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1.
BMJ Case Rep ; 17(1)2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38176751

RESUMO

The authors describe a female in her late twenties, presenting with catatonia and diagnosed with epilepsy, autism spectrum disorder, mild intellectual disability, psychosis, dysthymia, anxiety and bipolar disorder, receiving weekly electroconvulsive therapy (ECT). After testing, findings indicated an interstitial deletion in the 22q13.33 region associated with Phelan-McDermid syndrome. In addition, the patient had low cerebral spinal fluid tetrahydrobiopterin (BH4) levels, suggesting dysfunction in the pterin biosynthetic pathway. As a result, the patient started on sapropterin, a BH4 replacement small molecule. After sapropterin treatment, catatonia improved, and the need for ECT decreased. There was an improvement in her cognitive ability, attention and independence. However, there has been no improvement in seizure frequency.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Catatonia , Transtornos Cromossômicos , Transtorno Depressivo Maior , Fenilcetonúrias , Feminino , Humanos , Transtorno do Espectro Autista/complicações , Transtorno Autístico/complicações , Transtorno Autístico/genética , Catatonia/diagnóstico , Catatonia/terapia , Catatonia/complicações , Deleção Cromossômica , Transtornos Cromossômicos/complicações , Cromossomos Humanos Par 22 , Depressão , Transtorno Depressivo Maior/complicações , Fenilcetonúrias/complicações , Adulto
2.
Int J Dev Neurosci ; 84(1): 64-74, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37960995

RESUMO

PURPOSE: Toxoplasmosis is a disease caused by infection with a type of coccidial protozoan parasite called Toxoplasma gondii. The relationship between toxoplasmosis and cognitive disorders in neurodegenerative diseases has been proven. There is also evidence that children born to Toxoplasma-infected mothers are more likely to develop autism. METHODS: In the present study, Toxoplasma-infected pregnant BALB/c mice were given valproic acid to induce autism in their male offspring, and their social behaviors, learning, and memory were examined. Chronic toxoplasmosis was established in BALB/c mice by intraperitoneal injection of cyst form of T. gondii. To induce autism, 600 mg/kg of valproic acid was injected intraperitoneally into mice on the 12.5th day of pregnancy. The behavioral experiments, such as social interaction, novel object recognition, and passive avoidance tasks, were performed on male offspring at 50 days. RESULTS: Toxoplasma and valproic acid during the embryonic period caused social communication deficits and disrupted recognition memory and avoidance memory in offspring. Our findings showed that administering valproic acid to Toxoplasma-infected mothers exacerbates cognitive disorders in their offspring.


Assuntos
Transtorno Autístico , Disfunção Cognitiva , Toxoplasma , Toxoplasmose , Humanos , Gravidez , Feminino , Criança , Masculino , Animais , Camundongos , Ácido Valproico/toxicidade , Transtorno Autístico/induzido quimicamente , Transtorno Autístico/complicações , Camundongos Endogâmicos BALB C , Modelos Animais de Doenças , Toxoplasmose/complicações , Toxoplasmose/parasitologia , Toxoplasmose/psicologia
3.
Autism Res ; 17(4): 852-867, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38108575

RESUMO

Many commonly used prescription and over-the-counter medicines have potent anticholinergic (AC) effects. Among older adults, AC medications are associated with cognitive impairment and risk for cognitive disorders, including Alzheimer's disease. Collectively, the impact of AC medications is known as anticholinergic cognitive burden (ACB). Because of the high rates of co-occurring medical and psychiatric conditions, autistic adults may have high AC exposure and, thus, may experience elevated ACB. However, no research has characterized AC exposure or examined its associations with cognitive outcomes in autistic adults. Autistic adults (40-83 years) recruited via Simons Powering Autism Research's (SPARK) Research Match service self-reported their medication use (N = 415) and memory complaints (N = 382) at Time (T)1. At T2, 2 years later, a subset of T1 participants (N = 197) self-reported on decline in cognition. Medications were coded using two scales of AC potency. A high proportion (48.2%-62.9%, depending upon the AC potency scale) of autistic adults reported taking at least one medication with AC effects, and 20.5% to 26.5% of autistic adults reported clinically-relevant levels of AC medication (potency ≥3). After controlling for birth-sex, and age, hierarchical linear regression models showed total ACB scores and AC potency values of ≥3 predicted greater memory complaints. Logistic regression models showed that AC medicines at T1 were associated with self-reported cognitive decline at follow-up 2 years later. Understanding AC medications-including potentially earlier AC polypharmacy-and their impacts on cognition (e.g., dementia risk) in autistic adults is warranted.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Disfunção Cognitiva , Pessoa de Meia-Idade , Humanos , Idoso , Antagonistas Colinérgicos/efeitos adversos , Transtorno Autístico/complicações , Transtorno Autístico/tratamento farmacológico , Autorrelato , Transtorno do Espectro Autista/tratamento farmacológico
4.
J Pak Med Assoc ; 73(9): 1894-1896, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37817707

