Intolerance of uncertainty and anxiety as explanatory frameworks for extreme demand avoidance in children and adolescents.

BACKGROUND: Pathological demand avoidance (PDA) is a proposed subtype of autism spectrum disorder (ASD), characterised by extreme avoidance of demands. Demand avoidant behaviour has been proposed to be driven by an anxious need to be in control, although has never been explicitly studied. Emerging evidence suggests intolerance of uncertainty (IU) and anxiety may explain the behaviours seen in ASD. We propose these concepts may be useful starting points for furthering understanding of PDA. METHODS: In Study 1, quantitative methods examined the relationship between PDA, IU and anxiety using data collected in an online survey (N = 214). The sample included cases with clinically diagnosed PDA (n = 69) and those with no clinical diagnosis but parent-identified features of PDA (n = 151). 'Children with a diagnosis of PDA scored significantly higher on the IUS-P (t(212) = 2.45, p < .05) compared to those without a diagnosis of PDA. PDA diagnosis did not impact on scores on any other measure.' In Study 2, a selection of Study 1 participants (n = 11) were followed up with a telephone interview to gain descriptive data relating to PDA and its association with IU and anxiety. RESULTS: Regression analyses indicate that demand avoidant behaviour can be conceptualised in part as a possible attempt to increase certainty and predictability to alleviate increasing anxiety. Children and young people with PDA employed varying strategies to manage IU depending on the level of demand presented and degree of anxiety generated. These strategies can be represented by different features of the behaviour profile seen in PDA (control behaviour, withdrawal to fantasy, and meltdown). These behavioural features of PDA showed differential relationships with IU and anxiety, although all were predicted by IU, only meltdown demonstrated a mediation effect by anxiety. CONCLUSIONS: This study represents one of the first attempts to conceptualise and understand the behavioural features of the PDA profile in children and young people. It builds upon emerging evidence from the ASD literature that IU is a relevant construct for conceptualising demand avoidant behaviour in children who show PDA behaviour. This has potential clinical implications for the assessment and management of PDA in children and young people.

Receptive language is associated with visual perception in typically developing children and sensorimotor skills in autism spectrum conditions.

A number of studies have evidenced marked difficulties in language in autism spectrum conditions (ASC). Studies have also shown that language and word knowledge are associated with the same area of brain that is also responsible for visual perception in typically developing (TD) individuals. However, in ASC, research suggests word meaning is mapped differently, on to situational sensorimotor components within the brain. Furthermore, motor coordination is associated with communication skills. The current study explores whether motor coordination and visual perception are impaired in children with ASC, and whether difficulties in coordination and visual perception correlate with receptive language levels. 36 children took part: 18 with ASC and 18 TD children, matched on age and non-verbal reasoning. Both groups completed the Movement ABC, Beery-Buktenica Developmental Test of Visual-Motor Integration, British Picture Vocabulary Scale and Matrices (WASI). Results showed that ASC children scored significantly lower on receptive language, coordination and visual motor integration than the TD group. In the TD group receptive language significantly correlated with visual perception; in the ASC group receptive language significantly correlated with balance. These results imply that sensorimotor skills are associated with the understanding of language in ASC and thus the relationship between sensorimotor experiences and language warrants further investigation.

[Perisylvian magnetoencephalografic impairments in patients with autism spectrum disorders]. / Alteraciones magnetoencefalograficas perisilvianas en pacientes con trastornos del espectro autista.

INTRODUCTION: The perisylvian areas, located around the Sylvian fissure, are constituted by frontal, temporal and parietal brain regions. These are connected forming specialized neural networks and play a primary role in the development of linguistic skills and social cognition. These areas are a possible neuronal substrate of cognitive and behavioral impairments in patients with autism spectrum disorders (ASD). AIM: To locate and quantify epileptiform activity sources through magnetoencephalography in frontal perisylvian areas in children with idiopathic ASD. PATIENTS AND METHODS: Sixty-eight children with idiopathic ASD were studied by magnetoencephalography. The children were classified into two groups: a group of 41 children with autistic disorder and a combined group of 27 children with Asperger syndrome and children with pervasive developmental disorder not otherwise specified. The sources of magnetoencephalografic epileptiform activity detected in the frontal perisylvian were localized and quantified. RESULTS: The amount of epileptiform activity in frontal perisylvian region was significantly higher in children with autistic disorder. CONCLUSIONS: The amount of epileptiform activity in frontal perisylvian areas differed significantly between children with autistic disorder and those with Asperger syndrome and pervasive developmental disorder not otherwise specified.

