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1.
Reg Anesth Pain Med ; 2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39106989

RESUMO

BACKGROUND/IMPORTANCE: Chronic pain affects many people globally, requiring alternative management strategies. Psilocybin is gaining attention for its potential in chronic pain management despite being classified as Schedule I. OBJECTIVE: This systematic review critically evaluates the evidence for psilocybin, a Schedule I substance, in the treatment of chronic pain. The exact purpose of the review is to assess the impact of psilocybin on chronic pain relief, focusing on dosing protocols, treated conditions, and patient outcomes. EVIDENCE REVIEW: A comprehensive review of PubMed, CINAHL, Web of Science, Cochrane Library, and EMBASE was conducted up to January 2024. Eligibility criteria included studies evaluating psilocybin for chronic pain management. The risk of bias was assessed using the MASTER (MethodologicAl STandards for Epidemiological Research) scale, and the strength of evidence was graded using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). FINDINGS: The review identified 28 relevant studies focusing on dosing, treated conditions, and outcomes. The majority of the included studies (76.2%) were of low or very low quality. Several studies with moderate-to-low-quality evidence utilized a 0.14 mg/kg dosing protocol. The findings suggest promise for the use of psilocybin in chronic pain relief, though the quality of evidence is generally low. CONCLUSIONS: The current research shows potential for psilocybin as a treatment option for chronic pain relief. However, methodological issues and a lack of high-quality evidence underscore the need for further investigations with standardized protocols. Despite these limitations, the potential for psilocybin in chronic pain management is encouraging. PROSPERO REGISTRATION NUMBER: CRD42023493823.

2.
Healthcare (Basel) ; 12(16)2024 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-39201145

RESUMO

The Program for the Education and Enrichment of Relational Skills (PEERS®) is an evidence-based intervention developed for autistic individuals to support social communication, peer interactions, independence, and interpersonal relationships. Despite a demonstrated effectiveness for young autistic individuals in the US and several other countries, PEERS has yet to be modified to support the needs of autistic adults across the lifespan. The present study describes how our team sought autistic voices to adapt PEERS for adults of any age. Specifically, we aimed to address the needs of middle-aged and older adults and adapt the curriculum to be more neurodiversity-affirming. Between two cohorts that completed the program consecutively, we evaluated the acceptability of the adapted PEERS program and made refinements based on feedback from autistic participants and their study partners. Results indicated that Cohort 2 reported higher satisfaction with the PEERS components and overall program than Cohort 1, suggesting effective refinement. We present a framework of adaptations that more specifically address the needs of middle-aged and older adults in a neurodiverse-affirming way compared to previous iterations. Our approach to implementing an adapted PEERS curriculum across the adult lifespan may serve as a model for improved clinical care and cultivate the acceptance of neurodiversity in the interpersonal domains of autistic adults' lives.

3.
Sci Rep ; 14(1): 20120, 2024 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-39209988

RESUMO

Autism spectrum disorder (ASD) is diagnosed using comprehensive behavioral information. Neuroimaging offers additional information but lacks clinical utility for diagnosis. This study investigates whether multi-forms of magnetic resonance imaging (MRI) contrast can be used individually and in combination to produce a categorical classification of young individuals with ASD. MRI data were accessed from the Autism Brain Imaging Data Exchange (ABIDE). Young participants (ages 2-30) were selected, and two group cohorts consisted of 702 participants: 351 ASD and 351 controls. Image-based classification was performed using one-channel and two-channel inputs to 3D-DenseNet deep learning networks. The models were trained and tested using tenfold cross-validation. Two-channel models were twinned with combinations of structural MRI (sMRI) maps and amplitude of low-frequency fluctuations (ALFF) or fractional ALFF (fALFF) maps from resting-state functional MRI (rs-fMRI). All models produced classification accuracy that exceeded 65.1%. The two-channel ALFF-sMRI model achieved the highest mean accuracy of 76.9% ± 2.34. The one-channel ALFF-based model alone had mean accuracy of 72% ± 3.1. This study leveraged the ABIDE dataset to produce ASD classification results that are comparable and/or exceed literature values. The deep learning approach was conducive to diverse neuroimaging inputs. Findings reveal that the ALFF-sMRI two-channel model outperformed all others.