RESUMO

The phenotypically similar genetic diseases Zimmermann Laband syndrome (ZLS) and Temple-Baraitser syndrome (TMBTS) cause neurodevelopmental problems. Mutations in the gene coding for potassium voltage-gated channel, primarily KCNH1, cause these symptoms. An uncommon mutation in KCNH1 (p.Arg357Trp) present on Exon 7, reported to replace arginine with tryptophan at codon 357 of the KCNH1 protein c.1069C>T, caused pharma coresistantseizures and autistic behaviour in a 2.7-year-old boy. This mutation causes problems with protein modelling and has yet to be documented in any genetic databases around the world. This mutation was overlapped with GPHN gene, c.828+1G>A, in our patient, causing GPHN related spectrum disorder (autosomal dominant) along with molybdenum cofactor deficiency (autosomal recessive) leading to a neuropsychiatric presentation including autistic behaviour, making diagnosis and management even more complicated.


Assuntos
Anormalidades Múltiplas , Transtorno Autístico , Encefalopatias , Deficiência Intelectual , Masculino , Humanos , Pré-Escolar , Mutação de Sentido Incorreto , Transtorno Autístico/complicações , Transtorno Autístico/genética , Deficiência Intelectual/genética , Mutação , Canais de Potássio Éter-A-Go-Go/genética
5.
Mol Autism ; 14(1): 26, 2023 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-37491272

RESUMO

BACKGROUND: Septo-optic dysplasia (SOD) is a rare condition diagnosed in children with two or more of the following: hypopituitarism, midline brain abnormalities, and optic nerve hypoplasia. Children with SOD experience varied visual impairment and endocrine dysfunction. Autistic-like behaviours have been reported; however, their nature and prevalence remain to be fully understood. The present systematic review aimed to explore the type and prevalence of neurodevelopmental impairments in children with SOD spectrum conditions. METHODS: The search was conducted in PubMed, EMBASE, and PsycInfo. Hand-searching reference lists of included studies was conducted. All peer-reviewed, observational studies assessing behavioural and cognitive impairments or autism spectrum disorder (ASD) symptoms in children (< 18 years) with SOD, optic nerve hypoplasia, and SOD-plus were included. Studies were excluded if they did not report standardised measures of neurodevelopmental impairments or ASD outcomes. RESULTS: From 2132 screened articles, 20 articles reporting data from a total of 479 children were included in prevalence estimates. Of 14 studies assessing cognitive-developmental outcomes, 175 of 336 (52%) children presented with intellectual disability or developmental delay. A diagnosis of ASD or clinical level of symptoms was observed in 65 of 187 (35%) children across five studies. Only five studies assessed for dysfunction across behavioural, emotional, or social domains and reported impairments in 88 of 184 (48%) of children assessed. LIMITATIONS: Importantly, high heterogeneity among the samples in relation to their neuroanatomical, endocrine, and optic nerve involvement meant that it was not possible to statistically assess the relative contribution of these confounding factors to the specific neurodevelopmental phenotype. This was further limited by the variation in study designs and behavioural assessments used across the included studies, which may have increased the risk of information bias. CONCLUSIONS: This systematic review suggests that the prevalence of neurodevelopmental impairments in children within the SOD spectrum may be high. Clinicians should therefore consider including formal assessments of ASD symptoms and neurodevelopmental impairments alongside routine care. There is, additionally, a need for further research to define and validate a standardised battery of tools that accurately identify neurodevelopmental impairments in SOD spectrum conditions, and for research to identify the likely causal mechanisms.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Hipopituitarismo , Hipoplasia do Nervo Óptico , Displasia Septo-Óptica , Humanos , Displasia Septo-Óptica/epidemiologia , Displasia Septo-Óptica/diagnóstico , Displasia Septo-Óptica/genética , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/complicações , Hipoplasia do Nervo Óptico/complicações , Hipopituitarismo/etiologia , Transtorno Autístico/complicações
6.
J ECT ; 39(4): 269-270, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37310088

