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El-Ansary A, Alfawaz HA, Ben Bacha A, Al-Ayadhi L. Assessing the COX-2/PGE2 Ratio and Anti-Nucleosome Autoantibodies as Biomarkers of Autism Spectrum Disorders: Using Combined ROC Curves to Improve Diagnostic Values. Curr Issues Mol Biol 2024; 46:8699-8709. [PMID: 39194730 DOI: 10.3390/cimb46080513] [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: 07/08/2024] [Revised: 08/05/2024] [Accepted: 08/06/2024] [Indexed: 08/29/2024] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by restricted and repetitive behaviors as well as difficulties with social interaction. Numerous studies have revealed aberrant lipid mediators and autoimmunity as a recognized etiological cause of ASD that is amenable to therapeutic intervention. In this study, the relationship between the relative cyclooxygenase-2/prostaglandin E2 ratio (COX-2/PGE2) as a lipid mediator marker and anti-nucleosome autoantibodies as an autoimmunity marker of ASD was investigated using multiple regression and combined receiver operating characteristic (ROC) curve analyses. The study also sought to identify the linear combination of these variables that optimizes the partial area under the ROC curves. There were forty ASD children and forty-two age- and gender-matched controls included in the current study. Using combined ROC curve analysis, a notable increase in the area under the curve was seen in the patient group, using the control group as a reference group. Additionally, it was reported that the combined markers had improved specificity and sensitivity. This study demonstrates how the predictive value of particular biomarkers associated with lipid metabolism and autoimmunity in children with ASD can be measured using a ROC curve analysis. This technique should help us better understand the etiological mechanism of ASD and how it may adversely affect cellular homeostasis, which is essential to maintaining healthy metabolic pathways. Early diagnosis and intervention may be facilitated by this knowledge.
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Affiliation(s)
- Afaf El-Ansary
- Autism Center, Lotus Holistic Alternative Medical Center, P.O. Box 110281, Abu Dhabi 23251, United Arab Emirates
| | - Hanan A Alfawaz
- Department of Food Science and Nutrition, College of Food & Agriculture Sciences, King Saud University, P.O. Box 22452, Riyadh 11495, Saudi Arabia
| | - Abir Ben Bacha
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 22452, Riyadh 11495, Saudi Arabia
| | - Laila Al-Ayadhi
- Department of Physiology, Faculty of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461, Saudi Arabia
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Gubbiotti M, Balzarro M, Zoccante L, Di Gennaro G, Marchiafava M, Bedetti C, Rubilotta E. National Survey on bladder and bowel dysfunctions in Autism Spectrum Disorder population. Front Psychiatry 2024; 15:1140113. [PMID: 38528973 PMCID: PMC10961907 DOI: 10.3389/fpsyt.2024.1140113] [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: 01/08/2023] [Accepted: 02/06/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction To evaluate lower urinary tract symptoms (LUTS) and bowel disorders in a population of young subjects with autism spectrum disorder (ADS) by a national survey and to assess the relationship between the occurrence, frequency, and type of LUTS and the severity of behavioral and neuropsychiatric characteristics. Materials and methods A survey on LUTS and bowel disorders in the ASD population was sent by mail and social media through the main Italian Associations of ASD between February and September 2022. The correlation between LUTS and ASD severity was also assessed. Results The survey was completed by 502 subjects with a mean age of 16.6 years ± 10 years: male participants were 413 (mean age: 16.5 years ± 9.8 years), while female participants 89 (mean age: 17.2 years ± 10.9 years). ADS severity was found low in 29.9%, moderate in 27.1%, and severe in 43%. LUTS were reported by 77.1%, storage symptoms in 51.4%, and voiding symptoms in 60.6%. Urinary incontinence was reported by 12.5%. Enuresis was reported by 14.3% (72/502) of the respondents: primary enuresis in 70.8% (51/72), secondary in the remaining. Pads were used by 40 subjects with a median of 2.9 pads/day (range, 0-8). A toilet training program was performed by 61 of the respondents, with satisfactory results in 40/61 (65.6%). A significant correlation was found between greater ASD severity and higher LUTS rates. The mean VAS score on the impact of LUTS on family relationships was 2 ± 2.9. Regular bowel function was reported by 57.4% (288/502) of the respondents, while increased daily defecations were present in 11.2% (56/502), constipation in 31.5% (158/502), and fecal incontinence in 7.9% (40/502). Conclusion This survey demonstrated that LUTS are very common in the young ASD population and that the prevalence of urinary symptoms is related to higher severity of the ASD condition. Bowel disorders are often associated with urinary symptoms and dysfunctions. Urologists should be aware of the frequent occurrence of urological disorders and symptoms in individuals with ASD and should be involved in their clinical management in a multidisciplinary team that cares for these people.