Assuntos
Transtorno do Espectro Autista , Encéfalo , Imageamento por Ressonância Magnética , Neuroimagem , Humanos , Transtorno do Espectro Autista/diagnóstico por imagem , Transtorno do Espectro Autista/classificação , Masculino , Imageamento por Ressonância Magnética/métodos , Adolescente , Feminino , Criança , Adulto Jovem , Adulto , Neuroimagem/métodos , Pré-Escolar , Encéfalo/diagnóstico por imagem , Aprendizado Profundo , Mapeamento Encefálico/métodos
4.
Res Sq ; 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38699338

RESUMO

Epigenetic processes, including DNA methylation, are emerging as key areas of interest for their potential roles as biomarkers and contributors to the risk of neurodevelopmental, psychiatric, and other brain-based disorders. Despite this growing focus, there remains a notable gap in our understanding of how DNA methylation correlates with individual variations in brain function and structure. Additionally, the dynamics of these relationships during developmental periods, which are critical windows during which many disorders first appear, are still largely unexplored. The current study extends the field by examining if peripheral DNA methylation of myelination-related genes predicts white matter volume in a healthy pediatric population [N = 250; females = 113; age range 2 months-14 years; Mage = 5.14, SDage = 3.60]. We assessed if DNA methylation of 17 myelin-related genes predict white matter volume and if age moderates these relationships. Results highlight low variability in myelin-related epigenetic variance at birth, which rapidly increases non-linearly with age, and that DNA methylation, measured at both the level of a CpG site or gene, is highly predictive of white matter volume, in early childhood but not late childhood. These novel findings propel the field forward by establishing that DNA methylation of myelin-related genes from a peripheral tissue is a predictive marker of white matter volume in children and is influenced by developmental stage. The research underscores the significance of peripheral epigenetic patterns as a proxy for investigating the effects of environmental factors, behaviors, and disorders associated with white matter.

5.
Vaccine ; 42(4): 937-944, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38245390

RESUMO

Increased risks associated with Coronavirus disease 2019 (COVID-19) among individuals with autism spectrum disorder (ASD) combined with previous reports of heightened vaccine hesitancy among parents of children with ASD indicate the need for a better understanding of attitudes and behaviors related to COVID-19 vaccines among the ASD community. This study is the first to our knowledge to use a mixed-methods approach to understand attitudes toward COVID-19 vaccines among parents of children with ASD and autistic adults. Participants were 135 members of the ASD community residing in the state of Arizona (99 parents of children with ASD and 36 autistic adults) who responded to the third (Spring 2021) and fourth (Summer 2021) time points of a larger longitudinal online survey. Quantitative findings indicated that autistic adults had slightly more favorable attitudes toward COVID-19 vaccines than parents, and attitudes in both subsamples became more positive over time. However, both parents and autistic adults reported COVID-19 vaccine uptake that was consistent with or better than the general population at both time points. Thematic analysis of responses to open-ended questions identified five themes that characterized factors that contributed to participants' decisions about COVID-19 vaccinations, including: (1) Desiring a Return to Normalcy, (2) Protection of Self and Others, (3) Previous Experience with COVID-19 (4) Science and Medical Professionals,and (5) Skepticism Regarding Safety, Effectiveness, and Need. Current findings combined with emerging literature paint a relatively optimistic picture about COVID-19 vaccine acceptance in the ASD community.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , COVID-19 , Criança , Adulto , Humanos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Pais
6.
Int J Mol Sci ; 24(21)2023 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-37958971

RESUMO

Autism spectrum disorder (ASD) is a neurodevelopmental disability and recent evidence suggests that autistic adults are more likely to develop Alzheimer's disease (Alz) and other dementias compared to neurotypical (NT) adults. The ε4-allele of the Apolipoprotein E (APOE) gene is the strongest genetic risk factor for Alz and negatively impacts cognition in middle-aged and older (MA+) adults. This study aimed to determine the impact of the APOE ε4-allele on verbal learning and memory in MA+ autistic adults (ages 40-71 years) compared to matched NT adults. Using the Auditory Verbal Learning Test (AVLT), we found that ε4 carriers performed worse on short-term memory and verbal learning across diagnosis groups, but there was no interaction with diagnosis. In exploratory analyses within sex and diagnosis groups, only autistic men carrying APOE ε4 showed worse verbal learning (p = 0.02), compared to autistic men who were not carriers. Finally, the APOE ε4-allele did not significantly affect long-term memory in this sample. These findings replicate previous work indicating that the APOE ε4-allele negatively impacts short-term memory and verbal learning in MA+ adults and presents new preliminary findings that MA+ autistic men may be vulnerable to the effects of APOE ε4 on verbal learning. Future work with a larger sample is needed to determine if autistic women may also be vulnerable.