RESUMO

ABSTRACT: Catatonia is a syndrome with psychomotor, cognitive, and affective symptoms that has been associated with multiple psychiatric and medical conditions, including autism spectrum disorder. Fluctuations in weight can occur within catatonia by means of poor oral intake, treatment with atypical antipsychotics, and often overlooked psychomotor phenomena. We present a case of a patient with autism spectrum disorder and excessive psychomotor activity due to catatonia who initially experienced weight loss despite maintenance of oral intake and required increased caloric intake to maintain her weight. She was treated with electroconvulsive therapy. After the psychomotor phenomena associated with catatonia reduced, she gained 10 lb (4.5 kg) despite no further alterations to medications or diet. This case demonstrates that excessive psychomotor activity seen in catatonia may increase energy expenditure to the severity of altering caloric requirements and that weight is a salient biomarker to be monitored in catatonia, especially with those who have limited communication abilities.


Assuntos
Antipsicóticos , Transtorno do Espectro Autista , Transtorno Autístico , Catatonia , Eletroconvulsoterapia , Feminino , Humanos , Transtorno Autístico/complicações , Catatonia/complicações , Catatonia/terapia , Catatonia/diagnóstico , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/terapia , Antipsicóticos/uso terapêutico
7.
BMC Psychiatry ; 23(1): 216, 2023 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-36997907

RESUMO

BACKGROUND: Fronto-Temporal Dementia (FTD) is a neurodegenerative disorder featuring frontotemporal lobe atrophy which leads to profound changes in behavior and cognition in the affected subjects. Considering that the onset of this type of dementia is typically characterized by the development of affective symptoms, differential diagnosis between FTD and Bipolar Disorder (BD) is particularly difficult. An important overlapping feature between BD and FTD is the presence of catatonic symptoms: Catatonia is extremely frequent in FTD, and, on the other hand, BD is the psychiatric disease with the highest frequency of association with catatonic states. In this framework, it should be noted that also Autism Spectrum conditions have been reported to show high rates of comorbidity and overlapping features with BD. In addition, subjects with autistic traits were reported to show an increased vulnerability towards the development of mood and anxiety disorders, as well as increase the risk of mood episodes with mixed features, suicidal thoughts and catatonic symptoms. CASE PRESENTATION: We reported the case of a patient with a diagnosis of both BD and FTD who showed catatonic symptoms. OBJECTIVES: The aim of this case report is to evaluate the possible role of autistic traits in the illness trajectory of BD and FTD. CONCLUSION: This case confirms the presence of a continuum between psychiatric and neurological conditions, which should be considered as expressions of a same neurobiological system and further investigated in light of an integrative model.


Assuntos
Transtorno Autístico , Transtorno Bipolar , Catatonia , Demência Frontotemporal , Humanos , Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Autístico/complicações , Catatonia/diagnóstico , Catatonia/complicações , Demência Frontotemporal/complicações , Demência Frontotemporal/diagnóstico , Demência Frontotemporal/metabolismo , Afeto
9.
Spec Care Dentist ; 43(1): 3-8, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35636432

