RESUMO
Brain maturation from childhood to adulthood is associated with changes in structural and functional connectivity between remote brain regions. Altered connectivity plays an important role in the pathology of autism spectrum disorder (ASD), a severe neurodevelopmental disorder. ASD is associated with abnormal brain development and structurally altered interhemispheric connections. Cortico-cortical connectivity can be studied by a combination of transcranial magnetic stimulation (TMS) with concurrent EEG (TMS-EEG). TMS-evoked Interhemispheric Signal Propagation (ISP) is a correlate of interhemispheric connectivity related to the microstructure of the corpus callosum (CC). We used TMS-EEG to measure ISP in 22 ASD subjects (10-21 years) and 22 typically developing control subjects (9-19 years). We expected (1) maturational changes of ISP from childhood to young adulthood and also (2) reduced interhemispheric signal transfer in ASD. ISP was positively correlated with age in both ASD and typically developing control subjects. No difference in ISP between ASD and typically developing controls was found. Our findings demonstrate maturation of effective interhemispheric connectivity during adolescence. As ISP is related to the microstructure of the CC, the developmental change of ISP likely reflects maturation of the CC during the second life decade. The results support ISP as a valid parameter reflecting functional interhemispheric connectivity. Our results do not support a global deficit of interhemispheric connectivity in ASD.
Assuntos
Transtorno do Espectro Autista/patologia , Transtorno do Espectro Autista/fisiopatologia , Mapeamento Encefálico , Corpo Caloso/fisiopatologia , Potencial Evocado Motor/fisiologia , Lateralidade Funcional/fisiologia , Adolescente , Criança , Eletroencefalografia , Feminino , Humanos , Masculino , Processamento de Sinais Assistido por Computador , Estimulação Magnética Transcraniana , Adulto JovemRESUMO
Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.
Assuntos
Identidade de Gênero , Transexualidade/terapia , Adolescente , Adulto , Fatores Etários , Criança , Feminino , Seguimentos , Hormônios Esteroides Gonadais/uso terapêutico , Fidelidade a Diretrizes , Humanos , Masculino , Pacientes Desistentes do Tratamento/psicologia , Psicopatologia , Psicoterapia , Encaminhamento e Consulta , Procedimentos de Readequação Sexual/psicologia , Inquéritos e Questionários , Transexualidade/diagnóstico , Transexualidade/psicologia , Adulto JovemRESUMO
Autistic symptoms are frequently observed in children with attention-deficit/hyperactivity disorder (ADHD), but their etiology remains unclear. The main aim of this study was to describe risk factors for increased autistic symptoms in children with ADHD without an autism or autism-spectrum diagnosis. Comorbid psychiatric disorders, developmental delay, current medication, prenatal biological and postnatal psychosocial risk factors as well as parental autistic traits were assessed in 205 children with ADHD. Linear regression models identified maternal autistic traits, current familial risk factors and hyperactive symptoms as predictors of autistic symptoms in children with ADHD. Findings are indicative of possible genetic as well as environmental risk factors mediating autistic symptoms in children with ADHD. An additional validity analysis by ROC, area under the curve (AUC), suggested a cut-off of 11 to differentiate between ADHD and high-functioning ASD by the Social Communication Questionnaire (SCQ).
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno Autístico/diagnóstico , Transtorno Autístico/epidemiologia , Inquéritos e Questionários/normas , Adolescente , Área Sob a Curva , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno Autístico/psicologia , Criança , Transtornos Globais do Desenvolvimento Infantil/epidemiologia , Transtornos Globais do Desenvolvimento Infantil/psicologia , Comorbidade , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Mães/psicologia , Pais/psicologia , Escalas de Graduação Psiquiátrica , Curva ROC , Reprodutibilidade dos Testes , Fatores de RiscoRESUMO
Abnormalities in neurophysiological correlates of social perception are a well-known feature of autism spectrum disorder (ASD). However, little is known if and how ASD specific behavioral interventions may affect neural processing in ASD. The aim of the current study was to investigate for the first time, whether the group-based social skills training SOSTA-FRA would elicit changes in neurophysiological correlates of social perception in high-functioning ASD individuals aged 8-17 years. Event-related potentials (ERPs) of a facial emotion recognition (FER) and a biological motion perception task were examined. ERPs were compared between a randomized intervention and a treatment as usual group at three time points (baseline, post-intervention, and at 3 months follow-up). A reduction of P100 amplitude in the right hemisphere and a trend toward reduced N200 latency in the biological motion task were found after the training only in the intervention group, whereas behavioral performance remained stable. Change in N200 latencies and parent-rated social responsiveness showed small but statistically nonsignificant correlations. No changes were observed regarding FER. Results indicate that the intervention changed neural correlates of social perception in ASD. Especially neural correlates of biological motion perception, which is an important prerequisite for successful social interaction, were sensitive to change. ERPs of social perception tasks that are impaired in ASD can well be used to objectively measure neural processing improvement by behavioral intervention. Autism Res 2018, 11: 1376-1387. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: It is well known that people with autism spectrum disorder (ASD) process social information differently than other people and that these differences can also be seen in their brain activity. We also know that behavioral therapies, such as group-based social skills trainings can help people with ASD improve their behavior. But it is unclear how therapy changes social processing in the brain. The aim of our study was therefore to examine how neural processing of social stimuli changed after behavioral intervention. Comparing a group of children and adolescents that received the group-based social skills training SOSTA-FRA to a control group we found that the neural processing of human motion became faster and involved less brain resources after the intervention, while behavioral performance remained stable. No changes were seen for the processing of emotional facial expressions. We recommend that future studies should also analyze changes in brain function as well as behavioral changes as a secondary therapy outcome parameter.
