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Drahota A, Sridhar A, Moskowitz LJ, Kerns CM, Soorya L, Wainer A, Cohn E, Lerner MD. Community-based care for autistic youth: community providers' reported use of treatment practices in the United States. Front Psychiatry 2023; 14:1212084. [PMID: 37791130 PMCID: PMC10544899 DOI: 10.3389/fpsyt.2023.1212084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/09/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction To illustrate the landscape of community-based care for autistic youth in the United States, we identified transdisciplinary psychosocial intervention practice sets that community providers report utilizing to care for this population, and examined characteristics associated with provider-reported utilization. Methods The Usual Care for Autism Study (UCAS) Survey assessed provider demographics and provider-reported use of transdisciplinary practices for common ASD co-occurring problems: social difficulties, externalizing behaviors, and anxiety. Community practitioners (N = 701) from allied health, behavioral, education, medical, mental health and other disciplines who treat or work with autistic youth (7-22 years) participated. Results Exploratory factor analysis yielded four factors: Consequence-Based Strategies (CBS), Cognitive-Behavioral and Therapy Strategies (CBTS), Antecedent-Based Strategies (ABS), and Teaching Strategies (TS). Providers across disciplines reported utilizing ABS more often than other sets. Providers from behavioral disciplines, with less than 4-year or Master degrees, or with more experience reported the most use of ABS, CBS and CBTS. Medical and behavioral providers reported the most use of TS. Setting and child characteristics were associated with practice set use, indicating variability by disability and client socioeconomic status. Discussion Findings reflect the complexity and inconsistency of the service landscape for autistic youth across the U.S. Only by understanding the service landscape and predictors of practice utilization, can researchers, policymakers, provider groups, and the autistic community facilitate effective implementation strategy development and use to ultimately improve community-based care.
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Affiliation(s)
- Amy Drahota
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Aksheya Sridhar
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | | | - Connor M. Kerns
- Department of Psychology, University British Columbia, Vancouver, BC, Canada
| | - Latha Soorya
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Allison Wainer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Elizabeth Cohn
- School of Nursing, Hunter College, CUNY, New York, NY, United States
| | - Matthew D. Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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Brown C, Lerner M, Stadheim J, Kerns C, Moskowitz L, Cohn E, Drahota A, Soorya L, Wainer A. Provider Self-Reported Use and Usefulness of Intervention Strategies for Externalizing Behaviors in Youths with ASD. J Clin Child Adolesc Psychol 2023:1-15. [PMID: 37706638 PMCID: PMC10937329 DOI: 10.1080/15374416.2023.2251163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To examine predictors of implementation and perceived usefulness of four empirically supported strategies for treating externalizing behavior in youths with ASD. METHOD Participants were 557 providers in the United States with experience treating externalizing behavior in youths with ASD. Generalized estimating equations were used to determine whether self-reported use and usefulness of four empirically supported intervention strategies (functional communication training, functional behavior analysis, visual tools/supports, token economy) were predicted by key provider characteristics: professional discipline, experience, and practice specialization (across three indices) in ASD. Post-hoc contrasts were performed to identify provider groups reporting the greatest use and usefulness of the four strategies. RESULTS Strategies were most often used by providers with behavioral backgrounds, though perceived usefulness of strategies varied by providers' professional discipline. Compared to providers with more than 10 years of experience, less experienced providers endorsed the highest average use and usefulness of almost all strategies. Regarding ASD practice specialization, a lower volume of ASD cases, treating fewer youths with ASD over a 5-year period, and having a higher proportion of practice time working with youths with ASD reported were associated with greater use and usefulness of the strategies. CONCLUSIONS Empirically supported strategies are widely used by and perceived as useful by providers who treat youths with ASD and co-occurring externalizing behaviors. Use and usefulness varies based on provider discipline, experience, and ASD practice specialization.
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Affiliation(s)
| | | | - Jenna Stadheim
- Department of Educational Psychology, University of Nebraska-Lincoln
| | - Connor Kerns
- Department of Psychology, University of British Columbia
| | | | - Elizabeth Cohn
- Hunter-Bellevue School of Nursing, City University of New York
| | - Amy Drahota
- Department of Psychology, Michigan State University
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center
| | - Allison Wainer
- Department of Psychiatry, Rush University Medical Center
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3
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Breen MS, Fan X, Levy T, Pollak RM, Collins B, Osman A, Tocheva AS, Sahin M, Berry-Kravis E, Soorya L, Thurm A, Powell CM, Bernstein JA, Kolevzon A, Buxbaum JD. Large 22q13.3 deletions perturb peripheral transcriptomic and metabolomic profiles in Phelan-McDermid syndrome. HGG Adv 2023; 4:100145. [PMID: 36276299 PMCID: PMC9579712 DOI: 10.1016/j.xhgg.2022.100145] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/23/2022] [Indexed: 11/25/2022] Open
Abstract
Phelan-McDermid syndrome (PMS) is a rare neurodevelopmental disorder caused at least in part by haploinsufficiency of the SHANK3 gene, due to sequence variants in SHANK3 or subtelomeric 22q13.3 deletions. Phenotypic differences have been reported between PMS participants carrying small "class I" mutations and large "class II" mutations; however, the molecular perturbations underlying these divergent phenotypes remain obscure. Using peripheral blood transcriptome and serum metabolome profiling, we examined the molecular perturbations in the peripheral circulation associated with a full spectrum of PMS genotypes spanning class I (n = 37) and class II mutations (n = 39). Transcriptomic data revealed 52 genes with blood expression profiles that tightly scale with 22q.13.3 deletion size. Furthermore, we uncover 208 underexpressed genes in PMS participants with class II mutations, which were unchanged in class I mutations. These genes were not linked to 22q13.3 and were strongly enriched for glycosphingolipid metabolism, NCAM1 interactions, and cytotoxic natural killer (NK) immune cell signatures. In silico predictions estimated a reduction in CD56+ CD16- NK cell proportions in class II mutations, which was validated by mass cytometry time of flight. Global metabolomics profiling identified 24 metabolites that were significantly altered in PMS participants with class II mutations and confirmed a general reduction in sphingolipid metabolism. Collectively, these results provide new evidence linking PMS participants carrying class II mutations with decreased expression of cytotoxic cell signatures, reduced relative proportions of NK cells, and lower sphingolipid metabolism. These findings highlight alternative avenues for therapeutic development and offer new mechanistic insights supporting genotype-to-phenotype associations in PMS.
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Affiliation(s)
- Michael S Breen
- 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 Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xuanjia Fan
- 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
| | - Tess Levy
- 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
| | - Rebecca M Pollak
- 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
| | - Brett Collins
- 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
| | - Aya Osman
- 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
| | - Anna S Tocheva
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Rosamund Stone Zander Translational Neuroscience Center and F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Craig M Powell
- Department of Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA.,Civitan International Research Center, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Jonathan A Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 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
| | - Joseph D Buxbaum
- 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 Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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4
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Freitas C, Hunt BAE, Wong SM, Ristic L, Fragiadakis S, Chow S, Iaboni A, Brian J, Soorya L, Chen JL, Schachar R, Dunkley BT, Taylor MJ, Lerch JP, Anagnostou E. Atypical Functional Connectivity During Unfamiliar Music Listening in Children With Autism. Front Neurosci 2022; 16:829415. [PMID: 35516796 PMCID: PMC9063167 DOI: 10.3389/fnins.2022.829415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/10/2022] [Indexed: 12/30/2022] Open
Abstract
Background Atypical processing of unfamiliar, but less so familiar, stimuli has been described in Autism Spectrum Disorder (ASD), in particular in relation to face processing. We examined the construct of familiarity in ASD using familiar and unfamiliar songs, to investigate the link between familiarity and autism symptoms, such as repetitive behavior. Methods Forty-eight children, 24 with ASD (21 males, mean age = 9.96 years ± 1.54) and 24 typically developing (TD) controls (21 males, mean age = 10.17 ± 1.90) completed a music familiarity task using individually identified familiar compared to unfamiliar songs, while magnetoencephalography (MEG) was recorded. Each song was presented for 30 s. We used both amplitude envelope correlation (AEC) and the weighted phase lag index (wPLI) to assess functional connectivity between specific regions of interest (ROI) and non-ROI parcels, as well as at the whole brain level, to understand what is preserved and what is impaired in familiar music listening in this population. Results Increased wPLI synchronization for familiar vs. unfamiliar music was found for typically developing children in the gamma frequency. There were no significant differences within the ASD group for this comparison. During the processing of unfamiliar music, we demonstrated left lateralized increased theta and beta band connectivity in children with ASD compared to controls. An interaction effect found greater alpha band connectivity in the TD group compared to ASD to unfamiliar music only, anchored in the left insula. Conclusion Our results revealed atypical processing of unfamiliar songs in children with ASD, consistent with previous studies in other modalities reporting that processing novelty is a challenge for ASD. Relatively typical processing of familiar stimuli may represent a strength and may be of interest to strength-based intervention planning.
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Affiliation(s)
- Carina Freitas
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Benjamin A. E. Hunt
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Simeon M. Wong
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Leanne Ristic
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Susan Fragiadakis
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Stephanie Chow
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Alana Iaboni
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jessica Brian
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Joyce L. Chen
- Faculty of Kinesiology and Physical Education and Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Russell Schachar
- Department of Psychiatry Research, Hospital for Sick Children, Toronto, ON, Canada
| | - Benjamin T. Dunkley
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Margot J. Taylor
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Departments of Psychology and Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Jason P. Lerch
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Evdokia Anagnostou
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Neuroscience and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
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5
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Levy T, Foss-Feig JH, Betancur C, Siper PM, Trelles-Thorne MDP, Halpern D, Frank Y, Lozano R, Layton C, Britvan B, Bernstein JA, Buxbaum JD, Berry-Kravis E, Powell CM, Srivastava S, Sahin M, Soorya L, Thurm A, Kolevzon A. Strong evidence for genotype-phenotype correlations in Phelan-McDermid syndrome: results from the developmental synaptopathies consortium. Hum Mol Genet 2022; 31:625-637. [PMID: 34559195 PMCID: PMC8863417 DOI: 10.1093/hmg/ddab280] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/11/2022] Open
Abstract
Individuals with Phelan-McDermid syndrome (PMS) present with a wide range of developmental, medical, cognitive and behavioral abnormalities. Previous literature has begun to elucidate genotype-phenotype associations that may contribute to the wide spectrum of features. Here, we report results of genotype-phenotype associations in a cohort of 170 individuals with PMS. Genotypes were defined as Class I deletions (including SHANK3 only or SHANK3 with ARSA and/or ACR and RABL2B), Class II deletions (all other deletions) or sequence variants. Phenotype data were derived prospectively from direct evaluation, caregiver interview and questionnaires, and medical history. Analyses revealed individuals with Class I deletions or sequence variants had fewer delayed developmental milestones and higher cognitive ability compared to those with Class II deletions but had more skill regressions. Individuals with Class II deletions were more likely to have a variety of medical features, including renal abnormalities, spine abnormalities, and ataxic gait. Those with Class I deletions or sequence variants were more likely to have psychiatric diagnoses including bipolar disorder, depression, and schizophrenia. Autism spectrum disorder diagnoses did not differ between groups. This study represents the largest and most rigorous genotype-phenotype analysis in PMS to date and provides important information for considering clinical functioning, trajectories and comorbidities as a function of specific genetic alteration.
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Affiliation(s)
- Tess Levy
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Catalina Betancur
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Institut de Biologie Paris Seine, Paris 75005, France
| | - Paige M Siper
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maria del Pilar Trelles-Thorne
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Danielle Halpern
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Yitzchak Frank
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Reymundo Lozano
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Christina Layton
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bari Britvan
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Neurological Sciences, Biochemistry, Rush University Medical Center, Chicago, Illinois 60612, USA
| | - Craig M Powell
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
- Department of Psychiatry and Neuroscience Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - Siddharth Srivastava
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, Illinois 60612, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20814, USA
| | - Alexander Kolevzon
- To whom correspondence should be addressed at. Tel: 212-659-9134; Fax: 212-996-8931;
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Lerner MD, Brown CE, Sridhar A, Tschida JE, Felsman P, Libsack EJ, Kerns CM, Moskowitz LJ, Soorya L, Wainer A, Cohn E, Drahota A. Usual care for youth with autism spectrum disorder: Community-based providers' reported familiarity with treatment practices. Front Psychiatry 2022; 13:923025. [PMID: 35958649 PMCID: PMC9360540 DOI: 10.3389/fpsyt.2022.923025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine patterns and predictors of familiarity with transdisciplinary psychosocial (e.g., non-pharmacologic) practices for practitioners treating youths with autism spectrum disorder (ASD) in the United States. METHOD Practitioners (n = 701) from behavioral, education, medical, and mental health backgrounds who worked with youth (ages 7-22) with ASD completed the Usual Care for Autism Survey, which assessed provider demographics and self-reported familiarity with transdisciplinary treatment practices for the most common referral problems of ASD. We examined relations between provider-, setting-, and client-level characteristics with familiarity of key groups of the treatment practices (practice sets). Practice sets were identified using exploratory factor analysis (EFA), and demographic predictors of practice subsets were examined using generalized estimating equations (GEE). RESULTS The EFA yielded a three-factor solution: (1) environmental modifications/antecedent strategies; (2) behavior analytic strategies; and (3) cognitive strategies, with overall familiarity ranked in this order. Medical providers indicated the least familiarity across disciplines. More experience with ASD and treating those with intellectual disabilities predicted greater familiarity with only environmental modifications/antecedent strategies and behavior analytic, but not cognitive strategies. Experience treating low SES clients predicted familiarity with environmental modification and behavior analytic strategies while experience treating high SES clients predicted familiarity with behavior analytic and cognitive strategies. CONCLUSION This is the first study to identify transdisciplinary, interpretable sets of practices for treating youth with ASD based on community providers' reported familiarity. Results highlight factors associated with familiarity with practice sets, which is essential for mapping practice availability, and optimizing training and dissemination efforts for youth with ASD.
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Affiliation(s)
- Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Cynthia E Brown
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States.,School of Graduate Psychology, Pacific University, Hillsboro, OR, United States
| | - Aksheya Sridhar
- Department of Psychology, Michigan State University, Lansing, MI, United States
| | - Jessica E Tschida
- Department of Psychology, Michigan State University, Lansing, MI, United States
| | - Peter Felsman
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States.,Department of Social Work, Northern Michigan University, Marquette, MI, United States
| | - Erin J Libsack
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Connor M Kerns
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Lauren J Moskowitz
- Department of Psychology, St. John's University, Queens, NY, United States
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Allison Wainer
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Elizabeth Cohn
- Hunter-Bellevue School of Nursing, City University of New York, New York, NY, United States
| | - Amy Drahota
- Department of Psychology, Michigan State University, Lansing, MI, United States
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7
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Srivastava S, Condy E, Carmody E, Filip-Dhima R, Kapur K, Bernstein JA, Berry-Kravis E, Powell CM, Soorya L, Thurm A, Buxbaum JD, Sahin M, Kolevzon AL. Parent-reported measure of repetitive behavior in Phelan-McDermid syndrome. J Neurodev Disord 2021; 13:53. [PMID: 34740315 PMCID: PMC8570010 DOI: 10.1186/s11689-021-09398-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 10/14/2021] [Indexed: 12/03/2022] Open
Abstract
Background Phelan McDermid syndrome (PMS) is a neurogenetic condition associated with a high prevalence of intellectual disability (ID) and autism spectrum disorder (ASD). This study provides a more comprehensive and quantitative profile of repetitive behaviors within the context of ID seen with the condition. Methods Individuals age 3–21 years with a confirmed PMS diagnosis participated in a multicenter observational study evaluating the phenotype and natural history of the disorder. We evaluated data collected from this study pertaining to repetitive behaviors from the Repetitive Behavior Scales-Revised (RBS-R). Results There were n = 90 participants who were part of this analysis. Forty-seven percent (n = 42/90) were female, and the average age at baseline evaluation was 8.88 ± 4.72 years. The mean best estimate IQ of the cohort was 26.08 ± 17.67 (range = 3.4–88), with n = 8 with mild ID (or no ID), n = 20 with moderate ID, and n = 62 with severe-profound ID. The RBS-R total overall score was 16.46 ± 13.9 (compared to 33.14 ± 20.60 reported in previous studies of ASD) (Lam and Aman, 2007), and the total number of items endorsed was 10.40 ± 6.81 (range = 0–29). After statistical correction for multiple comparisons, IQ correlated with the RBS-R stereotypic behavior subscale score (rs = − 0.33, unadjusted p = 0.0014, adjusted p = 0.01) and RBS-R stereotypic behavior total number of endorsed items (rs = − 0.32, unadjusted p = 0.0019, adjusted p = 0.01). IQ did not correlate with any other RBS-R subscale scores. Conclusions The RBS-R total overall score in a PMS cohort appears milder compared to individuals with ASD characterized in previous studies. Stereotypic behavior in PMS may reflect cognitive functioning.