TITLE: Alteraciones magnetoencefalograficas perisilvianas en pacientes con trastornos del espectro autista.Introduccion. Las areas perisilvianas se situan alrededor de la cisura de Silvio y estan constituidas por regiones cerebrales frontales, temporales y parietales. Estas regiones estan conectadas formando redes neurales especializadas y desempeñan una funcion elemental en el desarrollo de las habilidades linguisticas y de la cognicion social. Estas areas son un posible sustrato neural de las alteraciones cognitivas y conductuales en los pacientes con trastornos del espectro autista (TEA). Objetivo. Localizar y cuantificar las fuentes de actividad epileptiforme mediante magnetoencefalografia en areas frontales perisilvianas en niños con TEA primario. Pacientes y metodos. Se estudio a 68 niños con TEA idiopatico mediante magnetoencefalografia. Se clasificaron en dos grupos: uno de 41 niños con trastorno autista y un grupo combinado de 27 niños con sindrome de Asperger y niños con trastorno generalizado del desarrollo no especificado. Se localizaron y se cuantificaron las fuentes de actividad epileptiforme magnetoencefalografica detectadas en las areas frontales perisilvianas. Resultados. La actividad epileptiforme en la region perisilviana frontal fue significativamente mayor en el grupo de niños con trastorno autista. Conclusiones. La localizacion y cantidad de actividad epileptiforme en areas frontales perisilvianas difirieron significativamente entre los niños con trastorno autista y aquellos con sindrome de Asperger y trastorno generalizado del desarrollo no especificado.

The Effects of Structured Physical Activity Program on Social Interaction and Communication for Children with Autism.

The purpose of this study was to investigate the effects of structured physical activity program on social interaction and communication of children with autism spectrum disorder (ASD). Fifty children with ASD from a special school were randomly divided into experimental and control groups. 25 children with ASD were placed in the experimental group, and the other 25 children as the control group participated in regular physical activity. A total of forty-one participants completed the study. A 12-week structured physical activity program was implemented with a total of 24 exercise sessions targeting social interaction and communication of children with ASD, and a quasi-experimental design was used for this study. Data were collected using quantitative and qualitative instruments. SSIS and ABLLS-R results showed that an overall improvement in social skills and social interaction for the experimental group across interim and posttests, F = 8.425, p = 0.001 (p < 0.005), and significant improvements appeared in communication, cooperation, social interaction, and self-control subdomains (p < 0.005). Conversely, no statistically significant differences were found in the control group (p > 0.005). The study concluded that the special structured physical activity program positively influenced social interaction and communication skills of children with ASD, especially in social skills, communication, prompt response, and frequency of expression.

Bases neurobiológicas del trastorno del espectro autista y del trastorno por déficit de atención/hiperactividad: diferenciación neural y sinaptogénesis / Neurobiological bases of autistic spectrum disorder and attention deficit hyperactivity disorder: neural differentiation and synaptogenesis

Objetivo. Conocer los procesos neurales ligados a la formación de sinapsis y circuitos cerebrales para entender su papel en las enfermedades del neurodesarrollo, como el trastorno del espectro autista (TEA) y el trastorno por déficit de atención/hiperactividad (TDAH). Desarrollo. La actividad de los circuitos neuronales es la base neurobiológica de la conducta y la actividad mental (emociones, memoria y pensamientos). Los procesos de diferenciación de las células neurales y la formación de circuitos por contactos sinápticos entre neuronas (sinaptogénesis) ocurren en el sistema nervioso central durante las últimas fases del desarrollo prenatal y los primeros meses después del nacimiento. Los TEA y el TDAH comparten rasgos biológicos, relacionados con alteraciones en los circuitos cerebrales y la función sináptica, que permiten tratarlos científicamente de forma conjunta. Desde el aspecto neurobiológico, el TEA y el TDAH son manifestaciones de anomalías en la formación de circuitos y contactos sinápticos en regiones cerebrales implicadas en la conducta social, especialmente en la corteza cerebral prefrontal. Estas anomalías son causadas por mutaciones en genes involucrados en la formación de sinapsis y plasticidad sináptica, la regulación de la morfología de las espinas dendríticas, la organización del citoesqueleto y el control del equilibrio excitador e inhibidor en la sinapsis. Conclusiones. El TEA y el TDAH son alteraciones funcionales de la corteza cerebral, que presenta anomalías estructurales en la disposición de las neuronas, en el patrón de conexiones de las columnas corticales y en la estructura de las espinas dendríticas. Estas alteraciones afectan fundamentalmente a la corteza prefrontal y sus conexiones (AU)

