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Gwaltney A, Potter SN, Peters SU, Barbieri-Welge RL, Horowitz LT, Noll LM, Hundley RJ, Bird LM, Tan WH, Sadhwani A, Wheeler A. Adaptive Skills of Individuals with Angelman Syndrome Assessed Using the Vineland Adaptive Behavior Scales, 2nd Edition. J Autism Dev Disord 2023:10.1007/s10803-023-06090-8. [PMID: 37581718 PMCID: PMC10867286 DOI: 10.1007/s10803-023-06090-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 08/16/2023]
Abstract
In the current study, we examined adaptive skills and trajectories over time in 257 individuals with Angelman syndrome (AS) using the Vineland Adaptive Behavior Scales, 2nd Edition. Multilevel linear models were used to examine differences between molecular subtypes over time, from one year to 13 years of age, in the adaptive domains of communication, daily living skills, socialization and motor skills. Individuals with non-deletion subtypes typically demonstrated a higher level of adaptive skills compared to those with deletion subtypes. Statistically significant growth was observed in all adaptive domains through at least early adolescence. Individuals with AS should continue to receive developmental services and educational supports through adolescence and into adulthood given the slow rates of growth being observed across adaptive domains.
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Affiliation(s)
| | | | - Sarika U Peters
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rene L Barbieri-Welge
- Developmental Evaluation Clinic, Rady Children's Hospital-San Diego, San Diego, CA, USA
| | | | - Lisa M Noll
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Rachel J Hundley
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lynne M Bird
- Division of Dysmorphology/Genetics, Rady Children's Hospital-San Diego, San Diego, CA, USA
- Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA
| | - Anjali Sadhwani
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02446, USA.
| | - Anne Wheeler
- RTI International, Research Triangle Park, NC, USA
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Sadhwani A, Wheeler A, Gwaltney A, Peters SU, Barbieri-Welge RL, Horowitz LT, Noll LM, Hundley RJ, Bird LM, Tan WH. Developmental Skills of Individuals with Angelman Syndrome Assessed Using the Bayley-III. J Autism Dev Disord 2023; 53:720-737. [PMID: 33517526 PMCID: PMC8322148 DOI: 10.1007/s10803-020-04861-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2020] [Indexed: 12/27/2022]
Abstract
We describe the development of 236 children with Angelman syndrome (AS) using the Bayley Scales of Infant and Toddler Development, Third Edition. Multilevel linear mixed modeling approaches were used to explore differences between molecular subtypes and over time. Individuals with AS continue to make slow gains in development through at least age 12 years of age at about 1-2 months/year based on age equivalent score and 1-16 growth score points/year depending on molecular subtype and domain. Children with a deletion have lower scores at baseline and slower rate of gaining skills while children with UBE3A variant subtype demonstrated higher scores as well as greater rates of skill attainment in all domains. The developmental profiles of UPD and ImpD were similar.
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Affiliation(s)
- Anjali Sadhwani
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, 02115, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Anne Wheeler
- RTI International, Research Triangle Park, NC, USA
| | | | - Sarika U. Peters
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rene L. Barbieri-Welge
- Developmental Evaluation Clinic, Rady Children’s Hospital - San Diego, San Diego, CA, USA
| | | | - Lisa M. Noll
- Psychology Service, Texas Children’s Hospital, Houston, TX, USA,Baylor College of Medicine, Houston, TX, USA
| | - Rachel J. Hundley
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lynne M. Bird
- Division of Dysmorphology/Genetics, Rady Children’s Hospital - San Diego, San Diego, CA, USA,Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | - Wen-Hann Tan
- Harvard Medical School, Boston, MA, USA,Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA
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Sadhwani A, Willen JM, Miller H, Barbieri-Welge R, Horowitz LT, Noll LM, Peters S, Hundley R, Bird LM, Tan WH. Neurodevelopmental profile of siblings with Angelman syndrome due to pathogenic UBE3A variants. J Intellect Disabil Res 2020; 64:246-250. [PMID: 31854050 PMCID: PMC8020893 DOI: 10.1111/jir.12700] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Angelman syndrome (AS) is a neurodevelopmental disorder caused by a lack of expression of the maternally inherited UBE3A gene on chromosome 15. Individuals with AS due to a UBE3A mutation are more likely to have siblings who also have AS compared with those with AS due to other cytogenetic/molecular mechanisms, but it is unknown whether the developmental outcome of siblings who have AS is similar. METHODS Through an ongoing AS Natural History Study, we identified seven pairs of siblings with AS due to a UBE3A mutation. We compared the neurodevelopment of the first-born and second-born siblings with AS participants who have a UBE3A mutation and have either typically developing siblings or no siblings. RESULTS Second-born AS participants due to a UBE3A mutation were more likely to be diagnosed at an earlier age. With the exception of higher expressive language scores among the second-born participants, no other differences were observed in the developmental and adaptive functioning skills across the different groups. CONCLUSIONS The presence of an older sibling with the same neurodevelopmental disorder is associated with an earlier age of diagnosis and may be associated with an improvement in expressive language skills; the developmental outcome of siblings with AS due to a UBE3A mutation is otherwise comparable.