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Affiliation(s)
| | - Matteo Balzarro
- Department of Urology, A.O.U.I. Verona University, Verona, Italy
| | - Leonardo Zoccante
- Department of Child Neuropsychiatry, A.O.U.I. Verona University, Verona, Italy
| | - Gianfranco Di Gennaro
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | - Moreno Marchiafava
- Department of Mental Health and Pathological Addictions, ASL Roma 5, Roma, Italy
| | - Chiara Bedetti
- Stroke Unite/Neurology, Città di Castello Hospital, Perugia, Italy
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Longo R, Allegrini F, Gusson E, Morbio R, Di Gennaro G, Gozzi LA, Marchini G, Zoccante L. Visual-motor involvement in autism spectrum disorder: could the stereopsis deficit affect motor coordination? Front Psychiatry 2023; 14:1130185. [PMID: 38034932 PMCID: PMC10687461 DOI: 10.3389/fpsyt.2023.1130185] [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: 12/22/2022] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
PurposeGiven the known difficulty in sensory processing and in motor skills in patients with Autism Spectrum Disorder (ASD), and since visual impairment could interfere with children’s behaviour, early detection and management of visual-motor difficulties are crucial. This exploratory study aims to evaluate the visual-motor status in a cohort of children affected by ASD.MethodsThe records of patients affected by ASD and admitted between 2018 and 2022 to the Pediatric University Hospital of Verona were reviewed. Best Corrected Visual Acuity, cycloplegic refraction, stereopsis, convergence, complete ocular motility, strabismus examination, slit-lamp anterior segment examination and fundus ophthalmoscopy were collected and reviewed.ResultsA total of 253 patients (203 ASD and 50 healthy controls) were included in the study. A higher number of total orthoptic defects were detected in the ASD group, in comparison with the control group. Specifically, a higher percentage of stereopsis deficit and convergence insufficiency was observed.ConclusionIn our cohort of children with ASD stereopsis deficit, convergence insufficiency and refractive errors are the most observed ocular conditions. These findings are consistent with the known alterations of motor skills and sensory processing in ASD. Moreover, our study supports the hypothesis that visual acuity is not compromised in children with ASD. As a result, a complete ophthalmic evaluation is highly recommended in children with ASD, to guarantee early detection and treatment of possible visual-motor defects.
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Affiliation(s)
- Rosa Longo
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Francesca Allegrini
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Elena Gusson
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Roberta Morbio
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Gianfranco Di Gennaro
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona, Italy
| | - Luigi Alberto Gozzi
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona, Italy
| | - Giorgio Marchini
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Integrated University Hospital of Verona, Verona, Italy
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona, Italy
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Pastore I, Bedin E, Marzari G, Bassi F, Gallo C, Mucignat-Caretta C. Behavioral guidance for improving dental care in autistic spectrum disorders. Front Psychiatry 2023; 14:1272638. [PMID: 38034927 PMCID: PMC10682214 DOI: 10.3389/fpsyt.2023.1272638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Autism spectrum disorders (ASDs) impair many aspects of everyday life and may prevent access to dental care, often limiting it to emergencies. Impaired oral health has long-lasting negative consequences on health status and on the acquisition of oral habits (e.g., oral respiration and grinding) or competencies (e.g., proper speech production). Children with ASD may be scared in the dental setting, which is rich in sensory stimuli and requires physical contact. Due to their behavioral manifestations, they represent a challenge for dentists and hygienists. We created a dedicated pathway with behavioral support for children with ASD to allow dental care and possibly limit the use of general anesthesia. Methods We evaluated the effects of behavioral support in a quasi-experimental design by comparing two groups of children with ASD. The first group (n = 84) was visited every 2 months for 3 years and received additional support (visual aids, caregiver training, and longer visit duration). A control group, matched for age and sex, was visited at least twice a year or more, if needed, according to standard healthcare guidelines. Results Compliance with the schedule was high throughout the 3 years. The degree of collaboration significantly improved after 1 year in the supported group, while the control group did not change. At the end of the study, collaboration remained significantly higher than at the beginning in the supported group. Half of dental treatments were possible without general anesthesia in supported children. No adverse effect was apparent on collaboration due to COVID-19 restrictions. Discussion Behavioral techniques improved the compliance of ASD children to regular dentistry visits and treatment. Furthermore, oral hygiene at home was similarly improved, addressing oral health from a lifelong perspective.