Aim. To know the neural processes linked to the activity of brain circuits in order to understand the consequences of their dysfunction and their role in the development of neurodevelopmental diseases, such as autistic spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). Development. The activity of neuronal circuits is the neurobiological basis of behavior and mental activity (emotions, memory and thoughts). The processes of differentiation of neural cells and the formation of circuits by synaptic contacts between neurons (synaptogenesis) occur in the central nervous system during the late stages of prenatal development and the first months after birth. ASD and ADHD share biological features, mainly related to alterations in brain circuits and synaptic function, which allow us to treat them scientifically together. From the neurobiological aspect, ASD and ADHD are manifestations of anomalies in the formation of circuits and synaptic contacts in the brain regions involved in social behavior, and especially in the prefrontal cerebral cortex. These anomalies are caused by mutations in genes involved synaptogenesis and synaptic plasticity, regulation of dendritic spine morphology, synaptic cytoskeletal organization, synthesis and degradation of synaptic proteins, and control of excitatory and inhibitory balance in the synaptic function. Conclusions. ASD and ADHD are functional alterations of the cerebral cortex, which present structural anomalies in the arrangement of neurons, in the pattern of connections of cortical columns and in the structure of dendritic spines. These alterations affect mainly the prefrontal cortex and its connections (AU)

Autosomal dominant mannose-binding lectin deficiency is associated with worse neurodevelopmental outcomes after cardiac surgery in infants.

OBJECTIVES: The MBL2 gene is the major genetic determinant of mannose-binding lectin (MBL)-an acute phase reactant. Low MBL levels have been associated with adverse outcomes in preterm infants. The MBL2Gly54Asp missense variant causes autosomal dominant MBL deficiency. We tested the hypothesis that MBL2Gly54Asp is associated with worse neurodevelopmental outcomes after cardiac surgery in neonates. METHODS: This is an analysis of a previously described cohort of patients with nonsyndromic congenital heart disease who underwent cardiac surgery with cardiopulmonary bypass before age 6 months (n = 295). Four-year neurodevelopment was assessed in 3 domains: Full-Scale Intellectual Quotient, the Visual Motor Integration development test, and the Child Behavior Checklist to assess behavior problems. The Child Behavior Checklist measured total behavior problems, pervasive developmental problems, and internalizing/externalizing problems. A multivariable linear regression model, adjusting for confounders, was fit. RESULTS: MBL2Gly54Asp was associated with a significantly increased covariate-adjusted pervasive developmental problem score (ß = 3.98; P = .0025). Sensitivity analyses of the interaction between age at first surgery and MBL genotype suggested effect modification for the patients with MBL2Gly54Asp (Pinteraction = .039), with the poorest neurodevelopment outcomes occurring in children who had surgery earlier in life. CONCLUSIONS: We report the novel finding that carriers of MBL2Gly54Asp causing autosomal dominant MBL deficiency have increased childhood pervasive developmental problems after cardiac surgery, independent of other covariates. Sensitivity analyses suggest that this effect may be larger in children who underwent surgery at earlier ages. These data support the role of nonsyndromic genetic variation in determining postsurgical neurodevelopment-related outcomes in children with congenital heart disease.

Frontal evoked γ activity modulates behavioural performance in Autism Spectrum Disorders in a perceptual simultaneity task.

Autism spectrum disorders (ASDs) are associated with anomalies in time perception. In a perceptual simultaneity task, individuals with ASD demonstrate superior performance compared to typically developing (TD) controls. γ-activity, a robust marker of visual processing, is reportedly altered in ASD in response to a wide variety of tasks and these differences may be related to superior performance in perceptual simultaneity. Using time-frequency analysis, we assessed evoked γ-band phase-locking in magnetoencephalographic recordings of 16 ASD individuals and 17 age-matched TD controls. Individuals judged whether presented visual stimuli were simultaneous or asynchronous. We identified left frontal γ-activity in ASD, which was associated with a reduced perception of simultaneity. Where feature binding was observed at a neurophysiological level in parieto-occipital cortices in ASD in apparent simultaneity (asynchronous stimuli with short delay between them), this did not predict the correct behavioural outcome. These findings suggest distinct γ profiles in ASD associated with the perception of simultaneity.