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Affiliation(s)
- Anjali Sadhwani
- Department of Psychiatry, Boston Children’s Hospital; Harvard Medical School, Boston, MA
| | - Jennifer M. Willen
- Div. of Genetics & Genomics, Boston Children’s Hospital; Harvard Medical School, Boston, MA
- Department of Psychiatry, Kennedy Krieger Institute, Baltimore, MD
| | - Hillary Miller
- Div. of Genetics & Genomics, Boston Children’s Hospital; Harvard Medical School, Boston, MA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | - Lisa M. Noll
- Psychology Service, Texas Children’s Hospital, Houston, TX
| | - Sarika Peters
- Div. of Developmental Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Rachel Hundley
- Div. of Developmental Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Lynne M. Bird
- University of California, San Diego, Department of Pediatrics and Genetics / Dysmorphology, Rady Children’s Hospital San Diego, San Diego, CA
| | - Wen-Hann Tan
- Div. of Genetics & Genomics, Boston Children’s Hospital; Harvard Medical School, Boston, MA
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Sadhwani A, Willen JM, LaVallee N, Stepanians M, Miller H, Peters SU, Barbieri-Welge RL, Horowitz LT, Noll LM, Hundley RJ, Bird LM, Tan WH. Maladaptive behaviors in individuals with Angelman syndrome. Am J Med Genet A 2019; 179:983-992. [PMID: 30942555 DOI: 10.1002/ajmg.a.61140] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 11/19/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 02/03/2023]
Abstract
Maladaptive behaviors are challenging and a source of stress for caregivers of individuals with Angelman Syndrome (AS). There is limited information on how these maladaptive behaviors vary over time among individuals with AS due to different genetic etiologies. In this study, caregivers of 301 individuals with AS were asked questions about their child's behavior and completed the Aberrant Behavior Checklist-Community version (ABC-C). Developmental functioning was evaluated with either the Bayley Scales of Infant Development, Third Edition (Bayley-III) or the Mullen Scales of Early Learning (MSEL). Family functioning was assessed using the parent-completed Parenting Stress Index (PSI) and the Family Quality of Life questionnaire (FQoL). Approximately 70% of participants had AS due to a deletion on the maternally-inherited copy of chromosome 15q11q13. Results revealed that at baseline, individuals with AS had low scores in the domains of lethargy (mean: 2.6-4.2 depending on genotype) and stereotypy (mean: 2.3-4.2 depending on genotype). Higher cognitive functioning was associated with increased irritability (r = 0.32, p < .01). Hyperactivity (p < .05) and irritability (p < .05) increased with age across all genotypes and should be ongoing targets for both behavioral and pharmacological treatment. Concerns for short attention span were endorsed by more than 70% of caregivers at baseline. Maladaptive behaviors, particularly hyperactivity, irritability and aggression, adversely affected parental stress, and family quality of life.
