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Hayes K, Adams HC, Robeson M, Zlomke KR. Bouncing Back: Resilience as a Protective Factor for the Impact of Child Problem Behavior on Caregiver Depressive Cognitions Among Youth with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:3697-3705. [PMID: 37594631 DOI: 10.1007/s10803-023-06094-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 08/19/2023]
Abstract
Caregivers of children with autism spectrum disorder (ASD) often report higher rates of depression and the related negative thought patterns that may precede a clinical diagnosis. These negative thought patterns are referred to as depressive cognitions. Depressive cognitions are exacerbated by child problem behaviors (CPB) but may be impacted by parental resilience. The current study examines relations between CPB and depressive cognitions and the role of resilience as a moderator among caregivers of children with ASD (n = 287) and a sample of caregivers of children who are typically developing (n = 207). Significant positive associations were found between CPB and depressive cognitions for caregivers of children with ASD and who are typically developing. A moderation analysis revealed that, among the ASD sample, the model accounted for 33% of the variance in caregiver depressive cognitions (R2 = 0.33, SE = 35.52, p < 0.001). The interaction of child problem behaviors and caregiver resilience on caregiver depressive cognitions was statistically significant (B = - 0.016, SE = 0.007, p = 0.037), thus resilience was a significant moderator, for caregivers of children with ASD. Resilience serves as a protective factor in the relationship between child problem behavior and caregiver depressive cognitions for caregivers of children with ASD only. This finding highlights the importance of assessing and supporting resilience among caregivers of children with ASD. Interventions addressing child behavior would benefit from additional components to bolster caregiver resilience to enhance caregiver mental health and protect against depressive cognitions.
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Affiliation(s)
- Katey Hayes
- Department of Psychology, University of South Alabama, 75 South University Blvd, UCOM 1000, Mobile, AL, 36688, USA.
| | - Haley C Adams
- Department of Psychology, University of South Alabama, 75 South University Blvd, UCOM 1000, Mobile, AL, 36688, USA
| | - Mackenzie Robeson
- Department of Psychology, University of South Alabama, 75 South University Blvd, UCOM 1000, Mobile, AL, 36688, USA
| | - Kimberly R Zlomke
- Department of Psychology, University of South Alabama, 75 South University Blvd, UCOM 1000, Mobile, AL, 36688, USA
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Martin JJ. APAQ at Forty: Publication Trends. Adapt Phys Activ Q 2024; 41:481-498. [PMID: 39231496 DOI: 10.1123/apaq.2024-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 09/06/2024] Open
Abstract
The purpose of the present study was to analyze Adapted Physical Activity Quarterly (APAQ) publications over the journal's fourth decade (2014-2023) and compare them with previous documentary analyses of the first 3 decades. Consistent with prior documentary analyses, publications were coded and analyzed based on the use of theory, research participants, topic, whether the study was an intervention, first-author country affiliation, and research method. The total number of published research papers increased substantially (n = 61) from the third to the fourth decade. Similar to prior documentary analyses, most of the research was quantitative (n = 140; 57.5%), followed by qualitative research (n = 96; 39.5%). There were far more qualitative-research publications in the fourth decade compared with the third decade (n = 34). This may reflect the continued acceptance and growth of qualitative research compared with 10-20 years ago. It may also reflect the value of rich in-depth exploratory research using small samples. Additional trends included more review papers and meta-analyses, possibly reflecting the increased knowledge base in particular areas requiring synthesis. The diversity of topics also increased, with papers on dignity, classification, coaching, and the Paralympics playing more prominent roles. The number of international publications also grew substantially. In brief, the current paper outlines both similarities and differences in APAQ's published research over the 4 decades of its existence.
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Azu MA, Han GT, Wolf JM, Naples AJ, Chawarska K, Dawson G, Bernier RA, Jeste SS, Dziura JD, Webb SJ, Sugar CA, Shic F, McPartland JC. Clinician-caregiver informant discrepancy is associated with sex, diagnosis age, and intervention use among autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241279999. [PMID: 39344965 DOI: 10.1177/13623613241279999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
LAY ABSTRACT In some cases, a clinician's perceptions of a child's autism-related behaviors are not the same as the child's caregiver's perceptions. Identifying how these discrepancies relate to the characteristics of the child is critical for ensuring that diagnosis procedures are unbiased and suitable for all children. This study examined whether discrepancies between clinician and caregiver reports of autism features related to the child's sex at birth. We also explored how the discrepancies related to the age at which the child received their autism diagnosis and how much intervention they received. We found that clinicians rated autism features higher than caregivers for boys and rated autism features lower than caregivers for girls. In addition, lower clinician relative to parent ratings was related to being diagnosed at an older age and receiving less intervention. These findings suggest that there is more to learn about the presentation of autism-related behaviors in girls. When caregiver and clinician ratings of autism features do not align, it may be important to consider caregivers' ratings to obtain a more accurate picture of the child's autism features and the support they may need.
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Wang X, Li C, Zhou L, Liu L, Qiu X, Huang D, Liu S, Zeng X, Wang L. Associations of prenatal exposure to PM 2.5 and its components with offsprings' neurodevelopmental and behavioral problems: A prospective cohort study from China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 282:116739. [PMID: 39029225 DOI: 10.1016/j.ecoenv.2024.116739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 07/10/2024] [Accepted: 07/13/2024] [Indexed: 07/21/2024]
Abstract
Prenatal exposure to fine particulate matter (PM2.5) has been linked with increased neurodevelopmental disorders. However, the most detrimental component of PM2.5 and the most vulnerable exposure time windows remain undetermined, especially in areas with high PM2.5 levels. In a prospective cohort study involving 4494 mother-child dyads, we examined the associations of prenatal exposure to PM2.5 and its four main components with children's neurodevelopmental and behavioral problems (NBPs), separately in three pregnancy trimesters. Poisson regression and generalized additive models were used to depict the linear and nonlinear associations, respectively. Weighted quantile sum and Bayesian kernel machine regression models were applied to examine the effects of exposure to both mixed and individual components. Results showed that exposure to PM2.5 and its components throughout the three trimesters increased the risk of children's NBPs (Risk ratio for PM2.5: 1.16, 95 % confidence interval 1.14-1.18 per μg/m3 in the first trimester; 1.15, 1.12-1.17 in the second trimester; 1.06, 1.04-1.08 in the third trimester), with associations gradually diminishing as pregnancy progressed (P values for trends < 0.05). Among the four main components of PM2.5, exposure to SO42- posed the highest risks on children's NBPs, while organic matter contributed the largest proportion to the overall impacts of PM2.5 exposure. These results underscore the significance of mitigating PM2.5 exposure in pregnant women to reduce the risk of neurodevelopmental disorders in offspring. Our findings would inform risk assessment of PM2.5 exposure and facilitate the development of precision preventive strategies targeting specific components of PM2.5 in similar areas with high levels of exposure.
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Affiliation(s)
- Xiaogang Wang
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Chanhua Li
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Lihong Zhou
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Lili Liu
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Xiaoqiang Qiu
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Shun Liu
- Department of Child and Adolescent Health & Maternal and Child Health, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China
| | - Xiaoyun Zeng
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, No. 1 Zhiyuan Road, Lingui District, Guilin, Guangxi, PR China.
| | - Lijun Wang
- Department of Epidemiology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Qingxiu District, Nanning, Guangxi, PR China.
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Qi K, Liu Y, Wang Z, Xiong X, Cai K, Xu Y, Shi Y, Sun Z, Dong X, Chen A. Recreational ball games are effective in improving social communication impairments among preschoolers diagnosed with autism spectrum disorder: a multi-arm controlled study. BMC Sports Sci Med Rehabil 2024; 16:176. [PMID: 39175073 PMCID: PMC11342502 DOI: 10.1186/s13102-024-00957-8] [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: 05/02/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND This study aimed to compare the effects of two 12-week training intervention experimental ball games combined with standard behavioral rehabilitation against a control group solely utilizing standard behavioral rehabilitation on social communication impairments (SCI) in preschool children with Autism Spectrum Disorder (ASD). METHODS A multi-arm controlled study design was implemented, involving 41 children diagnosed with ASD (mean age: 4.99 ± 0.76 years). 41 participants were randomized assigned to two experimental groups and a control group, The experimental group carried out ball combination training program group (BCTP) and mini-basketball training program group (MBTP) on the basis of routine behavioral rehabilitation, which underwent 12-week training interventions 5 times a week. The control group (n = 14) received only standard behavioral rehabilitation. Evaluations were conducted before and after interventions using the Social Responsiveness Scale, Second Edition (SRS-2). RESULTS The results suggest that both 12-week interventions, BCTP, and MBTP, led to significant improvements in social communication impairment among children with ASD (p < 0.05). Despite enhancing the overall scores on the SRS-2, these interventions displayed varying impacts across different sub-dimensions. BCTP primarily exhibited significant enhancements in social awareness and behavior pattern (p < 0.05), whereas MBTP significantly improved social cognition and social communication (p < 0.05). Both interventions showed slight improvements in social motivation. CONCLUSIONS The utilization of recreational ball games has showed to be effective in decreasing the impairment levels of children with ASD, while the control group experienced a worsening of outcomes. This suggests that irrespective of the specific ball game strategy employed, both can be employed on a weekly basis to complement standard behavioral rehabilitation and enhance the ability to improve the quality of life for children diagnosed with ASD. TRIAL REGISTRATION The trial is retrospectively registered on the Chinese Clinical Trial Registry (ChiCTR1900024973;August 5, 2019).
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Affiliation(s)
- Kai Qi
- Gdansk University of Physical Education and Sport, Gdansk, 80-336, Poland
| | - Yufei Liu
- Gdansk University of Physical Education and Sport, Gdansk, 80-336, Poland
| | - Zuopeng Wang
- Jiamusi University, Jiamusi, Heilongjiang, 154007, China
| | - Xuan Xiong
- Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Kelong Cai
- Yangzhou University, Yangzhou, Jiangsu, 225009, China
| | - Yifan Xu
- Gdansk University of Physical Education and Sport, Gdansk, 80-336, Poland
| | - Yifan Shi
- Yangzhou University, Yangzhou, Jiangsu, 225009, China
| | - Zhiyuan Sun
- Yangzhou University, Yangzhou, Jiangsu, 225009, China
| | - Xiaoxiao Dong
- Yangzhou University, Yangzhou, Jiangsu, 225009, China
| | - Aiguo Chen
- Nanjing Sport Institute, Nanjing, Jiangsu, 210014, China.
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Kaimal A, Hooversmith JM, Mansi MHA, Holmes PV, MohanKumar PS, MohanKumar SMJ. Prenatal Exposure to Bisphenol A and/or Diethylhexyl Phthalate Impacts Brain Monoamine Levels in Rat Offspring. J Xenobiot 2024; 14:1036-1050. [PMID: 39189173 PMCID: PMC11348251 DOI: 10.3390/jox14030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 08/28/2024] Open
Abstract
This study examines the sex-specific effects of gestational exposure (days 6-21) to endocrine-disrupting chemicals such as bisphenol A (BPA), diethylhexyl phthalate (DEHP), or their combination on brain monoamine levels that play an important role in regulating behavior. Pregnant Sprague-Dawley rats were orally administered saline, low doses (5 µg/kg BW/day) of BPA or DEHP, and their combination or a high dose (7.5 mg/kg BW/day) of DEHP alone or in combination with BPA during pregnancy. The offspring were subjected to a behavioral test and sacrificed in adulthood, and the brains were analyzed for neurotransmitter levels. In the paraventricular nucleus, there was a marked reduction in dopamine levels (p < 0.01) in male offspring from the BPA, DEHP, and B + D (HD) groups, which correlated well with their shock probe defensive burying times. Neurotransmitter changes in all brain regions examined were significant in female offspring, with DEHP (HD) females being affected the most, followed by the B + D groups. BPA and/or DEHP (LD) increased monoamine turnover in a region-specific manner in male offspring (p < 0.05). Overall, prenatal exposure to BPA, DEHP, or their combination alters monoamine levels in a brain region-specific, sex-specific, and dose-dependent manner, which could have implications for their behavioral and neuroendocrine effects.
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Affiliation(s)
- Amrita Kaimal
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA 30602, USA
| | - Jessica M Hooversmith
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA 30602, USA
| | - Maryam H Al Mansi
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Philip V Holmes
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA 30602, USA
| | - Puliyur S MohanKumar
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Sheba M J MohanKumar
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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Harrop C, Tomaszewski B, Putnam O, Klein C, Lamarche E, Klinger L. Are the diagnostic rates of autistic females increasing? An examination of state-wide trends. J Child Psychol Psychiatry 2024; 65:973-983. [PMID: 38181181 PMCID: PMC11161335 DOI: 10.1111/jcpp.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Autism has been considered a 'male-dominant' condition. However, recent research suggests that autistic females are underdiagnosed, misdiagnosed, and later diagnosed. Females may also have different and more nuanced behavioral profiles. To examine diagnosis rates of females, we used 20 years of state-wide data to characterize historical trends in the diagnosis of autism in females to determine whether the proportion of females diagnosed with autism has changed over time. METHODS Data were drawn from 10,247 participants (males = 8,319, females = 1928) who received an autism diagnosis between 2000 and 2021 from state-wide autism centers associated with the University of North Carolina TEACCH Autism Program. RESULTS The rates of females diagnosed with autism increased at a greater rate compared with males. Age of diagnosis remained consistently higher for females. Late diagnosis (defined as 13+) increased over time across both males and females, however, was more commonly associated with females, particularly those with co-occurring intellectual disability. CONCLUSIONS Our results indicate that the proportion of females diagnosed with autism has increased steadily over a 20-year period, which likely reflects greater societal knowledge of how autism may manifest differentially in females.