Assuntos
Doença de Alzheimer , Transtorno do Espectro Autista , Transtorno Autístico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alelos , Doença de Alzheimer/genética , Apolipoproteína E4/genética , Apolipoproteínas E/genética , Transtorno do Espectro Autista/genética , Transtorno Autístico/genética , Genótipo , Testes Neuropsicológicos , Aprendizagem Verbal
7.
Autism ; : 13623613231200679, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37837362

RESUMO

LAY ABSTRACT: Existing research has identified an increased risk of depression among autistic adults, which can negatively impact their adaptive functioning abilities and socioeconomic outcomes. Mobile app-based meditation is a feasible, accessible, and effective self-care solution for depression among neurotypical adults, but there is limited evidence for the long-term benefits of app-based meditation among autistic adults. Habits are a key behavioral strategy for maintaining behavior change, and anchoring is one effective habit formation intervention that has yet to be tested among autistic adults. This study demonstrates that it is both feasible and effective to integrate the anchoring habit formation strategy into an app-based meditation intervention for establishing meditation habits among autistic adults. In addition, the study shows that app-based meditation habits were successful at maintaining reductions in depressive symptoms over 6 months. These results demonstrate the power of anchoring-based habit formation interventions for establishing healthy habits among autistic adults, which offers a promising behavioral intervention technique for establishing other healthy habits among autistic adults. The study also shows that app-based meditation habits are an effective long-term self-care solution for managing depressive symptoms among autistic adults that should be used by mental health providers and policymakers. Future research should test this combined anchoring and app-based meditation intervention technique among larger samples of autistic adults and over longer durations to better understand the mechanisms underlying the success of this intervention.

8.
Am J Speech Lang Pathol ; 32(4): 1397-1412, 2023 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-37146603

RESUMO

PURPOSE: Precision medicine is an emerging intervention paradigm that leverages knowledge of risk factors such as genotypes, lifestyle, and environment toward proactive and personalized interventions. Regarding genetic risk factors, examples of interventions informed by the field of medical genomics are pharmacological interventions tailored to an individual's genotype and anticipatory guidance for children whose hearing impairment is predicted to be progressive. Here, we show how principles of precision medicine and insights from behavior genomics have relevance for novel management strategies of behaviorally expressed disorders, especially disorders of spoken language. METHOD: This tutorial presents an overview of precision medicine, medical genomics, and behavior genomics; case examples of improved outcomes; and strategic goals toward enhancing clinical practice. RESULTS: Speech-language pathologists (SLPs) see individuals with various communication disorders due to genetic variants. Ways of using insights from behavior genomics and implementing principles of precision medicine include recognizing early signs of undiagnosed genetic disorders in an individual's communication patterns, making appropriate referrals to genetics professionals, and incorporating genetic findings into management plans. Patients benefit from a genetics diagnosis by gaining a deeper and more prognostic understanding of their condition, obtaining more precisely targeted interventions, and learning about their recurrence risks. CONCLUSIONS: SLPs can achieve improved outcomes by expanding their purview to include genetics. To drive this new interdisciplinary framework forward, goals should include systematic training in clinical genetics for SLPs, enhanced understanding of genotype-phenotype associations, leveraging insights from animal models, optimizing interprofessional team efforts, and developing novel proactive and personalized interventions.


Assuntos
Transtornos da Comunicação , Patologia da Fala e Linguagem , Humanos , Fala , Medicina de Precisão , Transtornos da Comunicação/genética , Genômica , Comunicação , Patologia da Fala e Linguagem/educação
9.
J Psychiatry Neurosci ; 48(2): E102-E114, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36990468