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Affiliation(s)
- Anjali Sadhwani
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jennifer M Willen
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry, Kennedy Krieger Institute, Baltimore, Maryland
| | | | | | - Hillary Miller
- Division of Genetics and Genomics, Department of Biostatistics, Boston Children's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sarika U Peters
- Division of Developmental Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Rene L Barbieri-Welge
- Developmental Evaluation Clinic, Rady Children's Hospital San Diego, San Diego, California
| | | | - Lisa M Noll
- Psychology Service, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Rachel J Hundley
- Division of Developmental Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Lynne M Bird
- Department of Pediatrics, University of California, San Diego.,Genetics/Dysmorphology, Rady Children's Hospital, San Diego, California
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Tan WH, Bird LM, Sadhwani A, Barbieri-Welge RL, Skinner SA, Horowitz LT, Bacino CA, Noll LM, Fu C, Hundley RJ, Wink LK, Erickson CA, Barnes GN, Slavotinek A, Jeremy R, Rotenberg A, Kothare SV, Olson HE, Poduri A, Nespeca MP, Chu HC, Willen JM, Haas KF, Weeber EJ, Rufo PA. A randomized controlled trial of levodopa in patients with Angelman syndrome. Am J Med Genet A 2017; 176:1099-1107. [PMID: 28944563 DOI: 10.1002/ajmg.a.38457] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/06/2022]
Abstract
Treatment for Angelman syndrome (AS) is currently limited to symptomatic interventions. A mouse model of AS has reduced calcium/calmodulin-dependent kinase II activity due to excessive phosphorylation of specific threonine residues, leading to diminished long-term potentiation. In a rat model of Parkinson disease, levodopa reduced phosphorylation of various proteins, including calcium/calmodulin-dependent kinase II. Further studies demonstrated that AS mice treated with levodopa performed better on rotarod testing than untreated AS mice. We conducted a multi-center double-blind randomized placebo-controlled 1-year trial of levodopa / carbidopa with either 10 or 15 mg/kg/day of levodopa in children with AS. The outcome of this intervention was assessed using either the Bayley Scales of Infant Development or the Mullen Scales of Early Learning, as well as the Vineland Adaptive Behavior Scales, and the Aberrant Behavior Checklist. Of the 78 participants enrolled, 67 participants received study medication (33 on levodopa, 34 on placebo), and 55 participants (29 on levodopa, 26 on placebo) completed the 1-year study. There were no clinically or statistically significant changes in any of the outcome measures over a 1-year period comparing the levodopa and placebo groups. The number of adverse events reported, including the more serious adverse events, was similar in both groups, but none were related to treatment with levodopa. Our data demonstrate that levodopa is well-tolerated by children with AS. However, in the doses used in this study, it failed to improve their neurodevelopment or behavioral outcome.
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Affiliation(s)
- Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Lynne M Bird
- Genetics / Dysmorphology, Rady Children's Hospital San Diego; Department of Pediatrics, University of California, San Diego, California
| | - Anjali Sadhwani
- Department of Psychiatry, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Carlos A Bacino
- Genetics Service, Texas Children's Hospital; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Lisa M Noll
- Psychology Service, Texas Children's Hospital; Baylor College of Medicine, Houston, Texas
| | - Cary Fu
- Division of Pediatric Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Rachel J Hundley
- Division of Developmental Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Logan K Wink
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Craig A Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Gregory N Barnes
- Division of Pediatric Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Anne Slavotinek
- Department of Pediatrics, University of California, San Francisco, California
| | - Rita Jeremy
- Department of Pediatrics, University of California, San Francisco, California
| | - Alexander Rotenberg
- Department of Neurology, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Sanjeev V Kothare
- Department of Neurology, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Heather E Olson
- Department of Neurology, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Annapurna Poduri
- Department of Neurology, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Mark P Nespeca
- Neurology, Rady Children's Hospital San Diego; University of California, San Diego, California
| | - Hillary C Chu
- Division of Genetics and Genomics, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Jennifer M Willen
- Division of Genetics and Genomics, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
| | - Kevin F Haas
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Edwin J Weeber
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Paul A Rufo
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts
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Noll LM, Harding CG, Stilson SR, Weissmann L. The relationship between choice co-construction and symbolic play in mother-child dyads. Infant Behav Dev 1998. [DOI: 10.1016/s0163-6383(98)91816-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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