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Affiliation(s)
- Clare Harrop
- Department of Health Sciences, University of North Carolina at Chapel Hill, USA
- University of North Carolina TEACCH Autism Program
| | - Brianne Tomaszewski
- University of North Carolina TEACCH Autism Program
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA
| | - Orla Putnam
- Department of Health Sciences, University of North Carolina at Chapel Hill, USA
| | - Claire Klein
- University of North Carolina TEACCH Autism Program
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
| | | | - Laura Klinger
- University of North Carolina TEACCH Autism Program
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA
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Thomson AR, Pasanta D, Arichi T, Puts NA. Neurometabolite differences in Autism as assessed with Magnetic Resonance Spectroscopy: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 162:105728. [PMID: 38796123 DOI: 10.1016/j.neubiorev.2024.105728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/23/2024] [Accepted: 05/14/2024] [Indexed: 05/28/2024]
Abstract
1H-Magnetic Resonance Spectroscopy (MRS) is a non-invasive technique that can be used to quantify the concentrations of metabolites in the brain in vivo. MRS findings in the context of autism are inconsistent and conflicting. We performed a systematic review and meta-analysis of MRS studies measuring glutamate and gamma-aminobutyric acid (GABA), as well as brain metabolites involved in energy metabolism (glutamine, creatine), neural and glial integrity (e.g. n-acetyl aspartate (NAA), choline, myo-inositol) and oxidative stress (glutathione) in autism cohorts. Data were extracted and grouped by metabolite, brain region and several other factors before calculation of standardised effect sizes. Overall, we find significantly lower concentrations of GABA and NAA in autism, indicative of disruptions to the balance between excitation/inhibition within brain circuits, as well as neural integrity. Further analysis found these alterations are most pronounced in autistic children and in limbic brain regions relevant to autism phenotypes. Additionally, we show how study outcome varies due to demographic and methodological factors , emphasising the importance of conforming with standardised consensus study designs and transparent reporting.
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Affiliation(s)
- Alice R Thomson
- Department of Forensic and Neurodevelopmental Sciences, King's College London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, UK; Centre for the Developing Brain, King's College London, London, UK
| | - Duanghathai Pasanta
- Department of Forensic and Neurodevelopmental Sciences, King's College London, UK
| | - Tomoki Arichi
- MRC Centre for Neurodevelopmental Disorders, King's College London, UK; Centre for the Developing Brain, King's College London, London, UK
| | - Nicolaas A Puts
- Department of Forensic and Neurodevelopmental Sciences, King's College London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, UK.
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Wegiel J, Chadman K, London E, Wisniewski T, Wegiel J. Contribution of the serotonergic system to developmental brain abnormalities in autism spectrum disorder. Autism Res 2024; 17:1300-1321. [PMID: 38500252 PMCID: PMC11272444 DOI: 10.1002/aur.3123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/28/2024] [Indexed: 03/20/2024]
Abstract
This review highlights a key role of the serotonergic system in brain development and in distortions of normal brain development in early stages of fetal life resulting in cascades of abnormalities, including defects of neurogenesis, neuronal migration, neuronal growth, differentiation, and arborization, as well as defective neuronal circuit formation in the cortex, subcortical structures, brainstem, and cerebellum of autistic subjects. In autism, defects in regulation of neuronal growth are the most frequent and ubiquitous developmental changes associated with impaired neuron differentiation, smaller size, distorted shape, loss of spatial orientation, and distortion of cortex organization. Common developmental defects of the brain in autism include multiregional focal dysplastic changes contributing to local neuronal circuit distortion, epileptogenic activity, and epilepsy. There is a discrepancy between more than 500 reports demonstrating the contribution of the serotonergic system to autism's behavioral anomalies, highlighted by lack of studies of autistic subjects' brainstem raphe nuclei, the center of brain serotonergic innervation, and of the contribution of the serotonergic system to the diagnostic features of autism spectrum disorder (ASD). Discovery of severe fetal brainstem auditory system neuronal deficits and other anomalies leading to a spectrum of hearing deficits contributing to a cascade of behavioral alterations, including deficits of social and verbal communication in individuals with autism, is another argument to intensify postmortem studies of the type and topography of, and the severity of developmental defects in raphe nuclei and their contribution to abnormal brain development and to the broad spectrum of functional deficits and comorbid conditions in ASD.
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Affiliation(s)
- Jarek Wegiel
- Department of Developmental Neurobiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Kathryn Chadman
- Department of Developmental Neurobiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Eric London
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Thomas Wisniewski
- Department of Developmental Neurobiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
- Center for Cognitive Neurology, Department of Neurology, Pathology and Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Jerzy Wegiel
- Department of Developmental Neurobiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
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Gallin Z, Kolevzon AM, Reichenberg A, Hankerson SH, Kolevzon A. Racial Differences in the Prevalence of Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2024:10.1007/s10803-024-06403-5. [PMID: 38941049 DOI: 10.1007/s10803-024-06403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Racial differences in prevalence rates of autism spectrum disorder (ASD) have shifted in the United States (US) since the 1990s. This review addresses the nature and context of this shift and discusses potential contributing factors and areas for future research. METHODS Seventeen population-based epidemiological birth cohort studies on ASD prevalence in the US that included race as a variable are included in the review. Studies were identified via a keyword search on PubMed. To be included, studies were required to include race or ethnicity as a variable in the prevalence estimates, include at least 1000 cases with autism, and be published in English by June 3rd, 2023. RESULTS Results suggest that in nearly all birth cohorts prior to 2010, ASD prevalence rates were highest among White children. ASD prevalence rates among Black, Hispanic, and Asian/Pacific Islander (API) children (22.3, 22.5, and 22.2 per 1000, respectively) surpassed prevalence rates among White children (21.2 per 1000) in the 2010 birth cohort and continued to increase in the 2012 birth cohorts. CONCLUSIONS There are persistent racial differences in ASD prevalence in the US, and these differences were inverted after 2010, when ASD prevalence among Black, Hispanic, & API children surpassed ASD prevalence among White children. Possible drivers of this racial repatterning of ASD prevalence include changes in ASD screening and diagnosis, changes to health insurance policy, changes to immigration policy, and increased education attainment by minority groups.
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Affiliation(s)
- Zachary Gallin
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Abraham Reichenberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sidney H Hankerson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Sciences & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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11
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Torty C, Eyong K, Asindi A A, Usun E. Autism Spectrum Disorders in Calabar, Nigeria. IRANIAN JOURNAL OF CHILD NEUROLOGY 2024; 18:75-81. [PMID: 38988844 PMCID: PMC11231682 DOI: 10.22037/ijcn.v18i3.41744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/18/2024] [Indexed: 07/12/2024]
Abstract
Objectives Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is prevalent worldwide. The incidence of autism has increased worldwide. However, there is a dearth of data in sub-Saharan Africa. The study is aimed at determining the clinical and socio-developmental profile of children with ASD in a tertiary hospital in Nigeria. Materials & Methods This study is a six-year retrospective review of the medical records of children who presented with clinical autism diagnoses at the Department of Pediatrics, University of Calabar Teaching Hospital. Relevant data were extracted from the medical records of those who met the diagnostic criteria. Descriptive statistics were presented in proportions, percentages, and tables. Results Of the 1806 children with neurological disorders seen in the clinic within the study period, twenty-eight were found to have symptoms of autism based on the American Psychiatric Association›s Diagnostic and Statistical Manual V (DSM -5) criteria, giving a prevalence of 1.6%. The mean age at diagnosis was 3.8 ±1.4 (range 2 to 10) years, with a male-to-female ratio of 3:1. About two-thirds of the children diagnosed were older than three years. Seven percent of the children had siblings with autism, 53.5% of children with autism in the study had hyperactivity as comorbidity, while seizures were found in 7% of cases. Conclusion The prevalence of ASD among children seen in Calabar is 1.6%. Hyperactivity, mental retardation, and seizure disorders are associated comorbidities in the study. Late presentation is a common feature in this facility. Thus, increasing awareness is essential to enhance early recognition, timely diagnosis, and appropriate intervention.
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Affiliation(s)
- Chimaeze Torty
- Department of Paediatrics, University of Calabar
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Komomo Eyong
- Department of Paediatrics, University of Calabar
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Asindi Asindi A
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Edet Usun
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
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Fan Q, Ding M, Cheng W, Su L, Zhang Y, Liu Q, Wu Z. The clinical effects of Orff music therapy on children with autism spectrum disorder: a comprehensive evaluation. Front Neurol 2024; 15:1387060. [PMID: 38903168 PMCID: PMC11188925 DOI: 10.3389/fneur.2024.1387060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/15/2024] [Indexed: 06/22/2024] Open
Abstract
Objective This study aimed to investigate the clinical effects of Orff music therapy on children with Autism Spectrum Disorder (ASD) from the perspectives of parents, evaluators, and therapists. Methods 93 children with ASD aged 3-6 years participated in the study. They were divided into an observation group (n = 48) receiving comprehensive rehabilitation intervention including Orff music therapy, and a control group (n = 45) receiving only comprehensive rehabilitation intervention. The Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Psycho-educational Profile-3rd edition (PEP-3) were used for assessments before and after the intervention. Results There were no significant demographic differences between the two groups. Both groups showed significant improvements in Sensory, Relating, Language, CVP, EL, RL, VMI, AE, SR, and CARS scores at T1, T2, and T3 (T1 vs. T2, T2 vs. T3, T1 vs. T3) (all p < 0.05). The observation group demonstrated significant changes in Body and Object use and FM, while the control group showed some changes in these domains. Social and self-help, GM, CMB, and CVB also significantly improved in both groups after 6 months of intervention (all p < 0.05). In terms of different time intervals, the observation group showed greater improvements in Sensory, Relating, Language, CARS scores, EL, RL, and SR compared to the control group (all p < 0.05). The improvement levels in Body and Object use, CVP, FM, VMI, and AE did not differ significantly between the two groups in the T1-T2 interval, but were significantly higher in the observation group in the T2-T3 and T1-T3 intervals (all p < 0.05). The magnitude of changes in Social and self-help, GM, CMB, and CVB did not differ significantly between the groups. Conclusion Orff music therapy showed significant improvements in language expression, language comprehension, social skills, cognitive abilities, imitation abilities, emotional expression and fine motor in children with ASD. These findings provide support for the use of Orff music therapy as an effective intervention for children with ASD.
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Affiliation(s)
- Qiongli Fan
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Mengying Ding
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Wang Cheng
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China
- Department of Pediatrics, The General Hospital of Western Theater Command, Chengdu, China
| | - LiSha Su
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yuping Zhang
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Quanxing Liu
- Department of Thoracic Surgery, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhifeng Wu
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, China
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Alwetaid MY, Almanaa TN, Bakheet SA, Ansari MA, Nadeem A, Attia SM, Hussein MH, Attia MSM, Ahmad SF. Aflatoxin B 1 exposure exacerbates chemokine receptor expression in the BTBR T + Itpr3 tf/J Mouse Model, unveiling insights into autism spectrum disorder: A focus on brain and spleen. Reprod Toxicol 2024; 126:108599. [PMID: 38679149 DOI: 10.1016/j.reprotox.2024.108599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by significant difficulties in social interaction, communication, and repeated stereotypic behaviour. Aflatoxin B1 (AFB1) is the most potent and well-known mycotoxin in various food sources. Despite its propensity to generate significant biochemical and structural changes in human and animal tissues, the influence of AFB1 on ASD has yet to be thoroughly studied. Mounting evidence indicates that chemokine receptors play a crucial function in the central nervous system and are implicated in developing several neuroinflammatory disorders. Chemokine receptors in individuals with ASD were elevated in the anterior cingulate gyrus astrocytes, cerebellum, and brain. METHODS The BTBR T+Itpr3tf/J (BTBR) mice are inbred strains that exhibit strong and consistently observed deficits in social interactions, characterized by excessive self-grooming and limited vocalization in social contexts. We examined the impact of AFB1 on CCR3-, CCR7-, CCR9-, CXCR3-, CXCR4-, and CXCR6-expressing I-A/I-E+ cells in the spleen of the BTBR mouse model of autism. We evaluated the mRNA levels of CCR3, CCR7, CCR9, CXCR3, CXCR4, and CXCR6 chemokine receptors in the brain. RESULTS The exposure to AFB1 in BTBR mice resulted in a significant rise in the number of I-A/I-E+CCR3+, I-A/I-E+CCR7+, I-A/I-E+CCR9+, I-A/I-E+CXCR3+, I-A/I-E+CXCR4+, and I-A/I-E+CXCR6+ cells. Furthermore, exposure to AFB1 increased mRNA expression levels of CCR3, CCR7, CCR9, CXCR3, CXCR4, and CXCR6 in the brain. CONCLUSIONS These findings highlight that AFB1 exposure increases the expression of chemokine receptors in BTBR mice, indicating the necessity for further research into AFB1's role in the development of ASD.