Advances in understanding the pathophysiology of autism spectrum disorders.

Autism spectrum disorders (ASD) are common heterogeneous neurodevelopmental disorders with typical triad of symptoms: impaired social interaction, language and communication abnormalities and stereotypical behavior. Despite extensive research, the etiology and pathogenesis of ASD remain largely unclear. The lack of solid knowledge on the mechanisms of these disorders decreases the opportunities for pathogenetic treatment of autism. Various theories where proposed in order to explain the pathophysiology underlying ASD. Despite the fact that none of them is able to completely explain the impairments in the nervous system of ASD patients, these hypotheses were instrumental in highlighting the most important mechanisms in the development of this complex disorder. Some new theories are based on neurovisualization studies, others on the data from genomic studies, which become increasingly available worldwide. As the research in this field is largely dependent on the animal models, there is an ongoing discussion and search for the most appropriate one adequately reproducing the pathology. Here we provide an overview of current theories of the origin and development of ASD discussed in the context of existing and proposed rodent models of ASD.

Brain Resting-State Functional Connectivity Is Preserved Under Sevoflurane Anesthesia in Patients with Pervasive Developmental Disorders: A Pilot Study.

Functional connectivity studies play a huge role in understanding the relationship between the network connections and the behavioral phenotype of patients with pervasive developmental disorders (PDD). Some patients with PDD may not be able to tolerate the imaging procedure while they are awake, and, hence, they often need general anesthesia. General anesthesia is a confounding factor in functional imaging studies due to its effect on the functional connectivity. The objective of this study is to look at the resting-state functional connectivity (RS-FC) under sevoflurane anesthesia in patients with PDDs. Thirteen adults with PDD scheduled for magnetic resonance imaging (MRI) of the brain under general anesthesia were recruited for the study. Resting-state functional MRI (fMRI) scans were acquired at 1 minimum alveolar concentration (MAC) of sevoflurane. Spontaneous blood oxygenation level-dependent fluctuations were measured, and a seed-voxel analysis was done to identify the resting-state networks. Subjects' data were compared with data from 16 nonanesthetized healthy controls. Six networks (default mode network [DMN], executive control network [ECN], salience network [SN], auditory, visual, and sensorimotor) were investigated. At 1 MAC sevoflurane anesthesia, RS-FC was preserved in all the networks. Secondary analysis of connectivity showed a decrease in connectivity within the thalamus and an increase in DMN-ECN and DMN-SN cross-network connectivity in the anesthetized patient group compared to healthy controls. Previous reports suggested that even mild levels of anesthesia could reduce overall fluctuation levels in the major brain. However, our results provide strong evidence that most networks can sustain detectable levels of activity in patients with PDDs even under deep levels of anesthesia.

A group of very preterm children characterized by atypical gaze patterns.

OBJECTIVE: Very preterm (VP) children are at risk for social difficulties, including autism spectrum disorder (ASD). This study used eye tracking to determine viewing behaviors that may reflect these difficulties. DESIGN: The gaze patterns of 47 VP (mean gestational age: 28weeks, mean birth weight: 948g, and mean chronological age: 49months) were assessed while viewing dynamic social scenes and compared with those of 25 typically developing (TD) and 25 children with ASD. The temporo-spatial gaze patterns were summarized on a two-dimensional plane using multidimensional scaling (MDS) and the median of the TD children was used to characterize the gazes of the VP children. Time spent viewing the face was also compared. RESULTS: The VP children formed two clusters: one had a mean MDS distance comparable to that of TD group (n=32; VP-small), and the other had a larger mean distance comparable to that of ASD group (n=15; VP-large). The VP-large were similar to the ASD group by spending significantly less time viewing the face. Their performance was comparable to the TD during the initial 1s, but they could not remain focused on the face thereafter. CONCLUSIONS: The VP children were objectively classified into two groups based on gaze behaviors. One group was comparable to TD children, whereas the other had difficulty maintaining attention and exhibited atypical viewing behaviors similar to those of the ASD group. Our method may be useful in identifying VP children at higher risk for experiencing social difficulties.

Auditory preference of children with autism spectrum disorders.