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Affiliation(s)
- Siddharth Srivastava
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Emma Condy
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Erin Carmody
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rajna Filip-Dhima
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kush Kapur
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jonathan A Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Biochemistry, Rush University Medical Center, Chicago, IL, USA
| | - Craig M Powell
- Department of Neurobiology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.,Civitan International Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY, USA.,Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA
| | - Mustafa Sahin
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Lexander Kolevzon
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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8
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Condy E, Kaat AJ, Becker L, Sullivan N, Soorya L, Berger N, Berry-Kravis E, Michalak C, Thurm A. A novel measure of matching categories for early development: Item creation and pilot feasibility study. Res Dev Disabil 2021; 115:103993. [PMID: 34049209 PMCID: PMC8750168 DOI: 10.1016/j.ridd.2021.103993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/27/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Many cognitive tests assess a limited developmental span, making longitudinal measurement for trials aimed at improving cognition challenging. Tests targeting transitional skills, which integrate foundational abilities into complex schemas, may be amenable to assessment across a wide developmental span. Furthermore, tablet-based tests permit computer adaptive testing (CAT), which is psychometrically more efficient and could increase testing motivation, especially for children with developmental delays. Such measures may be useful for research and clinical practice. AIMS Outline the creation of a novel, tablet-based concept formation test, and evaluate its feasibility in individuals with mental ages less than 24-months. METHODS AND PROCEDURES Item generation, user interface construction, and pre-piloting were conducted in consultation with subject matter experts. Item content and interface parameters underwent iterative revisions, resulting in the pilot test. OUTCOMES AND RESULTS We created and piloted a tablet-based test of concept formation suitable for CAT-based administration with items of increasing difficulty based on target salience. We show feasibility in individuals with mental ages less than 24-months-old. CONCLUSIONS AND IMPLICATIONS Tablet-based assessment of concept formation may be a useful outcome measure of an aspect of cognitive ability in young children. Future work will address optimizing the user interface and developing CAT administration.
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Affiliation(s)
- Emma Condy
- National Institute of Mental Health, Bethesda, MD, United States
| | - Aaron J Kaat
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lindsey Becker
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
| | | | - Latha Soorya
- Rush University Medical Center, Chicago, IL, United States
| | - Natalie Berger
- Rush University Medical Center, Chicago, IL, United States
| | | | | | - Audrey Thurm
- National Institute of Mental Health, Bethesda, MD, United States.
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9
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Mariscal MG, Berry-Kravis E, Buxbaum JD, Ethridge LE, Filip-Dhima R, Foss-Feig JH, Kolevzon A, Modi ME, Mosconi MW, Nelson CA, Powell CM, Siper PM, Soorya L, Thaliath A, Thurm A, Zhang B, Sahin M, Levin AR. Shifted phase of EEG cross-frequency coupling in individuals with Phelan-McDermid syndrome. Mol Autism 2021; 12:29. [PMID: 33910615 PMCID: PMC8082621 DOI: 10.1186/s13229-020-00411-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Phelan-McDermid Syndrome (PMS) is a rare condition caused by deletion or mutation of the SHANK3 gene. Individuals with PMS frequently present with intellectual disability, autism spectrum disorder, and other neurodevelopmental challenges. Electroencephalography (EEG) can provide a window into network-level function in PMS. METHODS Here, we analyze EEG data collected across multiple sites in individuals with PMS (n = 26) and typically developing individuals (n = 15). We quantify oscillatory power, alpha-gamma phase-amplitude coupling strength, and phase bias, a measure of the phase of cross frequency coupling thought to reflect the balance of feedforward (bottom-up) and feedback (top-down) activity. RESULTS We find individuals with PMS display increased alpha-gamma phase bias (U = 3.841, p < 0.0005), predominantly over posterior electrodes. Most individuals with PMS demonstrate positive overall phase bias while most typically developing individuals demonstrate negative overall phase bias. Among individuals with PMS, strength of alpha-gamma phase-amplitude coupling was associated with Sameness, Ritualistic, and Compulsive behaviors as measured by the Repetitive Behavior Scales-Revised (Beta = 0.545, p = 0.011). CONCLUSIONS Increased phase bias suggests potential circuit-level mechanisms underlying phenotype in PMS, offering opportunities for back-translation of findings into animal models and targeting in clinical trials.
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Affiliation(s)
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Biochemistry, Rush University Medical Center, Chicago, IL, USA
| | - Joseph D Buxbaum
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY, USA
- Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA
| | - Lauren E Ethridge
- Department of Pediatrics, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Rajna Filip-Dhima
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Jennifer H Foss-Feig
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Alexander Kolevzon
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Meera E Modi
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Matthew W Mosconi
- Clinical Child Psychology Program, Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, KS, USA
| | - Charles A Nelson
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Craig M Powell
- Department of Neurobiology, UAB School of Medicine, Birmingham, AL, USA
| | - Paige M Siper
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | - Andrew Thaliath
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA
| | - Audrey Thurm
- Intramural Research Program, National Institute of Mental Health, Bethesda, USA
| | - Bo Zhang
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - April R Levin
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA.
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10
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Abstract
Testing cognitive skill development is important for diagnostic, prognostic, and monitoring purposes, especially for young children and individuals with neurodevelopmental disorders. Developmental tests have been created for infants and toddlers, while traditional IQ tests are often employed beginning in the later preschool period. However, IQ tests rely on developmental skills that are rapidly changing during early childhood. Here, we introduce the idea of prerequisite skills in developmental domains, which are discrete skills required for, but not explicitly tested by, traditional IQ tests. Focusing on general cognition, particularly among children with a chronological or mental age under 4 years, may fail to capture important nuances in skill development. New skill-based assessments are needed in general, and in particular for categorization, which is foundational to higher-order cognitive skills. Novel measures quantifying categorization skills would provide a more sensitive measure of development for young children and older individuals with low developmental levels.
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Affiliation(s)
- Aaron J Kaat
- Department of Medical Social Sciences, Feinberg Medical Center, Northwestern University, Chicago, IL
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA
| | - Emma Condy
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD
| | - Nancy R Sullivan
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Latha Soorya
- Deparment of Psychiatry and Behavioral Sciences, Rush University Medical College, Chicago, IL
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD
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11
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Abstract
Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition traditionally defined by core symptoms in social behavior, speech/communication, repetitive behavior, and restricted interests. Beyond the core symptoms, autism has strong association with other disorders such as intellectual disability (ID), epilepsy, schizophrenia among many others. This paper outlines a theory of ASD with capacity to connect heterogeneous "core" symptoms, medical and psychiatric comorbidities as well as other etiological theories of autism in a unifying cognitive framework rooted in neuroscience and genetics. Cognition is embedded into an ever-developing structure modified by experiences, including the outcomes of environment influencing behaviors. The key constraint of cognition is that the brain can handle only 7±2 relevant variables at a time, whereas sensory variables, i.e., the number of sensory neurons is orders of magnitude larger. As a result, (a) the extraction, (b) the encoding, and (c) the capability for the efficient cognitive manipulation of the relevant variables, and (d) the compensatory mechanisms that counteract computational delays of the distributed components are critical. We outline our theoretical model to describe a Cartesian Factor (CF) forming, autoencoder-like cognitive mechanism which breaks combinatorial explosion and is accelerated by internal reinforcing machineries and discuss the neural processes that support CF formation. Impairments in any of these aspects may disrupt learning, cognitive manipulation, decisions on interactions, and execution of decisions. We suggest that social interactions are the most susceptible to combinations of diverse small impairments and can be spoiled in many ways that pile up. Comorbidity is experienced, if any of the many potential impairments is relatively strong. We consider component spoiling impairments as the basic colors of autism, whereas the combinations of individual impairments make the palette of autism. We put forth arguments on the possibility of dissociating the different main elements of the impairments that can appear together. For example, impairments of generalization (domain general learning) and impairments of dealing with many variable problems, such as social situations may appear independently and may mutually enhance their impacts. We also consider mechanisms that may lead to protection.
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Affiliation(s)
- Ábel Fóthi
- Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary
- Department of Artificial Intelligence, Faculty of Informatics, Eötvös Loránd University, Budapest, Hungary
| | - Latha Soorya
- Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL, United States
| | - András Lőrincz
- Department of Artificial Intelligence, Faculty of Informatics, Eötvös Loránd University, Budapest, Hungary
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12
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Gergoudis K, Weinberg A, Templin J, Farmer C, Durkin A, Weissman J, Siper P, Foss-Feig J, Del Pilar Trelles M, Bernstein JA, Buxbaum JD, Berry-Kravis E, Powell CM, Sahin M, Soorya L, Thurm A, Kolevzon A. Psychometric Study of the Social Responsiveness Scale in Phelan-McDermid Syndrome. Autism Res 2020; 13:1383-1396. [PMID: 32406614 DOI: 10.1002/aur.2299] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/05/2020] [Accepted: 03/05/2020] [Indexed: 12/17/2022]
Abstract
The Social Responsiveness Scale-2 (SRS-2) is a quantitative measure used to characterize symptoms of autism spectrum disorder (ASD). However, research suggests that SRS-2 scores are significantly influenced by language ability and intellectual disability (ID). Efforts to refine the SRS-2 by Sturm, Kuhfeld, Kasari, and Mccracken [Journal of Child Psychology and Psychiatry, 58(9), 1053-1061] yielded a shortened form, yet its psychometric properties in populations with severe ID remain unknown. This study aims to examine the psychometric properties of the SRS-2 in Phelan-McDermid syndrome (PMS), a genetic condition associated with ASD and ID, thereby guiding score interpretation in this population and future development of targeted scales. Analyses, including Item Response Theory (IRT), were conducted on a sample of individuals with PMS (n = 91) recruited at six sites nationally. Psychometric properties evaluated include measures of reliability (internal consistency, test-retest reliability) and validity (structural, construct, content). While both SRS-2 forms are reliable, the shortened SRS-2 shows superior validity to the full SRS-2 for measuring ASD symptoms in PMS. On IRT analysis, the shortened SRS-2 shows excellent discrimination and precisely evaluates respondents across a wide range of ASD symptomatology but interpretation is limited by uncertain content validity and small sample size. The shortened SRS-2 shows some promise for use in PMS, but future refinements and additions are needed to develop items that are tailored to identify ASD in children with severe ID and specifically PMS. LAY SUMMARY: This study determined that a shortened form of the Social Responsiveness Scale, Second Edition (SRS-2) shows both promise and limitations for the characterization of autism symptomatology in individuals with Phelan-McDermid syndrome (PMS), a population characterized by intellectual disability (ID). Caution should be used when interpreting SRS-2 scores in individuals with ID and future research should modify existing items and develop new items to improve the SRS-2's ability to accurately characterize autism symptomatology in PMS. Autism Res 2020, 13: 1383-1396. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Kellie Gergoudis
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alan Weinberg
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan Templin
- Department of Psychology and Research in Education, University of Kansas, Lawrence, Kansas, USA
| | - Cristan Farmer
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Alison Durkin
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jordana Weissman
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paige Siper
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jennifer Foss-Feig
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maria Del Pilar Trelles
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan A Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Joseph D Buxbaum
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.,Department of Biochemistry, Rush University Medical Center, Chicago, Illinois, USA
| | - Craig M Powell
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Civitan International Research Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mustafa Sahin
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, Illinois, USA
| | - Audrey Thurm
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Alexander Kolevzon
- Seaver Autism Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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13
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Bassell J, Srivastava S, Prohl AK, Scherrer B, Kapur K, Filip-Dhima R, Berry-Kravis E, Soorya L, Thurm A, Powell CM, Bernstein JA, Buxbaum JD, Kolevzon A, Warfield SK, Sahin M. Diffusion Tensor Imaging Abnormalities in the Uncinate Fasciculus and Inferior Longitudinal Fasciculus in Phelan-McDermid Syndrome. Pediatr Neurol 2020; 106:24-31. [PMID: 32107139 PMCID: PMC7190002 DOI: 10.1016/j.pediatrneurol.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND This cohort study utilized diffusion tensor imaging tractography to compare the uncinate fasciculus and inferior longitudinal fasciculus in children with Phelan-McDermid syndrome with age-matched controls and investigated trends between autism spectrum diagnosis and the integrity of the uncinate fasciculus and inferior longitudinal fasciculus white matter tracts. METHODS This research was conducted under a longitudinal study that aims to map the genotype, phenotype, and natural history of Phelan-McDermid syndrome and identify biomarkers using neuroimaging (ClinicalTrial NCT02461420). Patients were aged three to 21 years and underwent longitudinal neuropsychologic assessment over 24 months. MRI processing and analyses were completed using previously validated image analysis software distributed as the Computational Radiology Kit (http://crl.med.harvard.edu/). Whole-brain connectivity was generated for each subject using a stochastic streamline tractography algorithm, and automatically defined regions of interest were used to map the uncinate fasciculus and inferior longitudinal fasciculus. RESULTS There were 10 participants (50% male; mean age 11.17 years) with Phelan-McDermid syndrome (n = 8 with autism). Age-matched controls, enrolled in a separate longitudinal study (NIH R01 NS079788), underwent the same neuroimaging protocol. There was a statistically significant decrease in the uncinate fasciculus fractional anisotropy measure and a statistically significant increase in uncinate fasciculus mean diffusivity measure, in the patient group versus controls in both right and left tracts (P ≤ 0.024). CONCLUSION Because the uncinate fasciculus plays a critical role in social and emotional interaction, this tract may underlie some deficits seen in the Phelan-McDermid syndrome population. These findings need to be replicated in a larger cohort.
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Affiliation(s)
- Julia Bassell
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Siddharth Srivastava
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anna K. Prohl
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benoit Scherrer
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kush Kapur
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rajna Filip-Dhima
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois,Department of Biochemistry, Rush University Medical Center, Chicago, Illinois
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, Illinois
| | - Audrey Thurm
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Craig M. Powell
- Department of Neurobiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama,Civitan International Research Center, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Jonathan A. Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Joseph D. Buxbaum
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, New York,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, New York,Department of Neuroscience, Mount Sinai School of Medicine, New York, New York
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, New York,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Simon K. Warfield
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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14
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Srivastava S, Scherrer B, Prohl AK, Filip-Dhima R, Kapur K, Kolevzon A, Buxbaum JD, Berry-Kravis E, Soorya L, Thurm A, Powell CM, Bernstein JA, Warfield SK, Sahin M. Volumetric Analysis of the Basal Ganglia and Cerebellar Structures in Patients with Phelan-McDermid Syndrome. Pediatr Neurol 2019; 90:37-43. [PMID: 30396833 PMCID: PMC6309632 DOI: 10.1016/j.pediatrneurol.2018.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/10/2018] [Accepted: 09/16/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Phelan-McDermid syndrome is caused by haploinsufficiency of SHANK3 on terminal chromosome 22. Knowledge about altered neuroanatomic circuitry in Phelan-McDermid syndrome comes from mouse models showing striatal hypertrophy in the basal ganglia, and from humans with evidence of cerebellar atrophy. To date, no studies have performed volumetric analysis on Phelan-McDermid syndrome patients. METHODS We performed volumetric analysis of baseline brain MRIs of Phelan-McDermid syndrome patients (ages three to 21 years) enrolled in a prospective natural history study (ClinicalTrials.gov NCT02461420). Using MRI segmentations carried out with PSTAPLE algorithm, we measured relative volumes (volume of the structure divided by the volume of the brain parenchyma) of basal ganglia and cerebellar structures. We compared these measurements to those of age- and sex-matched healthy controls part of another study. Among the patients, we performed linear regression of each relative volume using Repetitive Behavior Scale-Revised total score and Aberrant Behavior Checklist stereotypy score. Eleven patients with Phelan-McDermid syndrome (six females, five males) and 11 healthy controls were in this analysis. RESULTS At time of MRI, the mean age of the patients and controls was 9.24 (5.29) years and 9.00 (4.49) years, respectively (P = 0.66). Compared to controls, patients had decreased caudate (P ≤ 0.013), putamen (P ≤ 0.026), and left pallidum (P = 0.033) relative volumes. Relative volume of cerebellar vermal lobules I to V (beta coefficient = -17119, P = 0.017) decreased with increasing Repetitive Behavior Scale-Revised total score. CONCLUSIONS The volumes of the striatum and left pallidum are decreased in individuals with Phelan-McDermid syndrome. Cerebellar vermis volume may predict repetitive behavior severity in Phelan-McDermid syndrome. These findings warrant further investigation in larger samples.