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Affiliation(s)
- Mohammad Y Alwetaid
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Taghreed N Almanaa
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Saleh A Bakheet
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mushtaq A Ansari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ahmed Nadeem
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sabry M Attia
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Marwa H Hussein
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohamed S M Attia
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sheikh F Ahmad
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
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Kaya İ, Karayagmurlu A, Kitapçıoğlu S, Bakman N, Erbay MF, Dinçel M, Soylu N. Increased Hyperactivity with Decreased Parental Perceived Social Support Among Turkish Children with Autism Spectrum Disorder during Coronavirus Disease 2019 Pandemic. ALPHA PSYCHIATRY 2024; 25:350-355. [PMID: 39148591 PMCID: PMC11322725 DOI: 10.5152/alphapsychiatry.2024.231226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/07/2024] [Indexed: 08/17/2024]
Abstract
Objective The aim of the present study is to investigate the change in emotional/behavioral problems of children with autism spectrum disorder (ASD) and the perceived social support of parents during the coronavirus disease 2019 (COVID-19) pandemic. Methods A total of 51 children with ASD aged between 6 and 18 years took part in the study. The Aberrant Behavior Checklist (ABC), the Strengths and Difficulties Questionnaire (SDQ), and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to evaluate ASD symptoms, emotional/behavioral problems, and perceived social support, respectively. The cases were assessed before and 6 months after the pandemic. Results Our findings indicated that after the onset of the pandemic hyperactivity scores of children with ASD increased, whereas perceived social support of their parents decreased, compared to their pre-pandemic levels (P-value < .05). The increase in hyperactivity and irritability levels among children were positively associated with the presence of a chronic illness in the family and medication discontinuation (P-value < .05). Conclusion Quarantine in the COVID-19 pandemic may cause or worsen behavioral problems among children with ASD possibly due to problems related to poor medication adherence and lowered perceived social support among their parents. Clinicians working with children with special needs may be pro-active to assess and manage emotional/behavioral problems among this special population particularly during difficult times such as pandemic.
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Affiliation(s)
- İlyas Kaya
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Türkiye
| | - Ali Karayagmurlu
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Türkiye
| | | | - Nurgül Bakman
- Department of Child and Adolescent Psychiatrist, Siirt Research and Training Hospital, Siirt, Türkiye
| | - Muhammed Furkan Erbay
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Türkiye
| | - Melodi Dinçel
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Türkiye
| | - Nusret Soylu
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Türkiye
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15
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Jiang X, Chen X, Su J, Liu N. Prevalence of autism spectrum disorder in mainland china over the past 6 years: a systematic review and meta-analysis. BMC Psychiatry 2024; 24:404. [PMID: 38811881 PMCID: PMC11137880 DOI: 10.1186/s12888-024-05729-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 03/28/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Coupled with its rising prevalence, Autism spectrum disorder (ASD) has become a globally recognized public health concern. Nevertheless, large-scale, multicenter studies that analyze the epidemiology of ASD in China are relatively scarce. METHODS Literature searches were conducted in PubMed/Medline, Embase, the Cochrane Library, Wanfang Data Knowledge Service Platform, China Biology Medicine database (CBM), China Science and Technology Journal Database (CSTJ), and China National Knowledge Infrastructure (CNKI) to retrieve studies published before April 8, 2023, related to ASD prevalence among children aged 0 to 14 years in mainland China. Meta-analysis was conducted using RevMan 5.2 and Stata 14.0. RESULTS Twenty-one articles were included. The ASD prevalence among children in mainland China has been 0.7% (95% confidence interval(CI): 0.006-0.008) since 2017. The prevalence of ASD among boys was 1.0% (95% CI: 0.008-0.011), which was significantly higher than that among girls at 0.2% (95% CI: 0.002-0.003), with a statistically significant difference (OR = 3.198, 95% CI: 2.489-4.109, P = 0.000). Among the included studies, 18 reported an ASD prevalence of 0.8% (95% CI: 0.007-0.010), while 3 studies reported an autistic disorder (AD) prevalence of 0.7% (95% CI: 0.006-0.008). The prevalence of autism among urban children was 23.9% (95% CI: 0.149-0.328), and in rural areas, it was 0.7% (95% CI: 0.002-0.013), with no statistically significant difference (OR = 1.342, 95% CI: 0.258-6.975, P = 0.727). Regression analysis showed that factors such as region (P = 0.000), age (P = 0.000), study period (P = 0.000), sample size (P = 0.000), sampling method (P = 0.002), population source (P = 0.000), disease type (P = 0.000), quality score of the study (P = 0.000), and diagnostic criteria (P = 0.000) might have contributed to the heterogeneity in ASD prevalence. CONCLUSION The prevalence of ASD in China from 2017 to 2023 was 7/1000, showing an upward trend compared to that before 2017 (26.50/10,000). The male-to-female prevalence ratio was 5:1.The overall prevalence remained significantly lower than that reported in foreign countries.
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Affiliation(s)
- Xinhong Jiang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China
| | - Xianrui Chen
- Department of Pediatric Rehabilitation, Xiamen Rehabilitation Hospital, Xiamen, 361003, Fujian, China
| | - Jingying Su
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian, China.
| | - Nan Liu
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.
- Fujian Institute of Cerebrovascular Disease, Fuzhou, 350001, Fujian, China.
- Key Laboratory of Brain Aging and Neurodegenerative Diseases, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350001, Fujian, China.
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.
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16
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Yan X, Li Y, Li Q, Li Q, Xu G, Lu J, Yang W. Prevalence of Autism Spectrum Disorder Among Children and Adolescents in the United States from 2021 to 2022. J Autism Dev Disord 2024:10.1007/s10803-024-06390-7. [PMID: 38778000 DOI: 10.1007/s10803-024-06390-7] [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] [Accepted: 05/01/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE The prevalence of autism spectrum disorder (ASD) among children and adolescents seem to be high in countries around the world, and it's worth understanding the latest prevalence and trends of ASD in children and adolescents. The purpose of this study was to examine the latest prevalence and decade trend of ASD among individuals aged 3-17 years in the United States. METHODS A total of 13,198 individuals aged 3-17 years were included. Annual data were examined from the National Health Interview Survey (2021-2022). Weighted prevalence for each of the selected developmental disabilities were calculated. RESULTS This cross-sectional study estimated the weighted prevalence of autism spectrum disorder were 3.05, 3.79, and 3.42% among individuals aged 3-17 years in the US in 2021, 2022, and the 2-year overall, respectively. We also observed a decade-long upward trend even after adjusting for demographic characteristics (P for trend < .05). CONCLUSION The results of this study showed that the prevalence of ASD among children and adolescents aged 3-17 years in the United States remained high and has increased over the past decade. The further investigation is necessary to evaluate potential modifiable risk factors and causes of ASD.
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Affiliation(s)
- Xiaofang Yan
- Department of Child and Adolescent Health, School of Public Health, Guangdong Province, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Yanmei Li
- Department of Child and Adolescent Health, School of Public Health, Guangdong Province, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Qishan Li
- Department of Child and Adolescent Health, School of Public Health, Guangdong Province, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Qian Li
- Department of Child and Adolescent Health, School of Public Health, Guangdong Province, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Guifeng Xu
- Department of Pediatrics, The First Affiliated Hospital, University of Science and Technology of China, Hefei, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangdong Province, Guangzhou Medical University, Guangzhou, 510623, China.
| | - Wenhan Yang
- Department of Child and Adolescent Health, School of Public Health, Guangdong Province, Guangdong Pharmaceutical University, Guangzhou, 510006, China.
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Marsack-Topolewski CN, Samuel PS. Experiences of Parental Caregivers of Adults with Autism in Navigating the World of Employment. J Autism Dev Disord 2024:10.1007/s10803-024-06381-8. [PMID: 38764071 DOI: 10.1007/s10803-024-06381-8] [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] [Accepted: 04/24/2024] [Indexed: 05/21/2024]
Abstract
PURPOSE Caregiving often presents challenges for parents, particularly for parents of loved ones with disabilities or health challenges, who need and/or want to be employed. This study describes the employment experiences of aging parents as they continue to balance engagement in the paid workforce with the ongoing provision of care for their adult children with autism spectrum disorder (ASD). The purpose of this study was to examine the lived experiences of parents of adult children with ASD in the context of balancing career and caregiving responsibilities. METHODS The current study uses a qualitative phenomenological research approach to describe the lived experiences of 51 parents who were caring for an adult child with ASD. The parents participated in telephone interviews to obtain information about their career experiences while providing care and support to their adult children with ASD. RESULTS Three caregiving themes emerged including: (a) difficulty balancing caregiving with work responsibilities, (b) reasons for working, not working, or working intermittently, and (c) work as an escape or wanting to work more. CONCLUSION As more individuals with ASD reach adulthood, often relying to varying extents on their families for daily support, parental employment will continue to be impacted as they juggle their career with caregiving responsibilities. Economically, one or more family members typically need to work to sustain the family's needs and employment support should be considered. As a society, families often need to make choices even with an adult child with ASD of who will work, how, and when.
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Affiliation(s)
- Christina N Marsack-Topolewski
- School of Social Work, Eastern Michigan University, 206H Everett L. Marshall Building, Ypsilanti, Ypsilanti, MI, 48197, USA.
| | - Preethy S Samuel
- College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI, 48201, USA
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Sheldrick RC, Hooker JL, Carter AS, Feinberg E, Croen LA, Kuhn J, Slate E, Wetherby AM. The influence of loss to follow-up in autism screening research: Taking stock and moving forward. J Child Psychol Psychiatry 2024; 65:656-667. [PMID: 37469104 PMCID: PMC10801774 DOI: 10.1111/jcpp.13867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND How best to improve the early detection of autism spectrum disorder (ASD) is the subject of significant controversy. Some argue that universal ASD screeners are highly accurate, whereas others argue that evidence for this claim is insufficient. Relatedly, there is no clear consensus as to the optimal role of screening for making referral decisions for evaluation and treatment. Published screening research can meaningfully inform these questions-but only through careful consideration of children who do not complete diagnostic follow-up. METHODS We developed two simulation models that re-analyze the results of a large-scale validation study of the M-CHAT-R/F by Robins et al. (2014, Pediatrics, 133, 37). Model #1 re-analyzes screener accuracy across six scenarios, each reflecting different assumptions regarding loss to follow-up. Model #2 builds on this by closely examining differential attrition at each point of the multi-step detection process. RESULTS Estimates of sensitivity ranged from 40% to 94% across scenarios, demonstrating that estimates of accuracy depend on assumptions regarding the diagnostic status of children who were lost to follow-up. Across a range of plausible assumptions, data also suggest that children with undiagnosed ASD may be more likely to complete follow-up than children without ASD, highlighting the role of clinicians and caregivers in the detection process. CONCLUSIONS Using simulation modeling as a quantitative method to examine potential bias in screening studies, analyses suggest that ASD screening tools may be less accurate than is often reported. Models also demonstrate the critical importance of every step in a detection process-including steps that determine whether children should complete an additional evaluation. We conclude that parent and clinician decision-making regarding follow-up may contribute more to detection than is widely assumed.
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Affiliation(s)
| | | | - Alice S. Carter
- Department of Psychology, University of Massachusetts Boston, Boston, MA
| | - Emily Feinberg
- School of Public Health, Brown University, Providence, MA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Jocelyn Kuhn
- School of Public Health, Brown University, Providence, MA
| | - Elizabeth Slate
- Department of Statistics, Florida State University, Tallahassee, FL
| | - Amy M. Wetherby
- College of Medicine, Florida State University, Tallahassee, FL
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Modirrousta A, Harris YR. Parental strategies to promote theory of mind development in autistic children of color. Front Psychol 2024; 15:1347504. [PMID: 38699568 PMCID: PMC11064013 DOI: 10.3389/fpsyg.2024.1347504] [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: 11/30/2023] [Accepted: 03/22/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction Autism Spectrum Disorder is characterized by an impaired ability to take other people's perspectives, which is known as theory of mind. However, little is known about how theory of mind exhibits itself in autistic children of color and how parents foster their child's developmental skills in communities of color. Methods Two interviews were created to assess how parents appraise their child's developmental skills and help their child grow: a perspective-teaching interview and a general developmental skills interview. Four families participated in the study; three children were African American or mixed, while one had an Asian mother. Parents were asked how their child exhibited various developmental skills and how they helped their child with those milestones. Results Parents pointed at similar delays in theory of mind and other developmental skills, such as turn-taking and reading faces. They also provided similar strategies to teach those abilities, such as modeling and reinforcements. Several insights and common themes were found regarding autistic behaviors their children expressed and how those affected their parenting experiences. Discussion These findings allow for a better understanding of parents' experiences raising autistic children of color; future research could expand on their stories and create interventions tailored to these underrepresented communities.
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Ferrara R, Damato F, Iovino L, Marti F, Latina R, Colombi C, Ricci P. ESDM intervention in severe preschool autism: an Italian Case report, psychological and social medicine reflections. Ital J Pediatr 2024; 50:60. [PMID: 38575971 PMCID: PMC10993588 DOI: 10.1186/s13052-024-01626-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The goal of our contribution is to discuss a preschool intervention based on the Early Start Denver Model and the use of the main tools for the detection of adaptive behaviour in cases of autism: Vineland, ABAS. CASE PRESENTATION the work is the presentation of a clinical case that has benefited from an intervention with the Early Start Denver Model methodology for the benefit of a child with socio-cultural and economic disadvantages. This early intervention, in a child of 36 months, which followed the diagnosis, was possible thanks to the intervention of many third-sector organizations which allowed this child, with a serious autism profile, to receive an evidence-based intervention for free. At the beginning of the intervention, the child presented a diagnosis of severe autism with absence of gaze, vocalizations and other communicative impairments. The level of motor clumsiness was also quite high, as were stereotypies. CONCLUSIONS Research has shown the usefulness of intervening in this area with an early assessment and/or diagnosis and immediate intervention; however, public health services are not always able to maintain this pace. Our contribution therefore shows on the one hand the evidence of the improvements achieved by the child despite the low intensity of the treatment, and on the other hand, demonstrates the total versatility and adaptability of the Denver Model to the Italian context. In our conclusions, there are also some reflections on the tools used to measure adaptive behavior which seem to have a number of limitations and criticalities.