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Affiliation(s)
- Irene Pastore
- Community Dentistry Department, Ospedale Immacolata Concezione, Piove di Sacco, Italy
| | - Elena Bedin
- Community Dentistry Department, Ospedale Immacolata Concezione, Piove di Sacco, Italy
| | - Giulia Marzari
- Community Dentistry Department, Ospedale Immacolata Concezione, Piove di Sacco, Italy
| | - Francesca Bassi
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Claudio Gallo
- Community Dentistry Department, Ospedale Immacolata Concezione, Piove di Sacco, Italy
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Morales-Marín ME, Castro Martínez XH, Centeno Cruz F, Barajas-Olmos F, Náfate López O, Gómez Cotero AG, Orozco L, Nicolini Sánchez H. Differential DNA Methylation from Autistic Children Enriches Evidence for Genes Associated with ASD and New Candidate Genes. Brain Sci 2023; 13:1420. [PMID: 37891789 PMCID: PMC10605446 DOI: 10.3390/brainsci13101420] [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: 08/15/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
The etiology of Autism Spectrum Disorders (ASD) is a result of the interaction between genes and the environment. The study of epigenetic factors that affect gene expression, such as DNA methylation, has become an important area of research in ASD. In recent years, there has been an increasing body of evidence pointing to epigenetic mechanisms that influence brain development, as in the case of ASD, when gene methylation dysregulation is present. Our analysis revealed 853 differentially methylated CpG in ASD patients, affecting 509 genes across the genome. Enrichment analysis showed five related diseases, including autistic disorder and mental disorders, which are particularly significant. In this work, we identified 64 genes that were previously reported in the SFARI gene database, classified according to their impact index. Additionally, we identified new genes that have not been previously reported as candidates with differences in the methylation patterns of Mexican children with ASD.
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Affiliation(s)
- Mirna Edith Morales-Marín
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (X.H.C.M.); (H.N.S.)
| | - Xochitl Helga Castro Martínez
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (X.H.C.M.); (H.N.S.)
| | - Federico Centeno Cruz
- Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (F.C.C.); (F.B.-O.); (L.O.)
| | - Francisco Barajas-Olmos
- Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (F.C.C.); (F.B.-O.); (L.O.)
| | - Omar Náfate López
- Hospital de Especialidades Pediátricas, Tuxtla Gutiérrez 29045, Mexico;
| | - Amalia Guadalupe Gómez Cotero
- Centro de Investigación en Ciencias de la Salud, Unidad Santo Tomás, Instituto Politécnico Nacional, Mexico City 07738, Mexico;
| | - Lorena Orozco
- Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (F.C.C.); (F.B.-O.); (L.O.)
| | - Humberto Nicolini Sánchez
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico; (X.H.C.M.); (H.N.S.)