RESUMO

PURPOSE/AIM: To investigate the frequency of preventive dental care among adults with autism and explore factors associated with receiving regular preventive care. MATERIALS AND METHODS: De-identified data was collected from electronic health records of 18-year-old or older patients with autism that had at least one preventive dental procedure recorded. The data was then analyzed to describe the frequency of preventive dental procedures provided for this population and investigate what variables are associated with regular care. RESULTS: Sample size was 119, 67% were males, average age was 30.8 years, and 58% had Medicaid. Average BMI was 42.8, the prevalence of diabetes and heart disease were 16% and 34%, respectively, and 86% reported mental health problems. Recreational drug use was 6.8%, alcohol use was 19%, and tobacco use 16%. Xerostomia was reported by 32%, and the average number of medications was 7.2 ± 5.5. The average number of preventive dental visits was 7.9 ± 10.6, and 35% of the patients had at least one preventive dental visit per year. Only number of medications had a statistically significant association with number of preventive dental visits. CONCLUSIONS: Only one in every three adults with autism had at least one preventive dental visit per year.


Assuntos
Transtorno Autístico , Assistência Odontológica para a Pessoa com Deficiência , Odontologia Preventiva , Adolescente , Adulto , Feminino , Humanos , Masculino , Transtorno Autístico/complicações , Assistência Odontológica , Medicaid , Estados Unidos/epidemiologia
10.
Pediatr Obes ; 17(11): e12951, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35751176

RESUMO

BACKGROUND: Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) have an increased obesity risk. Although these conditions commonly co-occur, shared factors relating to obesity risk are unknown. OBJECTIVES: To examine the shared and unique associations of ADHD and autistic traits with eating behaviours and BMI. METHODS: Children (N = 4134) from the population-based Generation R Study were categorized into subgroups based on parent-reported ADHD and autistic traits scores at 6 years: ADHDHigh , ASDHigh , ADHD+ASDHigh and REF (reference group: ADHD+ASDLow ). Multiple linear regressions examined the associations between subgroups and eating behaviours (at 10 years) and BMIz (at 14 years), relative to REF. Mediation analyses tested the indirect effect of subgroup and BMIz through eating behaviours. RESULTS: ADHD + ASDHigh children expressed both food approach (increased food responsiveness and emotional overeating) and avoidant eating behaviours (increased emotional undereating, satiety responsiveness/ slowness in eating and picky eating, and decreased enjoyment in food). ASDHigh children were more food avoidant, while ADHDHigh children had more food approach behaviours and greater BMIz. ADHDHigh and BMIz were indirectly associated with food responsiveness and emotional overeating. CONCLUSIONS: ADHD and autistic trait phenotypes show distinct associations with potential obesity risk factors, and further research is needed to improve targeted early intervention.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno Autístico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/epidemiologia , Transtorno Autístico/complicações , Comportamento Alimentar/psicologia , Humanos , Hiperfagia/psicologia , Obesidade/etiologia
11.
Int J Pediatr Otorhinolaryngol ; 158: 111191, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35636082

RESUMO

INTRODUCTION: Obstructive sleep apnea (OSA) is common in autism spectrum disorder (ASD). Children with OSA can present with a range of symptoms including loud snoring, excessive daytime sleepiness, and changes in cognitive function. Some of these symptoms can overlap with and exacerbate symptoms of ASD, potentially delaying OSA diagnosis in children with both conditions. OBJECTIVE: The primary objective of this study was to assess between-group difference in OSA symptomatology and age at OSA diagnosis in children with and without ASD. METHODS: A retrospective chart review was conducted on 166 pediatric patients (<18 years) with OSA undergoing adenotonsillectomy at a single academic institution between 2019 and 2021. The control group consisted of 91 patients (54.9% male) without ASD. The ASD group included 75 patients (88.0% male). Autism severity was scored on a 1-4 scale using a novel methodology. Statistical analyses included Wilcoxon rank sum tests for continuous variables, chi-squared tests for categorical variables, and multivariable analyses as needed. RESULTS: There was a significant between-group difference in total number of reported OSA symptoms (p < 0.001), with more symptoms reported in patients with ASD. Within the ASD group, lower autism severity was associated with an increased number of reported OSA symptoms (p = 0.006). There was not a significant between-group difference in age at OSA diagnosis (p = 0.999); however, lower autism severity was associated with an increased age at diagnosis (p = 0.002). CONCLUSION: These findings suggest that OSA may present with a higher symptom burden in children with ASD, particularly for children with lower ASD severity, who often experience delays in OSA diagnosis. These findings and their clinical implications merit further explanation.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Apneia Obstrutiva do Sono , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno Autístico/complicações , Transtorno Autístico/diagnóstico , Transtorno Autístico/epidemiologia , Criança , Feminino , Humanos , Masculino , Polissonografia/métodos , Estudos Retrospectivos , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia
12.
Neuropsychopharmacology ; 47(11): 1901-1912, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35396500