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Affiliation(s)
- Rosaria Ferrara
- Department of Anatomy Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
| | - Felice Damato
- Department of Anatomy Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy
| | | | - Flavio Marti
- Department of Health Professions, A.O. San Camillo Forlanini, Rome, Italy
| | - Roberto Latina
- Nursing Science, Department of Health Promotion Science, Maternal and Infant Care, Internal Medicine, and Medical Specialities (PROMISE), University of Palermo, Palermo, Italy
| | | | - Pasquale Ricci
- Department of Anatomy Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy
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Guo Z, Tang X, Xiao S, Yan H, Sun S, Yang Z, Huang L, Chen Z, Wang Y. Systematic review and meta-analysis: multimodal functional and anatomical neural alterations in autism spectrum disorder. Mol Autism 2024; 15:16. [PMID: 38576034 PMCID: PMC10996269 DOI: 10.1186/s13229-024-00593-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND This meta-analysis aimed to explore the most robust findings across numerous existing resting-state functional imaging and voxel-based morphometry (VBM) studies on the functional and structural brain alterations in individuals with autism spectrum disorder (ASD). METHODS A whole-brain voxel-wise meta-analysis was conducted to compare the differences in the intrinsic functional activity and gray matter volume (GMV) between individuals with ASD and typically developing individuals (TDs) using Seed-based d Mapping software. RESULTS A total of 23 functional imaging studies (786 ASD, 710 TDs) and 52 VBM studies (1728 ASD, 1747 TDs) were included. Compared with TDs, individuals with ASD displayed resting-state functional decreases in the left insula (extending to left superior temporal gyrus [STG]), bilateral anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC), left angular gyrus and right inferior temporal gyrus, as well as increases in the right supplementary motor area and precuneus. For VBM meta-analysis, individuals with ASD displayed decreased GMV in the ACC/mPFC and left cerebellum, and increased GMV in the left middle temporal gyrus (extending to the left insula and STG), bilateral olfactory cortex, and right precentral gyrus. Further, individuals with ASD displayed decreased resting-state functional activity and increased GMV in the left insula after overlapping the functional and structural differences. CONCLUSIONS The present multimodal meta-analysis demonstrated that ASD exhibited similar alterations in both function and structure of the insula and ACC/mPFC, and functional or structural alterations in the default mode network (DMN), primary motor and sensory regions. These findings contribute to further understanding of the pathophysiology of ASD.
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Affiliation(s)
- Zixuan Guo
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xinyue Tang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shu Xiao
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hong Yan
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shilin Sun
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zibin Yang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Ying Wang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Di Vara S, Guerrera S, Menghini D, Scibelli F, Lupi E, Valeri G, Vicari S. Characterizing individual differences in children and adolescents with autism spectrum disorder: a descriptive study. Front Psychol 2024; 15:1323787. [PMID: 38476386 PMCID: PMC10927760 DOI: 10.3389/fpsyg.2024.1323787] [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: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a higher prevalence in male than in female participants. Recent studies have hypothesized the presence of different phenotypes in male and female participants with ASD. The present study aims to assess possible sex differences in cognitive and adaptive functioning, symptomatology of ASD, and psychopathological comorbidities in a large sample of children and adolescents with ASD. Methods The study included a total of 2,146 children and adolescents diagnosed with ASD, comprising 1785 boys (mean age 7.12 ± 3.69 years) and 361 girls (mean age 6.25 ± 3.30 years). The age of the participants ranged from 1.35 to 19.05 years (mean age 9.98 ± 3.64). The study sought to include all children and adolescents diagnosed with Autism or ASD. Results Present results showed that girls with ASD had lower IQs than boys but similar adaptive functioning. The severity of symptoms of ASD was greater in boys than in girls, as were scores on psychopathological measures. With increasing age, boys with ASD showed greater impairment in social communication skills than girls and increased psychopathological comorbidities. Older girls showed fewer restricted and repetitive behaviors. Discussion Exploring phenotypic differences in children and adolescents with ASD fosters an understanding of subtle diagnostic facets that may go unrecognized, allowing for increasingly individualized and tailored interventions.
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Affiliation(s)
- S. Di Vara
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - S. Guerrera
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - D. Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - F. Scibelli
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - E. Lupi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - G. Valeri
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - S. Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, Rome, Italy
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Klaiman C, White S, Richardson S, McQueen E, Walum H, Aoki C, Smith C, Minjarez M, Bernier R, Pedapati E, Bishop S, Ence W, Wainer A, Moriuchi J, Tay SW, Deng Y, Jones W, Gillespie S, Klin A. Expert Clinician Certainty in Diagnosing Autism Spectrum Disorder in 16-30-Month-Olds: A Multi-site Trial Secondary Analysis. J Autism Dev Disord 2024; 54:393-408. [PMID: 36396807 PMCID: PMC9672659 DOI: 10.1007/s10803-022-05812-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 11/18/2022]
Abstract
Differential diagnosis of young children with suspected autism spectrum disorder (ASD) is challenging, and clinician uncertainty about a child's diagnosis may contribute to misdiagnosis and subsequent delays in access to early treatment. The current study was designed to replicate and expand a recent report in this Journal (McDonnell et al. in J Autism Dev Disord 49:1391-1401, https://doi.org/10.1080/15374416.2020.1823850 , 2019), in which only 60% of diagnoses were made with complete certainty by clinicians evaluating 478 toddlers and preschool children referred for possible ASD to specialized clinics. In this study, secondary analyses were performed on diagnostic, demographic and clinical data for 496 16-30-month-old children who were consecutive referrals to a 6-site clinical trial executed by specialized centers with experienced clinicians following best-practice procedures for the diagnosis of ASD. Overall, 70.2% of diagnoses were made with complete certainty. The most important factor associated with clinician uncertainty was mid-level autism-related symptomatology. Mid-level verbal age equivalents were also associated with clinician uncertainty, but measures of symptomatology were stronger predictors. None of the socio-demographic variables, including sex of the child, was significantly associated with clinician certainty. Close to one third of early diagnoses of ASD are made with a degree of uncertainty. The delineation of specific ranges on the ADOS-2 most likely to result in clinician uncertainty identified in this study may provide an opportunity to reduce random subjectivity in diagnostic decision-making via calibration of young-child diagnostic thresholds based on later-age longitudinal diagnostic outcome data, and via standardization of decision-making in regard to clinical scenarios frequently encountered by clinicians.
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Affiliation(s)
- Cheryl Klaiman
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Stormi White
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Shana Richardson
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Emma McQueen
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Hasse Walum
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Christa Aoki
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | - Mendy Minjarez
- Seattle Children's Hospital & Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Raphael Bernier
- Seattle Children's Hospital & Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Ernest Pedapati
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Somer Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - Whitney Ence
- University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Warren Jones
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Center for Translational Social Neuroscience, Emory University, 954 Gatewood Road, Atlanta, GA, USA
| | - Scott Gillespie
- Pediatric Biostatistics Core, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Ami Klin
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
- Center for Translational Social Neuroscience, Emory University, 954 Gatewood Road, Atlanta, GA, USA.
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So WC, Wong E, Ng W, Fuego J, Lay S, So MT, Lee YY, Chan WY, Chua LY, Lam HL, Lam WT, Li HM, Leung WT, Ng YH, Wong WT. Seeing through a robot's eyes: A cross-sectional exploratory study in developing a robotic screening technology for autism. Autism Res 2024; 17:366-380. [PMID: 38183409 DOI: 10.1002/aur.3087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/09/2023] [Indexed: 01/08/2024]
Abstract
The present exploratory cross-sectional case-control study sought to develop a reliable and scalable screening tool for autism using a social robot. The robot HUMANE, installed with computer vision and linked with recognition technology, detected the direction of eye gaze of children. Children aged 3-8 (M = 5.52; N = 199) participated, 87 of whom had been confirmed with autism, 55 of whom were suspected to have autism, and 57 of whom were not considered to cause any concern for having autism. Before a session, a human experimenter instructed HUMANE to narrate a story to a child. HUMANE prompted the child to return his/her eye gaze to the robot if the child looked away, and praised the child when it re-established its eye gaze quickly after a prompt. The reliability of eye gaze detection was checked across all pairs of human raters and HUMANE and reached 0.90, indicating excellent interrater agreement. Using the pre-specified reference standard (Autism Spectrum Quotient), the sensitivity and specificity of the index tests (i.e., the number of robot prompts and duration of inattentiveness) reached 0.88 or above and the Diagnostic Odds Ratios were beyond 190. These results show that social robots may detect atypical eye patterns, suggesting a potential future for screening autism using social robots.
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Affiliation(s)
- Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Elsa Wong
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - Wingo Ng
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - John Fuego
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - Sally Lay
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - Ming-Ting So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yuen-Yung Lee
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wai-Yan Chan
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lok-Ying Chua
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hiu-Lok Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-Tung Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hin-Miu Li
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-To Leung
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yu-Hei Ng
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-Ting Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
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Nagai Y, Nomura K, Uemura O. Primitive reflexes in very low birth weight infants later diagnosed with autism spectrum disorder. Minerva Pediatr (Torino) 2024; 76:19-23. [PMID: 32549029 DOI: 10.23736/s2724-5276.20.05784-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND As early screening and diagnosis is very important in treatment and intervention of autism spectrum disorder (ASD), we investigated the relationship between primitive reflexes and ASD. METHODS Of 88 very low birth weight infants (<1500 g) born from April 2010 to March 2012, subjects comprised 38 examined for 18 primitive reflexes between age 38 and 45 weeks corrected age and followed-up over 6 years. ASD was diagnosed using Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) and Autism Diagnostic Observation Schedule Second Edition (ADOS-2). We compared the number of abnormal primitive reflexes between two groups (11 children with and 19 without ASD) after excluding eight children with cerebral palsy in this case-control study. RESULTS Twenty cases showed one to four hypoactive reflex(es) and two showed one hyperactive reflex together with hypoactive reflex(es). Ten out of 11 cases with ASD had one to four abnormal reflex(es). The number of abnormal hypoactive primitive reflexes was significantly higher in the ASD group (P=0.002). CONCLUSIONS The result suggests primitive reflexes can be one of the key elements in very early infancy to identify ASD in low-birth-weight infants. Abnormal hypoactive primitive reflex of low-birth-weight infants with ASD may inform future research of the pathogenesis of ASD.
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Affiliation(s)
- Yukiyo Nagai
- Department of Pediatrics, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan -
| | - Kayo Nomura
- Department of Pediatrics, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Osamu Uemura
- Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Obu, Japan
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26
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Rodnyy AY, Kondaurova EM, Tsybko AS, Popova NK, Kudlay DA, Naumenko VS. The brain serotonin system in autism. Rev Neurosci 2024; 35:1-20. [PMID: 37415576 DOI: 10.1515/revneuro-2023-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/10/2023] [Indexed: 07/08/2023]
Abstract
Autism spectrum disorders (ASDs) are among the most common neurodevelopmental diseases. These disorders are characterized by lack of social interaction, by repetitive behavior, and often anxiety and learning disabilities. The brain serotonin (5-HT) system is known to be crucially implicated in a wide range of physiological functions and in the control of different kinds of normal and pathological behavior. A growing number of studies indicate the involvement of the brain 5-HT system in the mechanisms underlying both ASD development and ASD-related behavioral disorders. There are some review papers describing the role of separate key players of the 5-HT system in an ASD and/or autistic-like behavior. In this review, we summarize existing data on the participation of all members of the brain 5-HT system, namely, 5-HT transporter, tryptophan hydroxylase 2, MAOA, and 5-HT receptors, in autism in human and various animal models. Additionally, we describe the most recent studies involving modern techniques for in vivo regulation of gene expression that are aimed at identifying exact roles of 5-HT receptors, MAOA, and 5-HT transporter in the mechanisms underlying autistic-like behavior. Altogether, results of multiple research articles show that the brain 5-HT system intimately partakes in the control of some types of ASD-related behavior, and that specific changes in a function of a certain 5-HT receptor, transporter, and/or enzyme may normalize this aberrant behavior. These data give hope that some of clinically used 5-HT-related drugs have potential for ASD treatment.
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Affiliation(s)
- Alexander Ya Rodnyy
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Akad. Lavrentyeva Ave. 10, Novosibirsk 630090, Russia
| | - Elena M Kondaurova
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Akad. Lavrentyeva Ave. 10, Novosibirsk 630090, Russia
| | - Anton S Tsybko
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Akad. Lavrentyeva Ave. 10, Novosibirsk 630090, Russia
| | - Nina K Popova
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Akad. Lavrentyeva Ave. 10, Novosibirsk 630090, Russia
| | - Dmitry A Kudlay
- NRC Institute of Immunology FMBA of Russia, Kashirskoe Highway 24, Moscow 115522, Russia
- Sechenov's University, 8-2 Trubetskaya Str., Moscow 119991, Russia
| | - Vladimir S Naumenko
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Akad. Lavrentyeva Ave. 10, Novosibirsk 630090, Russia
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Huang M, Wang J, Liu W, Zhou H. Advances in the role of the GADD45 family in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. Front Neurosci 2024; 18:1349409. [PMID: 38332860 PMCID: PMC10850240 DOI: 10.3389/fnins.2024.1349409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/10/2024] [Indexed: 02/10/2024] Open
Abstract
The growth arrest and DNA damage inducible protein 45 (GADD45) family comprises stress-induced nuclear proteins that interact with DNA demethylases to facilitate DNA demethylation, thereby regulating diverse cellular processes including oxidative stress, DNA damage repair, apoptosis, proliferation, differentiation, inflammation, and neuroplasticity by modulating the expression patterns of specific genes. Widely expressed in the central nervous system, the GADD45 family plays a pivotal role in various neurological disorders, rendering it a potential therapeutic target for central nervous system diseases. This review presented a comprehensive overview of the expression patterns and potential mechanisms of action associated with each member of GADD45 family (GADD45α, GADD45β, and GADD45γ) in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders, while also explored strategies to harness these mechanisms for intervention and treatment. Future research should prioritize the development of effective modulators targeting the GADD45 family for clinical trials aimed at treating central nervous system diseases.