RESUMO

BACKGROUND: Mindfulness-based stress reduction (MBSR) alleviates depression and anxiety in adults with autism spectrum disorder (ASD); however, underlying therapeutic neural mechanisms and mindfulness-specific effects have yet to be elucidated. METHODS: We randomly assigned adults with ASD to MBSR or social support/education (SE). They completed questionnaires that assessed depression, anxiety, mindfulness traits, autistic traits and executive functioning abilities as well as a self-reflection functional MRI task. We used repeated-measures analysis of covariance (ANCOVA) to evaluate behavioural changes. To identify task-specific connectivity changes, we performed a generalized psychophysiological interactions (gPPI) functional connectivity (FC) analysis on regions of interest (ROIs; insula, amygdala, cingulum and prefrontal cortex [PFC]). We used Pearson correlations to explore brain-behaviour relationships. RESULTS: Our final sample included 78 adults with ASD - 39 who received MBSR and 39 who received SE. Mindfulness-based stress reduction uniquely improved executive functioning abilities and increased mindfulness traits, whereas both MBSR and SE groups showed reductions in depression, anxiety and autistic traits. Decreases specific to MBSR in insula-thalamus FC were associated with anxiety reduction and increased mindfulness traits, including the trait "nonjudgment;" MBSR-specific decreases in PFC-posterior cingulate connectivity correlated with improved working memory. Both groups showed decreased amygdala-sensorimotor and medial-lateral PFC connectivity, which corresponded with reduced depression. LIMITATIONS: Larger sample sizes and neuropsychological evaluations are needed to replicate and extend these findings. CONCLUSION: Together, our findings suggest that MBSR and SE are similarly efficacious for depression, anxiety and autistic traits, whereas MBSR produced additional salutary effects related to executive functioning and mindfulness traits. Findings from gPPI identified shared and distinct therapeutic neural mechanisms, implicating the default mode and salience networks. Our results mark an early step toward the development of personalized medicine for psychiatric symptoms in ASD and offer novel neural targets for future neurostimulation research. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04017793.


Assuntos
Transtorno do Espectro Autista , Atenção Plena , Humanos , Adulto , Atenção Plena/métodos , Transtorno do Espectro Autista/diagnóstico por imagem , Transtorno do Espectro Autista/terapia , Ansiedade/psicologia , Transtornos de Ansiedade , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/terapia , Apoio Social
10.
Front Aging Neurosci ; 14: 1029166, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36437999

RESUMO

Research aimed at understanding cognitive and brain aging in adults with autism spectrum disorder (ASD) is growing, but critical longitudinal work is scant. Adults with ASD struggle with tasks involving visual memory compared with neurotypical adults (NT). This may be related to differences in size or integrity of the hippocampus and its' primary structural connectivity pathway, the fornix. The aim of this study was to describe preliminary findings of longitudinal aging trajectories in short- and long-term visual memory abilities in middle-age and older adults with ASD, compared with matched NT adults. We then evaluated baseline multi-modal imaging metrics of the hippocampal system, including the relatively novel metric of free-water, as potential correlates of longitudinal memory change in the ASD group. Middle-age and older adults with ASD (n = 25) and matched NT adults (n = 25) between the ages of 40 and 70 years were followed longitudinally at ~2-year intervals (range 2-5 years). Participants completed the Wechsler Memory Scale III Visual Reproduction task. Longitudinal mixed models were utilized to detect group differences in memory change with baseline age and sex as covariates. Hippocampal volume was measured via T1-weighted MRI images with FreeSurfer. Fornix fractional anisotropy and hippocampal and fornix free-water were measured from diffusion tensor imaging scans. Exploratory correlations were run between individual hippocampal system metrics and longitudinal slopes of visual memory change. There was a significant group by time interaction for long-term visual memory, such that middle-age and older adults with ASD declined faster than matched NT adults. There was no group by time interaction for short-term visual memory. Baseline hippocampal free-water was the only hippocampal system metric that correlated with long-term visual memory change in the ASD group. As one of the first longitudinal cognitive and brain aging studies in middle-age and older adults with ASD, our findings suggest vulnerabilities for accelerated long-term visual memory decline, compared to matched NT adults. Further, baseline hippocampal free-water may be a predictor of visual memory change in middle-age and older adults with ASD. These preliminary findings lay the groundwork for future prognostic applications of MRI for cognitive aging in middle-age and older adults with ASD.