RESUMO

Atypical responses to sensory stimuli are considered as a core aspect and early life marker of autism spectrum disorders (ASD). Although recent findings performed in mouse ASD genetic models report sensory deficits, these were explored exclusively during juvenile or adult period. Whether sensory dysfunctions might be present at the early life stage and rescued by therapeutic strategy are fairly uninvestigated. Here we found that under cool environment neonatal mice lacking the autism-associated gene Magel2 present pup calls hypo-reactivity and are retrieved with delay by their wild-type dam. This neonatal atypical sensory reactivity to cool stimuli was not associated with autonomic thermoregulatory alteration but with a deficit of the oxytocinergic system. Indeed, we show in control neonates that pharmacogenetic inactivation of hypothalamic oxytocin neurons mimicked atypical thermosensory reactivity found in Magel2 mutants. Furthermore, pharmacological intranasal administration of oxytocin to Magel2 neonates was able to rescue both the atypical thermosensory response and the maternal pup retrieval. This preclinical study establishes for the first-time early life impairments in thermosensory integration and suggest a therapeutic potential benefit of intranasal oxytocin treatment on neonatal atypical sensory reactivity for autism.


Assuntos
Transtorno Autístico , Hipestesia , Comportamento Materno , Ocitocina , Proteínas , Administração Intranasal , Fatores Etários , Animais , Antígenos de Neoplasias/genética , Antígenos de Neoplasias/metabolismo , Transtorno do Espectro Autista/complicações , Transtorno Autístico/complicações , Transtorno Autístico/genética , Transtorno Autístico/metabolismo , Fármacos do Sistema Nervoso Central/administração & dosagem , Fármacos do Sistema Nervoso Central/metabolismo , Feminino , Hipestesia/etiologia , Hipestesia/genética , Hipestesia/metabolismo , Hipotálamo/efeitos dos fármacos , Hipotálamo/metabolismo , Comportamento Materno/fisiologia , Camundongos , Ocitocina/administração & dosagem , Ocitocina/metabolismo , Proteínas/genética , Proteínas/metabolismo , Comportamento Social
13.
Int J Mol Sci ; 23(6)2022 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-35328799

RESUMO

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental disease. To date, more than 1000 genes have been shown to be associated with ASD, and only a few of these genes account for more than 1% of autism cases. Klf7 is an important transcription factor of cell proliferation and differentiation in the nervous system, but whether klf7 is involved in autism is unclear. METHODS: We first performed ChIP-seq analysis of klf7 in N2A cells, then performed behavioral tests and RNA-seq in klf7+/- mice, and finally restored mice with adeno-associated virus (AAV)-mediated overexpression of klf7 in klf7+/- mice. RESULTS: Klf7 targeted genes are enriched with ASD genes, and 631 ASD risk genes are also differentially expressed in klf7+/- mice which exhibited the core symptoms of ASD. When klf7 levels were increased in the central nervous system (CNS) in klf7+/- adult mice, deficits in social interaction, repetitive behavior and majority of dysregulated ASD genes were rescued in the adults, suggesting transcriptional regulation. Moreover, knockdown of klf7 in human brain organoids caused dysregulation of 517 ASD risk genes, 344 of which were shared with klf7+/- mice, including some high-confidence ASD genes. CONCLUSIONS: Our findings highlight a klf7 regulation of ASD genes and provide new insights into the pathogenesis of ASD and promising targets for further research on mechanisms and treatments.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Animais , Transtorno do Espectro Autista/genética , Transtorno Autístico/complicações , Transtorno Autístico/genética , Diferenciação Celular , Regulação da Expressão Gênica , Humanos , Fatores de Transcrição Kruppel-Like/genética , Fatores de Transcrição Kruppel-Like/metabolismo , Camundongos
14.
Autism Res ; 15(3): 551-569, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35199959