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Affiliation(s)
- Siddharth Srivastava
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts,USA,F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Benoit Scherrer
- Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Anna K. Prohl
- Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rajna Filip-Dhima
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts,USA
| | - Kush Kapur
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts,USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph D. Buxbaum
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY, USA,Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA,Department of Biochemistry, Rush University Medical Center, Chicago, IL, USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | - Audrey Thurm
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Craig M. Powell
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Psychiatry and Neuroscience Graduate Program, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jonathan A Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Simon K. Warfield
- Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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15
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Gu X, Zhou TJ, Anagnostou E, Soorya L, Kolevzon A, Hof PR, Fan J. Heightened brain response to pain anticipation in high-functioning adults with autism spectrum disorder. Eur J Neurosci 2018; 47:592-601. [PMID: 28452081 PMCID: PMC5659957 DOI: 10.1111/ejn.13598] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder (ASD) is marked by both socio-communicative difficulties and abnormalities in sensory processing. Much of the work on sensory deficits in ASD has focused on tactile sensations and the perceptual aspects of somatosensation, such as encoding of stimulus intensity and location. Although aberrant pain processing has often been noted in clinical observations of patients with ASD, it remains largely uninvestigated. Importantly, the neural mechanism underlying higher order cognitive aspects of pain processing such as pain anticipation also remains unknown. Here we examined both pain perception and anticipation in high-functioning adults with ASD and matched healthy controls (HC) using an anticipatory pain paradigm in combination with functional magnetic resonance imaging (fMRI) and concurrent skin conductance response (SCR) recording. Participants were asked to choose a level of electrical stimulation that would feel moderately painful to them. Compared to HC group, ASD group chose a lower level of stimulation prior to fMRI. However, ASD participants showed greater activation in both rostral and dorsal anterior cingulate cortex during the anticipation of stimulation, but not during stimulation delivery. There was no significant group difference in insular activation during either pain anticipation or perception. However, activity in the left anterior insula correlated with SCR during pain anticipation. Taken together, these results suggest that ASD is marked with aberrantly higher level of sensitivity to upcoming aversive stimuli, which may reflect abnormal attentional orientation to nociceptive signals and a failure in interoceptive inference.
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Affiliation(s)
- Xiaosi Gu
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75235, USA
| | - Thomas J. Zhou
- Department of Psychology, Queens College, The City University of New York, Flushing, NY 11367, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Evdokia Anagnostou
- Bloorview Research Institute, University of Toronto, Toronto, Canada M4G 1R8
| | - Latha Soorya
- Department of Psychiatry, Rush University, Chicago, IL 60612, USA
| | - Alexander Kolevzon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Patrick R. Hof
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Flushing, NY 11367, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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16
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Kerns CM, Moskowitz LJ, Rosen T, Drahota A, Wainer A, Josephson AR, Soorya L, Cohn E, Chacko A, Lerner MD. A Multisite, Multidisciplinary Delphi Consensus Study Describing "Usual Care" Intervention Strategies for School-Age to Transition-Age Youth With Autism. J Clin Child Adolesc Psychol 2018; 48:S247-S268. [PMID: 29384389 DOI: 10.1080/15374416.2017.1410826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Understanding usual care is important to reduce health disparities and improve the dissemination of evidence-based practices for youth (ages 7-22 years) with autism spectrum disorder (ASD). A barrier to describing "usual ASD care" is the lack of a common vocabulary and inventory of the practices used by a diverse provider field. To address this barrier, we gathered input from expert providers to develop an inventory of usual care practices and assess expert familiarity and perceptions of these practices as interventions for anxiety, externalizing, and social difficulties in ASD. Purposeful sampling recruited 66 expert ASD providers representing multiple disciplines from 5 sites. Via a 2-round Delphi poll, experts reviewed, suggested revisions to and rated 49 literature-derived practices on several dimensions (familiarity, usefulness, common use, research support). A revised list of 55 practices and anonymous summary of group characteristics and ratings was then returned for further review. Results yielded 55 intervention practices, 48 of which were identified as "familiar" approaches by consensus (≥ 75% endorsement). Greater variation was observed in practices identified by consensus as most often used, useful, and research supported, depending upon the target problem. Findings provide an inventory of practices, reflective of the multidisciplinary language and approaches of expert ASD providers. This inventory may be used to better assess what constitutes usual care for youth with ASD in the United States. Moreover, findings offer insights from clinical experts regarding the range and acceptability of practices that may inform and ground treatment research, dissemination, and implementation efforts.
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Affiliation(s)
- Connor M Kerns
- a A.J. Drexel Autism Institute and Community Health & Prevention, School of Public Health , Drexel University
| | | | - Tamara Rosen
- c Department of Psychology , Stony Brook University
| | - Amy Drahota
- d Department of Psychology , Michigan State University, Child & Adolescent Services Research Center
| | - Allison Wainer
- e Department of Psychiatry , Rush University Medical Center
| | | | - Latha Soorya
- e Department of Psychiatry , Rush University Medical Center
| | - Elizabeth Cohn
- f Center for Health Innovation, College of Nursing and Public Health , Adelphi University
| | - Anil Chacko
- g Department of Applied Psychology , New York University
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17
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Soorya L, Leon J, Trelles MP, Thurm A. Framework for assessing individuals with rare genetic disorders associated with profound intellectual and multiple disabilities (PIMD): the example of Phelan McDermid Syndrome. Clin Neuropsychol 2017; 32:1226-1255. [PMID: 29265961 DOI: 10.1080/13854046.2017.1413211] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Specialized strategies are needed to understand the complex neuropsychological impairments reported in individuals with profound intellectual and multiple disabilities (PIMD) associated with rare genetic disorders. METHODS This narrative review focuses on assessment of individuals with Phelan-McDermid Syndrome (PMS) as a condition commonly associated with PIMD. Published case series and prospective studies were reviewed to evaluate approaches to cognitive, language, motor/sensory, and behavioral domains. This review is framed using general principles for neuropsychological evaluation in PIMD. RESULTS Neuropsychological assessment domains and tools varied across published reports. Adaptive behavior measures, out-of-range developmental assessments, and social-communication measures were commonly used. Available findings were used to shape a recommended framework with potential to improve measurement of clinical outcomes and advance scientific discovery. CONCLUSIONS The recommended framework outlines an inter-disciplinary and multimodal neuropsychological assessment process relying on modified standardized assessments, functional assessments, and caregiver/informant reports when evaluating individuals with PIMD. Arrested development and skill variability/regression are also discussed as additional, important considerations in neuropsychological evaluation of individuals with PIMD and rare genetic disorders.
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Affiliation(s)
- Latha Soorya
- a Department of Psychiatry , Rush University Medical Center , Chicago , IL , USA
| | - Jill Leon
- b Intramural Research Program , National Institute of Mental Health , Bethesda , MD , USA
| | - M Pilar Trelles
- c Department of Psychiatry , Icahn School of Medicine , New York , NY , USA
| | - Audrey Thurm
- b Intramural Research Program , National Institute of Mental Health , Bethesda , MD , USA
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18
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Kolevzon A, Bush L, Wang AT, Halpern D, Frank Y, Grodberg D, Rapaport R, Tavassoli T, Chaplin W, Soorya L, Buxbaum JD. Erratum: A pilot controlled trial of insulin-like growth factor-1 in children with Phelan-McDermid syndrome. Mol Autism 2015; 6:31. [PMID: 26034557 PMCID: PMC4450831 DOI: 10.1186/s13229-015-0025-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/05/2015] [Indexed: 11/10/2022] Open
Abstract
[This corrects the article DOI: 10.1186/2040-2392-5-54.].
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Affiliation(s)
- Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Friedman Brain Institute, New York, NY USA ; Mindich Child Health Institute, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Pediatrics, New York, NY USA
| | - Lauren Bush
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Departments of Psychiatry, New York, NY USA
| | - A Ting Wang
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Friedman Brain Institute, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Neuroscience, New York, NY USA
| | - Danielle Halpern
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Departments of Psychiatry, New York, NY USA
| | - Yitzchak Frank
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Pediatrics, New York, NY USA ; Departments of Neurology, New York, NY USA
| | - David Grodberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Departments of Psychiatry, New York, NY USA
| | - Robert Rapaport
- Icahn School of Medicine at Mount Sinai, New York, NY USA ; Departments of Pediatrics, New York, NY USA ; Departments of Endocrinology and Diabetes, New York, NY USA
| | - Teresa Tavassoli
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Departments of Psychiatry, New York, NY USA
| | - William Chaplin
- Department of Psychology, St John's University, New York, NY USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA ; Friedman Brain Institute, New York, NY USA ; Mindich Child Health Institute, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Neuroscience, New York, NY USA ; Departments of Genetics and Genomic Sciences, New York, NY USA
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19
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Gu X, Eilam-Stock T, Zhou T, Anagnostou E, Kolevzon A, Soorya L, Hof PR, Friston KJ, Fan J. Autonomic and brain responses associated with empathy deficits in autism spectrum disorder. Hum Brain Mapp 2015; 36:3323-38. [PMID: 25995134 PMCID: PMC4545680 DOI: 10.1002/hbm.22840] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/08/2015] [Accepted: 05/03/2015] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence suggests that autonomic signals and their cortical representations are closely linked to emotional processes, and that related abnormalities could lead to social deficits. Although socio‐emotional impairments are a defining feature of autism spectrum disorder (ASD), empirical evidence directly supporting the link between autonomic, cortical, and socio‐emotional abnormalities in ASD is still lacking. In this study, we examined autonomic arousal indexed by skin conductance responses (SCR), concurrent cortical responses measured by functional magnetic resonance imaging, and effective brain connectivity estimated by dynamic causal modeling in seventeen unmedicated high‐functioning adults with ASD and seventeen matched controls while they performed an empathy‐for‐pain task. Compared to controls, adults with ASD showed enhanced SCR related to empathetic pain, along with increased neural activity in the anterior insular cortex, although their behavioral empathetic pain discriminability was reduced and overall SCR was decreased. ASD individuals also showed enhanced correlation between SCR and neural activities in the anterior insular cortex. Importantly, significant group differences in effective brain connectivity were limited to greater reduction in the negative intrinsic connectivity of the anterior insular cortex in the ASD group, indicating a failure in attenuating anterior insular responses to empathetic pain. These results suggest that aberrant interoceptive precision, as indexed by abnormalities in autonomic activity and its central representations, may underlie empathy deficits in ASD. Hum Brain Mapp 36:3323–3338, 2015. © 2015 The Authors Human Brain Mapping Published byWiley Periodicals, Inc.
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Affiliation(s)
- Xiaosi Gu
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom.,Virignia Tech Carilion Research Institute, Roanoke, Virignia
| | - Tehila Eilam-Stock
- Department of Psychology, Queens College, The City University of New York, Flushing, New York.,The Graduate Center, The City University of New York, New York, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Thomas Zhou
- Department of Psychology, Queens College, The City University of New York, Flushing, New York
| | | | - Alexander Kolevzon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Patrick R Hof
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York.,Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Karl J Friston
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Flushing, New York.,The Graduate Center, The City University of New York, New York, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York.,Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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20
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Kolevzon A, Bush L, Wang AT, Halpern D, Frank Y, Grodberg D, Rapaport R, Tavassoli T, Chaplin W, Soorya L, Buxbaum JD. A pilot controlled trial of insulin-like growth factor-1 in children with Phelan-McDermid syndrome. Mol Autism 2014; 5:54. [PMID: 25685306 PMCID: PMC4326443 DOI: 10.1186/2040-2392-5-54] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/20/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is now understood to have multiple genetic risk genes and one example is SHANK3. SHANK3 deletions and mutations disrupt synaptic function and result in Phelan-McDermid syndrome (PMS), which causes a monogenic form of ASD with a frequency of at least 0.5% of ASD cases. Recent evidence from preclinical studies with mouse and human neuronal models of SHANK3 deficiency suggest that insulin-like growth factor-1 (IGF-1) can reverse synaptic plasticity and motor learning deficits. The objective of this study was to pilot IGF-1 treatment in children with PMS to evaluate safety, tolerability, and efficacy for core deficits of ASD, including social impairment and restricted and repetitive behaviors. METHODS Nine children with PMS aged 5 to 15 were enrolled in a placebo-controlled, double-blind, crossover design study, with 3 months of treatment with IGF-1 and 3 months of placebo in random order, separated by a 4-week wash-out period. RESULTS Compared to the placebo phase, the IGF-1 phase was associated with significant improvement in both social impairment and restrictive behaviors, as measured by the Aberrant Behavior Checklist and the Repetitive Behavior Scale, respectively. IGF-1 was found to be well tolerated and there were no serious adverse events in any participants. CONCLUSIONS This study establishes the feasibility of IGF-1 treatment in PMS and contributes pilot data from the first controlled treatment trial in the syndrome. Results also provide proof of concept to advance knowledge about developing targeted treatments for additional causes of ASD associated with impaired synaptic development and function.
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Affiliation(s)
- Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Friedman Brain Institute, New York, NY USA ; Mindich Child Health Institute, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Pediatrics, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Lauren Bush
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Departments of Psychiatry, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - A Ting Wang
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Friedman Brain Institute, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Neuroscience, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Danielle Halpern
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Departments of Psychiatry, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Yitzchak Frank
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Departments of Psychiatry, New York, NY USA ; Departments of Pediatrics, New York, NY USA ; Departments of Neurology, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - David Grodberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Departments of Psychiatry, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Robert Rapaport
- Departments of Pediatrics, New York, NY USA ; Departments of Endocrinology and Diabetes, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Teresa Tavassoli
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Departments of Psychiatry, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - William Chaplin
- Department of Psychology, St John's University, New York, NY USA
| | - Latha Soorya
- Department of Psychiatry, Rush University Medical Center, Chicago, IL USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY 10029 USA ; Friedman Brain Institute, New York, NY USA ; Mindich Child Health Institute, New York, NY USA ; Departments of Psychiatry, New York, NY USA ; Departments of Neuroscience, New York, NY USA ; Departments of Genetics and Genomic Sciences, New York, NY USA ; Icahn School of Medicine at Mount Sinai, New York, NY USA
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21
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Weinger PM, Zemon V, Soorya L, Gordon J. Low-contrast response deficits and increased neural noise in children with autism spectrum disorder. Neuropsychologia 2014; 63:10-8. [PMID: 25107679 DOI: 10.1016/j.neuropsychologia.2014.07.031] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 06/13/2014] [Accepted: 07/28/2014] [Indexed: 11/26/2022]
Abstract
A battery of short-duration neurophysiological tests were designed and implemented using visual evoked potentials (VEPs) to examine specific neural mechanisms in children with and without autism spectrum disorder (ASD). Contrast-sweep conditions (bright or dark isolated-checks) were used to elicit steady-state VEPs to examine the integrity of ON/OFF pathways. Children with ASD displayed deficits in low-contrast responses at the stimulus frequency of 12.5 Hz, notably under conditions that emphasized activity in the magnocellular pathway. Signal-to-noise ratios were weaker in the ASD group, particularly for the OFF pathway. There were no group differences in the amplitude of responses. In addition, the ASD group displayed significantly higher levels of neural noise than controls. For the response at the stimulus frequency, the ASD group produced a relatively constant level of noise across the contrast range tested, with higher levels than controls at low contrasts and approximately equal levels of noise at moderate to high contrasts.