Research on children with autism spectrum disorders suggests differences from neurotypical children in the preference for 'social' versus 'nonsocial' sounds. Conclusions have been based largely on the use of head-turn methodology which has various limitations as a means of establishing auditory preference. In the present study, preference was assessed by measuring the frequency with which children pressed a button to hear different sounds using an interactive toy. Contrary to prior results, both groups displayed a strong preference for the highly social sounds. These findings have implications for approaches to language intervention and for theoretical debates regarding social motivation.

Developing a classification system of social communication functioning of preschool children with autism spectrum disorder.

AIM: Impairments in social communication are the hallmark of autism spectrum disorder (ASD). Operationalizing 'severity' in ASD has been challenging; thus, stratifying by functioning has not been possible. The purpose of this study is to describe the development of the Autism Classification System of Functioning: Social Communication (ACSF:SC) and to evaluate its consistency within and between parent and professional ratings. METHOD: (1) ACSF:SC development based on focus groups and surveys involving parents, educators, and clinicians familiar with preschoolers with ASD; and (2) evaluation of the intra- and interrater agreement of the ACSF:SC using weighted kappa (кw ). RESULTS: Seventy-six participants were involved in the development process. Core characteristics of social communication were ascertained: communicative intent; communicative skills and reciprocity; and impact of environment. Five ACSF:SC levels were created and content-validated across participants. Best capacity and typical performance agreement ratings varied as follows: intrarater agreement on 41 children was кw =0.61 to 0.69 for parents, and кw =0.71 to 0.95 for professionals; interrater agreement between professionals was кw =0.47 to 0.61, and between parents and professionals was кw =0.33 to 0.53. INTERPRETATION: Perspectives from parents and professionals informed ACSF:SC development, providing common descriptions of the levels of everyday communicative abilities of children with ASD to complement the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Rater agreement demonstrates that the ACSF:SC can be used with acceptable consistency compared with other functional classification systems.

Are There Differences in Neurocognition and Social Cognition Among Adolescents with Schizophrenia, a Pervasive Developmental Disorder, and Both Disorders?

Schizophrenia (SCH) and pervasive developmental disorders (PDDs) belong to different diagnostic categories. There is, however, overlap between these 2 diagnostic groups. The aim of this preliminary study was to evaluate some aspects of neurocognitions and social cognitions in adolescents with SCH (n = 10, 2 boys and 8 girls; age range = 13.3-17.7 years), a PDD (n = 15, 7 boys and 8 girls; age range = 13.3-18.0 years), or both disorders (n = 8, 5 boys and 3 girls; age range = 13.5-18 years). Eight subtests (Information, Similarities, Arithmetic, Comprehension, Picture Completion, Coding B, Block Design, and Object Assembly) of the Wechsler Intelligence Scale for Children-Third Version and 2 subtests (Theory of Mind [ToM] and Affect Recognition) of the NEPSY-II were administered. Adolescents with both disorders and those with a PDD only performed better on visual processing tasks than did adolescents with SCH only. On the other hand, adolescents with both disorders as well as those with SCH only experienced more problems with processing speed than did adolescents with a PDD only. Adolescents with SCH only performed significantly more poorly with verbal ToM tasks compared with those with a PDD only. Adolescents with both disorders performed as well as those with SCH only. All in all, our preliminary findings support the current idea that SCH and PDDs are separate disorders.

Behavioral outcomes of picky eating in childhood: a prospective study in the general population.

BACKGROUND: Picky eaters in the general population form a heterogeneous group. It is important to differentiate between children with transient picky eating (PE) and persistent PE behavior when adverse outcomes are studied. We analyzed four PE trajectories to determine the associations with child mental health prospectively. METHODS: From a population-based cohort, 3,748 participants were assessed for PE at 1.5, 3, and 6 years of age using maternal reports. Four trajectories were defined: persistent (PE at all ages); remitting (PE before 6 years only); late-onset (PE at 6 years only); and never (no PE at any assessment). Child's problem behaviors were assessed with the Teacher's Report Form at 7 years of age. We examined associations between picky eating trajectories and emotional problems, behavioral problems and pervasive developmental problems using logistic regressions. Analyses were adjusted for child, parental, and socioeconomic confounders. We also adjusted for maternal-reported baseline problem behavior at age 1.5 years; the never picky eating group was used as reference. RESULTS: Persisting PE predicted pervasive developmental problems at age 7 years (OR = 2.00, 95% CI: 1.10-3.63). The association remained when adjusted for baseline pervasive developmental problems at 1.5 years (OR = 1.96, 95% CI: 1.10-3.51). Persistent PE was not associated with behavioral (OR = 0.92, 95% CI: 0.53-1.60) or emotional problems (OR = 1.24, 95% CI: 0.74-2.07). Other PE trajectories were not related to child behavioral or emotional problems. CONCLUSIONS: Persistent PE may be a symptom or sign of pervasive developmental problems, but is not predictive of other behavioral problems. Remitting PE was not associated with adverse mental health outcomes, which further indicates that it may be part of normal development.