11.
Autism Res ; 15(10): 1810-1823, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36053945

RESUMO

Research studying aging in adults with autism spectrum disorder (ASD) is growing, but longitudinal work is needed. Autistic adults have increased risk of dementia, altered hippocampal volumes and fornix integrity, and verbal memory difficulties compared with neurotypical (NT) adults. This study examined longitudinal aging in middle-age adults with ASD versus a matched NT group, and compared findings with cross-sectional age effects across a broad adult age range. Participants were 194 adults with (n = 106; 74 male) and without (n = 88; 52 male) ASD, ages 18-71. Participants (n = 45; 40-70 age range) with two visits (2-3 years apart) were included in a longitudinal analysis. Hippocampal volume, fornix fractional anisotropy (FA), and verbal memory were measured via T1-weighted MRI, diffusion tensor imaging, and the Rey Auditory Verbal Learning Test, respectively. Longitudinal mixed models were used for hippocampal system variables and reliable change index categories were used for Auditory Verbal Learning Test analyses. Multivariate regression was used for cross-sectional analyses. Middle-age adults with ASD had greater longitudinal hippocampal volume loss and were more likely to show clinically meaningful decline in short-term memory, compared with NT. In contrast, cross-sectional associations between increasing age and worsening short-term memory were identified in NT, but not autistic adults. Reduced fornix FA and long-term memory in ASD were found across the broad cross-sectional age range. These preliminary longitudinal findings suggest accelerated hippocampal volume loss in ASD and slightly higher rates of clinically-meaningful decline in verbal short-term memory. Contradictory cross-sectional and longitudinal results underscore the importance of longitudinal aging research in autistic adults. LAY SUMMARY: Autistic adults have increased risk of dementia, differences in brain memory structures, and difficulty with memory compared with neurotypical (NT) adults. However, there are no publications that follow the same middle-age autistic adults over time to see how their brain and memory change. Our preliminary findings in a small middle-age autism sample suggest a key memory brain structure, the hippocampus, may shrink faster over 2-3 years compared with NT, and short-term memory may become more challenging for some. Across a broad adult range, autistic adults also had reduced integrity of connections to the hippocampus and greater challenges with long-term memory. In our larger sample across a broad age range, the results did not hint at this aforementioned pattern of accelerated aging. This underscores the importance of more aging research in autism, and especially research where people are followed over time.


Assuntos
Transtorno do Espectro Autista , Demência , Adolescente , Adulto , Idoso , Transtorno do Espectro Autista/complicações , Pré-Escolar , Estudos Transversais , Imagem de Tensor de Difusão , Hipocampo/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Adulto Jovem
12.
Nat Commun ; 13(1): 3490, 2022 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715418

RESUMO

Endocannabinoid (eCB), 2-arachidonoyl-glycerol (2-AG), the most abundant eCB in the brain, regulates diverse neural functions. Here we linked multiple homozygous loss-of-function mutations in 2-AG synthase diacylglycerol lipase ß (DAGLB) to an early onset autosomal recessive Parkinsonism. DAGLB is the main 2-AG synthase in human and mouse substantia nigra (SN) dopaminergic neurons (DANs). In mice, the SN 2-AG levels were markedly correlated with motor performance during locomotor skill acquisition. Genetic knockdown of Daglb in nigral DANs substantially reduced SN 2-AG levels and impaired locomotor skill learning, particularly the across-session learning. Conversely, pharmacological inhibition of 2-AG degradation increased nigral 2-AG levels, DAN activity and dopamine release and rescued the locomotor skill learning deficits. Together, we demonstrate that DAGLB-deficiency contributes to the pathogenesis of Parkinsonism, reveal the importance of DAGLB-mediated 2-AG biosynthesis in nigral DANs in regulating neuronal activity and dopamine release, and suggest potential benefits of 2-AG augmentation in alleviating Parkinsonism.


Assuntos
Neurônios Dopaminérgicos , Lipase Lipoproteica/metabolismo , Transtornos Parkinsonianos , Animais , Dopamina/metabolismo , Neurônios Dopaminérgicos/metabolismo , Endocanabinoides/metabolismo , Camundongos , Transtornos Parkinsonianos/metabolismo , Substância Negra/metabolismo
13.
Int J Dev Disabil ; 68(3): 388-394, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35602997

RESUMO

The necessity of promoting physical activity in individuals with Autism Spectrum Disorder (ASD) has been emphasized for decades. One of the barriers to participate in physical activity for individuals with ASD is limited interest and motivation. Therefore, understanding the motivation to exercise in this population is important. The objective was to determine the effect of using contingent reinforcement in the form of watching a preferred DVD to increase duration of time pedalling on a stationary bicycle within their predetermined target heart rate zone (THRZ) in children with ASD. Using a crossover design, seven participants (11 2.7 years) who were diagnosed with ASD were randomly assigned to either Group A or B. Time spent pedalling on a bicycle within the THRZ was analysed using a linear mixed-effect model with Bonferroni adjustments. The results showed that the DVD intervention motivated children with ASD to exercise for more than 10 minutes in moderate to vigorous physical activity compared to when they were exercising without watching a DVD. This result is significant as number of studies have revealed that 10 minutes of exercise could bring improvements in activities of daily living such as behaviors and academic performance in school.