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Affiliation(s)
- Paige M Weinger
- Icahn School of Medicine at Mount Sinai Seaver Autism Center, Psychiatry One Gustave Levy Place, Box 1230 Atran Building E Level, Room 22, New York, NY 10029, United States.
| | | | - Latha Soorya
- Rush University Medical Center, Chicago, Illinois, United States
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22
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Pinto D, Delaby E, Merico D, Barbosa M, Merikangas A, Klei L, Thiruvahindrapuram B, Xu X, Ziman R, Wang Z, Vorstman JAS, Thompson A, Regan R, Pilorge M, Pellecchia G, Pagnamenta AT, Oliveira B, Marshall CR, Magalhaes TR, Lowe JK, Howe JL, Griswold AJ, Gilbert J, Duketis E, Dombroski BA, De Jonge MV, Cuccaro M, Crawford EL, Correia CT, Conroy J, Conceição IC, Chiocchetti AG, Casey JP, Cai G, Cabrol C, Bolshakova N, Bacchelli E, Anney R, Gallinger S, Cotterchio M, Casey G, Zwaigenbaum L, Wittemeyer K, Wing K, Wallace S, van Engeland H, Tryfon A, Thomson S, Soorya L, Rogé B, Roberts W, Poustka F, Mouga S, Minshew N, McInnes LA, McGrew SG, Lord C, Leboyer M, Le Couteur AS, Kolevzon A, Jiménez González P, Jacob S, Holt R, Guter S, Green J, Green A, Gillberg C, Fernandez BA, Duque F, Delorme R, Dawson G, Chaste P, Café C, Brennan S, Bourgeron T, Bolton PF, Bölte S, Bernier R, Baird G, Bailey AJ, Anagnostou E, Almeida J, Wijsman EM, Vieland VJ, Vicente AM, Schellenberg GD, Pericak-Vance M, Paterson AD, Parr JR, Oliveira G, Nurnberger JI, Monaco AP, Maestrini E, Klauck SM, Hakonarson H, Haines JL, Geschwind DH, Freitag CM, Folstein SE, Ennis S, Coon H, Battaglia A, Szatmari P, Sutcliffe JS, Hallmayer J, Gill M, Cook EH, Buxbaum JD, Devlin B, Gallagher L, Betancur C, Scherer SW. Convergence of genes and cellular pathways dysregulated in autism spectrum disorders. Am J Hum Genet 2014; 94:677-94. [PMID: 24768552 PMCID: PMC4067558 DOI: 10.1016/j.ajhg.2014.03.018] [Citation(s) in RCA: 659] [Impact Index Per Article: 65.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 03/25/2014] [Indexed: 12/15/2022] Open
Abstract
Rare copy-number variation (CNV) is an important source of risk for autism spectrum disorders (ASDs). We analyzed 2,446 ASD-affected families and confirmed an excess of genic deletions and duplications in affected versus control groups (1.41-fold, p = 1.0 × 10−5) and an increase in affected subjects carrying exonic pathogenic CNVs overlapping known loci associated with dominant or X-linked ASD and intellectual disability (odds ratio = 12.62, p = 2.7 × 10−15, ∼3% of ASD subjects). Pathogenic CNVs, often showing variable expressivity, included rare de novo and inherited events at 36 loci, implicating ASD-associated genes (CHD2, HDAC4, and GDI1) previously linked to other neurodevelopmental disorders, as well as other genes such as SETD5, MIR137, and HDAC9. Consistent with hypothesized gender-specific modulators, females with ASD were more likely to have highly penetrant CNVs (p = 0.017) and were also overrepresented among subjects with fragile X syndrome protein targets (p = 0.02). Genes affected by de novo CNVs and/or loss-of-function single-nucleotide variants converged on networks related to neuronal signaling and development, synapse function, and chromatin regulation.
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Affiliation(s)
- Dalila Pinto
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Elsa Delaby
- Institut National de la Santé et de la Recherche Médicale U1130, 75005 Paris, France; Centre National de la Recherche Scientifique UMR 8246, 75005 Paris, France; Neuroscience Paris Seine, Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, 75005 Paris, France
| | - Daniele Merico
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
| | - Mafalda Barbosa
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Alison Merikangas
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 8, Ireland
| | - Lambertus Klei
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Bhooma Thiruvahindrapuram
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
| | - Xiao Xu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Robert Ziman
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
| | - Zhuozhi Wang
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
| | - Jacob A S Vorstman
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Ann Thompson
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Regina Regan
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin 12, Ireland; Academic Centre on Rare Diseases, School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
| | - Marion Pilorge
- Institut National de la Santé et de la Recherche Médicale U1130, 75005 Paris, France; Centre National de la Recherche Scientifique UMR 8246, 75005 Paris, France; Neuroscience Paris Seine, Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, 75005 Paris, France
| | - Giovanna Pellecchia
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
| | | | - Bárbara Oliveira
- Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal; Center for Biodiversity, Functional, & Integrative Genomics, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal
| | - Christian R Marshall
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada; McLaughlin Centre, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Tiago R Magalhaes
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin 12, Ireland; Academic Centre on Rare Diseases, School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
| | - Jennifer K Lowe
- Department of Neurology and Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jennifer L Howe
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
| | - Anthony J Griswold
- John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - John Gilbert
- John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Eftichia Duketis
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, 60528 Frankfurt am Main, Germany
| | - Beth A Dombroski
- Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Maretha V De Jonge
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Michael Cuccaro
- John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Emily L Crawford
- Vanderbilt Brain Institute, Center for Human Genetics Research, and Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Catarina T Correia
- Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal; Center for Biodiversity, Functional, & Integrative Genomics, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal
| | - Judith Conroy
- Academic Centre on Rare Diseases, School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland; Children's University Hospital Temple Street, Dublin 1, Ireland
| | - Inês C Conceição
- Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal; Center for Biodiversity, Functional, & Integrative Genomics, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal
| | - Andreas G Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, 60528 Frankfurt am Main, Germany
| | - Jillian P Casey
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin 12, Ireland; Academic Centre on Rare Diseases, School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
| | - Guiqing Cai
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Christelle Cabrol
- Institut National de la Santé et de la Recherche Médicale U1130, 75005 Paris, France; Centre National de la Recherche Scientifique UMR 8246, 75005 Paris, France; Neuroscience Paris Seine, Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, 75005 Paris, France
| | - Nadia Bolshakova
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 8, Ireland
| | - Elena Bacchelli
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
| | - Richard Anney
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 8, Ireland
| | - Steven Gallinger
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | | | - Graham Casey
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB T6B 2H3, Canada
| | | | - Kirsty Wing
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Simon Wallace
- Department of Psychiatry, University of Oxford and Warneford Hospital, Oxford OX3 7JX, UK
| | - Herman van Engeland
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Ana Tryfon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Susanne Thomson
- Vanderbilt Brain Institute, Center for Human Genetics Research, and Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Latha Soorya
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bernadette Rogé
- Unité de Recherche Interdisciplinaire Octogone, Centre d'Etudes et de Recherches en Psychopathologie, Toulouse 2 University, 31058 Toulouse, France
| | - Wendy Roberts
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Fritz Poustka
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, 60528 Frankfurt am Main, Germany
| | - Susana Mouga
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clinica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal; University Clinic of Pediatrics and Institute for Biomedical Imaging and Life Science, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Nancy Minshew
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - L Alison McInnes
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Susan G McGrew
- Department of Pediatrics, Vanderbilt University, Nashville, TN 37232, USA
| | - Catherine Lord
- NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY 10065, USA
| | - Marion Leboyer
- FondaMental Foundation, 94010 Créteil, France; Institut National de la Santé et de la Recherche U955, Psychiatrie Génétique, 94010 Créteil, France; Faculté de Médecine, Université Paris Est, 94010 Créteil, France; Department of Psychiatry, Henri Mondor-Albert Chenevier Hospital, Assistance Publique - Hôpitaux de Paris, 94010 Créteil, France
| | - Ann S Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE1 4LP, UK
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Patricia Jiménez González
- Child Developmental and Behavioral Unit, Hospital Nacional de Niños Dr. Sáenz Herrera, Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Suma Jacob
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA; Institute of Translational Neuroscience and Department of Psychiatry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Richard Holt
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Stephen Guter
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA
| | - Jonathan Green
- Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester M13 9PL, UK; Manchester Academic Health Sciences Centre, Manchester M13 9NT, UK
| | - Andrew Green
- Academic Centre on Rare Diseases, School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland; National Centre for Medical Genetics, Our Lady's Children's Hospital, Dublin 12, Ireland
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, University of Gothenburg, 41119 Gothenburg, Sweden
| | - Bridget A Fernandez
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL A1B 3V6, Canada
| | - Frederico Duque
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clinica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal; University Clinic of Pediatrics and Institute for Biomedical Imaging and Life Science, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Richard Delorme
- FondaMental Foundation, 94010 Créteil, France; Human Genetics and Cognitive Functions Unit, Institut Pasteur, 75015 Paris, France; Centre National de la Recherche Scientifique URA 2182 (Genes, Synapses, and Cognition), Institut Pasteur, 75015 Paris, France; Department of Child and Adolescent Psychiatry, Robert Debré Hospital, Assistance Publique - Hôpitaux de Paris, 75019 Paris, France
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Pauline Chaste
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; FondaMental Foundation, 94010 Créteil, France
| | - Cátia Café
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clinica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal
| | - Sean Brennan
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 8, Ireland
| | - Thomas Bourgeron
- FondaMental Foundation, 94010 Créteil, France; Human Genetics and Cognitive Functions Unit, Institut Pasteur, 75015 Paris, France; Centre National de la Recherche Scientifique URA 2182 (Genes, Synapses, and Cognition), Institut Pasteur, 75015 Paris, France; University Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France
| | - Patrick F Bolton
- Institute of Psychiatry, King's College London, London SE5 8AF, UK; South London & Maudsley Biomedical Research Centre for Mental Health, London SE5 8AF, UK
| | - Sven Bölte
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Frankfurt, 60528 Frankfurt, Germany
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
| | - Gillian Baird
- Paediatric Neurodisability, King's Health Partners, King's College London, London WC2R 2LS, UK
| | - Anthony J Bailey
- Department of Psychiatry, University of Oxford and Warneford Hospital, Oxford OX3 7JX, UK
| | - Evdokia Anagnostou
- Bloorview Research Institute, University of Toronto, Toronto, ON M4G 1R8, Canada
| | - Joana Almeida
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clinica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal
| | - Ellen M Wijsman
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA 98195, USA; Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Veronica J Vieland
- Battelle Center for Mathematical Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Astrid M Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal; Center for Biodiversity, Functional, & Integrative Genomics, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal
| | - Gerard D Schellenberg
- Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margaret Pericak-Vance
- John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Foundation Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Andrew D Paterson
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada; Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Guiomar Oliveira
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clinica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal; University Clinic of Pediatrics and Institute for Biomedical Imaging and Life Science, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - John I Nurnberger
- Institute of Psychiatric Research, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Medical and Molecular Genetics and Program in Medical Neuroscience, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Anthony P Monaco
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; Office of the President, Tufts University, Medford, MA 02155, USA
| | - Elena Maestrini
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
| | - Sabine M Klauck
- Division of Molecular Genome Analysis, German Cancer Research Center (Deutsches Krebsforschungszentrum), 69120 Heidelberg, Germany
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jonathan L Haines
- Vanderbilt Brain Institute, Center for Human Genetics Research, and Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Daniel H Geschwind
- Department of Neurology and Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, 60528 Frankfurt am Main, Germany
| | - Susan E Folstein
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Sean Ennis
- Academic Centre on Rare Diseases, School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland; National Centre for Medical Genetics, Our Lady's Children's Hospital, Dublin 12, Ireland
| | - Hilary Coon
- Utah Autism Research Program, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
| | - Agatino Battaglia
- Stella Maris Clinical Research Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone, Pisa, Italy
| | - Peter Szatmari
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - James S Sutcliffe
- Vanderbilt Brain Institute, Center for Human Genetics Research, and Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Joachim Hallmayer
- Department of Psychiatry, Stanford University Medical School, Stanford, CA 94305, USA
| | - Michael Gill
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 8, Ireland
| | - Edwin H Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bernie Devlin
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Louise Gallagher
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 8, Ireland
| | - Catalina Betancur
- Institut National de la Santé et de la Recherche Médicale U1130, 75005 Paris, France; Centre National de la Recherche Scientifique UMR 8246, 75005 Paris, France; Neuroscience Paris Seine, Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, 75005 Paris, France.
| | - Stephen W Scherer
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada; McLaughlin Centre, University of Toronto, Toronto, ON M5S 1A1, Canada.
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Eilam-Stock T, Xu P, Cao M, Gu X, Van Dam NT, Anagnostou E, Kolevzon A, Soorya L, Park Y, Siller M, He Y, Hof PR, Fan J. Abnormal autonomic and associated brain activities during rest in autism spectrum disorder. ACTA ACUST UNITED AC 2014; 137:153-71. [PMID: 24424916 DOI: 10.1093/brain/awt294] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorders are associated with social and emotional deficits, the aetiology of which are not well understood. A growing consensus is that the autonomic nervous system serves a key role in emotional processes, by providing physiological signals essential to subjective states. We hypothesized that altered autonomic processing is related to the socio-emotional deficits in autism spectrum disorders. Here, we investigated the relationship between non-specific skin conductance response, an objective index of sympathetic neural activity, and brain fluctuations during rest in high-functioning adults with autism spectrum disorder relative to neurotypical controls. Compared with control participants, individuals with autism spectrum disorder showed less skin conductance responses overall. They also showed weaker correlations between skin conductance responses and frontal brain regions, including the anterior cingulate and anterior insular cortices. Additionally, skin conductance responses were found to have less contribution to default mode network connectivity in individuals with autism spectrum disorders relative to controls. These results suggest that autonomic processing is altered in autism spectrum disorders, which may be related to the abnormal socio-emotional behaviours that characterize this condition.
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Affiliation(s)
- Tehila Eilam-Stock
- 1 Department of Psychology, Queens College, City University of New York, Flushing, NY 11367, USA
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Anagnostou E, Soorya L, Brian J, Dupuis A, Mankad D, Smile S, Jacob S. Intranasal oxytocin in the treatment of autism spectrum disorders: a review of literature and early safety and efficacy data in youth. Brain Res 2014; 1580:188-98. [PMID: 24508578 DOI: 10.1016/j.brainres.2014.01.049] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/26/2014] [Accepted: 01/28/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is a paucity of treatments targeting core symptom domains in Autism Spectrum Disorder (ASD). Several animal models and research in typically developing volunteers suggests that manipulation of the oxytocin system may have therapeutic potential for the treatment of social deficits. We review the literature for oxytocin and ASD and report on early dosing, safety and efficacy data of multi-dose oxytocin on aspects of social cognition/function, as well as repetitive behaviors and co-occurring anxiety within ASD. METHODS Fifteen children and adolescents with verbal IQs≥70 were diagnosed with ASD using the ADOS and the ADI-R. They participated in a modified maximum tolerated dose study of intranasal oxytocin (Syntocinon). Data were modeled using repeated measures regression analysis controlling for week, dose, age, and sex. RESULTS Among 4 doses tested, the highest dose evaluated, 0.4 IU/kg/dose, was found to be well tolerated. No serious or severe adverse events were reported and adverse events reported/observed were mild to moderate. Over 12 weeks of treatment, several measures of social cognition/function, repetitive behaviors and anxiety showed sensitivity to change with some measures suggesting maintenance of effect 3 months past discontinuation of intranasal oxytocin. CONCLUSIONS This pilot study suggests that daily administration of intranasal oxytocin at 0.4 IU/kg/dose in children and adolescents with ASD is safe and has therapeutic potential. Larger studies are warranted. This article is part of a Special Issue entitled Oxytocin and Social Behav.
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Affiliation(s)
- Evdokia Anagnostou
- Bloorview Research Institute, University of Toronto, 150 Kilgour Road, Toronto, ON, Canada M4G 1R8.
| | - Latha Soorya
- Rush University Medical Center, Department of Psychiatry, 2150 West Harrison Street, Chicago, IL 606103, USA
| | - Jessica Brian
- Bloorview Research Institute, University of Toronto, 150 Kilgour Road, Toronto, ON, Canada M4G 1R8
| | - Annie Dupuis
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, 555 University Avenue, Toronto, Canada M5G 1X8
| | - Deepali Mankad
- Bloorview Research Institute, University of Toronto, 150 Kilgour Road, Toronto, ON, Canada M4G 1R8
| | - Sharon Smile
- Bloorview Research Institute, University of Toronto, 150 Kilgour Road, Toronto, ON, Canada M4G 1R8
| | - Suma Jacob
- University of Minnesota, Department of Psychiatry & Pediatrics, 2101 6th Street SE, Minneapolis, MN 55455, USA
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25
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Soorya L, Kolevzon A, Zweifach J, Lim T, Dobry Y, Schwartz L, Frank Y, Wang AT, Cai G, Parkhomenko E, Halpern D, Grodberg D, Angarita B, Willner JP, Yang A, Canitano R, Chaplin W, Betancur C, Buxbaum JD. Prospective investigation of autism and genotype-phenotype correlations in 22q13 deletion syndrome and SHANK3 deficiency. Mol Autism 2013; 4:18. [PMID: 23758760 PMCID: PMC3707861 DOI: 10.1186/2040-2392-4-18] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 04/23/2013] [Indexed: 01/30/2023] Open
Abstract
Background 22q13 deletion syndrome, also known as Phelan-McDermid syndrome, is a neurodevelopmental disorder characterized by intellectual disability, hypotonia, delayed or absent speech, and autistic features. SHANK3 has been identified as the critical gene in the neurological and behavioral aspects of this syndrome. The phenotype of SHANK3 deficiency has been described primarily from case studies, with limited evaluation of behavioral and cognitive deficits. The present study used a prospective design and inter-disciplinary clinical evaluations to assess patients with SHANK3 deficiency, with the goal of providing a comprehensive picture of the medical and behavioral profile of the syndrome. Methods A serially ascertained sample of patients with SHANK3 deficiency (n = 32) was evaluated by a team of child psychiatrists, neurologists, clinical geneticists, molecular geneticists and psychologists. Patients were evaluated for autism spectrum disorder using the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule-G. Results Thirty participants with 22q13.3 deletions ranging in size from 101 kb to 8.45 Mb and two participants with de novo SHANK3 mutations were included. The sample was characterized by high rates of autism spectrum disorder: 27 (84%) met criteria for autism spectrum disorder and 24 (75%) for autistic disorder. Most patients (77%) exhibited severe to profound intellectual disability and only five (19%) used some words spontaneously to communicate. Dysmorphic features, hypotonia, gait disturbance, recurring upper respiratory tract infections, gastroesophageal reflux and seizures were also common. Analysis of genotype-phenotype correlations indicated that larger deletions were associated with increased levels of dysmorphic features, medical comorbidities and social communication impairments related to autism. Analyses of individuals with small deletions or point mutations identified features related to SHANK3 haploinsufficiency, including ASD, seizures and abnormal EEG, hypotonia, sleep disturbances, abnormal brain MRI, gastroesophageal reflux, and certain dysmorphic features. Conclusions This study supports findings from previous research on the severity of intellectual, motor, and speech impairments seen in SHANK3 deficiency, and highlights the prominence of autism spectrum disorder in the syndrome. Limitations of existing evaluation tools are discussed, along with the need for natural history studies to inform clinical monitoring and treatment development in SHANK3 deficiency.