RESUMO

Given inconsistent evidence on preconception or prenatal tobacco use and offspring autism spectrum disorder (ASD), this study assessed associations of maternal smoking with ASD and ASD-related traits. Among 72 cohorts in the Environmental Influences on Child Health Outcomes consortium, 11 had ASD diagnosis and prenatal tobaccosmoking (n = 8648). and 7 had Social Responsiveness Scale (SRS) scores of ASD traits (n = 2399). Cohorts had diagnoses alone (6), traits alone (2), or both (5). Diagnoses drew from parent/caregiver report, review of records, or standardized instruments. Regression models estimated smoking-related odds ratios (ORs) for diagnoses and standardized mean differences for SRS scores. Cohort-specific ORs were meta-analyzed. Overall, maternal smoking was unassociated with child ASD (adjusted OR, 1.08; 95% confidence interval [CI], 0.72-1.61). However, heterogeneity across studies was strong: preterm cohorts showed reduced ASD risk for exposed children. After excluding preterm cohorts (biased by restrictions on causal intermediate and exposure opportunity) and small cohorts (very few ASD cases in either smoking category), the adjusted OR for ASD from maternal smoking was 1.44 (95% CI, 1.02-2.03). Children of smoking (versus non-smoking) mothers had more ASD traits (SRS T-score + 2.37 points, 95% CI, 0.73-4.01 points), with results homogeneous across cohorts. Maternal preconception/prenatal smoking was consistently associated with quantitative ASD traits and modestly associated with ASD diagnosis among sufficiently powered United States cohorts of non-preterm children. Limitations resulting from self-reported smoking and unmeasured confounders preclude definitive conclusions. Nevertheless, counseling on potential and known risks to the child from maternal smoking is warranted for pregnant women and pregnancy planners. LAY SUMMARY: Evidence on the association between maternal prenatal smoking and the child's risk for autism spectrum disorder has been conflicting, with some studies reporting harmful effects, and others finding reduced risks. Our analysis of children in the ECHO consortium found that maternal prenatal tobacco smoking is consistently associated with an increase in autism-related symptoms in the general population and modestly associated with elevated risk for a diagnosis of autism spectrum disorder when looking at a combined analysis from multiple studies that each included both pre- and full-term births. However, this study is not proof of a causal connection. Future studies to clarify the role of smoking in autism-like behaviors or autism diagnoses should collect more reliable data on smoking and measure other exposures or lifestyle factors that might have confounded our results.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Efeitos Tardios da Exposição Pré-Natal , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/etiologia , Transtorno Autístico/complicações , Criança , Feminino , Humanos , Recém-Nascido , Mães/psicologia , Razão de Chances , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fumar Tabaco , Estados Unidos
15.
J Neurodev Disord ; 14(1): 5, 2022 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-35021989