14.
Nutrients ; 14(10)2022 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-35631206

RESUMO

We used functional magnetic resonance imaging (fMRI) to investigate cross-sectional differences in functional connectivity across cognitive networks at rest among age and sex matched college students with very low food security [food insecurity (FI); n = 20] and with high food security (n = 20). The participants completed the Behavior Rating Inventory of Executive Function-2 (BRIEF-2) and Adverse Childhood Experiences (ACEs) questionnaires. Seven-minute resting-state fMRI scans were collected. Independent Component Analysis assessed group connectivity differences in three large-scale networks: the default-mode network (DMN), the frontoparietal network (FPN), and the salience network (SN). FI was associated with poorer Global BRIEF scores (adjusted ß = 8.36; 95% CI: 2.32, 14.40) and five BRIEF subscales: Inhibit, Initiate, Working Memory, Plan, and Organize (p-values < 0.05). The students with FI had greater functional connectivity between the FPN and left middle temporal gyrus (cluster size p-FWE = 0.029), the SN and precuneus (cluster size p-FWE < 0.001), and the SN and right middle frontal gyrus (cluster size p-FWE = 0.016) compared to the students with high food security. Exploratory correlations revealed that greater connectivity between the SN and right middle frontal gyrus was associated with poorer BRIEF Inhibit scores (p = 0.038), and greater connectivity between the FPN and left middle temporal gyrus was associated with poorer BRIEF Organize scores (p = 0.024) for the students with FI. Greater functional connectivity between the FPN, DMN, and SN at rest may contribute to executive function difficulties for college students with FI.


Assuntos
Mapeamento Encefálico , Encéfalo , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Estudos Transversais , Insegurança Alimentar , Humanos , Estudantes
15.
Res Dev Disabil ; 125: 104232, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35447501

RESUMO

BACKGROUND: The unprecedented challenges introduced by the Coronavirus disease 2019 (COVID-19) pandemic may be amplified for children with autism spectrum disorder (ASD) and their families. AIMS: The current study aimed to describe the experiences of children with ASD and their families during the pandemic and to identify the needs of this community during emergency situations. METHODS AND PROCEDURES: Participants were 122 parents of 122 children and adolescents (aged 3-18 years; one parent per family participated) with ASD living in Arizona, USA who participated in the first time point (July/August 2020) of a larger longitudinal survey study. A qualitative approach based in grounded theory methodology was used to analyze six open-ended survey questions. OUTCOMES AND RESULTS: The resulting conceptual model included a core category, Longing for Stability, and four main categories: Public Health Measures Yielding New Challenges and Unexpected Gains, Experiencing Abrupt Changes across Developmental Domains, Changing Family Dynamics, and Protective Factors. CONCLUSIONS: Findings add to limited research examining whether, and how, emergency events uniquely impact the ASD community, identifying potential methods by which services can be proactively adapted to best support the needs of children with ASD.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , COVID-19 , Adolescente , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , COVID-19/epidemiologia , Criança , Humanos , Pandemias , Pais
16.
Cereb Cortex ; 33(2): 316-329, 2022 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-35212373

RESUMO

The male preponderance in autism spectrum disorder (ASD) led to the hypothesis that aspects of female biology are protective against ASD. Females with ASD (ASD-F) report more compensatory behaviors (i.e. "camouflaging") to overcome ASD-related social differences, which may be a mechanism of protection. No studies have examined sex-related brain pathways supporting camouflaging in ASD-F, despite its potential to inform mechanisms underlying the ASD sex bias. We used functional connectivity (FC) to investigate "sex-atypical" and "sex-typical" FC patterns linked to camouflaging in adults with ASD and examined multimodal coherence of findings via structural connectometry. Exploratory associations with cognitive/emotional functioning examined the adaptive nature of FC patterns. We found (i) "sex-atypical" FC patterns linked to camouflaging in the hypothalamus and precuneus and (ii) "sex-typical" patterns in the right anterior cingulate and anterior parahippocampus. Higher hypothalamic FC with a limbic reward cluster also correlated with better cognitive control/emotion recognition. Structural connectometry validated FC results with consistent brain pathways/effect patterns implicated in ASD-F. In summary, "male-typical" and "female-typical" brain connectivity patterns support camouflaging in ASD-F in circuits implicated in reward, emotion, and memory retrieval. "Sex-atypical" results are consistent with fetal steroidogenic/neuroinflammatory hypotheses. However, female genetics/biology may contribute to "female-typical" patterns implicated in camouflaging.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Masculino , Adulto , Humanos , Feminino , Transtorno do Espectro Autista/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Vias Neurais/diagnóstico por imagem
17.
Qual Life Res ; 31(5): 1427-1440, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34655389