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Affiliation(s)
- Latha Soorya
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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26
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Anagnostou E, Soorya L, Chaplin W, Bartz J, Halpern D, Wasserman S, Wang AT, Pepa L, Tanel N, Kushki A, Hollander E. Intranasal oxytocin versus placebo in the treatment of adults with autism spectrum disorders: a randomized controlled trial. Mol Autism 2012; 3:16. [PMID: 23216716 PMCID: PMC3539865 DOI: 10.1186/2040-2392-3-16] [Citation(s) in RCA: 238] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 10/31/2012] [Indexed: 12/30/2022] Open
Abstract
UNLABELLED BACKGROUND There are no effective medications for the treatment of social cognition/function deficits in autism spectrum disorder (ASD), and adult intervention literature in this area is sparse. Emerging data from animal models and genetic association studies as well as early, single-dose intervention studies suggest that the oxytocin system may be a potential therapeutic target for social cognition/function deficits in ASD. The primary aim of this study was to examine the safety/therapeutic effects of intranasal oxytocin versus placebo in adults with ASD, with respect to the two core symptom domains of social cognition/functioning and repetitive behaviors. METHODS This was a pilot, randomized, double-blind, placebo-controlled, parallel design trial of intranasal oxytocin versus placebo in 19 adults with ASD (16 males; 33.20 ± 13.29 years). Subjects were randomized to 24 IU intranasal oxytocin or placebo in the morning and afternoon for 6 weeks. Measures of social function/cognition (the Diagnostic Analysis of Nonverbal Accuracy) and repetitive behaviors (Repetitive Behavior Scale Revised) were administered. Secondary measures included the Social Responsiveness Scale, Reading-the-Mind-in-the-Eyes Test and the Yale Brown Obsessive Compulsive Scale - compulsion subscale and quality of life (World Health Organization Quality of Life Questionnaire - emotional/social subscales). Full-information maximum-likelihood parameter estimates were obtained and tested using mixed-effects regression analyses. RESULTS Although no significant changes were detected in the primary outcome measures after correcting for baseline differences, results suggested improvements after 6 weeks in measures of social cognition (Reading-the-Mind-in-the-Eyes Test, p = 0.002, d = 1.2), and quality of life (World Health Organization Quality of Life Questionnaire - emotion, p = 0.031, d = 0.84), both secondary measures. Oxytocin was well tolerated and no serious adverse effects were reported. CONCLUSIONS This pilot study suggests that there is therapeutic potential to daily administration of intranasal oxytocin in adults with ASD and that larger and longer studies are warranted. TRIAL REGISTRATION NCT00490802.
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Affiliation(s)
- Evdokia Anagnostou
- Mount Sinai School of Medicine, One Gustave L, Levy Place, New York, NY 10029-6574, USA.
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Anney R, Klei L, Pinto D, Almeida J, Bacchelli E, Baird G, Bolshakova N, Bölte S, Bolton PF, Bourgeron T, Brennan S, Brian J, Casey J, Conroy J, Correia C, Corsello C, Crawford EL, de Jonge M, Delorme R, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Fombonne E, Gilbert J, Gillberg C, Glessner JT, Green A, Green J, Guter SJ, Heron EA, Holt R, Howe JL, Hughes G, Hus V, Igliozzi R, Jacob S, Kenny GP, Kim C, Kolevzon A, Kustanovich V, Lajonchere CM, Lamb JA, Law-Smith M, Leboyer M, Le Couteur A, Leventhal BL, Liu XQ, Lombard F, Lord C, Lotspeich L, Lund SC, Magalhaes TR, Mantoulan C, McDougle CJ, Melhem NM, Merikangas A, Minshew NJ, Mirza GK, Munson J, Noakes C, Nygren G, Papanikolaou K, Pagnamenta AT, Parrini B, Paton T, Pickles A, Posey DJ, Poustka F, Ragoussis J, Regan R, Roberts W, Roeder K, Roge B, Rutter ML, Schlitt S, Shah N, Sheffield VC, Soorya L, Sousa I, Stoppioni V, Sykes N, Tancredi R, Thompson AP, Thomson S, Tryfon A, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Vorstman JAS, Wallace S, Wing K, Wittemeyer K, Wood S, Zurawiecki D, Zwaigenbaum L, Bailey AJ, Battaglia A, Cantor RM, Coon H, Cuccaro ML, Dawson G, Ennis S, Freitag CM, Geschwind DH, Haines JL, Klauck SM, McMahon WM, Maestrini E, Miller J, Monaco AP, Nelson SF, Nurnberger JI, Oliveira G, Parr JR, Pericak-Vance MA, Piven J, Schellenberg GD, Scherer SW, Vicente AM, Wassink TH, Wijsman EM, Betancur C, Buxbaum JD, Cook EH, Gallagher L, Gill M, Hallmayer J, Paterson AD, Sutcliffe JS, Szatmari P, Vieland VJ, Hakonarson H, Devlin B. Individual common variants exert weak effects on the risk for autism spectrum disorders. Hum Mol Genet 2012; 21:4781-92. [PMID: 22843504 PMCID: PMC3471395 DOI: 10.1093/hmg/dds301] [Citation(s) in RCA: 254] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/13/2012] [Accepted: 07/19/2012] [Indexed: 11/13/2022] Open
Abstract
While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD families and bringing the total to 2705 families analysed (Stages 1 and 2). In addition to evaluating the association of individual single nucleotide polymorphisms (SNPs), we also sought evidence that common variants, en masse, might affect the risk. Despite genotyping over a million SNPs covering the genome, no single SNP shows significant association with ASD or selected phenotypes at a genome-wide level. The SNP that achieves the smallest P-value from secondary analyses is rs1718101. It falls in CNTNAP2, a gene previously implicated in susceptibility for ASD. This SNP also shows modest association with age of word/phrase acquisition in ASD subjects, of interest because features of language development are also associated with other variation in CNTNAP2. In contrast, allele scores derived from the transmission of common alleles to Stage 1 cases significantly predict case status in the independent Stage 2 sample. Despite being significant, the variance explained by these allele scores was small (Vm< 1%). Based on results from individual SNPs and their en masse effect on risk, as inferred from the allele score results, it is reasonable to conclude that common variants affect the risk for ASD but their individual effects are modest.
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Affiliation(s)
- Richard Anney
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Lambertus Klei
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15232, USA
| | - Dalila Pinto
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children and Department of Molecular Genetics, University of Toronto, Toronto, ON, CanadaM5G 1L7
| | - Joana Almeida
- Hospital Pediátrico de Coimbra, 3000–076 Coimbra, Portugal
| | - Elena Bacchelli
- Department of Biology, University of Bologna, 40126 Bologna, Italy
| | - Gillian Baird
- Guy's and St Thomas' NHS Trust & King's College, London SE1 9RT, UK
| | - Nadia Bolshakova
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Sven Bölte
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | | | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur and
- University Paris Diderot-Paris 7, CNRS URA 2182, Fondation FondaMental, 75015 Paris, France
| | - Sean Brennan
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Jessica Brian
- Autism Research Unit, The Hospital for Sick Children and Bloorview Kids Rehabilitation, University of Toronto, Toronto, ON, CanadaM5G 1Z8
| | - Jillian Casey
- School of Medicine, Medical Science University College, Dublin 4, Ireland
| | - Judith Conroy
- School of Medicine, Medical Science University College, Dublin 4, Ireland
| | - Catarina Correia
- Instituto Nacional de Saude Dr Ricardo Jorge and Instituto Gulbenkian de Cîencia, 1649-016 Lisbon, Portugal
- BioFIG—Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisboa, Portugal
| | - Christina Corsello
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Emily L. Crawford
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, and Centers for Human Genetics Research and Molecular Neuroscience and
| | - Maretha de Jonge
- Department of Child Psychiatry, University Medical Center, Utrecht, 3508 GA, The Netherlands
| | - Richard Delorme
- Child and Adolescent Psychiatry, APHP, Hôpital Robert Debré, 75019 Paris, France
| | - Eftichia Duketis
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | | | | | - Penny Farrar
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Bridget A. Fernandez
- Disciplines of Genetics and Medicine, Memorial University of Newfoundland,St John's, NL, CanadaA1B 3V6
| | - Susan E. Folstein
- Department of Psychiatry, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Eric Fombonne
- Division of Psychiatry, McGill University, Montreal, QC, CanadaH3A 1A1
| | - John Gilbert
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL 33101, USA
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joseph T. Glessner
- The Center for Applied Genomics, Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Andrew Green
- School of Medicine, Medical Science University College, Dublin 4, Ireland
| | - Jonathan Green
- Academic Department of Child Psychiatry, University of Manchester, Manchester M9 7AA, UK
| | - Stephen J. Guter
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60608, USA
| | - Elizabeth A. Heron
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Richard Holt
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Jennifer L. Howe
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children and Department of Molecular Genetics, University of Toronto, Toronto, ON, CanadaM5G 1L7
| | - Gillian Hughes
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Vanessa Hus
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Roberta Igliozzi
- BioFIG—Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisboa, Portugal
| | - Suma Jacob
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60608, USA
| | - Graham P. Kenny
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Cecilia Kim
- The Center for Applied Genomics, Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Alexander Kolevzon
- The Seaver Autism Center for Research and Treatment, Department of Psychiatry, The Friedman Brain Institute, Mount Sinai School of Medicine, New York NY 10029, USA
| | - Vlad Kustanovich
- Autism Genetic Resource Exchange, Autism Speaks, Los Angeles, CA 90036-4234, USA
| | - Clara M. Lajonchere
- Autism Genetic Resource Exchange, Autism Speaks, Los Angeles, CA 90036-4234, USA
| | | | - Miriam Law-Smith
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Marion Leboyer
- Department of Psychiatry, Groupe hospitalier Henri Mondor-Albert Chenevier, INSERM U995, AP-HP; University Paris 12, Fondation FondaMental, Créteil 94000, France
| | - Ann Le Couteur
- Institutes of Neuroscience and Health and Society, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Bennett L. Leventhal
- Nathan Kline Institute for Psychiatric Research (NKI), 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
- Department of Child and Adolescent Psychiatry, New York University, NYU Child Study Center, New York, NY 10016, USA
| | - Xiao-Qing Liu
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Frances Lombard
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Catherine Lord
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, NY, USA
| | - Linda Lotspeich
- Department of Psychiatry, Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Sabata C. Lund
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, and Centers for Human Genetics Research and Molecular Neuroscience and
| | - Tiago R. Magalhaes
- Instituto Nacional de Saude Dr Ricardo Jorge and Instituto Gulbenkian de Cîencia, 1649-016 Lisbon, Portugal
- BioFIG—Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisboa, Portugal
| | - Carine Mantoulan
- Centre d'Eudes et de Recherches en Psychopathologie, University de Toulouse Le Mirail, Toulouse 31200, France
| | - Christopher J. McDougle
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Nadine M. Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15232, USA
| | - Alison Merikangas
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Nancy J. Minshew
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15232, USA
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Ghazala K. Mirza
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Jeff Munson
- Department of Psychiatry and Behavioral Sciences
| | - Carolyn Noakes
- Autism Research Unit, The Hospital for Sick Children and Bloorview Kids Rehabilitation, University of Toronto, Toronto, ON, CanadaM5G 1Z8
| | - Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Katerina Papanikolaou
- University Department of Child Psychiatry, Athens University, Medical School, Agia Sophia Children's Hospital, 115 27 Athens, Greece
| | | | - Barbara Parrini
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone (Pisa), Italy
| | - Tara Paton
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children and Department of Molecular Genetics, University of Toronto, Toronto, ON, CanadaM5G 1L7
| | - Andrew Pickles
- Department of Medicine, School of Epidemiology and Health Science, University of Manchester, Manchester M13 9PT, UK
| | - David J. Posey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Fritz Poustka
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | - Jiannis Ragoussis
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Regina Regan
- School of Medicine, Medical Science University College, Dublin 4, Ireland
| | - Wendy Roberts
- Autism Research Unit, The Hospital for Sick Children and Bloorview Kids Rehabilitation, University of Toronto, Toronto, ON, CanadaM5G 1Z8
| | - Kathryn Roeder
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Bernadette Roge
- Centre d'Eudes et de Recherches en Psychopathologie, University de Toulouse Le Mirail, Toulouse 31200, France
| | - Michael L. Rutter
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London SE5 8AF, UK
| | - Sabine Schlitt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | - Naisha Shah
- School of Medicine, Medical Science University College, Dublin 4, Ireland
| | - Val C. Sheffield
- Department of Pediatrics and Howard Hughes Medical Institute Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Latha Soorya
- The Seaver Autism Center for Research and Treatment, Department of Psychiatry, The Friedman Brain Institute, Mount Sinai School of Medicine, New York NY 10029, USA
| | - Inês Sousa
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Vera Stoppioni
- Neuropsichiatria Infantile, Ospedale Santa Croce, 61032 Fano, Italy
| | - Nuala Sykes
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Raffaella Tancredi
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone (Pisa), Italy
| | - Ann P. Thompson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, CanadaL8N 3Z5
| | - Susanne Thomson
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, and Centers for Human Genetics Research and Molecular Neuroscience and
| | - Ana Tryfon
- The Seaver Autism Center for Research and Treatment, Department of Psychiatry, The Friedman Brain Institute, Mount Sinai School of Medicine, New York NY 10029, USA
| | - John Tsiantis
- University Department of Child Psychiatry, Athens University, Medical School, Agia Sophia Children's Hospital, 115 27 Athens, Greece
| | - Herman Van Engeland
- Department of Child Psychiatry, University Medical Center, Utrecht, 3508 GA, The Netherlands
| | - John B. Vincent
- Centre for Addiction and Mental Health, Clarke Institute and Department of Psychiatry, University of Toronto, Toronto, ON, CanadaM5G 1X8
| | - Fred Volkmar
- Child Study Centre, Yale University, New Haven, CT 06520, USA
| | - JAS Vorstman
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands
| | - Simon Wallace
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX, UK
| | - Kirsty Wing
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Kerstin Wittemeyer
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX, UK
| | - Shawn Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15232, USA
| | - Danielle Zurawiecki
- The Seaver Autism Center for Research and Treatment, Department of Psychiatry, The Friedman Brain Institute, Mount Sinai School of Medicine, New York NY 10029, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB, CanadaT6G 2J3
| | - Anthony J. Bailey
- BC Mental Health and Addictions Research Unit, University of British Columbia, Vancouver, BC, CanadaV5Z4H4
| | - Agatino Battaglia
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone (Pisa), Italy
| | | | - Hilary Coon
- Psychiatry Department, University of Utah Medical School, Salt Lake City, UT 84108, USA
| | - Michael L. Cuccaro
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL 33101, USA
| | | | - Sean Ennis
- School of Medicine, Medical Science University College, Dublin 4, Ireland
| | - Christine M. Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | - Daniel H. Geschwind
- Department of Neurology, Los Angeles School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Jonathan L. Haines
- Center for Human Genetics Research, Vanderbilt University Medical Centre, Nashville, TN 37232, USA
| | - Sabine M. Klauck
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - William M. McMahon
- Psychiatry Department, University of Utah Medical School, Salt Lake City, UT 84108, USA
| | - Elena Maestrini
- Department of Biology, University of Bologna, 40126 Bologna, Italy
| | - Judith Miller
- Psychiatry Department, University of Utah Medical School, Salt Lake City, UT 84108, USA
| | - Anthony P. Monaco
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
- Office of the President, Tufts University, Boston, MA, USA
| | | | - John I. Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | | | - Jeremy R. Parr
- Institutes of Neuroscience and Health and Society, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | | | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3366, USA
| | - Gerard D. Schellenberg
- Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Stephen W. Scherer
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children and Department of Molecular Genetics, University of Toronto, Toronto, ON, CanadaM5G 1L7
| | - Astrid M. Vicente
- Instituto Nacional de Saude Dr Ricardo Jorge and Instituto Gulbenkian de Cîencia, 1649-016 Lisbon, Portugal
- BioFIG—Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisboa, Portugal
| | - Thomas H. Wassink
- Department of Psychiatry, Carver College of Medicine, Iowa City, IA 52242, USA
| | - Ellen M. Wijsman
- Department of Biostatistics and
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Catalina Betancur
- INSERM U952
- CNRS UMR 7224 and
- UPMC Univ Paris 06, Paris 75005, France and
| | - Joseph D. Buxbaum
- The Seaver Autism Center for Research and Treatment, Department of Psychiatry, The Friedman Brain Institute, Mount Sinai School of Medicine, New York NY 10029, USA
| | - Edwin H. Cook
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60608, USA
| | - Louise Gallagher
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Michael Gill
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Joachim Hallmayer
- Department of Psychiatry, Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Andrew D. Paterson
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children and Department of Molecular Genetics, University of Toronto, Toronto, ON, CanadaM5G 1L7
| | - James S. Sutcliffe
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, and Centers for Human Genetics Research and Molecular Neuroscience and
| | - Peter Szatmari
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, CanadaL8N 3Z5
| | - Veronica J. Vieland
- Battelle Center for Mathematical Medicine, The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, OH 43205, USA
| | - Hakon Hakonarson
- The Center for Applied Genomics, Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Bernie Devlin
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15232, USA
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Fan J, Bernardi S, Van Dam NT, Anagnostou E, Gu X, Martin L, Park Y, Liu X, Kolevzon A, Soorya L, Grodberg D, Hollander E, Hof PR. Functional deficits of the attentional networks in autism. Brain Behav 2012; 2:647-60. [PMID: 23139910 PMCID: PMC3489817 DOI: 10.1002/brb3.90] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 07/20/2012] [Accepted: 07/30/2012] [Indexed: 11/12/2022] Open
Abstract
Attentional dysfunction is among the most consistent observations of autism spectrum disorders (ASD). However, the neural nature of this deficit in ASD is still unclear. In this study, we aimed to identify the neurobehavioral correlates of attentional dysfunction in ASD. We used the Attention Network Test-Revised and functional magnetic resonance imaging to examine alerting, orienting, and executive control functions, as well as the neural substrates underlying these attentional functions in unmedicated, high-functioning adults with ASD (n = 12) and matched healthy controls (HC, n = 12). Compared with HC, individuals with ASD showed increased error rates in alerting and executive control, accompanied by lower activity in the mid-frontal gyrus and the caudate nucleus for alerting, and by the absence of significant functional activation in the anterior cingulate cortex (ACC) for executive control. In addition, greater behavioral deficiency in executive control in ASD was correlated with less functional activation of the ACC. These findings of behavioral and neural abnormalities in alerting and executive control of attention in ASD may suggest core attentional deficits, which require further investigation.