- Grupo Médico Carracci, Mexico City 03740, Mexico
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Zaffanello M, Piacentini G, Nosetti L, Zoccante L. Sleep Disordered Breathing in Children with Autism Spectrum Disorder: An In-Depth Review of Correlations and Complexities. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1609. [PMID: 37892271 PMCID: PMC10605434 DOI: 10.3390/children10101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Sleep-disordered breathing is a significant problem affecting the pediatric population. These conditions can affect sleep quality and children's overall health and well-being. Difficulties in social interaction, communication, and repetitive behavioral patterns characterize autism spectrum disorder. Sleep disturbances are common in children with ASD. This literature review aims to gather and analyze available studies on the relationship between SDB and children with autism spectrum disorder. We comprehensively searched the literature using major search engines (PubMed, Scopus, and Web of Science). After removing duplicates, we extracted a total of 96 records. We selected 19 studies for inclusion after a thorough title and abstract screening process. Seven articles were ultimately incorporated into this analysis. The research findings presented herein emphasize the substantial influence of sleep-disordered breathing on pediatric individuals diagnosed with autism spectrum disorder (ASD). These findings reveal a high incidence of SDB in children with ASD, emphasizing the importance of early diagnosis and specialized treatment. Obesity in this population further complicates matters, requiring focused weight management strategies. Surgical interventions, such as adenotonsillectomy, have shown promise in improving behavioral issues in children with ASD affected by OSA, regardless of their obesity status. However, more comprehensive studies are necessary to investigate the benefits of A&T treatment, specifically in children with ASD and OSA. The complex relationship between ASD, SDB, and other factors, such as joint hypermobility and muscle hypotonia, suggests a need for multidisciplinary treatment approaches. Physiotherapy can play a critical role in addressing these intricate health issues. Early sleep assessments and tailored weight management strategies are essential for timely diagnosis and intervention in children with ASD. Policy initiatives should support these efforts to enhance the overall well-being of this population. Further research is crucial to understand the complex causes of sleep disturbances in children with ASD and to develop effective interventions considering the multifaceted nature of these conditions.
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Affiliation(s)
- Marco Zaffanello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy;
| | - Giorgio Piacentini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy;
| | - Luana Nosetti
- Department of Pediatrics, Pediatric Sleep Disorders Center, “F. Del Ponte” Hospital, Insubria University, 21100 Varese, Italy;
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, 37126 Verona, Italy;
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Veronese S, Zoccante L, Smania N, Sbarbati A. Stretch marks: a visible expression of connective's involvement in autism spectrum disorders. Front Psychiatry 2023; 14:1155854. [PMID: 37448494 PMCID: PMC10338011 DOI: 10.3389/fpsyt.2023.1155854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
In autism spectrum disorders (ASDs) in the pediatric population, skin manifestations are generally attributable to the concomitance of allergic forms or to accidental, self-inflicted or abusive lesions. However, clinical evidence has highlighted the presence of an increasing number of abdominal stretch marks, probably caused by the increase in the number of obesity cases in the pediatric population, in general, and therefore also among children with ASD. Stretch marks are often attributed to obesity, as they have an incidence of more than 50% in obese individuals. In the first part of this article we hypothesized that in addition to obesity there are other factors, such as a structural alteration on the skin in people with ASD, which can contribute/aggravate the phenomenon of stretch marks. Despite the high frequency with which stretch marks are found in children with ASD, this aspect has never been studied, the structure of the skin of children with ASD is not known. Furthermore, it is not known whether this structure is different from that of subjects without ASD. In the second part of the article, we hypothesized the mechanisms of the negative impact of simple abdominal stretch marks on the symptomatic picture of children with ASD. The presence of stretch marks, altered tactile perception, altered sensitivity to clothing fabrics can be a combination that influences development and determines negative consequences in the neurological picture of a child with ASD, as it is already known that the altered sensory perception in children with ASD contributes to the deterioration of social behavior. Furthermore, the presence of stretch marks may play a role in the postural and motor defects of children with ASD.
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Affiliation(s)
- Sheila Veronese
- Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, Italy
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, Verona, Italy
- Autism Spectrum Disorders Regional Centre of Verona, Verona, Italy
| | - Nicola Smania
- Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, Italy
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Yano N, Hosokawa K. The importance of comprehensive support based on the three pillars of exercise, nutrition, and sleep for improving core symptoms of autism spectrum disorders. Front Psychiatry 2023; 14:1119142. [PMID: 37260760 PMCID: PMC10228143 DOI: 10.3389/fpsyt.2023.1119142] [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: 12/08/2022] [Accepted: 03/15/2023] [Indexed: 06/02/2023] Open
Abstract
Autism spectrum disorder (ASD) is classified as a neurodevelopmental disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM)-V, which first described ASD, lists persistent deficits in social communication and interrelationships, as well as limited and recurrent modes of behavior, interests, and activities as diagnostic items. Until recently, understanding the pathophysiology of ASD has been mostly from a neurophysiological perspective, and interventions have been mostly behavioral and psychological. In recent years, however, it has become clear that ASD also affects many bodily systems, including the immune system, the sensorimotor system, and the gut-brain axis, and that these factors simultaneously influence it. In light of this background, a new "connectivome theory" has been proposed as a hypothesis for understanding ASD. "Exercise," "nutrition," and "sleep," which are discussed in this mini-review, have a particularly strong relationship with the immune, musculoskeletal, and gut systems among the pathologies mentioned in the "connectivome theory," furthermore, many reports suggest improvements in stereo-responsive behavior and social and communication skills, which are the core symptoms of ASD. In addition, these interventions are characterized by being less subject to location and cost limitations and excel in the continuity of therapeutic intervention, and the three interventions may have a reciprocal positive impact and may function as three pillars to support ASD.