RESUMO

PURPOSE: Adults with autism spectrum disorder (ASD) consistently report worse functional health and well-being, compared to neurotypical (NT) peers. In a series of studies, we aimed to elucidated the effects of sex, age, and their interaction on health-related quality of life (HRQoL) and evaluated the effectiveness of mindfulness-based stress reduction (MBSR) for improving health-, disability-, and autism-related QoL, with possible sex and age outcome moderators, in adults with ASD. METHODS: Study 1 used the 36-Item Short Form Survey to compare mental and physical HRQoL composite scores in adults with ASD (n = 67) and matched NT adults (n = 66). Study 2 was a randomized pilot evaluation of the effect of MBSR, compared to an active control intervention with social support and relaxation education (support/education; n = 56), on the World Health Organization QoL BREF, Disability, and Autism-Specific scales in adults with ASD. RESULTS: In Study 1, we replicated findings that mental HRQoL is worse in both men and women with ASD, compared to NT counterparts, but physical HRQoL is only worse in women with ASD. We present novel findings that older age is associated with better mental HRQoL in women with ASD only. In Study 2, MBSR improved disability-related QoL in adults with ASD over and above the support/education intervention, but both interventions improved mental HRQoL. Lastly, both interventions were more effective for HRQoL improvements in women with ASD. CONCLUSION: Findings encourage precision medicine approaches tailored to age and sex groups for best HRQoL outcomes in adults with ASD. CLINICALTRIALS: gov Identifier: NCT04017793.


Assuntos
Transtorno do Espectro Autista , Atenção Plena , Adulto , Transtorno do Espectro Autista/terapia , Feminino , Humanos , Masculino , Projetos Piloto , Qualidade de Vida/psicologia , Apoio Social
18.
Neuroinformatics ; 20(2): 301-316, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-33978926

RESUMO

Uncovering the complex network of the brain is of great interest to the field of neuroimaging. Mining from these rich datasets, scientists try to unveil the fundamental biological mechanisms in the human brain. However, neuroimaging data collected for constructing brain networks is generally costly, and thus extracting useful information from a limited sample size of brain networks is demanding. Currently, there are two common trends in neuroimaging data collection that could be exploited to gain more information: 1) multimodal data, and 2) longitudinal data. It has been shown that these two types of data provide complementary information. Nonetheless, it is challenging to learn brain network representations that can simultaneously capture network properties from multimodal as well as longitudinal datasets. Here we propose a general fusion framework for multi-source learning of brain networks - multimodal brain network fusion with longitudinal coupling (MMLC). In our framework, three layers of information are considered, including cross-sectional similarity, multimodal coupling, and longitudinal consistency. Specifically, we jointly factorize multimodal networks and construct a rotation-based constraint to couple network variance across time. We also adopt the consensus factorization as the group consistent pattern. Using two publicly available brain imaging datasets, we demonstrate that MMLC may better predict psychometric scores than some other state-of-the-art brain network representation learning algorithms. Additionally, the discovered significant brain regions are synergistic with previous literature. Our new approach may boost statistical power and sheds new light on neuroimaging network biomarkers for future psychometric prediction research by integrating longitudinal and multimodal neuroimaging data.


Assuntos
Algoritmos , Neuroimagem , Biomarcadores , Encéfalo/diagnóstico por imagem , Estudos Transversais , Humanos , Imageamento por Ressonância Magnética , Neuroimagem/métodos
19.
Artigo em Inglês | MEDLINE | ID: mdl-34395921

RESUMO

Emerging research suggests mindfulness-based therapies positively impact adults with autism spectrum disorder (ASD). However, questions concerning intervention active ingredients, the breadth and duration of impact, and psychological and neural mechanisms of change remain. Here we discuss what is known about mindfulness-based therapies in adults with ASD and offer suggestions for future research.

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