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Affiliation(s)
| | | | | | - Hongyan Zhou
- Hubei Key Laboratory of Cognitive and Affective Disorders, Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China
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28
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Chen X, Tong J, Zhang W, Wang X, Ma S, Shi D, Yan D, Liu Y. Factors predicting depressive symptoms in parents of children with autism spectrum disorder in eastern China. BMC Public Health 2024; 24:226. [PMID: 38238720 PMCID: PMC10797873 DOI: 10.1186/s12889-024-17731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Parents of children with autism spectrum disorder (ASD) are at a higher risk of depression than parents of typically developing children and those of children with other developmental disorders. Depression affects the well-being and quality of life of parents of children with ASD and has serious consequences for the long-term health outcomes of children with ASD. Therefore, this study explored the current status of depressive symptoms in parents of children with ASD in eastern China and further analyzed multiple aspects of the predictors of depressive symptoms. METHODS A multicenter cross-sectional survey was conducted among parents of children with ASD in the rehabilitation department of a large specialized hospital and 10 rehabilitation centers for children with special needs in Lianyungang, Jiangsu Province, Eastern China. A structured questionnaire that focused on child-related factors, parent-related factors, depressive symptoms, courtesy stigma, and social support was used to obtain data. Binary logistic regression was used to identify the independent predictors of depressive symptoms in parents of children with ASD. RESULTS A total of 409 parents of children with ASD were recruited, of whom 18.8% had depressive symptoms. Parents of children with ASD who raised a child who spoke few to no words (odds ratio [OR]: 2.747, 95% confidence interval [CI]: 1.026-7.357), claimed a high economic burden (OR: 3.215, 95% CI: 1.234-8.379), reported no change or increased severity of ASD in their children (OR: 2.518, 95% CI: 1.108-5.720), and those with a higher courtesy stigma score (OR: 1.189, 95% CI: 1.093-1.294) were more likely to have depressive symptoms. Conversely, parents of children with ASD who were employed (OR: 0.427, 95% CI: 0.201-0.907), satisfied with their current marital status (OR: 0.429, 95% CI: 0.221-0.834), and those with a higher social support score (OR: 0.973, 95% CI: 0.950-0.996) were less likely to have depressive symptoms. CONCLUSIONS Depressive symptoms are common in parents of children with ASD in eastern China. Therefore, screening and intervention for depressive symptoms in parents of children with ASD is necessary, especially for those with high-risk factors.
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Affiliation(s)
- Xu Chen
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, 222000, Lianyungang, Jiangsu, China
| | - Jiao Tong
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, 222000, Lianyungang, Jiangsu, China
| | - Weijing Zhang
- National Health Commission Contraceptives Adverse Reaction Surveillance Center, NO.277 Fenghuang west Street, Gulou District, 210036, Nanjing, Jiangsu, China
- Jiangsu Health Development Research Center, Nanjing, Jiangsu, China
- Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment, Nanjing, Jiangsu, China
| | - Xin Wang
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, 222000, Lianyungang, Jiangsu, China
| | - Shan Ma
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, 222000, Lianyungang, Jiangsu, China
| | - Dongdong Shi
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, 222000, Lianyungang, Jiangsu, China
| | - Dongmei Yan
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, 222000, Lianyungang, Jiangsu, China.
| | - Yan Liu
- National Health Commission Contraceptives Adverse Reaction Surveillance Center, NO.277 Fenghuang west Street, Gulou District, 210036, Nanjing, Jiangsu, China.
- Jiangsu Health Development Research Center, Nanjing, Jiangsu, China.
- Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment, Nanjing, Jiangsu, China.
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Sánchez Pedroche A, Valera-Pozo M, Mateus Moreno A, Lara Díaz MF, Aguilar-Mediavilla E, Adrover-Roig D. Is language impaired in Spanish-speaking children with autism spectrum disorder level 1? AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415241275931. [PMID: 39221433 PMCID: PMC11363034 DOI: 10.1177/23969415241275931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
The current diagnostic criteria for the autism spectrum disorder (ASD) include the possibility to specify concomitant language difficulties. Purpose Our main aim was to explore whether children with ASD-Level 1 (ASD-L1) present difficulties in the acquisition of structural language, as little work has been done in this regard so far. As a secondary aim we evaluated the degree to which the potential language impairment in ASD is directly associated with their social communication deficits or it represents a distinct deficit. Methods To further clarify the nature and characteristics of putative language difficulties in ASD-L1, we evaluated language skills in 89 children and preadolescents diagnosed with ASD-L1, and a group of typically developing participants (TD). All of them were between 8 and 13 years old and had similar socioeconomic backgrounds. Results Children with ASD-L1 obtained lower scores than those in TD group in repeating sentences, in finding the semantic relationships between words, and in applying word structure rules (morphology). Congruently, the core language standard score was lower in the ASD-L1 group, and the proportion of language delay was significantly higher in the ASD-L1 group than in the control group. Conclusion Language scores were associated with autistic traits; thus, language performance in ASD-L1 is closely related to autistic symptoms. These results are discussed according to the literature on linguistic deficits in ASD-L1 and their relations with phonological working memory.
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Affiliation(s)
- Alberto Sánchez Pedroche
- Department of Applied Pedagogy and Educational Psychology, Institute of Research and Innovation in Education (IRIE), University of Balearic Islands, Palma, Spain
| | - Mario Valera-Pozo
- Department of Applied Pedagogy and Educational Psychology, Institute of Research and Innovation in Education (IRIE), University of Balearic Islands, Palma, Spain
| | - Angelica Mateus Moreno
- Human Communication Department, Faculty of Medicine, Universidad Nacional de Colombia, Bogotà, Colombia
| | - Maria Fernanda Lara Díaz
- Human Communication Department, Faculty of Medicine, Universidad Nacional de Colombia, Bogotà, Colombia
| | | | - Daniel Adrover-Roig
- Department of Applied Pedagogy and Educational Psychology, Institute of Research and Innovation in Education (IRIE), University of Balearic Islands, Palma, Spain
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30
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Alasiri RM, Albarrak DA, Alghaith DM, Alsayari OS, Alqahtani YS, Bafarat AY, Tashkandi NF. Quality of Life of Autistic Children and Supported Programs in Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e51645. [PMID: 38313888 PMCID: PMC10837822 DOI: 10.7759/cureus.51645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurobehavioral condition marked by social interaction challenges, communication deficits, and repetitive behaviors, with studies in Saudi Arabia showing varying prevalence rates in different regions. This study aimed to evaluate the social context of autistic children and the quality of life (QOL) for families of children with autism utilizing the Beach Center Family Quality of Life Scale (BCFQOL). METHODS This cross-sectional study, conducted at King Abdulaziz Medical City in Saudi Arabia over a six-month period, included ASD children aged 1-14 years. The QOL was measured using the BCFQOL scale for families. Data were analyzed using the Jamovi software (Windows version 2.4.1, the Jamovi Project, retrieved from https://www.jamovi.org). RESULTS A total of 102 responses were collected in the study. The overall satisfaction score was 93.6±16.6 out of 125, with 85.3% of participants expressing satisfaction. Domains explored included family interaction (23.8±5.29 out of 30), parenting practices (23.9±3.83 out of 30), emotional well-being (13.1±4.16 out of 20), physical and material well-being (18.7±4.24 out of 25), and disability-related support (14.2±4.0 out of 20). In terms of specific sociodemographic factors, no statistically significant differences in satisfaction were observed across various categories. CONCLUSION Families of children with ASD in Saudi Arabia generally report high levels of satisfaction, as assessed by the BCFQOL. The study covered various domains, including family interaction, parenting practices, emotional well-being, physical well-being, and disability-related support, with most respondents expressing satisfaction in these areas. Notably, sociodemographic factors did not significantly influence satisfaction levels, underscoring the pervasive nature of the findings across different demographic groups. Further studies with a larger sample size and a longer follow-up period are required to validate these findings.
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Affiliation(s)
- Rahaf Mohammed Alasiri
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Danah Abdullah Albarrak
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Deemah Meshal Alghaith
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Ohoud Saad Alsayari
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Yasmeen Salem Alqahtani
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
| | - Ammar Y Bafarat
- Psychiatry, King Abdulaziz Hospital, Jeddah, SAU
- Psychiatry, Ministry of National Guard Health Affairs, Alahsa, SAU
| | - Noha Farouk Tashkandi
- Medical Research, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
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Yenkoyan K, Mkhitaryan M, Bjørklund G. Environmental Risk Factors in Autism Spectrum Disorder: A Narrative Review. Curr Med Chem 2024; 31:2345-2360. [PMID: 38204225 DOI: 10.2174/0109298673252471231121045529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 01/12/2024]
Abstract
Existing evidence indicates that environmental factors might contribute up to 50% of the variance in autism spectrum disorder (ASD) risk. This structured narrative review offers a comprehensive synthesis of current knowledge on environmental risk factors in ASD, including evaluation of conflicting evidence, exploration of underlying mechanisms, and suggestions for future research directions. Analysis of diverse epidemiological investigations indicates that certain environmental factors, including advanced parental age, preterm birth, delivery complications, and exposure to toxic metals, drugs, air pollutants, and endocrine-disrupting chemicals, are linked to an increased ASD risk through various mechanisms such as oxidative stress, inflammation, hypoxia, and its consequences, changes in neurotransmitters, disruption of signaling pathways and some others. On the other hand, pregnancy-related factors such as maternal diabetes, maternal obesity, and caesarian section show a weaker association with ASD risk. At the same time, other environmental factors, such as vaccination, maternal smoking, or alcohol consumption, are not linked to the risk of ASD. Regarding nutritional elements data are inconclusive. These findings highlight the significance of environmental factors in ASD etiology and emphasize that more focused research is needed to target the risk factors of ASD. Environmental interventions targeting modifiable risk factors might offer promising avenues for ASD prevention and treatment.
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Affiliation(s)
| | - Meri Mkhitaryan
- Neuroscience Laboratory, Cobrain Center, YSMU, Yerevan, 0025, Armenia
| | - Geir Bjørklund
- Department of Research, Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
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Canitano R, Bozzi Y. Autism Spectrum Disorder with Epilepsy: A Research Protocol for a Clinical and Genetic Study. Genes (Basel) 2023; 15:61. [PMID: 38254951 PMCID: PMC10815607 DOI: 10.3390/genes15010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental condition affecting ~1% of people worldwide. Core ASD features present with impaired social communication abilities, repetitive and stereotyped behaviors, and atypical sensory responses and are often associated with a series of comorbidities. Among these, epilepsy is frequently observed. The co-occurrence of ASD and epilepsy is currently thought to result from common abnormal neurodevelopmental pathways, including an imbalanced excitation/inhibition ratio. However, the pathological mechanisms involved in ASD-epilepsy co-morbidity are still largely unknown. Here, we propose a research protocol aiming to investigate electrophysiological and genetic features in subjects with ASD and epilepsy. This study will include a detailed electroencephalographic (EEG) and blood transcriptomic characterization of subjects with ASD with and without epilepsy. The combined approach of EEG and transcriptomic studies in the same subjects will contribute to a novel stratification paradigm of the heterogeneous ASD population based on quantitative gene expression and neurophysiological biomarkers. In addition, our protocol has the potential to indicate new therapeutic options, thus amending the current condition of absence of data and guidelines for the treatment of ASD with epilepsy.
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Affiliation(s)
- Roberto Canitano
- Division of Child and Adolescent Neuropsychiatry, University Hospital of Siena, 53100 Siena, Italy
| | - Yuri Bozzi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068 Rovereto, Italy;
- CNR Institute of Neuroscience, 56124 Pisa, Italy
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Oge-Enver E, Isat E, Cansever MS, Zubarioglu T, Yilmaz G, Cebi MN, Aktuglu-Zeybek C, Kiykim E. Urinary neopterin and biopterin indicate that inflammation has a role in autism spectrum disorder. Metab Brain Dis 2023; 38:2645-2651. [PMID: 37688715 DOI: 10.1007/s11011-023-01287-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/01/2023] [Indexed: 09/11/2023]
Abstract
Inflammation is thought to be involved in the pathogenesis of autism spectrum disorder (ASD). Pteridine metabolites are biomarkers of inflammation that increase on immune system activation. In this study, we investigated the urinary pteridine metabolites in ASD patients as a possible biomarker for immune activation and inflammation. This observational, cross-sectional, prospective study collected urine samples from 212 patients with ASD and 68 age- and sex-matched healthy individuals. Urine neopterin (NE) and biopterin (BIO) levels were measured. Patients who had chronic disorders, active infection at the time of sampling, or high C-reactive protein levels were excluded. The urine NE and BIO concentrations were determined by high-performance liquid chromatography. The ratios of both NE and BIO to creatinine (CRE) were used to standardise the measurements. The NE/CRE and NE/BIO levels were significantly higher in ASD patients than controls. Univariate and multivariate models revealed a significant increase in NE/CRE and NE/BIO in ASD patients. There was a significant relationship between the NE/BIO [average area under the curve (AUC) = 0.717; range: 0.637-0.797] and NE/CRE (average AUC = 0.756; range: 0.684-0.828) ratios, which distinguished individuals with ASD from controls. The elevated NE/CRE and NE/BIO ratios suggest that inflammation and T cell-mediated immunity are involved in the pathophysiology of autism. NE/BIO could serve as a diagnostic inflammatory marker in the pathogenesis of ASD.