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Affiliation(s)
- Jin Fan
- Department of Psychology, Queens College, City University of New York New York ; Department of Psychiatry, Mount Sinai School of Medicine New York ; Fishberg Department of Neuroscience and Friedman Brain Institute, Mount Sinai School of Medicine New York ; Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine New York
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Brandt T, Desai K, Grodberg D, Mehta L, Cohen N, Tryfon A, Kolevzon A, Soorya L, Buxbaum JD, Edelmann L. Complex autism spectrum disorder in a patient with a 17q12 microduplication. Am J Med Genet A 2012; 158A:1170-7. [PMID: 22488896 DOI: 10.1002/ajmg.a.35267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 12/26/2011] [Indexed: 11/10/2022]
Abstract
Autism spectrum disorders (ASDs) are phenotypically complex developmental neuropsychiatric disorders affecting approximately 0.6% of the population. About 30-70% of affected children are also considered to have intellectual disability (ID). The underlying genetic causes of ASDs are diverse with a defined etiology in 16-20%. Array comparative genomic hybridization (aCGH) has proven useful in identifying sub-microscopic chromosome aberrations in a subset of patients, some of which have been shown to be recurrent. One such aberration is the 1.4 Mb microdeletion at chromosome 17q12, which has been reported to be associated with renal disease, growth restriction, diabetes, cognitive impairment, seizures, and in some cases an ASD. Patients with the reciprocal chromosome 17q12 microduplication typically have also been identified with ID and in some cases seizures and behavioral abnormalities. Here we report a patient with a de novo, 1.4 Mb microduplication diagnosed with significant ID involving complex deficits and autism. To our knowledge, this is the first report of a patient with the 17q12 microduplication and a complex ASD phenotype.
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Affiliation(s)
- Tracy Brandt
- Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, New York 100029, USA
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Casey JP, Magalhaes T, Conroy JM, Regan R, Shah N, Anney R, Shields DC, Abrahams BS, Almeida J, Bacchelli E, Bailey AJ, Baird G, Battaglia A, Berney T, Bolshakova N, Bolton PF, Bourgeron T, Brennan S, Cali P, Correia C, Corsello C, Coutanche M, Dawson G, de Jonge M, Delorme R, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Foley S, Fombonne E, Freitag CM, Gilbert J, Gillberg C, Glessner JT, Green J, Guter SJ, Hakonarson H, Holt R, Hughes G, Hus V, Igliozzi R, Kim C, Klauck SM, Kolevzon A, Lamb JA, Leboyer M, Le Couteur A, Leventhal BL, Lord C, Lund SC, Maestrini E, Mantoulan C, Marshall CR, McConachie H, McDougle CJ, McGrath J, McMahon WM, Merikangas A, Miller J, Minopoli F, Mirza GK, Munson J, Nelson SF, Nygren G, Oliveira G, Pagnamenta AT, Papanikolaou K, Parr JR, Parrini B, Pickles A, Pinto D, Piven J, Posey DJ, Poustka A, Poustka F, Ragoussis J, Roge B, Rutter ML, Sequeira AF, Soorya L, Sousa I, Sykes N, Stoppioni V, Tancredi R, Tauber M, Thompson AP, Thomson S, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Vorstman JAS, Wallace S, Wang K, Wassink TH, White K, Wing K, Wittemeyer K, Yaspan BL, Zwaigenbaum L, Betancur C, Buxbaum JD, Cantor RM, Cook EH, Coon H, Cuccaro ML, Geschwind DH, Haines JL, Hallmayer J, Monaco AP, Nurnberger JI, Pericak-Vance MA, Schellenberg GD, Scherer SW, Sutcliffe JS, Szatmari P, Vieland VJ, Wijsman EM, Green A, Gill M, Gallagher L, Vicente A, Ennis S. A novel approach of homozygous haplotype sharing identifies candidate genes in autism spectrum disorder. Hum Genet 2012; 131:565-79. [PMID: 21996756 PMCID: PMC3303079 DOI: 10.1007/s00439-011-1094-6] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/15/2011] [Indexed: 01/18/2023]
Abstract
Autism spectrum disorder (ASD) is a highly heritable disorder of complex and heterogeneous aetiology. It is primarily characterized by altered cognitive ability including impaired language and communication skills and fundamental deficits in social reciprocity. Despite some notable successes in neuropsychiatric genetics, overall, the high heritability of ASD (~90%) remains poorly explained by common genetic risk variants. However, recent studies suggest that rare genomic variation, in particular copy number variation, may account for a significant proportion of the genetic basis of ASD. We present a large scale analysis to identify candidate genes which may contain low-frequency recessive variation contributing to ASD while taking into account the potential contribution of population differences to the genetic heterogeneity of ASD. Our strategy, homozygous haplotype (HH) mapping, aims to detect homozygous segments of identical haplotype structure that are shared at a higher frequency amongst ASD patients compared to parental controls. The analysis was performed on 1,402 Autism Genome Project trios genotyped for 1 million single nucleotide polymorphisms (SNPs). We identified 25 known and 1,218 novel ASD candidate genes in the discovery analysis including CADM2, ABHD14A, CHRFAM7A, GRIK2, GRM3, EPHA3, FGF10, KCND2, PDZK1, IMMP2L and FOXP2. Furthermore, 10 of the previously reported ASD genes and 300 of the novel candidates identified in the discovery analysis were replicated in an independent sample of 1,182 trios. Our results demonstrate that regions of HH are significantly enriched for previously reported ASD candidate genes and the observed association is independent of gene size (odds ratio 2.10). Our findings highlight the applicability of HH mapping in complex disorders such as ASD and offer an alternative approach to the analysis of genome-wide association data.
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Affiliation(s)
- Jillian P. Casey
- School of Medicine and Medical Science University College, Dublin 4, Ireland
| | - Tiago Magalhaes
- Instituto Nacional de Saude Dr Ricardo Jorge, Av Padre Cruz 1649-016, Lisbon, Portugal
- BioFIG, Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisbon, Portugal
- Instituto Gulbenkian de Cîencia, Rua Quinta Grande, 2780-156 Oeiras, Portugal
| | - Judith M. Conroy
- School of Medicine and Medical Science University College, Dublin 4, Ireland
| | - Regina Regan
- School of Medicine and Medical Science University College, Dublin 4, Ireland
| | - Naisha Shah
- School of Medicine and Medical Science University College, Dublin 4, Ireland
| | - Richard Anney
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Denis C. Shields
- School of Medicine and Medical Science University College, Dublin 4, Ireland
| | - Brett S. Abrahams
- Department of Neurology, Center for Autism Research and Treatment, Program in Neurogenetics, Semel Institute, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Joana Almeida
- Hospital Pediátrico de Coimbra, 3000–076 Coimbra, Portugal
| | - Elena Bacchelli
- Department of Biology, University of Bologna, 40126 Bologna, Italy
| | - Anthony J. Bailey
- Department of Psychiatry, University of British Columbia, Vancouver, V6T 2A1 Canada
| | | | - Agatino Battaglia
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone, Pisa, Italy
| | - Tom Berney
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | - Nadia Bolshakova
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Patrick F. Bolton
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London, SE5 8AF UK
| | - Thomas Bourgeron
- Department of Human Genetics and Cognitive Functions, Institut Pasteur, University Paris Diderot-Paris 7, CNRS URA 2182, Fondation FondaMental, 75015 Paris, France
| | - Sean Brennan
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Phil Cali
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Catarina Correia
- Instituto Nacional de Saude Dr Ricardo Jorge, Av Padre Cruz 1649-016, Lisbon, Portugal
- BioFIG, Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisbon, Portugal
- Instituto Gulbenkian de Cîencia, Rua Quinta Grande, 2780-156 Oeiras, Portugal
| | - Christina Corsello
- Autism and Communicative Disorders Centre, University of Michigan, Ann Arbor, MI 48109-2054 USA
| | - Marc Coutanche
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX UK
| | - Geraldine Dawson
- Autism Speaks, New York, 10016 USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599-3366 USA
| | - Maretha de Jonge
- Department of Child and Adolescent Psychiatry, University Medical Center, 3508 Utrecht, GA The Netherlands
| | - Richard Delorme
- INSERM U 955, Fondation FondaMental, APHP, Hôpital Robert Debré, Child and Adolescent Psychiatry, 75019 Paris, France
| | - Eftichia Duketis
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | | | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195 USA
| | - Penny Farrar
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Bridget A. Fernandez
- Disciplines of Genetics and Medicine, Memorial University of Newfoundland, St John’s Newfoundland, A1B 3V6 Canada
| | - Susan E. Folstein
- Department of Psychiatry, University of Miami School of Medicine, Miami, FL 33136 USA
| | - Suzanne Foley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX UK
| | - Eric Fombonne
- Division of Psychiatry, McGill University, Montreal, QC H3A 1A1 Canada
| | - Christine M. Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | - John Gilbert
- The John P. Hussman Institute for Human Genomics, University of Miami School of Medicine, Miami, FL 33136 USA
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, S41345 Gothenburg, Sweden
| | - Joseph T. Glessner
- The Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
| | - Jonathan Green
- Academic Department of Child Psychiatry, Booth Hall of Children’s Hospital, Blackley, Manchester, M9 7AA UK
| | - Stephen J. Guter
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Hakon Hakonarson
- The Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 USA
| | - Richard Holt
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Gillian Hughes
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Vanessa Hus
- Autism and Communicative Disorders Centre, University of Michigan, Ann Arbor, MI 48109-2054 USA
| | - Roberta Igliozzi
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone, Pisa, Italy
| | - Cecilia Kim
- The Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
| | - Sabine M. Klauck
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Alexander Kolevzon
- Department of Psychiatry, The Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, 10029 USA
| | - Janine A. Lamb
- Centre for Integrated Genomic Medical Research, University of Manchester, Manchester, M13 9PT UK
| | - Marion Leboyer
- INSERM U995, Department of Psychiatry, Groupe Hospitalier Henri Mondor-Albert Chenevier, AP-HP, University Paris 12, Fondation FondaMental, 94000 Créteil, France
| | - Ann Le Couteur
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | - Bennett L. Leventhal
- Nathan Kline Institute for Psychiatric Research (NKI), 140 Old Orangeburg Road, Orangeburg, NY 10962 USA
- Department of Child and Adolescent Psychiatry, New York University, NYU Child Study Center, 550 First Avenue, New York, NY 10016 USA
| | - Catherine Lord
- Autism and Communicative Disorders Centre, University of Michigan, Ann Arbor, MI 48109-2054 USA
| | - Sabata C. Lund
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, Centers for Human Genetics Research and Molecular Neuroscience, Vanderbilt University, Nashville, TN 37232 USA
| | - Elena Maestrini
- Department of Biology, University of Bologna, 40126 Bologna, Italy
| | - Carine Mantoulan
- Octogone/CERPP (Centre d’Eudes et de Recherches en Psychopathologie), University de Toulouse Le Mirail, 31058 Toulouse Cedex, France
| | - Christian R. Marshall
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, ON M5G 1L7 Canada
| | - Helen McConachie
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | | | - Jane McGrath
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - William M. McMahon
- Psychiatry Department, University of Utah Medical School, Salt Lake City, UT 84108 USA
| | - Alison Merikangas
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Judith Miller
- Psychiatry Department, University of Utah Medical School, Salt Lake City, UT 84108 USA
| | | | - Ghazala K. Mirza
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Jeff Munson
- Department of Psychiatry and Behavioural Sciences, University of Washington, Seattle, WA 98195 USA
| | - Stanley F. Nelson
- Department of Human Genetics, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095 USA
| | - Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, S41345 Gothenburg, Sweden
| | | | | | - Katerina Papanikolaou
- University Department of Child Psychiatry, Athens University, Medical School, Agia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - Jeremy R. Parr
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, NE1 7RU UK
| | - Barbara Parrini
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone, Pisa, Italy
| | - Andrew Pickles
- Department of Medicine, School of Epidemiology and Health Science, University of Manchester, Manchester, M13 9PT UK
| | - Dalila Pinto
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, ON M5G 1L7 Canada
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, CB3366, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3366 USA
| | - David J. Posey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Annemarie Poustka
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Fritz Poustka
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, J.W. Goethe University Frankfurt, 60528 Frankfurt, Germany
| | - Jiannis Ragoussis
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Bernadette Roge
- Octogone/CERPP (Centre d’Eudes et de Recherches en Psychopathologie), University de Toulouse Le Mirail, 31058 Toulouse Cedex, France
| | - Michael L. Rutter
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, SE5 8AF UK
| | - Ana F. Sequeira
- Instituto Nacional de Saude Dr Ricardo Jorge, Av Padre Cruz 1649-016, Lisbon, Portugal
- BioFIG, Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisbon, Portugal
- Instituto Gulbenkian de Cîencia, Rua Quinta Grande, 2780-156 Oeiras, Portugal
| | - Latha Soorya
- Department of Psychiatry, The Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, 10029 USA
| | - Inês Sousa
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Nuala Sykes
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Vera Stoppioni
- Neuropsichiatria Infantile, Ospedale Santa Croce, 61032 Fano, Italy
| | - Raffaella Tancredi
- Stella Maris Institute for Child and Adolescent Neuropsychiatry, 56128 Calambrone, Pisa, Italy
| | - Maïté Tauber
- Octogone/CERPP (Centre d’Eudes et de Recherches en Psychopathologie), University de Toulouse Le Mirail, 31058 Toulouse Cedex, France
| | - Ann P. Thompson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3Z5 Canada
| | - Susanne Thomson
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, Centers for Human Genetics Research and Molecular Neuroscience, Vanderbilt University, Nashville, TN 37232 USA
| | - John Tsiantis
- University Department of Child Psychiatry, Athens University, Medical School, Agia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - Herman Van Engeland
- Department of Child and Adolescent Psychiatry, University Medical Center, 3508 Utrecht, GA The Netherlands
| | - John B. Vincent
- Department of Psychiatry, Centre for Addiction and Mental Health, Clarke Institute, University of Toronto, Toronto, ON M5G 1X8 Canada
