1
|
Oztan O, Zyga O, Stafford DEJ, Parker KJ. Linking oxytocin and arginine vasopressin signaling abnormalities to social behavior impairments in Prader-Willi syndrome. Neurosci Biobehav Rev 2022; 142:104870. [PMID: 36113782 PMCID: PMC11024898 DOI: 10.1016/j.neubiorev.2022.104870] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 05/17/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/19/2022]
Abstract
Prader-Willi syndrome (PWS) is a genetic neurodevelopmental disorder. Global hypothalamic dysfunction is a core feature of PWS and has been implicated as a driver of many of PWS's phenotypic characteristics (e.g., hyperphagia-induced obesity, hypogonadism, short stature). Although the two neuropeptides (i.e., oxytocin [OXT] and arginine vasopressin [AVP]) most implicated in mammalian prosocial functioning are of hypothalamic origin, and social functioning is markedly impaired in PWS, there has been little consideration of how dysregulation of these neuropeptide signaling pathways may contribute to PWS's social behavior impairments. The present article addresses this gap in knowledge by providing a comprehensive review of the preclinical and clinical PWS literature-spanning endogenous neuropeptide measurement to exogenous neuropeptide administration studies-to better understand the roles of OXT and AVP signaling in this population. The preponderance of evidence indicates that OXT and AVP signaling are indeed dysregulated in PWS, and that these neuropeptide pathways may provide promising targets for therapeutic intervention in a patient population that currently lacks a pharmacological strategy for its debilitating social behavior symptoms.
Collapse
Affiliation(s)
- Ozge Oztan
- 1201 Welch Road, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Olena Zyga
- 1201 Welch Road, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Diane E J Stafford
- Center for Academic Medicine, 453 Quarry Road, Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Palo Alto, CA 94304, USA
| | - Karen J Parker
- 1201 Welch Road, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; 300 Pasteur Drive, Department of Comparative Medicine, Stanford University, Stanford, CA 94305, USA.
| |
Collapse
|
2
|
Clarke L, Zyga O, Pineo-Cavanaugh PL, Jeng M, Fischbein NJ, Partap S, Katznelson L, Parker KJ. Socio-behavioral dysfunction in disorders of hypothalamic-pituitary involvement: The potential role of disease-induced oxytocin and vasopressin signaling deficits. Neurosci Biobehav Rev 2022; 140:104770. [PMID: 35803395 PMCID: PMC10999113 DOI: 10.1016/j.neubiorev.2022.104770] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 02/10/2022] [Revised: 06/16/2022] [Accepted: 07/02/2022] [Indexed: 10/17/2022]
Abstract
Disorders involving hypothalamic and pituitary (HPIT) structures-including craniopharyngioma, Langerhans cell histiocytosis, and intracranial germ cell tumors-can disrupt brain and endocrine function. An area of emerging clinical concern in patients with these disorders is the co-occurring socio-behavioral dysfunction that persists after standard hormone replacement therapy. Although the two neuropeptides most implicated in mammalian social functioning (oxytocin and arginine vasopressin) are of hypothalamic origin, little is known about how disease-induced damage to HPIT structures may disrupt neuropeptide signaling and, in turn, impact patients' socio-behavioral functioning. Here we provide a clinical primer on disorders of HPIT involvement and a review of neuropeptide signaling and socio-behavioral functioning in relevant animal models and patient populations. This collective evidence suggests that neuropeptide signaling disruptions contribute to socio-behavioral deficits experienced by patients with disorders of HPIT involvement. A better understanding of the biological underpinnings of patients' socio-behavioral symptoms is now needed to enable the development of the first targeted pharmacological strategies by which to manage patients' socio-behavioral dysfunction.