Assuntos
Transtorno do Espectro Autista/fisiopatologia , Terapia Comportamental/métodos , Percepção de Movimento/fisiologia , Habilidades Sociais , Adolescente , Criança , Potenciais Evocados/fisiologia , Reconhecimento Facial/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Pais , Percepção SocialRESUMO
The underlying neural mechanisms of implicit and explicit facial emotion recognition (FER) were studied in children and adolescents with autism spectrum disorder (ASD) compared to matched typically developing controls (TDC). EEG was obtained from N = 21 ASD and N = 16 TDC. Task performance, visual (P100, N170) and cognitive (late positive potential) event-related-potentials, as well as coherence were compared across groups. TDC showed a task-dependent increase and a stronger lateralization of P100 amplitude during the explicit task and task-dependent modulation of intra-hemispheric coherence in the beta band. In contrast, the ASD group showed no task dependent modulation. Results indicate disruptions in early visual processing and top-down attentional processes as contributing factors to FER deficits in ASD.
Assuntos
Transtorno do Espectro Autista/fisiopatologia , Potenciais Evocados , Expressão Facial , Reconhecimento Facial , Adolescente , Atenção , Estudos de Casos e Controles , Criança , Emoções , Feminino , Humanos , MasculinoRESUMO
Atypical visual processing of biological motion contributes to social impairments in autism spectrum disorders (ASD). However, the exact temporal sequence of deficits of cortical biological motion processing in ASD has not been studied to date. We used 64-channel electroencephalography to study event-related potentials associated with human motion perception in 17 children and adolescents with ASD and 21 typical controls. A spatio-temporal source analysis was performed to assess the brain structures involved in these processes. We expected altered activity already during early stimulus processing and reduced activity during subsequent biological motion specific processes in ASD. In response to both, random and biological motion, the P100 amplitude was decreased suggesting unspecific deficits in visual processing, and the occipito-temporal N200 showed atypical lateralization in ASD suggesting altered hemispheric specialization. A slow positive deflection after 400 ms, reflecting top-down processes, and human motion-specific dipole activation differed slightly between groups, with reduced and more diffuse activation in the ASD-group. The latter could be an indicator of a disrupted neuronal network for biological motion processing in ADS. Furthermore, early visual processing (P100) seems to be correlated to biological motion-specific activation. This emphasizes the relevance of early sensory processing for higher order processing deficits in ASD.
Assuntos
Encéfalo/fisiopatologia , Transtornos Globais do Desenvolvimento Infantil/fisiopatologia , Potenciais Evocados Visuais/fisiologia , Percepção de Movimento/fisiologia , Percepção Social , Adolescente , Criança , Eletroencefalografia , Humanos , Masculino , Testes Neuropsicológicos , Estimulação LuminosaRESUMO
Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by problems in social behaviour, which are sometimes similar to some symptoms of autism-spectrum disorders (ASD). However, neuronal mechanisms of ASD-like deficits in ADHD have rarely been studied. The processing of biological motion-recently discussed as a marker of social cognition-was found to be disrupted in ASD in several studies. Thus in the present study we tested if biological motion processing is disrupted in ADHD. We used 64-channel EEG and spatio-temporal source analysis to assess event-related potentials associated with human motion processing in 21 children and adolescents with ADHD and 21 matched typically developing controls. On the behavioural level, all subjects were able to differentiate between human and scrambled motion. But in response to both scrambled and biological motion, the N200 amplitude was decreased in subjects with ADHD. After a spatio-temporal dipole analysis, a human motion specific activation was observable in occipital-temporal regions with a reduced and more diffuse activation in ADHD subjects. These results point towards neuronal determined alterations in the processing of biological motion in ADHD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Potenciais Evocados/fisiologia , Movimento (Física) , Percepção Visual/fisiologia , Adolescente , Comportamento , Estudos de Casos e Controles , Criança , Transtornos Globais do Desenvolvimento Infantil/fisiopatologia , Humanos , Estimulação LuminosaRESUMO
A potential clinical and etiological overlap between schizophrenia (SZ) and bipolar disorder (BD) has long been a subject of discussion. Imaging studies imply functional and structural alterations of the hippocampus in both diseases. Thus, imaging this core memory region could provide insight into the pathophysiology of these disorders and the associated cognitive deficits. To examine possible shared alterations in the hippocampus, we conducted a multi-modal assessment, including functional and structural imaging as well as neurobehavioral measures of memory performance in BD and SZ patients compared with healthy controls. We assessed episodic memory performance, using tests of verbal and visual learning (HVLT, BVMT) in three groups of participants: BD patients (n = 21), SZ patients (n = 21) and matched (age, gender, education) healthy control subjects (n = 21). In addition, we examined hippocampal resting state functional connectivity, hippocampal volume using voxel-based morphometry (VBM) and fibre integrity of hippocampal connections using diffusion tensor imaging (DTI). We found memory deficits, changes in functional connectivity within the hippocampal network as well as volumetric reductions and altered white matter fibre integrity across patient groups in comparison with controls. However, SZ patients when directly compared with BD patients were more severely affected in several of the assessed parameters (verbal learning, left hippocampal volumes, mean diffusivity of bilateral cingulum and right uncinated fasciculus). The results of our study suggest a graded expression of verbal learning deficits accompanied by structural alterations within the hippocampus in BD patients and SZ patients, with SZ patients being more strongly affected. Our findings imply that these two disorders may share some common pathophysiological mechanisms. The results could thus help to further advance and integrate current pathophysiological models of SZ and BD.