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Affiliation(s)
- Nozomu Yano
- Graduate School of Health Sciences, Doctoral Course, Kagoshima University Graduate School, Kagoshima, Japan
| | - Kenji Hosokawa
- Department of Child Care and Education, Odawara Junior College, Nagoya, Japan
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Bulbena A, Rosado S, Cabaleiro M, Martinez M, Baeza-Velasco C, Martin LM, Batlle S, Bulbena-Cabré A. Validation of the neuroconnective endophenotype questionnaire (NEQ): a new clinical tool for medicine and psychiatry resulting from the contribution of Ehlers-Danlos syndrome. Front Med (Lausanne) 2023; 10:1039223. [PMID: 37234249 PMCID: PMC10206165 DOI: 10.3389/fmed.2023.1039223] [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: 09/07/2022] [Accepted: 03/22/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction The link between anxiety disorders and joint hypermobility syndrome (now under hypermobility spectrum disorders, which include hypermobile Ehlers-Danlos syndrome) has been widely replicated over the past 30 years and has grown beyond the initial nosological limits. To integrate clinical and research progress in this field, a new neuroconnective endophenotype (NE) and its corresponding instrument, the Neuroconnective Endophenotype Questionnaire (NEQ), have been developed. This new clinical construct, created with the active participation of patients, includes both somatic and psychological dimensions and symptoms and resilience items. Methods The NE includes five dimensions: (1) sensorial sensitivity, (2) body signs and symptoms, (3) somatic conditions, (4) polar behavioral strategies, and (5) psychological and psychopathological dimensions. The NEQ information is collected through four self-administered questionnaires (sensorial sensitivity, body signs and symptoms, polar behavioral strategies, and psychological characteristics) and a structured diagnostic part that should be completed by a trained observer. This hetero-administered part incorporates (a) psychiatric diagnoses (using structured criteria, e.g., MINI), (b) somatic disorders diagnosis, using structured criteria, and (c) assessment of joint hypermobility criteria. Results In a sample of 36 anxiety cases with 36 matched controls, the NEQ obtained high scores for test-retest, inter-rater reliability, and internal consistency. As for predictive validity, cases and controls significantly differed in all five dimensions and hypermobility measurements. Discussion We can conclude that the NEQ has achieved acceptable reliability and validity values and, therefore, is ready to be used and tested in different samples. This original and consistent construct including somatic and mental items may improve clinical specificity, the search for more comprehensive therapies, and their genetic and neuroimaging bases.
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Affiliation(s)
- Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Silvia Rosado
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
- Doctorate Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
| | - Marina Cabaleiro
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - María Martinez
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Carolina Baeza-Velasco
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Paris, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Luis-Miguel Martin
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Santiago Batlle
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
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Zerman N, Zotti F, Chirumbolo S, Zangani A, Mauro G, Zoccante L. Insights on dental care management and prevention in children with autism spectrum disorder (ASD). What is new? FRONTIERS IN ORAL HEALTH 2022; 3:998831. [PMID: 36238091 PMCID: PMC9551997 DOI: 10.3389/froh.2022.998831] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Autistic subjects represent a severe concern to dentistry due to the considerable difficulty in managing their oral health, maintaining routine toothbrushing, and preventing dental and periodontal problems. The social and economic burden of managing dental care in autism spectrum disorder (ASD) children is particularly cumbersome for families and public and private health expenditure, especially when children reach the dentist following a late diagnosis with evident oral health problems. An early diagnosis of ASD helps dentists better address these children's oral health. Unfortunately, insufficient attention is paid to the training and education of general pediatricians, dentists, and dental hygienists, allowing them to get to approach the different clinical aspects of ASD. Usually, children diagnosed with ASD are scheduled for dental appointments like their neurotypical peers, whereas their needs are typically complex and personalized. Scant attention is also devoted to these patients by commercial manufacturers of dental products and devices for oral hygiene and prevention of caries and periodontal diseases, leaving parents without the support and often failing when they address the oral health of autistic children. The difficulties of oral care do not derive simply from the behavior of ASD patients, as is commonly assumed, and therefore cannot be overcome solely by the patience and attention of parents and dentists. Genetics, dietary habits, sensory impairments, and cognition disorders are other causes contributing in various degrees to the impact on the mood and psychological reactions of autistic children towards dentists. How can we prevent teeth caries, periodontal disorders, and other oral health impairments by properly managing ASD children? This manuscript gives an up-to-date overview of these problems and helps to provide good remarks.