Collapse
Affiliation(s)
- Lauren Clarke
- Department of Psychiatry and Behavioral Sciences, Stanford University, 1201 Welch Road, MSLS P-104, Stanford, CA 94305, USA
| | - Olena Zyga
- Department of Psychiatry and Behavioral Sciences, Stanford University, 1201 Welch Road, MSLS P-104, Stanford, CA 94305, USA
| | - Psalm L Pineo-Cavanaugh
- Department of Psychiatry and Behavioral Sciences, Stanford University, 1201 Welch Road, MSLS P-104, Stanford, CA 94305, USA
| | - Michael Jeng
- Department of Pediatrics (Hematology/Oncology Division), Stanford University, 1000 Welch Road, Suite 300, Palo Alto, CA 94304, USA
| | - Nancy J Fischbein
- Department of Radiology, Stanford University, 450 Quarry Rd, Suite 5659, Palo Alto, CA 94304, USA
| | - Sonia Partap
- Department of Neurology and Neurological Sciences (Child Neurology Division), Stanford University, 750 Welch Road, Suite 317, Palo Alto, CA 94304, USA
| | - Laurence Katznelson
- Departments of Neurosurgery and Medicine (Endocrinology Division), Stanford University, 875 Blake Wilbur Drive, Stanford, CA 94305, USA
| | - Karen J Parker
- Department of Psychiatry and Behavioral Sciences, Stanford University, 1201 Welch Road, MSLS P-104, Stanford, CA 94305, USA; Department of Comparative Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA.
| |
Collapse
|
3
|
Dimitropoulos A, Doernberg EA, Russ SW, Zyga O. Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training. J Autism Dev Disord 2022; 52:5191-5206. [PMID: 35932366 PMCID: PMC9361891 DOI: 10.1007/s10803-022-05695-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.
Collapse
Affiliation(s)
| | | | | | - Olena Zyga
- Cleveland Clinic Center for Autism, Rocky River, OH, USA
| |
Collapse
|
4
|
Bailey B, Zyga O, Meeker H, Kirk J, Russ SW. A comparison of curricula: Examining the efficacy of a school-based musical theater intervention. J Intellect Disabil 2021; 25:370-386. [PMID: 31750754 DOI: 10.1177/1744629519883159] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Students qualifying for services under the Individuals with Disabilities Education Act may experience challenges meeting the socioemotional demands of the school environment, creating a need for targeted interventions that can be delivered within school settings. The current study used a mixed-methods approach to examine the efficacy of a 4-week school-based musical theater intervention delivered to 121 elementary students with intellectual and developmental disabilities. Quantitative analyses of teacher-reported changes in student engagement pre- and post-intervention were conducted to compare student gains made across two intervention curricula, followed by qualitative content analyses of teachers' responses to open-ended survey questions. Results indicated an overall benefit of the musical theater intervention, with increases found in composite scores on the teacher-report Student Engagement Survey measure after completion of both intervention curricula; however, gains in individual survey item scores differed by curricula. Additionally, qualitative analyses provided positive insight into several aspects of the intervention.
Collapse
Affiliation(s)
| | - Olena Zyga
- 2546Case Western Reserve University, USA
| | | | | | | |
Collapse
|
5
|
Dimitropoulos A, Zyga O, Doernberg E, Russ SW. Show me what happens next: Preliminary efficacy of a remote play-based intervention for children with Prader-Willi syndrome. Res Dev Disabil 2021; 108:103820. [PMID: 33307337 DOI: 10.1016/j.ridd.2020.103820] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/05/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
Prader-Willi Syndrome (PWS) is characterized by decreased social and emotional functioning. Due to the low base-rate of children with PWS, developing behavioral interventions for individuals with PWS is faced with the challenge of enrolling enough local participants for adequate study of behavioral intervention efficacy. However, these types of studies are greatly needed in PWS and telehealth methodology may be useful in addressing this challenge. This article is a follow-up to a previous feasibility study (Dimitropoulos et al., 2017) and reports on the preliminary efficacy of a telehealth intervention delivered to 15 children, ages 6-12, with PWS. Overall, children demonstrated significantly improved cognitive and affective processes in pretend play and general cognitive flexibility following the 6-week remote intervention. These findings are limited by the lack of control group and small sample size which should be considered when interpreting results. Overall, these preliminary findings point to the potential role pretend play can serve as a means of enacting cognitive and behavioral change via telehealth.