RESUMO

BACKGROUND: RASopathies are genetic syndromes that result from pathogenic variants in the RAS-MAPK cellular signaling pathway. These syndromes, which include neurofibromatosis type 1, Noonan syndrome, cardiofaciocutaneous syndrome, and Costello syndrome, are associated with a complex array of medical and behavioral health complications. Despite a heightened risk for social challenges and autism spectrum disorder (ASD), few studies have compared different aspects of social behavior across these conditions. It is also unknown whether the underlying neuropsychological characteristics that contribute to social competence and socially empathetic ("prosocial") behaviors differ in children with RASopathies as compared to children with nonsyndromic (i.e., idiopathic) ASD. METHODS: In this cross-sectional, survey-based investigation, caregivers of preschool and school-aged children with RASopathies (n = 202) or with idiopathic ASD (n = 109) provided demographic, medical, and developmental information about their child, including psychiatric comorbidities. For children who were able to communicate verbally, caregivers also completed standardized rating scales to assess social competence and empathetic behavior as well as symptoms of hyperactivity/inattention and emotional problems. RESULTS: As compared to children with idiopathic ASD, children with RASopathies were rated as demonstrating more resilience in the domain of empathy relative to their overall social competence. Similarities and differences emerged in the psychological factors that predicted social behavior in these two groups. Stronger communication skills and fewer hyperactive-impulsive behaviors were associated with increased empathy and social competence for both groups. Greater emotional challenges were associated with lower social competence for children with RASopathies and stronger empathy for children with idiopathic ASD. Among children with RASopathy and a co-occurring ASD diagnosis, socially empathetic behaviors were observed more often as compared to children with idiopathic ASD. CONCLUSIONS: Findings suggest that the development of social behavior among children with RASopathies involves a distinct pattern of strengths and weaknesses as compared to a behaviorally defined disorder (idiopathic ASD). Identification of areas of resilience as well as behavioral and social challenges will support more targeted intervention.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/complicações , Criança , Pré-Escolar , Estudos Transversais , Insuficiência de Crescimento/complicações , Insuficiência de Crescimento/genética , Humanos , Comportamento Social
16.
Res Dev Disabil ; 122: 104167, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34998116

RESUMO

BACKGROUND: There is a lack of autism screening instruments for deaf or hard of hearing (DHH) adults with intellectual disability. AIMS: This study examined the diagnostic validity of the Pervasive Developmental Disorder in Mental Retardation Scale and the Diagnostic Behavioral Assessment for autism spectrum disorder - Revised in this rare population. METHODS AND PARTICIPANTS: 56 DHH adults with intellectual disability living in three specialized therapeutic communities were examined, 9 of whom met criteria for autism. OUTCOMES AND RESULTS: With minimal adaptions regarding item interpretation, both tools showed good diagnostic and high convergent validity. Items probing for difficulties in reciprocal social interaction and restricted interests were discriminant between individuals with and without autism. CONCLUSION: These data suggest that both autism screening tools are feasible and psychometrically sound when used with appropriate adaptations for DHH adults with intellectual disability.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Deficiência Intelectual , Adulto , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/diagnóstico , Transtorno Autístico/complicações , Transtorno Autístico/diagnóstico , Estudos de Viabilidade , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/diagnóstico , Programas de Rastreamento
17.
Autism ; 26(6): 1353-1363, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34623179

RESUMO

LAY ABSTRACT: It is widely believed that early diagnosis and treatment of autism spectrum disorder is essential for better outcome. This is demonstrated by the American Academy of Pediatrics recommendation to screen all 1.5-2.5-year-old toddlers for autism spectrum disorder. However, multiple longitudinal studies of children diagnosed with autism spectrum disorder at 1.5-6 years of age and treated in community settings have not reported any associations between earlier diagnosis and improved outcome in core autism spectrum disorder symptoms. In this study, we measured changes in core autism spectrum disorder symptoms over a 1-2-year period in 131 children diagnosed with autism spectrum disorder at 1.2-5 years of age, and treated in the community. The results revealed that children who were diagnosed before 2.5 years of age were three times more likely to exhibit considerable improvements in social autism spectrum disorder symptoms in comparison to children diagnosed at later ages. These results highlight the importance of early diagnosis and treatment of autism spectrum disorder even in community settings with heterogeneous services. In addition, these results motivate further prioritization of universal screening for autism spectrum disorder before 2.5 years of age.


Assuntos
Transtorno do Espectro Autista , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/diagnóstico , Transtorno Autístico/complicações , Criança , Pré-Escolar , Diagnóstico Precoce , Humanos , Lactente , Estudos Longitudinais , Programas de Rastreamento/métodos
18.
J Autism Dev Disord ; 52(6): 2747-2761, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34247301