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Affiliation(s)
- Ece Oge-Enver
- Cerrahpasa Medical Faculty, Department of Pediatrics, Division of Nutrition and Metabolism, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Esra Isat
- Cerrahpasa Medical Faculty, Department of Pediatrics, Division of Nutrition and Metabolism, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mehmet Serif Cansever
- Department of Medical Services and Techniques, Vocational School of Health Services, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Tanyel Zubarioglu
- Cerrahpasa Medical Faculty, Department of Pediatrics, Division of Nutrition and Metabolism, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Gizem Yilmaz
- Cerrahpasa Medical Faculty, Department of Pediatrics, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Memnune Nur Cebi
- Cerrahpasa Medical Faculty, Department of Pediatrics, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Cigdem Aktuglu-Zeybek
- Cerrahpasa Medical Faculty, Department of Pediatrics, Division of Nutrition and Metabolism, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ertugrul Kiykim
- Cerrahpasa Medical Faculty, Department of Pediatrics, Division of Nutrition and Metabolism, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Almuqhim F, Saeed F. ASD-GResTM: Deep Learning Framework for ASD classification using Gramian Angular Field. PROCEEDINGS. IEEE INTERNATIONAL CONFERENCE ON BIOINFORMATICS AND BIOMEDICINE 2023; 2023:2837-2843. [PMID: 39021439 PMCID: PMC11254319 DOI: 10.1109/bibm58861.2023.10385743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Autism Spectrum Disorder (ASD) is a heterogeneous disorder in children, and the current clinical diagnosis is accomplished using behavioral, cognitive, developmental, and language metrics. These clinical metrics can be imperfect measures as they are subject to high test-retest variability, and are influenced by assessment factors such as environment, social structure, or comorbid disorders. Advances in neuroimaging coupled with machine-learning provides an opportunity to develop methods that are more quantifiable, and reliable than existing clinical techniques. In this paper, we design and develop a deep-learning model that operates on functional magnetic resonance imaging (fMRI) data, and can classify between ASD and neurotypical brains. We introduce a novel strategy to transform time-series data extracted from fMRI signals into Gramian Angular Field (GAF) while locking in the temporal and spatial patterns in the data. Our motivation is to design and develop a novel framework that could encode the time-series, acquired from fMRI data, into images that can be used by deep-learning architectures that have been successful in computer vision. In our proposed framework called ASD-GResTM, we used a Convolutional Neural Network (CNN) to extract useful features from GAF images. We then used a Long Short-Term Memory (LSTM) layer to learn the activities between the regions. Finally, the output representations of the last LSTM layer are applied to a single-layer perceptron (SPL) to get the final classification. Our extensive experimentation demonstrates high accuracy across 4 centers, and outperforms state-of-the-art models on two centers with an increase in the accuracy of 17.58% and 6.7%, respectively as compared to the state of the art. Our model achieved the maximum accuracy of 81.78% with high degree of sensitivity and specificity. All training, validation, and testing was accomplished using openly available ABIDE-I benchmarking dataset.
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Affiliation(s)
- Fahad Almuqhim
- Knight Foundation School of Computing and Information Sciences (KFSCIS), Florida International University (FIU), Miami, FL, USA
| | - Fahad Saeed
- Knight Foundation School of Computing and Information Sciences (KFSCIS), Florida International University (FIU), Miami, FL, USA
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Kereszturi É. Diversity and Classification of Genetic Variations in Autism Spectrum Disorder. Int J Mol Sci 2023; 24:16768. [PMID: 38069091 PMCID: PMC10706722 DOI: 10.3390/ijms242316768] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/19/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition with symptoms that affect the whole personality and all aspects of life. Although there is a high degree of heterogeneity in both its etiology and its characteristic behavioral patterns, the disorder is well-captured along the autistic triad. Currently, ASD status can be confirmed following an assessment of behavioral features, but there is a growing emphasis on conceptualizing autism as a spectrum, which allows for establishing a diagnosis based on the level of support need, free of discrete categories. Since ASD has a high genetic predominance, the number of genetic variations identified in the background of the condition is increasing exponentially as genetic testing methods are rapidly evolving. However, due to the huge amount of data to be analyzed, grouping the different DNA variations is still challenging. Therefore, in the present review, a multidimensional classification scheme was developed to accommodate most of the currently known genetic variants associated with autism. Genetic variations have been grouped according to six criteria (extent, time of onset, information content, frequency, number of genes involved, inheritance pattern), which are themselves not discrete categories, but form a coherent continuum in line with the autism spectrum approach.
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Affiliation(s)
- Éva Kereszturi
- Department of Molecular Biology, Semmelweis University, H-1085 Budapest, Hungary
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Chen X, Tong J, Jiang B, Ma S, Wang X, Sun X, Liu Y, Yan D, Wang L. Courtesy stigma among primary caregivers of children with autism spectrum disorder in eastern China. Front Psychiatry 2023; 14:1236025. [PMID: 38045614 PMCID: PMC10690950 DOI: 10.3389/fpsyt.2023.1236025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction The experience and perception of stigma is a common problem among primary caregivers of children with autism spectrum disorder (ASD), and has a profound adverse impact on primary caregivers and children with ASD; however, few studies have explored courtesy stigma among primary caregivers of children with ASD in the Chinese context. The aim of this study was to explore the status of courtesy stigma among primary caregivers of children with ASD in Lianyungang, Jiangsu Province, Eastern China, and to conduct in-depth analysis of its predictors from multiple perspectives. Methods An institution-based multi-center cross-sectional survey was conducted in the rehabilitation department of a large specialized hospital and 10 rehabilitation centers for children with special needs in Lianyungang, Jiangsu Province, Eastern China, from October 2022 to February 2023. A structured questionnaire to assess child-related factors, primary caregiver-related factors, courtesy stigma, general self-efficacy, and social support, was used to collect data. Predictors of courtesy stigma among primary caregivers of children with ASD were identified by linear regression. Results A total of 428 primary caregivers of children with ASD were recruited. The mean ± standard deviation (SD) score for courtesy stigma was 7.49 ± 4.13. Multiple linear regression analysis revealed that primary caregivers of children with ASD who were not too satisfied with their current marital status (β = 1.21, 95% CI: 0.34-2.08, p < 0.05) were more likely to have a high courtesy stigma; however, significantly lower courtesy stigma was observed in primary caregivers of children with ASD who were not picky eaters (β = -1.33, 95% CI: -2.08 - -0.58, p < 0.05), and who reported low level challenge in caring for children with ASD (β = -1.16, 95% CI: -2.20 - -0.12, p < 0.05), good general self-efficacy (β = -0.16, 95% CI: -0.25 - -0.06, p < 0.05), and good social support (β = -0.04, 95% CI: -0.08 - -0.01, p < 0.05). Conclusion There is a high level of courtesy stigma among primary caregivers of children with ASD in eastern China, and it is affected by numerous factors. More resources should be directed to groups that are more likely to experience stigma.
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Affiliation(s)
- Xu Chen
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Jiao Tong
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | | | - Shan Ma
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Xin Wang
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Xun Sun
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Yuan Liu
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Dongmei Yan
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Leilei Wang
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
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Chen R, Routh BN, Gaudet AD, Fonken LK. Circadian Regulation of the Neuroimmune Environment Across the Lifespan: From Brain Development to Aging. J Biol Rhythms 2023; 38:419-446. [PMID: 37357738 PMCID: PMC10475217 DOI: 10.1177/07487304231178950] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Circadian clocks confer 24-h periodicity to biological systems, to ultimately maximize energy efficiency and promote survival in a world with regular environmental light cycles. In mammals, circadian rhythms regulate myriad physiological functions, including the immune, endocrine, and central nervous systems. Within the central nervous system, specialized glial cells such as astrocytes and microglia survey and maintain the neuroimmune environment. The contributions of these neuroimmune cells to both homeostatic and pathogenic demands vary greatly across the day. Moreover, the function of these cells changes across the lifespan. In this review, we discuss circadian regulation of the neuroimmune environment across the lifespan, with a focus on microglia and astrocytes. Circadian rhythms emerge in early life concurrent with neuroimmune sculpting of brain circuits and wane late in life alongside increasing immunosenescence and neurodegeneration. Importantly, circadian dysregulation can alter immune function, which may contribute to susceptibility to neurodevelopmental and neurodegenerative diseases. In this review, we highlight circadian neuroimmune interactions across the lifespan and share evidence that circadian dysregulation within the neuroimmune system may be a critical component in human neurodevelopmental and neurodegenerative diseases.
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Affiliation(s)
- Ruizhuo Chen
- Division of Pharmacology & Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Brandy N. Routh
- Division of Pharmacology & Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas
- Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Andrew D. Gaudet
- Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
- Department of Psychology, The University of Texas at Austin, Austin, Texas
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Laura K. Fonken
- Division of Pharmacology & Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas
- Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
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38
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Wormwood KL, Charette L, Ryan JP, Darie CC, Woods AG. A Proteomics Investigation of Salivary Profiles as Potential Biomarkers for Autism Spectrum Disorder (ASD). Protein J 2023; 42:607-620. [PMID: 37566278 DOI: 10.1007/s10930-023-10146-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects approximately 1/68 children, with a more recent study suggesting numbers as high as 1/36. According to Diagnostic and Statistical Manual of Mental Disorders, the etiology of ASD is unknown and diagnosis of this disorder is behavioral. There is currently no biomarker signature for ASD, however, identifying a biomarker signature is crucial as it would aid in diagnosis, identifying treatment targets, monitoring treatments, and identifying the etiology of the disorder. Here we used nanoliquid chromatography-tandem mass spectrometry (nanoLC-MS/MS) to investigate the saliva from individuals with ASD and matched controls in a 14 vs 14 study. We found numerous proteins to have statistically significant dysregulations, including lactotransferrin, transferrin, polymeric immunoglobulin receptor, Ig A L, Ig J chain, mucin 5 AC, and lipocalin 1 isoform X1. These findings are consistent with previous studies by our lab, and others, and point to dysregulations in the immune system, lipid metabolism and/or transport, and gastrointestinal disturbances, which are common and reoccurring topics in ASD research.
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Affiliation(s)
- Kelly L Wormwood
- Biochemistry & Proteomics Laboratories, Department of Chemistry & Biomolecular Science, Clarkson University, 8 Clarkson Ave, Box 5810, Potsdam, NY, 13699, USA
| | - Laci Charette
- Center for Neurobehavioral Health and Department of Psychology, SUNY Plattsburgh, Plattsburgh, NY, USA
| | - Jeanne P Ryan
- Center for Neurobehavioral Health and Department of Psychology, SUNY Plattsburgh, Plattsburgh, NY, USA
| | - Costel C Darie
- Biochemistry & Proteomics Laboratories, Department of Chemistry & Biomolecular Science, Clarkson University, 8 Clarkson Ave, Box 5810, Potsdam, NY, 13699, USA.
| | - Alisa G Woods
- Biochemistry & Proteomics Laboratories, Department of Chemistry & Biomolecular Science, Clarkson University, 8 Clarkson Ave, Box 5810, Potsdam, NY, 13699, USA
- Center for Neurobehavioral Health and Department of Psychology, SUNY Plattsburgh, Plattsburgh, NY, USA
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MacKenzie KT, Mazefsky CA, Eack SM. Obtaining a First Diagnosis of Autism Spectrum Disorder: Descriptions of the Diagnostic Process and Correlates of Parent Satisfaction from a National Sample. J Autism Dev Disord 2023; 53:3799-3812. [PMID: 35896863 DOI: 10.1007/s10803-022-05673-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/27/2022]
Abstract
Obtaining an autism spectrum disorder (ASD) diagnosis is often challenging for parents. The purpose of this study was to better understand this process and examine how elements of the process may influence parent satisfaction. A total of 406 parents of autistic children participated. Participants were administered a survey covering the ASD diagnostic process. Parents had developmental concerns early but experienced long wait times and usually attended many appointments. Mean diagnostic age was 3.26 years and overall delay was 1.20 years. Stress and being told there was "no problem" were significantly associated with parental satisfaction with the process. Findings provide insight into challenges experienced by families of autistic children and can help pinpoint areas where the diagnostic process may be improved.
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Affiliation(s)
- Kristen T MacKenzie
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Shaun M Eack
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- University of Pittsburgh School of Social Work, Pittsburgh, PA, USA
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40
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Tang X, Feng C, Zhao Y, Zhang H, Gao Y, Cao X, Hong Q, Lin J, Zhuang H, Feng Y, Wang H, Shen L. A study of genetic heterogeneity in autism spectrum disorders based on plasma proteomic and metabolomic analysis: multiomics study of autism heterogeneity. MedComm (Beijing) 2023; 4:e380. [PMID: 37752942 PMCID: PMC10518435 DOI: 10.1002/mco2.380] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Genetic heterogeneity poses a challenge to research and clinical translation of autism spectrum disorder (ASD). In this study, we conducted a plasma proteomic and metabolomic study of children with ASD with and without risk genes (de novo mutation) and controls to explore the impact of genetic heterogeneity on the search for biomarkers for ASD. In terms of the proteomic and metabolomic profiles, the groups of children with ASD carrying and those not carrying de novo mutation tended to cluster and overlap, and integrating them yielded differentially expressed proteins and differential metabolites that effectively distinguished ASD from controls. The mechanisms associated with them focus on several common and previously reported mechanisms. Proteomics results highlight the role of complement, inflammation and immunity, and cell adhesion. The main pathways of metabolic perturbations include amino acid, vitamin, glycerophospholipid, tryptophan, and glutamates metabolic pathways and solute carriers-related pathways. Integrating the two omics analyses revealed that L-glutamic acid and malate dehydrogenase may play key roles in the pathogenesis of ASD. These results suggest that children with ASD may have important underlying common mechanisms. They are not only potential therapeutic targets for ASD but also important contributors to the study of biomarkers for the disease.