Collapse
Affiliation(s)
| | - Olena Zyga
- Case Westerm Reserve University, Department of Psychological Sciences, United States
| | - Ellen Doernberg
- Case Westerm Reserve University, Department of Psychological Sciences, United States.
| | - Sandra W Russ
- Case Westerm Reserve University, Department of Psychological Sciences, United States
| |
Collapse
|
6
|
Itskovich E, Zyga O, Libove RA, Phillips JM, Garner JP, Parker KJ. Complex Interplay Between Cognitive Ability and Social Motivation in Predicting Social Skill: A Unique Role for Social Motivation in Children With Autism. Autism Res 2020; 14:86-92. [DOI: 10.1002/aur.2409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/28/2020] [Accepted: 09/29/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Elena Itskovich
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Olena Zyga
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Robin A. Libove
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Joseph P. Garner
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
- Department of Comparative Medicine Stanford University Stanford California USA
| | - Karen J. Parker
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| |
Collapse
|
7
|
Zyga O, Dimitropoulos A. Preliminary Characterization of Parent-Child Interaction in Preschoolers With Prader-Willi Syndrome: The Relationship Between Engagement and Parental Stress. Am J Intellect Dev Disabil 2020; 125:76-84. [PMID: 31877257 DOI: 10.1352/1944-7558-125.1.76] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Early parent-child interactions (PCI) impact social cognitive development. Relatedly, children with various developmental disorders exhibit abnormal parental attachment relationships. Parental characteristics and behaviors can impact PCI and socioemotional development as well. No research has examined the parent-child dynamic in Prader-Willi syndrome (PWS), a neurodevelopmental disorder that presents with social cognitive deficits. This article provides a preliminary characterization of PCI quality and parenting stress in 17 PWS parent-child dyads, children ages 3-5 years, in comparison to 20 typically developing children and their parent. Results suggest early PCI disruption in preschoolers with PWS and their parents report increased levels of stress in various domains. These findings have important implications not only on parent well-being in PWS but its impact on child development.
Collapse
Affiliation(s)
- Olena Zyga
- Olena Zyga and Anastasia Dimitropoulos, Case Western Reserve University
| | | |
Collapse
|
8
|
Frygner-Holm S, Russ S, Quitmann J, Ring L, Zyga O, Hansson M, Ljungman G, Höglund AT. Pretend Play as an Intervention for Children With Cancer: A Feasibility Study. J Pediatr Oncol Nurs 2019; 37:65-75. [PMID: 31540566 DOI: 10.1177/1043454219874695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children with cancer suffer from symptoms and burdensome treatments that often cause distress to children and their families. Mortality is one aspect of cancer diagnosis, while another is the quality of life and well-being during and after the treatment. By supporting children's communication, self-efficacy and coping ability in the care situation, children are given the possibilities for increased independence and participation and are allowed to develop an influence over their care. The aim of this study was to develop and evaluate the feasibility and acceptability of an adult-facilitated pretend play intervention for children with cancer. Five children with ongoing treatment for cancer were invited to a play intervention that consisted of six to eight sessions of structured pretend play aimed at increasing participation, independence, and well-being. A mixed method design was used to evaluate the feasibility and acceptability of the play intervention. Measures were collected before and after interventions, and in conjunction with every play session. Results suggest that the children enjoyed the play intervention. Findings indicate small improvements regarding self-efficacy in care situations and equal or increased quality of life for participants. A main finding was that no adverse events or increased worrying was reported in conjunction with play sessions. Therefore, the intervention is regarded as safe, feasible, and acceptable as reported by participants and their primary caregivers and a possible means of increasing participation and independence in children with a cancer diagnosis.