| | - Fred Volkmar
- Child Study Centre, Yale University, New Haven, CT 06520 USA
| | - Jacob A. S. Vorstman
- Department of Child and Adolescent Psychiatry, University Medical Center, 3508 Utrecht, GA The Netherlands
| | - Simon Wallace
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX UK
| | - Kai Wang
- The Center for Applied Genomics, Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
| | - Thomas H. Wassink
- Department of Psychiatry, Carver College of Medicine, Iowa City, IA 52242 USA
| | - Kathy White
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX UK
| | - Kirsty Wing
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - Kerstin Wittemeyer
- Autism Centre for Education and Research, School of Education, University of Birmingham, Birmingham, B15 2TT UK
| | - Brian L. Yaspan
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, Centers for Human Genetics Research and Molecular Neuroscience, Vanderbilt University, Nashville, TN 37232 USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2J3 Canada
| | - Catalina Betancur
- INSERM U952 and CNRS UMR 7224, UPMC Univ Paris 06, Paris, 75005 France
| | - Joseph D. Buxbaum
- Department of Psychiatry, The Seaver Autism Center for Research and Treatment, Mount Sinai School of Medicine, New York, 10029 USA
- Departments of Genetics and Genomic Sciences and Neuroscience, Mount Sinai School of Medicine, New York, 10029 USA
- Department of Neuroscience, Mount Sinai School of Medicine, New York, 10029 USA
| | - Rita M. Cantor
- Department of Human Genetics, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095 USA
| | - Edwin H. Cook
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Hilary Coon
- Psychiatry Department, University of Utah Medical School, Salt Lake City, UT 84108 USA
| | - Michael L. Cuccaro
- The John P. Hussman Institute for Human Genomics, University of Miami School of Medicine, Miami, FL 33136 USA
| | - Daniel H. Geschwind
- Department of Neurology, Center for Autism Research and Treatment, Program in Neurogenetics, Semel Institute, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Jonathan L. Haines
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, Centers for Human Genetics Research and Molecular Neuroscience, Vanderbilt University, Nashville, TN 37232 USA
| | - Joachim Hallmayer
- Department of Psychiatry, Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94304 USA
| | - Anthony P. Monaco
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN UK
| | - John I. Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Margaret A. Pericak-Vance
- The John P. Hussman Institute for Human Genomics, University of Miami School of Medicine, Miami, FL 33136 USA
| | - Gerard D. Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Pennsylvania, 19104 USA
| | - Stephen W. Scherer
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, ON M5G 1L7 Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A1 Canada
| | - James S. Sutcliffe
- Department of Molecular Physiology and Biophysics, Vanderbilt Kennedy Center, Centers for Human Genetics Research and Molecular Neuroscience, Vanderbilt University, Nashville, TN 37232 USA
| | - Peter Szatmari
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3Z5 Canada
| | - Veronica J. Vieland
- Battelle Center for Mathematical Medicine, The Research Institute at Nationwide Children’s Hospital and The Ohio State University, Columbus, OH 43205 USA
| | - Ellen M. Wijsman
- Department of Biostatistics, University of Washington, Seattle, WA 98195 USA
- Department of Medicine, University of Washington, Seattle, WA 98195 USA
| | - Andrew Green
- School of Medicine and Medical Science University College, Dublin 4, Ireland
| | - Michael Gill
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Louise Gallagher
- Autism Genetics Group, Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
| | - Astrid Vicente
- Instituto Nacional de Saude Dr Ricardo Jorge, Av Padre Cruz 1649-016, Lisbon, Portugal
- BioFIG, Center for Biodiversity, Functional and Integrative Genomics, Campus da FCUL, C2.2.12, Campo Grande, 1749-016 Lisbon, Portugal
- Instituto Gulbenkian de Cîencia, Rua Quinta Grande, 2780-156 Oeiras, Portugal
| | - Sean Ennis
- School of Medicine and Medical Science University College, Dublin 4, Ireland
- Health Sciences Centre, University College Dublin, Dublin, Ireland
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Hollander E, Soorya L, Chaplin W, Anagnostou E, Taylor BP, Ferretti CJ, Wasserman S, Swanson E, Settipani C. A double-blind placebo-controlled trial of fluoxetine for repetitive behaviors and global severity in adult autism spectrum disorders. Am J Psychiatry 2012; 169:292-9. [PMID: 22193531 DOI: 10.1176/appi.ajp.2011.10050764] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The effects of fluoxetine and placebo on repetitive behaviors and global severity were compared in adults with autism spectrum disorders (ASDs). METHOD Adults with ASDs were enrolled in a 12-week double-blind placebo-controlled fluoxetine trial. Thirty-seven were randomly assigned to fluoxetine (N=22) or placebo (N=15). Dosage followed a fixed schedule, starting at 10 mg/day and increasing as tolerated up to 80 mg/day. Repetitive behaviors were measured with the compulsion subscale of the Yale-Brown Obsessive Compulsive Scale; the Clinical Global Impression (CGI) improvement scale was used to rate improvement in obsessive-compulsive symptoms and overall severity. RESULTS There was a significant treatment-by-time interaction indicating a significantly greater reduction in repetitive behaviors across time for fluoxetine than for placebo. With overall response defined as a CGI global improvement score of 2 or less, there were significantly more responders at week 12 in the fluoxetine group than in the placebo group. The risk ratio was 1.5 for CGI global improvement (responders: fluoxetine, 35%; placebo, 0%) and 1.8 for CGI-rated improvement in obsessive-compulsive symptoms (responders: fluoxetine, 50%; placebo, 8%). Only mild and moderate side effects were observed. CONCLUSIONS Fluoxetine treatment, compared to placebo, resulted in significantly greater improvement in repetitive behaviors, according to both the Yale-Brown compulsion subscale and CGI rating of obsessive-compulsive symptoms, as well as on the CGI overall improvement rating. Fluoxetine appeared to be well tolerated. These findings stand in contrast to findings in a trial of citalopram for childhood autism.
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Affiliation(s)
- Eric Hollander
- Autism and Obsessive-Compulsive Spectrum Program, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, USA.
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Ameis SH, Fan J, Rockel C, Voineskos AN, Lobaugh NJ, Soorya L, Wang AT, Hollander E, Anagnostou E. Impaired structural connectivity of socio-emotional circuits in autism spectrum disorders: a diffusion tensor imaging study. PLoS One 2011; 6:e28044. [PMID: 22132206 PMCID: PMC3223195 DOI: 10.1371/journal.pone.0028044] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Accepted: 10/31/2011] [Indexed: 12/21/2022] Open
Abstract
Background Abnormal white matter development may disrupt integration within neural circuits, causing particular impairments in higher-order behaviours. In autism spectrum disorders (ASDs), white matter alterations may contribute to characteristic deficits in complex socio-emotional and communication domains. Here, we used diffusion tensor imaging (DTI) and tract based spatial statistics (TBSS) to evaluate white matter microstructure in ASD. Methods/Principal Findings DTI scans were acquired for 19 children and adolescents with ASD (∼8–18 years; mean 12.4±3.1) and 16 age and IQ matched controls (∼8–18 years; mean 12.3±3.6) on a 3T MRI system. DTI values for fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity, were measured. Age by group interactions for global and voxel-wise white matter indices were examined. Voxel-wise analyses comparing ASD with controls in: (i) the full cohort (ii), children only (≤12 yrs.), and (iii) adolescents only (>12 yrs.) were performed, followed by tract-specific comparisons. Significant age-by-group interactions on global DTI indices were found for all three diffusivity measures, but not for fractional anisotropy. Voxel-wise analyses revealed prominent diffusion measure differences in ASD children but not adolescents, when compared to healthy controls. Widespread increases in mean and radial diffusivity in ASD children were prominent in frontal white matter voxels. Follow-up tract-specific analyses highlighted disruption to pathways integrating frontal, temporal, and occipital structures involved in socio-emotional processing. Conclusions/Significance Our findings highlight disruption of neural circuitry in ASD, particularly in those white matter tracts that integrate the complex socio-emotional processing that is impaired in this disorder.
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Affiliation(s)
- Stephanie H. Ameis
- Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Flushing, New York, United States of America
- Departments of Psychiatry and Neuroscience, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Conrad Rockel
- Department of Psychology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N. Voineskos
- The Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Nancy J. Lobaugh
- LC Campbell Cognitive Neurology Research Unit and Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Latha Soorya
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America
| | - A. Ting Wang
- Departments of Psychiatry and Neuroscience, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Eric Hollander
- Department of Psychiatry, Montefiore Medical Center, University Hospital for Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Evdokia Anagnostou
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America
- Bloorview Research Institute, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Grodberg D, Weinger PM, Kolevzon A, Soorya L, Buxbaum JD. Brief Report: The Autism Mental Status Examination: Development of a Brief Autism-Focused Exam. J Autism Dev Disord 2011; 42:455-9. [DOI: 10.1007/s10803-011-1255-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Grodberg D, Weinger P, Kolevzon A, Soorya L, Buxbaum J. FC05-04 - The gamse (grodberg autism mental status examination). Preliminary development of a standardized autism-focused exam. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73541-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BackgroundThe traditional mental status examination, used universally in psychiatry, does not provide flexibility to accommodate the developmental perspective necessary for the examination of patients with Autism Spectrum Disorder (ASD). The Grodberg Autism Mental Status Examination (GAMSE), developed at the Seaver Autism Center for Research and Treatment, prompts the observation and recording of social, communicative and behavioral functioning in patients with ASD. The GAMSE contains 8 items, which produce a total score ranging from 0 to 16.Objectives1. To determine the validity of the GAMSE in accurately predicting diagnostic classification based on a gold standard observational assessment.2. To establish inter-rater reliability.MethodsEighty consecutive patients receiving autism diagnostic evaluations at the Seaver Autism Center were administered the GAMSE and the Autism Diagnostic Observation Schedule (ADOS) as part of standard intake procedures. The classification accuracy of the GAMSE was assessed using the ADOS as the gold standard. Inter-rater reliability on the GAMSE was also examined (n = 44).ResultsA receiver-operating characteristic (ROC) curve analysis was used to determine a cut-off score based on the 8 items of the GAMSE. The most effective cut-off score of greater than or equal to 5 predicted outcome on the ADOS with a sensitivity of 0.94 and a specificity of 0.81. Co-rating of 44 participants on the AMSE resulted in an average measures intra-class correlation of 0.85.ConclusionsPreliminary results indicate excellent classification accuracy and suggest that the GAMSE may act as a useful standardized autism assessment tool for clinical and research endeavors.
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Anney R, Klei L, Pinto D, Regan R, Conroy J, Magalhaes TR, Correia C, Abrahams BS, Sykes N, Pagnamenta AT, Almeida J, Bacchelli E, Bailey AJ, Baird G, Battaglia A, Berney T, Bolshakova N, Bölte S, Bolton PF, Bourgeron T, Brennan S, Brian J, Carson AR, Casallo G, Casey J, Chu SH, Cochrane L, Corsello C, Crawford EL, Crossett A, Dawson G, de Jonge M, Delorme R, Drmic I, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Fombonne E, Freitag CM, Gilbert J, Gillberg C, Glessner JT, Goldberg J, Green J, Guter SJ, Hakonarson H, Heron EA, Hill M, Holt R, Howe JL, Hughes G, Hus V, Igliozzi R, Kim C, Klauck SM, Kolevzon A, Korvatska O, Kustanovich V, Lajonchere CM, Lamb JA, Laskawiec M, Leboyer M, Le Couteur A, Leventhal BL, Lionel AC, Liu XQ, Lord C, Lotspeich L, Lund SC, Maestrini E, Mahoney W, Mantoulan C, Marshall CR, McConachie H, McDougle CJ, McGrath J, McMahon WM, Melhem NM, Merikangas A, Migita O, Minshew NJ, Mirza GK, Munson J, Nelson SF, Noakes C, Noor A, Nygren G, Oliveira G, Papanikolaou K, Parr JR, Parrini B, Paton T, Pickles A, Piven J, Posey DJ, Poustka A, Poustka F, Prasad A, Ragoussis J, Renshaw K, Rickaby J, Roberts W, Roeder K, Roge B, Rutter ML, Bierut LJ, Rice JP, Salt J, Sansom K, Sato D, Segurado R, Senman L, Shah N, Sheffield VC, Soorya L, Sousa I, Stoppioni V, Strawbridge C, Tancredi R, Tansey K, Thiruvahindrapduram B, Thompson AP, Thomson S, Tryfon A, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Wallace S, Wang K, Wang Z, Wassink TH, Wing K, Wittemeyer K, Wood S, Yaspan BL, Zurawiecki D, Zwaigenbaum L, Betancur C, Buxbaum JD, Cantor RM, Cook EH, Coon H, Cuccaro ML, Gallagher L, Geschwind DH, Gill M, Haines JL, Miller J, Monaco AP, Nurnberger JI, Paterson AD, Pericak-Vance MA, Schellenberg GD, Scherer SW, Sutcliffe JS, Szatmari P, Vicente AM, Vieland VJ, Wijsman EM, Devlin B, Ennis S, Hallmayer J. A genome-wide scan for common alleles affecting risk for autism. Hum Mol Genet 2010; 19:4072-82. [PMID: 20663923 PMCID: PMC2947401 DOI: 10.1093/hmg/ddq307] [Citation(s) in RCA: 432] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Although autism spectrum disorders (ASDs) have a substantial genetic basis, most of the known genetic risk has been traced to rare variants, principally copy number variants (CNVs). To identify common risk variation, the Autism Genome Project (AGP) Consortium genotyped 1558 rigorously defined ASD families for 1 million single-nucleotide polymorphisms (SNPs) and analyzed these SNP genotypes for association with ASD. In one of four primary association analyses, the association signal for marker rs4141463, located within MACROD2, crossed the genome-wide association significance threshold of P < 5 × 10−8. When a smaller replication sample was analyzed, the risk allele at rs4141463 was again over-transmitted; yet, consistent with the winner's curse, its effect size in the replication sample was much smaller; and, for the combined samples, the association signal barely fell below the P < 5 × 10−8 threshold. Exploratory analyses of phenotypic subtypes yielded no significant associations after correction for multiple testing. They did, however, yield strong signals within several genes, KIAA0564, PLD5, POU6F2, ST8SIA2 and TAF1C.