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Affiliation(s)
- Nicoletta Zerman
- Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy
| | - Francesca Zotti
- Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessandro Zangani
- Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy
| | | | - Leonardo Zoccante
- Autism Veneto Region Center, Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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The Management of Toe Walking in Children with Autism Spectrum Disorder: "Cast and Go". CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101477. [PMID: 36291413 PMCID: PMC9600566 DOI: 10.3390/children9101477] [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: 07/30/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/25/2022]
Abstract
Background: Toe walking is associated with autism spectrum disorders (ASD). Correction of this “behavior” is a health challenge. The toe walker is affected by the contact refusal with the outside world: touching the ground as little as possible, trying to avoid any contact. A structured equines foot is a possible consequence. Method: We present the “Cast and Go” protocol, used in 22 idiopathic toe walker children with ASD treated from 2015 to 2020. The treatment was performed by a single senior experienced doctor with botulinum injection, ankle casts and rehabilitative therapies. All patients underwent pre- and post-treatment clinical evaluation using ankle dorsiflexion angle and casting number as treatment. We aimed to identify the intervention with the shortest acquisition time for the management of toe walking. Results: Our findings demonstrated the baseline ankle dorsiflexion angle influenced the casting number (p < 0.01) and male patients had a higher baseline ankle dorsiflexion angle than female patients (p < 0.01). No adverse events were observed. Conclusions: These findings suggested that the “Cast and Go” protocol could be a promising, dynamic and effective practice for toe walking disease in ASD patients.
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Liu D, Bu D, Li H, Wang Q, Ding X, Fang X. Intestinal metabolites and the risk of autistic spectrum disorder: A two-sample Mendelian randomization study. Front Psychiatry 2022; 13:1034214. [PMID: 36713927 PMCID: PMC9877426 DOI: 10.3389/fpsyt.2022.1034214] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Observational studies have reported a strong association between autistic spectrum disorder (ASD) and intestinal metabolites. However, it is unclear whether this correlation is causally or violated by confounding or backward causality. Therefore, this study explored the potential causal relationship between intestinal metabolites and dependent metabolites on ASD. METHODS We used a two-sample Mendelian random analysis and selected variants closely related to intestinal flora-dependent metabolites as instrumental variables. MR-Egger, inverse variance weighted (IVW), MR-PRESSO, maximum likelihood, and weighted median were performed to reveal their causal relationships. Ten metabolites were studied, which included trimethylamine-N-oxide, betaine, carnitine, choline, glutamate, kynurenine, phenylalanine, serotonin, tryptophan, and tyrosine. Sensitivity tests were also performed to evaluate the robustness of the MR study. RESULTS The IVW method revealed that serotonin may increase the ASD risk (OR 1.060, 95% CI: 1.006-1.118), while choline could decrease the ASD risk (OR 0.925, 95% CI: 0.868-0.988). However, no definite causality was observed between other intestinal metabolites (e.g., trimethylamine-N-oxide, betaine, and carnitine) with ASD. Additionally, neither the funnel plot nor the MR-Egger test showed horizontal pleiotropy, and the MR-PRESSO test found no outliers. Cochran's Q test showed no significant heterogeneity among the studies, suggesting the robustness of the study. CONCLUSION Our study found potential causality from intestinal metabolites on ASD. Clinicians are encouraged to offer preventive measures to such populations.
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Affiliation(s)
- Deyang Liu
- Department of Rehabilitation Medicine, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Dengyin Bu
- Department of Psychiatric Medicine, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, China
| | - Hong Li
- Department of Rehabilitation Medicine, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Qingsong Wang
- Department of Rehabilitation Medicine, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Xudong Ding
- Department of Rehabilitation Medicine, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Xiaolu Fang
- Department of Clinical Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
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