RESUMO

We studied the association of early-life environmental and child factors with disruptive behaviors in children with autistic traits around age 7, in the Avon Longitudinal Study of Parents and Children (n = 6,401). Logistic regression with the least absolute shrinkage and selection operator indicated that disruptive behaviors were associated with prenatal smoking, no seafood-consumption during pregnancy, breech presentation at delivery, neonatal feeding problems, low social-economic situation, suboptimal preschool family environment, maternal depression, maternal antisocial behavior, male sex, and difficult child temperament. Compared to controls, male sex, maternal depression, and suboptimal preschool family environment were related to autistic traits without disruptive behaviors. Thus, there may be a difference in early-life factors related to autism spectrum disorder with and without disruptive behaviors.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Comportamento Problema , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/epidemiologia , Transtorno Autístico/complicações , Criança , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Pais , Gravidez
19.
Autism Res ; 15(3): 531-538, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34951517

RESUMO

This study evaluated the association between placental pathology and gross morphology and the risk of autism spectrum disorders (ASD). We conducted a matched case-control study of children with confirmed ASD who were born between 2000 and 2017 at one of three university-affiliated hospitals in Montreal, Quebec. Cases, who were identified through the Montreal Children's Hospital Autism Spectrum Disorders Program, were matched to babies (1:5) born at the same hospital and on the same day. Multi-fetal births were excluded. Maternal demographics, pregnancy characteristics and placental pathologies were collected from hospital charts by abstractors blind to autism diagnoses. This current study consisted of data from a single-site that had pathology reports available. Pearson chi-square and Wilcoxon rank-sum tests were used to estimate p-values. Our study consisted of 107 ASD cases and 526 matched controls. Mothers of cases and controls were similar in terms of parity, gravidity, smoking status, BMI, rates of clinical chorioamnionitis, chronic hypertension, and gestational diabetes. Age at delivery of <25 years was more common among mothers of controls. Compared with controls, cases were more likely born male, <32 weeks of gestation, and weighing <1500 g. Cases and controls had similar rates of placental inflammation, vasculitis, and other placental pathologies. There were no differences in placental weight, placental thickness, umbilical cord length, and umbilical cord insertion between the two groups. In conclusion, placental pathology and gross morphology do not appear to be associated with ASD, suggesting that any perinatal determinants of autism are not likely to be mediated through placental pathology. LAY SUMMARY: Data from a matched case-control study consisting of neonates born between 2000 and 2017 at one of three McGill-affiliated hospitals were used to examine the relationship between placental pathology and morphology and the development of autism. No differences in placental pathology and gross morphology were found between those with and without autism, which suggests that placental abnormalities are unlikely to either cause or mediate the development of autism.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Diabetes Gestacional , Transtorno do Espectro Autista/patologia , Transtorno Autístico/complicações , Estudos de Casos e Controles , Criança , Feminino , Humanos , Recém-Nascido , Masculino , Placenta/patologia , Gravidez
20.
J Appl Biomed ; 19(2): 91-96, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34907708

RESUMO

The aim of the present research has been to determine whether there is a relationship between brain abnormalities found on magnetic resonance imaging (MRI) and autistic psychopathology. A retrospective analysis covering a period between 1998 and 2015 included 489 children with autism (404 boys, 85 girls; average age 8.0 ± 4.2 years) who underwent an MRI of the brain. For clinical diagnosis of autism, the International Classification of Diseases, 10th revision (ICD-10), was used. Autistic psychopathology was evaluated by means of the Autism Diagnostic Interview - Revised. The Spearman nonparametric correlation analysis and chi-square test were used to examine the possible relationships between variables. The group of autistic children did not manifest a statistically significant correlation between the parameters examined on MRI and autistic psychopathology. A correlation between other cysts and repetitive behavior was significant only at trend level (P = 0.054). Gliosis of the brain was significantly more frequent in autistic children with mental retardation than in children without mental retardation (14.1% vs. 7.4%; P = 0.028). Nonmyelinated areas in the brain were significantly more frequent in autistic children with autistic regression than in children without autistic regression (29.9% vs. 15.7%; P = 0.008). Mental retardation was significantly more frequent in autistic children with autistic regression than in children without regression (73.2% vs. 52.5%; P = 0.002). Our research study did not reveal a statistically significant correlation of brain abnormalities on MRI with autistic psychopathology.


Assuntos
Transtorno Autístico , Deficiência Intelectual , Transtorno Autístico/complicações , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Deficiências do Desenvolvimento , Feminino , Humanos , Masculino , Estudos Retrospectivos
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