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Affiliation(s)
- Richard Anney
- Department of Psychiatry, School of Medicine, Trinity College, Dublin 8, Ireland
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Pinto D, Pagnamenta AT, Klei L, Anney R, Merico D, Regan R, Conroy J, Magalhaes TR, Correia C, Abrahams BS, Almeida J, Bacchelli E, Bader GD, Bailey AJ, Baird G, Battaglia A, Berney T, Bolshakova N, Bölte S, Bolton PF, Bourgeron T, Brennan S, Brian J, Bryson SE, Carson AR, Casallo G, Casey J, Chung BHY, Cochrane L, Corsello C, Crawford EL, Crossett A, Cytrynbaum C, Dawson G, de Jonge M, Delorme R, Drmic I, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Fombonne E, Freitag CM, Gilbert J, Gillberg C, Glessner JT, Goldberg J, Green A, Green J, Guter SJ, Hakonarson H, Heron EA, Hill M, Holt R, Howe JL, Hughes G, Hus V, Igliozzi R, Kim C, Klauck SM, Kolevzon A, Korvatska O, Kustanovich V, Lajonchere CM, Lamb JA, Laskawiec M, Leboyer M, Le Couteur A, Leventhal BL, Lionel AC, Liu XQ, Lord C, Lotspeich L, Lund SC, Maestrini E, Mahoney W, Mantoulan C, Marshall CR, McConachie H, McDougle CJ, McGrath J, McMahon WM, Merikangas A, Migita O, Minshew NJ, Mirza GK, Munson J, Nelson SF, Noakes C, Noor A, Nygren G, Oliveira G, Papanikolaou K, Parr JR, Parrini B, Paton T, Pickles A, Pilorge M, Piven J, Ponting CP, Posey DJ, Poustka A, Poustka F, Prasad A, Ragoussis J, Renshaw K, Rickaby J, Roberts W, Roeder K, Roge B, Rutter ML, Bierut LJ, Rice JP, Salt J, Sansom K, Sato D, Segurado R, Sequeira AF, Senman L, Shah N, Sheffield VC, Soorya L, Sousa I, Stein O, Sykes N, Stoppioni V, Strawbridge C, Tancredi R, Tansey K, Thiruvahindrapduram B, Thompson AP, Thomson S, Tryfon A, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Wallace S, Wang K, Wang Z, Wassink TH, Webber C, Weksberg R, Wing K, Wittemeyer K, Wood S, Wu J, Yaspan BL, Zurawiecki D, Zwaigenbaum L, Buxbaum JD, Cantor RM, Cook EH, Coon H, Cuccaro ML, Devlin B, Ennis S, Gallagher L, Geschwind DH, Gill M, Haines JL, Hallmayer J, Miller J, Monaco AP, Nurnberger JI, Paterson AD, Pericak-Vance MA, Schellenberg GD, Szatmari P, Vicente AM, Vieland VJ, Wijsman EM, Scherer SW, Sutcliffe JS, Betancur C. Functional impact of global rare copy number variation in autism spectrum disorders. Nature 2010; 466:368-72. [PMID: 20531469 DOI: 10.1038/nature09146] [Citation(s) in RCA: 1441] [Impact Index Per Article: 102.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 05/07/2010] [Indexed: 12/18/2022]
Abstract
The autism spectrum disorders (ASDs) are a group of conditions characterized by impairments in reciprocal social interaction and communication, and the presence of restricted and repetitive behaviours. Individuals with an ASD vary greatly in cognitive development, which can range from above average to intellectual disability. Although ASDs are known to be highly heritable ( approximately 90%), the underlying genetic determinants are still largely unknown. Here we analysed the genome-wide characteristics of rare (<1% frequency) copy number variation in ASD using dense genotyping arrays. When comparing 996 ASD individuals of European ancestry to 1,287 matched controls, cases were found to carry a higher global burden of rare, genic copy number variants (CNVs) (1.19 fold, P = 0.012), especially so for loci previously implicated in either ASD and/or intellectual disability (1.69 fold, P = 3.4 x 10(-4)). Among the CNVs there were numerous de novo and inherited events, sometimes in combination in a given family, implicating many novel ASD genes such as SHANK2, SYNGAP1, DLGAP2 and the X-linked DDX53-PTCHD1 locus. We also discovered an enrichment of CNVs disrupting functional gene sets involved in cellular proliferation, projection and motility, and GTPase/Ras signalling. Our results reveal many new genetic and functional targets in ASD that may lead to final connected pathways.
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Affiliation(s)
- Dalila Pinto
- The Centre for Applied Genomics and Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Ontario M5G 1L7, Canada
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Glessner JT, Wang K, Cai G, Korvatska O, Kim CE, Wood S, Zhang H, Estes A, Brune CW, Bradfield JP, Imielinski M, Frackelton EC, Reichert J, Crawford EL, Munson J, Sleiman PMA, Chiavacci R, Annaiah K, Thomas K, Hou C, Glaberson W, Flory J, Otieno F, Garris M, Soorya L, Klei L, Piven J, Meyer KJ, Anagnostou E, Sakurai T, Game RM, Rudd DS, Zurawiecki D, McDougle CJ, Davis LK, Miller J, Posey DJ, Michaels S, Kolevzon A, Silverman JM, Bernier R, Levy SE, Schultz RT, Dawson G, Owley T, McMahon WM, Wassink TH, Sweeney JA, Nurnberger JI, Coon H, Sutcliffe JS, Minshew NJ, Grant SFA, Bucan M, Cook EH, Buxbaum JD, Devlin B, Schellenberg GD, Hakonarson H. Autism genome-wide copy number variation reveals ubiquitin and neuronal genes. Nature 2009; 459:569-73. [PMID: 19404257 DOI: 10.1038/nature07953] [Citation(s) in RCA: 1005] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Accepted: 02/27/2009] [Indexed: 01/09/2023]
Abstract
Autism spectrum disorders (ASDs) are childhood neurodevelopmental disorders with complex genetic origins. Previous studies focusing on candidate genes or genomic regions have identified several copy number variations (CNVs) that are associated with an increased risk of ASDs. Here we present the results from a whole-genome CNV study on a cohort of 859 ASD cases and 1,409 healthy children of European ancestry who were genotyped with approximately 550,000 single nucleotide polymorphism markers, in an attempt to comprehensively identify CNVs conferring susceptibility to ASDs. Positive findings were evaluated in an independent cohort of 1,336 ASD cases and 1,110 controls of European ancestry. Besides previously reported ASD candidate genes, such as NRXN1 (ref. 10) and CNTN4 (refs 11, 12), several new susceptibility genes encoding neuronal cell-adhesion molecules, including NLGN1 and ASTN2, were enriched with CNVs in ASD cases compared to controls (P = 9.5 x 10(-3)). Furthermore, CNVs within or surrounding genes involved in the ubiquitin pathways, including UBE3A, PARK2, RFWD2 and FBXO40, were affected by CNVs not observed in controls (P = 3.3 x 10(-3)). We also identified duplications 55 kilobases upstream of complementary DNA AK123120 (P = 3.6 x 10(-6)). Although these variants may be individually rare, they target genes involved in neuronal cell-adhesion or ubiquitin degradation, indicating that these two important gene networks expressed within the central nervous system may contribute to the genetic susceptibility of ASD.
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Affiliation(s)
- Joseph T Glessner
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
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Cai G, Edelmann L, Goldsmith JE, Cohen N, Nakamine A, Reichert JG, Hoffman EJ, Zurawiecki DM, Silverman JM, Hollander E, Soorya L, Anagnostou E, Betancur C, Buxbaum JD. Multiplex ligation-dependent probe amplification for genetic screening in autism spectrum disorders: efficient identification of known microduplications and identification of a novel microduplication in ASMT. BMC Med Genomics 2008; 1:50. [PMID: 18925931 PMCID: PMC2588447 DOI: 10.1186/1755-8794-1-50] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 10/16/2008] [Indexed: 11/10/2022] Open
Abstract
Background It has previously been shown that specific microdeletions and microduplications, many of which also associated with cognitive impairment (CI), can present with autism spectrum disorders (ASDs). Multiplex ligation-dependent probe amplification (MLPA) represents an efficient method to screen for such recurrent microdeletions and microduplications. Methods In the current study, a total of 279 unrelated subjects ascertained for ASDs were screened for genomic disorders associated with CI using MLPA. Fluorescence in situ hybridization (FISH), quantitative polymerase chain reaction (Q-PCR) and/or direct DNA sequencing were used to validate potential microdeletions and microduplications. Methylation-sensitive MLPA was used to characterize individuals with duplications in the Prader-Willi/Angelman (PWA) region. Results MLPA showed two subjects with typical ASD-associated interstitial duplications of the 15q11-q13 PWA region of maternal origin. Two additional subjects showed smaller, de novo duplications of the PWA region that had not been previously characterized. Genes in these two novel duplications include GABRB3 and ATP10A in one case, and MKRN3, MAGEL2 and NDN in the other. In addition, two subjects showed duplications of the 22q11/DiGeorge syndrome region. One individual was found to carry a 12 kb deletion in one copy of the ASPA gene on 17p13, which when mutated in both alleles leads to Canavan disease. Two subjects showed partial duplication of the TM4SF2 gene on Xp11.4, previously implicated in X-linked non-specific mental retardation, but in our subsequent analyses such variants were also found in controls. A partial duplication in the ASMT gene, located in the pseudoautosomal region 1 (PAR1) of the sex chromosomes and previously suggested to be involved in ASD susceptibility, was observed in 6–7% of the cases but in only 2% of controls (P = 0.003). Conclusion MLPA proves to be an efficient method to screen for chromosomal abnormalities. We identified duplications in 15q11-q13 and in 22q11, including new de novo small duplications, as likely contributing to ASD in the current sample by increasing liability and/or exacerbating symptoms. Our data indicate that duplications in TM4SF2 are not associated with the phenotype given their presence in controls. The results in PAR1/PAR2 are the first large-scale studies of gene dosage in these regions, and the findings at the ASMT locus indicate that further studies of the duplication of the ASMT gene are needed in order to gain insight into its potential involvement in ASD. Our studies also identify some limitations of MLPA, where single base changes in probe binding sequences alter results. In summary, our studies indicate that MLPA, with a focus on accepted medical genetic conditions, may be an inexpensive method for detection of microdeletions and microduplications in ASD patients for purposes of genetic counselling if MLPA-identified deletions are validated by additional methods.
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Affiliation(s)
- Guiqing Cai
- Laboratory of Molecular Neuropsychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Abstract
This article provides an overview of psychopharmacological treatments for repetitive behaviors in autism spectrum disorders (ASDs) in the context of current conceptualizations of this understudied core symptom domain. The available literature on the widely used selective serotonin reuptake inhibitors (SSRIs), including fluvoxamine, fluoxetine, citalopram, escitalopram, and sertraline, are reviewed. In addition to SSRIs, research on effects of other pharmacologic interventions such as divalproex sodium, risperidone, and the neuropeptide oxytocin are presented. To date, data are mixed for interventions commonly prescribed in clinical practice and suggest several areas of investigation in advancing research on the medication management of repetitive behaviors.
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Affiliation(s)
- Latha Soorya
- Department of Psychiatry, Seaver & New York Autism Center of Excellence, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA.
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Hollander E, Bartz J, Chaplin W, Phillips A, Sumner J, Soorya L, Anagnostou E, Wasserman S. Oxytocin increases retention of social cognition in autism. Biol Psychiatry 2007; 61:498-503. [PMID: 16904652 DOI: 10.1016/j.biopsych.2006.05.030] [Citation(s) in RCA: 464] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Revised: 05/12/2006] [Accepted: 05/16/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oxytocin dysfunction might contribute to the development of social deficits in autism, a core symptom domain and potential target for intervention. This study explored the effect of intravenous oxytocin administration on the retention of social information in autism. METHODS Oxytocin and placebo challenges were administered to 15 adult subjects diagnosed with autism or Asperger's disorder, and comprehension of affective speech (happy, indifferent, angry, and sad) in neutral content sentences was tested. RESULTS All subjects showed improvements in affective speech comprehension from pre- to post-infusion; however, whereas those who received placebo first tended to revert to baseline after a delay, those who received oxytocin first retained the ability to accurately assign emotional significance to speech intonation on the speech comprehension task. CONCLUSIONS These results are consistent with studies linking oxytocin to social recognition in rodents as well as studies linking oxytocin to prosocial behavior in humans and suggest that oxytocin might facilitate social information processing in those with autism. These findings also provide preliminary support for the use of oxytocin in the treatment of autism.
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Affiliation(s)
- Eric Hollander
- Mount Sinai School of Medicine, New York, New York, USA.
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Wasserman S, Iyengar R, Chaplin WF, Watner D, Waldoks SE, Anagnostou E, Soorya L, Hollander E. Levetiracetam versus placebo in childhood and adolescent autism: a double-blind placebo-controlled study. Int Clin Psychopharmacol 2006; 21:363-7. [PMID: 17012983 DOI: 10.1097/01.yic.0000224787.13782.0f] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to determine the safety and efficacy of the anticonvulsant levetiracetam in the treatment of children with autism. A previous open-label study in autistic children treated with levetiracetam demonstrated effectiveness in hyperactivity, impulsivity/aggression, and mood lability. Twenty patients with autism ranging from 5 to 17 years of age were entered into a 10-week, placebo-controlled, double-blind trial of levetiracetam versus placebo. The mean maximum dosage for levetiracetam was 862.50+/-279.19 mg/day. We evaluated global improvement of autism with the Clinical Global Impression-Improvement (CGI-I) Scale and aggression and affective instability with the Aberrant Behavior Checklist (ABC) parent and teacher ratings. We measured repetitive behaviors using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score and impulsivity and hyperactivity with the Conners' Rating Scale-Revised: Long Version for parent and teacher. No significant difference was found between levetiracetam and placebo groups comparing the change in CGI-I (t=0.350, d.f.=13.621, P=0.765), nor on change in ABC, CY-BOCS or Conners' scales. These findings suggest that levetiracetam does not improve behavioral disturbances of autism, but are limited by the small sample size and lack of stratification of the autistic sample at baseline.
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Affiliation(s)
- Stacey Wasserman
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Anagnostou E, Esposito K, Soorya L, Chaplin W, Wasserman S, Hollander E. Divalproex versus placebo for the prevention of irritability associated with fluoxetine treatment in autism spectrum disorder. J Clin Psychopharmacol 2006; 26:444-6. [PMID: 16855475 DOI: 10.1097/01.jcp.0000227703.72117.bc] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hollander E, Soorya L, Wasserman S, Esposito K, Chaplin W, Anagnostou E. Divalproex sodium vs. placebo in the treatment of repetitive behaviours in autism spectrum disorder. Int J Neuropsychopharmacol 2006; 9:209-13. [PMID: 16316486 DOI: 10.1017/s1461145705005791] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2005] [Revised: 05/04/2005] [Accepted: 05/10/2005] [Indexed: 11/06/2022] Open
Abstract
Autism is a neurodevelopmental disorder characterized by impairment in three core symptom domains: socialization, communication, and repetitive/stereotyped behaviours. Other associated symptom domains are also affected including impulsivity/aggression, self-injury, anxiety, and mood lability. Divalproex has been shown to have efficacy in treating epilepsy, bipolar disorder, mood lability, and impulsive aggression. The present study evaluated the use of divalproex in the treatment of repetitive, compulsive-like symptoms of autism spectrum disorder (ASD). Thirteen individuals with ASD participated in an 8-wk, double-blind, placebo-controlled trial of divalproex sodium vs. placebo. There was a significant group difference on improvement in repetitive behaviours as measured by the Children's Yale-Brown Obsessive Compulsive Scale (C-YBOCS) (p=0.037) and a large effect size (d=1.616). This study provides preliminary support for the use of divalproex in treating repetitive behaviours in ASD. Further research is needed to evaluate the specificity and mechanism of action of these findings.
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Affiliation(s)
- Eric Hollander
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Hollander E, Anagnostou E, Chaplin W, Esposito K, Haznedar MM, Licalzi E, Wasserman S, Soorya L, Buchsbaum M. Striatal volume on magnetic resonance imaging and repetitive behaviors in autism. Biol Psychiatry 2005; 58:226-32. [PMID: 15939406 DOI: 10.1016/j.biopsych.2005.03.040] [Citation(s) in RCA: 241] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Revised: 03/14/2005] [Accepted: 03/25/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND The repetitive behaviors seen in autism phenotypically resemble those seen in obsessive-compulsive disorder (OCD) and Tourette Syndrome (TS), disorders in which structural and functional abnormalities of the basal ganglia (BG) are present and correspond to the severity of repetitive behaviors. METHODS Seventeen subjects with autism by DSM-IV and Autism Diagnostic Interview (ADI) and 17 matched controls completed a 1.5 T magnetic resonance image (MRI) of the brain. Two blinded researchers, with good inter-rater reliability, outlined the right and left caudate and putamen. Autistic and control BG volumes covaried for total brain volume were compared using analysis of covariance. BG volumes within the autistic group were correlated with the ADI Repetitive Behavior scores (ADI-C domain). RESULTS Right caudate volume controlled for total brain volume was significantly larger in autistic subjects than in controls. In addition, right caudate and total putamen volumes correlated positively with repetitive behavior scores on the ADI-C domain, particularly the higher order OCD-like repetitive behaviors. CONCLUSIONS Increased right caudate volume in autism is of interest, since this has also been observed in OCD patients. Increased volume of the right caudate and total putamen positively correlated with greater repetitive behaviors, supporting the hypothesis of BG dysfunction associated with repetitive behaviors in autistic adults.
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Affiliation(s)
- Eric Hollander
- Department of Psychiatry, Mount Sinai School of Medicine, Annenberg Bldg., 1 Gustave L. Levy Place, New York, NY 10029, USA.
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