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Affiliation(s)
- Xiaoxiao Tang
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Chengyun Feng
- Maternal and Child Health Hospital of BaoanShenzhenP. R. China
| | - Yuxi Zhao
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Huajie Zhang
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Yan Gao
- Maternal and Child Health Hospital of BaoanShenzhenP. R. China
| | - Xueshan Cao
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Qi Hong
- Maternal and Child Health Hospital of BaoanShenzhenP. R. China
| | - Jing Lin
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Hongbin Zhuang
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Yuying Feng
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Hanghang Wang
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
| | - Liming Shen
- College of Life Science and OceanographyShenzhen UniversityShenzhenP. R. China
- Shenzhen‐Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research InstitutionsShenzhenP. R. China
- Shenzhen Key Laboratory of Marine Biotechnology and EcologyShenzhenP. R. China
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László K, Vörös D, Correia P, Fazekas CL, Török B, Plangár I, Zelena D. Vasopressin as Possible Treatment Option in Autism Spectrum Disorder. Biomedicines 2023; 11:2603. [PMID: 37892977 PMCID: PMC10603886 DOI: 10.3390/biomedicines11102603] [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: 08/10/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is rather common, presenting with prevalent early problems in social communication and accompanied by repetitive behavior. As vasopressin was implicated not only in salt-water homeostasis and stress-axis regulation, but also in social behavior, its role in the development of ASD might be suggested. In this review, we summarized a wide range of problems associated with ASD to which vasopressin might contribute, from social skills to communication, motor function problems, autonomous nervous system alterations as well as sleep disturbances, and altered sensory information processing. Beside functional connections between vasopressin and ASD, we draw attention to the anatomical background, highlighting several brain areas, including the paraventricular nucleus of the hypothalamus, medial preoptic area, lateral septum, bed nucleus of stria terminalis, amygdala, hippocampus, olfactory bulb and even the cerebellum, either producing vasopressin or containing vasopressinergic receptors (presumably V1a). Sex differences in the vasopressinergic system might underline the male prevalence of ASD. Moreover, vasopressin might contribute to the effectiveness of available off-label therapies as well as serve as a possible target for intervention. In this sense, vasopressin, but paradoxically also V1a receptor antagonist, were found to be effective in some clinical trials. We concluded that although vasopressin might be an effective candidate for ASD treatment, we might assume that only a subgroup (e.g., with stress-axis disturbances), a certain sex (most probably males) and a certain brain area (targeting by means of virus vectors) would benefit from this therapy.
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Affiliation(s)
- Kristóf László
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dávid Vörös
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Pedro Correia
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Csilla Lea Fazekas
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Bibiána Török
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Imola Plangár
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dóra Zelena
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
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Jones W, Klaiman C, Richardson S, Lambha M, Reid M, Hamner T, Beacham C, Lewis P, Paredes J, Edwards L, Marrus N, Constantino JN, Shultz S, Klin A. Development and Replication of Objective Measurements of Social Visual Engagement to Aid in Early Diagnosis and Assessment of Autism. JAMA Netw Open 2023; 6:e2330145. [PMID: 37669054 PMCID: PMC10481232 DOI: 10.1001/jamanetworkopen.2023.30145] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/11/2023] [Indexed: 09/06/2023] Open
Abstract
Importance Autism spectrum disorder is a common and early-emerging neurodevelopmental condition. While 80% of parents report having had concerns for their child's development before age 2 years, many children are not diagnosed until ages 4 to 5 years or later. Objective To develop an objective performance-based tool to aid in early diagnosis and assessment of autism in children younger than 3 years. Design, Setting, and Participants In 2 prospective, consecutively enrolled, broad-spectrum, double-blind studies, we developed an objective eye-tracking-based index test for children aged 16 to 30 months, compared its performance with best-practice reference standard diagnosis of autism (discovery study), and then replicated findings in an independent sample (replication study). Discovery and replication studies were conducted in specialty centers for autism diagnosis and treatment. Reference standard diagnoses were made using best-practice standardized protocols by specialists blind to eye-tracking results. Eye-tracking tests were administered by staff blind to clinical results. Children were enrolled from April 27, 2013, until September 26, 2017. Data were analyzed from March 28, 2018, to January 3, 2019. Main Outcomes and Measures Prespecified primary end points were the sensitivity and specificity of the eye-tracking-based index test compared with the reference standard. Prespecified secondary end points measured convergent validity between eye-tracking-based indices and reference standard assessments of social disability, verbal ability, and nonverbal ability. Results Data were collected from 1089 children: 719 children (mean [SD] age, 22.4 [3.6] months) in the discovery study, and 370 children (mean [SD] age, 25.4 [6.0] months) in the replication study. In discovery, 224 (31.2%) were female and 495 (68.8%) male; in replication, 120 (32.4%) were female and 250 (67.6%) male. Based on reference standard expert clinical diagnosis, there were 386 participants (53.7%) with nonautism diagnoses and 333 (46.3%) with autism diagnoses in discovery, and 184 participants (49.7%) with nonautism diagnoses and 186 (50.3%) with autism diagnoses in replication. In the discovery study, the area under the receiver operating characteristic curve was 0.90 (95% CI, 0.88-0.92), sensitivity was 81.9% (95% CI, 77.3%-85.7%), and specificity was 89.9% (95% CI, 86.4%-92.5%). In the replication study, the area under the receiver operating characteristic curve was 0.89 (95% CI, 0.86-0.93), sensitivity was 80.6% (95% CI, 74.1%-85.7%), and specificity was 82.3% (95% CI, 76.1%-87.2%). Eye-tracking test results correlated with expert clinical assessments of children's individual levels of ability, explaining 68.6% (95% CI, 58.3%-78.6%), 63.4% (95% CI, 47.9%-79.2%), and 49.0% (95% CI, 33.8%-65.4%) of variance in reference standard assessments of social disability, verbal ability, and nonverbal cognitive ability, respectively. Conclusions and Relevance In two diagnostic studies of children younger than 3 years, objective eye-tracking-based measurements of social visual engagement quantified diagnostic status as well as individual levels of social disability, verbal ability, and nonverbal ability in autism. These findings suggest that objective measurements of social visual engagement can be used to aid in autism diagnosis and assessment.
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Affiliation(s)
- Warren Jones
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Center for Translational Social Neuroscience, Emory University, Atlanta, Georgia
| | - Cheryl Klaiman
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Shana Richardson
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Meena Lambha
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Morganne Reid
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Taralee Hamner
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Chloe Beacham
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Peter Lewis
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Jose Paredes
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Laura Edwards
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Natasha Marrus
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, Missouri
- Intellectual and Developmental Disabilities Research Center, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - John N. Constantino
- Intellectual and Developmental Disabilities Research Center, Washington University in St Louis School of Medicine, St Louis, Missouri
- Now with Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia
- Now with Division of Behavioral and Mental Health, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Sarah Shultz
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Ami Klin
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Division of Autism and Related Disabilities, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Center for Translational Social Neuroscience, Emory University, Atlanta, Georgia
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Salmeh A, Al-Saadi M, AlZaidi N, Al Hamwi N, Jumaah SS, Karimzadeh S, Dhafer T, Al-Rubaiay W, Al-Rawi N. Influence of parental knowledge and attitudes on the oral and dental health status of autistic children: A systematic review. SPECIAL CARE IN DENTISTRY 2023; 43:645-655. [PMID: 36707248 DOI: 10.1111/scd.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/25/2022] [Accepted: 01/05/2023] [Indexed: 01/29/2023]
Abstract
AIMS This paper aims to systematically review the current evidence surrounding the influence of parental knowledge and attitudes on the oral and dental health status of autistic children. METHODS AND RESULTS Data were sourced from EBSCOhost, ProQuest One Academic, Ovid MEDLINE, and Scopus. Additional records were manually identified through other sources. Literature search identified 610 relevant articles for screening, of which nine were ultimately selected for inclusion following full-text review. A custom data collection sheet was constructed by the authors to extract data based on selected parameters addressing the focused research question. Extracted data were combined in an evidence table based on the collection sheet parameters. Study characteristics and findings were then descriptively summarized and compared. Due to heterogenicity, meta-analysis was not viable. While all included cross-sectional studies have predominantly shown no statistically significant association between parental knowledge and oral health, three experimental studies have conversely reported significant oral health improvements following educational interventions; suggesting a strong correlation. CONCLUSION Autistic children are susceptible to oral diseases, necessitating parental attention. Current evidence regarding this topic is limited and conflicting. The present systematic review faces limitations: included studies were few and predominantly cross-sectional. Moreover, study samples were small, predominantly male, conveniently recruited, and geographically limited. This paper serves as a foundation to guide future research and inspire oral health education and wellness promotion programs.
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Affiliation(s)
- Abdulrahman Salmeh
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Meena Al-Saadi
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Nadia AlZaidi
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Noura Al Hamwi
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sarah Safaa Jumaah
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Shamma Karimzadeh
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Taiba Dhafer
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ward Al-Rubaiay
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Natheer Al-Rawi
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Lee IH, Walker DI, Lin Y, Smith MR, Mandl KD, Jones DP, Kong SW. Association between Neuroligin-1 polymorphism and plasma glutamine levels in individuals with autism spectrum disorder. EBioMedicine 2023; 95:104746. [PMID: 37544204 PMCID: PMC10427990 DOI: 10.1016/j.ebiom.2023.104746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Unravelling the relationships between candidate genes and autism spectrum disorder (ASD) phenotypes remains an outstanding challenge. Endophenotypes, defined as inheritable, measurable quantitative traits, might provide intermediary links between genetic risk factors and multifaceted ASD phenotypes. In this study, we sought to determine whether plasma metabolite levels could serve as endophenotypes in individuals with ASD and their family members. METHODS We employed an untargeted, high-resolution metabolomics platform to analyse 14,342 features across 1099 plasma samples. These samples were collected from probands and their family members participating in the Autism Genetic Resource Exchange (AGRE) (N = 658), compared with neurotypical individuals enrolled in the PrecisionLink Health Discovery (PLHD) program at Boston Children's Hospital (N = 441). We conducted a metabolite quantitative trait loci (mQTL) analysis using whole-genome genotyping data from each cohort in AGRE and PLHD, aiming to prioritize significant mQTL and metabolite pairs that were exclusively observed in AGRE. FINDINGS Within the AGRE group, we identified 54 significant associations between genotypes and metabolite levels (P < 5.27 × 10-11), 44 of which were not observed in the PLHD group. Plasma glutamine levels were found to be associated with variants in the NLGN1 gene, a gene that encodes post-synaptic cell-adhesion molecules in excitatory neurons. This association was not detected in the PLHD group. Notably, a significant negative correlation between plasma glutamine and glutamate levels was observed in the AGRE group, but not in the PLHD group. Furthermore, plasma glutamine levels showed a negative correlation with the severity of restrictive and repetitive behaviours (RRB) in ASD, although no direct association was observed between RRB severity and the NLGN1 genotype. INTERPRETATION Our findings suggest that plasma glutamine levels could potentially serve as an endophenotype, thus establishing a link between the genetic risk associated with NLGN1 and the severity of RRB in ASD. This identified association could facilitate the development of novel therapeutic targets, assist in selecting specific cohorts for clinical trials, and provide insights into target symptoms for future ASD treatment strategies. FUNDING This work was supported by the National Institute of Health (grant numbers: R01MH107205, U01TR002623, R24OD024622, OT2OD032720, and R01NS129188) and the PrecisionLink Biobank for Health Discovery at Boston Children's Hospital.
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Affiliation(s)
- In-Hee Lee
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, 02215, USA
| | - Douglas I Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Yufei Lin
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, 02215, USA
| | - Matthew Ryan Smith
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University, Atlanta, GA, 30602, USA; Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, 30033, USA
| | - Kenneth D Mandl
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, 02215, USA; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University, Atlanta, GA, 30602, USA
| | - Sek Won Kong
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, 02215, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA.
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Alibutud R, Hansali S, Cao X, Zhou A, Mahaganapathy V, Azaro M, Gwin C, Wilson S, Buyske S, Bartlett CW, Flax JF, Brzustowicz LM, Xing J. Structural Variations Contribute to the Genetic Etiology of Autism Spectrum Disorder and Language Impairments. Int J Mol Sci 2023; 24:13248. [PMID: 37686052 PMCID: PMC10487745 DOI: 10.3390/ijms241713248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by restrictive interests and/or repetitive behaviors and deficits in social interaction and communication. ASD is a multifactorial disease with a complex polygenic genetic architecture. Its genetic contributing factors are not yet fully understood, especially large structural variations (SVs). In this study, we aimed to assess the contribution of SVs, including copy number variants (CNVs), insertions, deletions, duplications, and mobile element insertions, to ASD and related language impairments in the New Jersey Language and Autism Genetics Study (NJLAGS) cohort. Within the cohort, ~77% of the families contain SVs that followed expected segregation or de novo patterns and passed our filtering criteria. These SVs affected 344 brain-expressed genes and can potentially contribute to the genetic etiology of the disorders. Gene Ontology and protein-protein interaction network analysis suggested several clusters of genes in different functional categories, such as neuronal development and histone modification machinery. Genes and biological processes identified in this study contribute to the understanding of ASD and related neurodevelopment disorders.
