite this uncertainty, individual differences in PR are clearly present in autism, suggesting additional research is needed to determine the variables relating to PR among those with ASD and to examine the possible existence of physiological subtype responders in the population.
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Affiliation(s)
- Sinéad Lydon
- a School of Psychology, Trinity College Dublin , Dublin , Ireland
| | - Olive Healy
- a School of Psychology, Trinity College Dublin , Dublin , Ireland
| | - Phil Reed
- b Department of Psychology , Swansea University , Swansea , UK
| | - Teresa Mulhern
- c School of Psychology, National University of Ireland , Galway , Ireland , and
| | - Brian M Hughes
- c School of Psychology, National University of Ireland , Galway , Ireland , and
| | - Matthew S Goodwin
- d Department of Health Sciences , Northeastern University , Boston , MA , USA
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48
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Chen C, Hung AY, Fan YT, Tan S, Hong H, Cheng Y. Linkage between pain sensitivity and empathic response in adolescents with autism spectrum conditions and conduct disorder symptoms. Autism Res 2016; 10:267-275. [PMID: 27305862 DOI: 10.1002/aur.1653] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 04/01/2016] [Accepted: 05/22/2016] [Indexed: 12/14/2022]
Abstract
Lack of empathy is one of the behavioral hallmarks in individuals with autism spectrum conditions (ASC) as well as youth with conduct disorder symptoms (CDS). Previous research has reliably documented considerable overlap between the perception of others' pain and first-hand experience of pain. However, the linkage between empathy for pain and sensitivity to physical pain needs to be empirically determined, particularly in individuals with empathy deficits. This study measured the pressure pain threshold, which indexes sensitization of peripheral nociceptors, and assessed subjective ratings of unpleasantness and pain intensity in response to empathy-eliciting stimuli depicting physical bodily injuries in three age- and sex-matched participant groups: ASC, CDS, and typically developing controls (TDC). The results indicated that the pain threshold was lowest in the ASC group and highest in the CDS group. The ASC group displayed lower ratings of unpleasantness and pain intensity than did the TDC and CDS groups. Within the ASC and CDS, pain intensity ratings were significantly correlated with unpleasantness ratings to others' pain. Moreover, the ASC significantly differed from the TDC in the correlation between pain threshold values and unpleasantness ratings. These findings may cast some light on the linkage between atypical low-level sensory functioning, for instance altered pain sensitivity, and high-level empathic processing. Autism Res 2017, 10: 267-275. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Chenyi Chen
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - An-Yi Hung
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Yang-Teng Fan
- Department of Sociology, Nation Chengchi University, Taipei, Taiwan
| | - Shuai Tan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hua Hong
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yawei Cheng
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Department of Physical Medicine & Rehabilitation, National Yang-Ming University Hospital, Yilan, Taiwan
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Williams AC. Autoextraction of twelve permanent teeth in a child with autistic spectrum disorder. Int J Paediatr Dent 2016; 26:157-9. [PMID: 25809601 DOI: 10.1111/ipd.12161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This report discusses self-injurious behaviour; this is not unusual in people with autistic spectrum disorders but is not commonly experienced as autoextraction. CASE REPORT This case concerns a 12 year old child who presented as a new patient with two teeth missing. He then went on to remove a further ten teeth over a relatively short space of time. CONCLUSION The recognition of autoextraction by the dental team is important. its management involves a multidisciplinary team which includes professionals from education, health and social care who work together to prevent progressive self-injury.
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Parental-reported pain insensitivity in Dup15q. Epilepsy Behav 2016; 55:124-7. [PMID: 26773682 DOI: 10.1016/j.yebeh.2015.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/06/2015] [Accepted: 10/08/2015] [Indexed: 11/23/2022]
Abstract
Parents of children with chromosome 15q duplication syndrome (Dup15q) have anecdotally reported high pain threshold as a feature of the disorder. The purpose of this study was to document parental-reported estimates of the frequency of high pain tolerance and the stimuli that fail to evoke a normal pain response. We sent an online survey to 840 families with children with Dup15q to explore the frequency and clinical manifestations of high pain threshold. There were 216 respondents (25.7%). A high pain threshold was reported in 87% of children at some time. There was a trend (p=0.06) for high pain threshold to be more commonly observed among children with the isodicentric (85.6%) and other genetic variants (95%) than interstitial (69.6%) duplications. There was no association between reports of high pain threshold and reports of an intellectual disability (91% of cases), autism spectrum disorder (83% of cases), or self-injurious behavior (40% of cases). Reports included many dramatic cases such as severe burns, broken bones, and electrical traumas, which were associated with little or no evidence of a painful stimulus. A high pain threshold is reported in other disorders associated with intellectual disability and autism; the underlying mechanism in Dup15q and other disorders remains undefined.
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