Collapse
Affiliation(s)
| | - Sandra Russ
- Case Western Reserve University, Cleveland, OH, USA
| | - Julia Quitmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Olena Zyga
- Case Western Reserve University, Cleveland, OH, USA
| | | | | | | |
Collapse
|
9
|
Dimitropoulos A, Zyga O, Russ SW. Early Social Cognitive Ability in Preschoolers with Prader–Willi Syndrome and Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:4441-4454. [DOI: 10.1007/s10803-019-04152-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Zyga O, Russ SW, Dimitropoulos A. The PRETEND Program: Evaluating the Feasibility of a Remote Parent-Training Intervention for Children With Prader-Willi Syndrome. Am J Intellect Dev Disabil 2018; 123:574-584. [PMID: 30421972 DOI: 10.1352/1944-7558-123.6.574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Research has shown that children with Prader-Willi syndrome (PWS) have social-cognitive challenges and decreased quality parent-child interactions. However, given the low prevalence rate, developing interventions for children with PWS is faced with the significant challenge of enrolling enough participants for local studies. To better understand the feasibility and acceptability of telehealth, the current study delivered a 6-week remote parent training intervention to 15 primary caregivers of a child with PWS (ages 3-6). Behavioral Intervention Rating Scale results indicate good acceptability (5.64/6.00) and satisfaction (4.75/5.00) with the intervention. These results are one of the first to support the use of telehealth in conducting parent training in rare disorders, such as PWS.
Collapse
Affiliation(s)
- Olena Zyga
- Olena Zyga, Sandra W. Russ, and Anastasia Dimitropoulos, Case Western Reserve University
| | - Sandra W Russ
- Olena Zyga, Sandra W. Russ, and Anastasia Dimitropoulos, Case Western Reserve University
| | | |
Collapse
|
11
|
Zyga O, Russ SW, Meeker H, Kirk J. A preliminary investigation of a school-based musical theater intervention program for children with intellectual disabilities. J Intellect Disabil 2018; 22:262-278. [PMID: 28355942 DOI: 10.1177/1744629517699334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The presence of an intellectual disability may cause a child to have significant deficits in social skills and emotion regulation abilities across development. A vital next step is to find interventions that can be delivered in the school environment and across disability categories that target socioemotional factors. The current study investigated the feasibility of delivering a school-based musical theater program to students with intellectual disability across a range of school settings. A within-group repeated-measures design was used to analyze pre- and post-video recordings of the intervention program, which were coded for six domains of socioemotional ability across all participants ( n = 47). Results showed that significant gains across all domains were observed. However, these gains related to school- and individual-level student factors, such as grade level, severity of disability, and baseline social skill ability.
Collapse
Affiliation(s)
- Olena Zyga
- Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Jodi Kirk
- The Musical Theater Project, Cleveland, OH, USA
| |
Collapse
|
12
|
Zyga O, Russ S, Ievers-Landis CE, Dimitropoulos A. Assessment of pretend play in Prader-Willi syndrome: a direct comparison to autism spectrum disorder. J Autism Dev Disord 2015; 45:975-87. [PMID: 25241008 DOI: 10.1007/s10803-014-2252-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Children with Prader-Willi syndrome (PWS) are at risk for autism spectrum disorder (ASD), including pervasive social deficits. While play impairments in ASD are well documented, play abilities in PWS have not been evaluated. Fourteen children with PWS and ten children with ASD were administered the Autism Diagnostic Observation Schedule (ADOS) (Lord et al. in Autism Diagnostic Observation Schedule manual. Western Psychological Services, Los Angeles, 2006) as part of a larger project. A modified Affect in Play Scale (APS; Russ in Play in child development and psychotherapy: toward empirically supported practice. Lawrence Erlbaum Associates Publishers, Mahwah, 2004; Pretend play in childhood: foundation of adult creativity. APA Books, Washington, 2014) was used to score ADOS play activities. Results indicate both groups scored below normative data on measures of imagination, organization, and affective expression during individual play. In addition, the inclusion of a play partner in both groups increased all scaled scores on the APS. These findings suggest children with PWS show impaired pretend play abilities similar to ASD. Further research is warranted and should focus on constructing and validating programs aimed at improving symbolic and functional play abilities within these populations.
Collapse
Affiliation(s)
- Olena Zyga
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road, Mather Memorial Building, Rm 109, Cleveland, OH, 44106, USA,
| | | | | | | |
Collapse
|