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Affiliation(s)
- Rohan Alibutud
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Sammy Hansali
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Xiaolong Cao
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Anbo Zhou
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Vaidhyanathan Mahaganapathy
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Marco Azaro
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Christine Gwin
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Sherri Wilson
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Steven Buyske
- Department of Statistics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA;
| | - Christopher W. Bartlett
- The Steve Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA;
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43205, USA
| | - Judy F. Flax
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
| | - Linda M. Brzustowicz
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
- The Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Jinchuan Xing
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (R.A.); (S.H.); (X.C.); (A.Z.); (V.M.); (M.A.); (C.G.); (S.W.); (J.F.F.); (L.M.B.)
- The Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
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46
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Morrel J, Singapuri K, Landa RJ, Reetzke R. Neural correlates and predictors of speech and language development in infants at elevated likelihood for autism: a systematic review. Front Hum Neurosci 2023; 17:1211676. [PMID: 37662636 PMCID: PMC10469683 DOI: 10.3389/fnhum.2023.1211676] [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: 04/25/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Autism spectrum disorder (ASD) is an increasingly prevalent and heterogeneous neurodevelopmental condition, characterized by social communicative differences, and a combination of repetitive behaviors, focused interests, and sensory sensitivities. Early speech and language delays are characteristic of young autistic children and are one of the first concerns reported by parents; often before their child's second birthday. Elucidating the neural mechanisms underlying these delays has the potential to improve early detection and intervention efforts. To fill this gap, this systematic review aimed to synthesize evidence on early neurobiological correlates and predictors of speech and language development across different neuroimaging modalities in infants with and without a family history of autism [at an elevated (EL infants) and low likelihood (LL infants) for developing autism, respectively]. A comprehensive, systematic review identified 24 peer-reviewed articles published between 2012 and 2023, utilizing structural magnetic resonance imaging (MRI; n = 2), functional MRI (fMRI; n = 4), functional near-infrared spectroscopy (fNIRS; n = 4), and electroencephalography (EEG; n = 14). Three main themes in results emerged: compared to LL infants, EL infants exhibited (1) atypical language-related neural lateralization; (2) alterations in structural and functional connectivity; and (3) mixed profiles of neural sensitivity to speech and non-speech stimuli, with some differences detected as early as 6 weeks of age. These findings suggest that neuroimaging techniques may be sensitive to early indicators of speech and language delays well before overt behavioral delays emerge. Future research should aim to harmonize experimental paradigms both within and across neuroimaging modalities and additionally address the feasibility, acceptability, and scalability of implementing such methodologies in non-academic, community-based settings.
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Affiliation(s)
- Jessica Morrel
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Kripi Singapuri
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Rebecca J. Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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47
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Wu CM, Zhang B, Trenor CC, Rivkin MJ, Danehy A, Lehman LL. Autism Spectrum Disorder in Children With Perinatal Ischemic Stroke Varies by Stroke Type. J Child Neurol 2023; 38:513-517. [PMID: 37499178 DOI: 10.1177/08830738231188395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background and Objectives: Perinatal stroke leads to significant morbidity over a child's lifetime, including diagnosis of various neurodevelopmental disorders. Specific studies examining the prevalence of autism spectrum disorder in children with perinatal stroke are scarce. Following the clinical observation of autism spectrum disorder in a pediatric referral stroke center, we evaluated the rate of autism spectrum disorder diagnosis after perinatal ischemic stroke, including analysis by subtypes of perinatal ischemic stroke. Methods: We retrospectively examined all children diagnosed with perinatal ischemic stroke, who were ≥18 months old at the time of last follow-up at a single institution from 2008 through 2021. We classified patients as having autism spectrum disorder if they were diagnosed by a neurologist, neuropsychologist, clinical psychologist, or developmental pediatrician. Multivariable logistic regression was performed to examine the association between ischemic stroke subtype and autism spectrum disorder. Results: Among 260 children with perinatal stroke, 19 children (7.3%) also had autism spectrum disorder. Children with perinatal venous stroke had 3-fold higher odds of autism spectrum disorder compared to those with perinatal arterial ischemic stroke (adjusted odds ratio: 3.01, 95% confidence interval: 1.07-8.47). Conclusion: In our perinatal ischemic stroke population, children with venous stroke had higher odds of autism spectrum disorder compared to those with arterial ischemic stroke alone. Prospective studies are needed to further investigate the role of perinatal stroke in autism spectrum disorder development.
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Affiliation(s)
- Clara M Wu
- Neurology Department, Boston Children's Hospital, Boston, MA, USA
| | - Bo Zhang
- Neurology Department, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Cameron C Trenor
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Division of Hematology and Oncology, Boston Children's Hospital, Boston, MA, USA
- Stroke and Cerebrovascular Center Boston Children's Hospital, Boston, MA, USA
| | - Michael J Rivkin
- Neurology Department, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Stroke and Cerebrovascular Center Boston Children's Hospital, Boston, MA, USA
| | - Amy Danehy
- Harvard Medical School, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Stroke and Cerebrovascular Center Boston Children's Hospital, Boston, MA, USA
| | - Laura L Lehman
- Neurology Department, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Stroke and Cerebrovascular Center Boston Children's Hospital, Boston, MA, USA
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Strathearn L, Momany A, Kovács EH, Guiler W, Ladd-Acosta C. The intersection of genome, epigenome and social experience in autism spectrum disorder: Exploring modifiable pathways for intervention. Neurobiol Learn Mem 2023; 202:107761. [PMID: 37121464 PMCID: PMC10330448 DOI: 10.1016/j.nlm.2023.107761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 02/22/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
The number of children diagnosed with autism spectrum disorder (ASD) has increased substantially over the past two decades. Current research suggests that both genetic and environmental risk factors are involved in the etiology of ASD. The goal of this paper is to examine how one specific environmental factor, early social experience, may be correlated with DNA methylation (DNAm) changes in genes associated with ASD. We present an innovative model which proposes that polygenic risk and changes in DNAm due to social experience may both contribute to the symptoms of ASD. Previous research on genetic and environmental factors implicated in the etiology of ASD will be reviewed, with an emphasis on the oxytocin receptor gene, which may be epigenetically altered by early social experience, and which plays a crucial role in social and cognitive development. Identifying an environmental risk factor for ASD (e.g., social experience) that could be modified via early intervention and which results in epigenetic (DNAm) changes, could transform our understanding of this condition, facilitate earlier identification of ASD, and guide early intervention efforts.
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Affiliation(s)
- Lane Strathearn
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, 51 Newton Road 2-471 Bowen Science Building, Iowa City, IA 52241, USA; Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA 52242, USA; Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, 100 Hawkins Drive, Iowa City, IA 52242, USA; Hawkeye Intellectual and Developmental Disabilities Research Center (Hawk-IDDRC), University of Iowa, 100 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Allison Momany
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Hawkeye Intellectual and Developmental Disabilities Research Center (Hawk-IDDRC), University of Iowa, 100 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Emese Hc Kovács
- Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, 51 Newton Road 2-471 Bowen Science Building, Iowa City, IA 52241, USA.
| | - William Guiler
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA 52242, USA.
| | - Christine Ladd-Acosta
- Department of Epidemiology and the Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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Ghahreman Y, Hosseini SA, Hassani S, Derakhshanpour F, Hassani MJ, Hosseini P. An Investigation on Cognitive and Behavioral Effects of Donepezil on Autistic Children in Winter 2020 in Gorgan's Taleghani Pediatric Hospital. IRANIAN JOURNAL OF CHILD NEUROLOGY 2023; 17:55-67. [PMID: 37637783 PMCID: PMC10448840 DOI: 10.22037/ijcn.v17i2.37324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 07/11/2022] [Indexed: 08/29/2023]
Abstract
Objectives The present investigation has been done to study the behavioral effects of donepezil in autistic children, given that not much research has been carried out concerning using this drug for treating autism. Materials & Methods A cross-sectional and analytic-descriptive study was done on twenty patients with autism, aged 4-17, who visited the neurology clinic of Gorgan's Taleghani Pediatric Hospital and Yasha Pediatric Autism Clinic, Iran from 2019 to 2020. Demographic information, including sex, age, father's education, mother's education ,patient's education, family status, other problems, and ethnicity, were documented using a checklist, having been filled in during interviews with the parents. Before the trial, ABC cognitive and behavioral tests were taken to determine the children's current status. After the tests, these children received a daily dose of donepezil (10mg) before sleep for three months. At the end of the three months, the cognitive and behavioral tests were taken from the children once again. In order to analyze the effects of different factors on the studied variables, including irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech before and after the administration of donepezil in patients, a generalized linear model and to test the effects of donepezil on the studied variables, paired t-test was used. Results In this study, twenty patients were registered for the investigation, 12 (60%) male and eight (40%) female. Age groups 5-6 had the highest frequency, and age group 17 had the lowest. Regardingthe parents' education, the highest frequency was for bachelor's degrees, and the lowest was for less-than-high school education and master's degree. The highest frequency for the patients' education was kindergarten (60%), and then groups without education (20%) and elementary school-level education (15%). Most of the studied patients (80%) did not have other problems besides autism, and only 20% had other problems besides autism. The family status of 15% of the families was 'separated,' and ethnically, most patients (80%) were Fars, while the rest (20%) were Turkmen. None of the analyzed factors (age, sex, father's education, mother's education, patient's education, other problems, family status, and ethnicity) had a significant effect on the studied variables after the administration of donepezil. Among the studied variables prior to the administration of donepezil and among the analyzed factors, the father's education, the patient's education, other problems, and family status had only a significant effect on stereotypic behavior. The present research findings of the present research indicated that all the studied variables, including irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech, were significantly decreased toward the desired goal. The decreased amounts in irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech after the administration of donepezil were, respectively, 38%, 44%, 54%, 41%, and 54% and on average, these behaviors were reduced by 46%. Conclusion The present investigation has shown that all the studied variables, including irritability, lethargy, stereotypic behavior, hyperactivity, and inappropriate speech, were significantly decreased towards the desired goal by 46%. This significant decrease is indicative of the effectiveness of the treatment of autism patients with donepezil, and therefore, this drug can be placed as a prominent and essential part of the medical therapy of autism.
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Affiliation(s)
- Yamin Ghahreman
- Neonatal and Children's Health Research Center Taleghani Medicine Educational Center Golestan University of Medical Sciences Gorgan, Iran
| | - Seyed Ahmad Hosseini
- Neonatal and Children's Health Research Center Taleghani Medicine Educational Center Golestan University of Medical Sciences Gorgan, Iran
| | - Saeed Hassani
- Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - Firouzeh Derakhshanpour
- Neonatal and Children's Health Research Center Taleghani Medicine Educational Center Golestan University of Medical Sciences Gorgan, Iran
| | - Mohammad Javad Hassani
- Neonatal and Children's Health Research Center Taleghani Medicine Educational Center Golestan University of Medical Sciences Gorgan, Iran
| | - Parnian Hosseini
- Neonatal and Children's Health Research Center Taleghani Medicine Educational Center Golestan University of Medical Sciences Gorgan, Iran
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Ma HT, Zhang HC, Zuo ZF, Liu YX. Heterogeneous organization of Locus coeruleus: An intrinsic mechanism for functional complexity. Physiol Behav 2023; 268:114231. [PMID: 37172640 DOI: 10.1016/j.physbeh.2023.114231] [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: 01/30/2023] [Revised: 04/06/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Locus coeruleus (LC) is a small nucleus located deep in the brainstem that contains the majority of central noradrenergic neurons, which provide the primary source of noradrenaline (NA) throughout the entire central nervous system (CNS).The release of neurotransmitter NA is considered to modulate arousal, sensory processing, attention, aversive and adaptive stress responses as well as high-order cognitive function and memory, with the highly ramified axonal arborizations of LC-NA neurons sending wide projections to the targeted brain areas. For over 30 years, LC was thought to be a homogeneous nucleus in structure and function due to the widespread uniform release of NA by LC-NA neurons and simultaneous action in several CNS regions, such as the prefrontal cortex, hippocampus, cerebellum, and spinal cord. However, recent advances in neuroscience tools have revealed that LC is probably not so homogeneous as we previous thought and exhibits heterogeneity in various aspects. Accumulating studies have shown that the functional complexity of LC may be attributed to its heterogeneity in developmental origin, projection patterns, topography distribution, morphology and molecular organization, electrophysiological properties and sex differences. This review will highlight the heterogeneity of LC and its critical role in modulating diverse behavioral outcomes.
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Affiliation(s)
- Hai-Tao Ma
- Department of Neurobiology, School of Basic Medicine, Jinzhou Medical University, Jinzhou, Liaoning, 121000, China; Department of Neurobiology, School of Basic Medicine, Capital Medical University, Beijing, 100069, China.
| | - Hao-Chen Zhang
- Department of Neurobiology, School of Basic Medicine, Capital Medical University, Beijing, 100069, China
| | - Zhong-Fu Zuo
- Department of Human Anatomy, Histology and Embryology, Jinzhou Medical University, Jinzhou, 121000, China
| | - Ying-Xue Liu
- Department of Human Anatomy, Histology and Embryology, Jinzhou Medical University, Jinzhou, 121000, China.
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