Causation model of autism: Audiovisual brain specialization in infancy competes with social brain networks.

Earliest identifiable findings in autism indicate that the autistic brain develops differently from the typical brain in the first year of life, after a period of typical development. Twin studies suggest that autism has an environmental component contributing to causation. Increased availability of audiovisual (AV) materials and viewing practices of infants parallel the time frame of the rise in prevalence of autism spectrum disorder (ASD). Studies have shown an association between ASD and increased TV/cable screen exposure in infancy, suggesting AV exposure in infancy as a possible contributing cause of ASD. Infants are attracted to the saliency of AV materials, yet do not have the experience to recognize these stimuli as socially relevant. The authors present a developmental model of autism in which exposure to screen-based AV input in genetically susceptible infants stimulates specialization of non-social sensory processing in the brain. Through a process of neuroplasticity, the autistic infant develops the skills that are driven by the AV viewing. The AV developed neuronal pathways compete with preference for social processing, negatively affecting development of social brain pathways and causing global developmental delay. This model explains atypical face and speech processing, as well as preference for AV synchrony over biological motion in ASD. Neural hyper-connectivity, enlarged brain size and special abilities in visual, auditory and motion processing in ASD are also explained by the model. Positive effects of early intervention are predicted by the model. Researchers studying causation of autism have largely overlooked AV exposure in infancy as a potential contributing factor. The authors call for increased public awareness of the association between early screen viewing and ASD, and a concerted research effort to determine the extent of causal relationship.

Visual orientation processing in autism spectrum disorder: No sign of enhanced early cortical function.

It has been suggested that enhanced perceptual processing underlies some of the social difficulties associated with autism spectrum disorder (ASD). While a variety of visual tasks have been reported in which individuals with ASD outperform neurotypical individuals in control groups, the precise origin of such effects within the visual pathway remains unclear. It has recently been established that visual acuity is intact yet unremarkable in ASD. This suggests that the earliest levels of retinal processing are an unlikely candidate as the source of differences. The next potential levels for divergent visual processing are those involved in processing simple aspects of visual stimuli, such as orientation and spatial frequency, considered to be functions of early visual cortex. Here we focused on the basic processing of orientation. In three experiments, we assessed three basic aspects of orientation processing-discrimination, veridical perception, and detection-in participants with ASD in comparison to age-, gender-, and IQ-matched adults without ASD. Each experiment allowed for both qualitative and quantitative comparisons between the two groups. These provided a dense array of data indicating that participants with ASD perceive orientation of low-level stimuli in a qualitatively (as well as quantitatively) similar manner to participants without ASD in control groups, with no evidence of superior processing in detection, precision, or accuracy aspects of orientation perception. These results suggest that the source for altered perceptual abilities should be sought elsewhere, possibly in specific subgroups of people with ASD, other aspects of low-level vision such as spatial frequency, or subsequent levels of visual processing.

Using hyperbaric oxygen for autism treatment: A review and discussion of literature.

PURPOSE: To determine whether hyperbaric oxygen (HBO2) therapy should be used for the treatment of autism spectrum disorders (ASD). METHODS: A literature search was performed on PubMed, Cochrane Library and DynaMed for studies evaluating the use of HBO2 for ASD treatment. The studies were then reviewed for the highest quality evidence. RESULTS: The evidence is weak for the use of HBO2 in ASD, with only one, likely flawed, randomized control study showing treatment benefit. CONCLUSIONS: HBO2 should not be recommended for ASD treatment until more conclusive favorable results and long-term outcomes are demonstrated from well-designed controlled trials.

Neuroimaging endophenotypes in autism spectrum disorder.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that has a strong genetic basis, and is heterogeneous in its etiopathogenesis and clinical presentation. Neuroimaging studies, in concert with neuropathological and clinical research, have been instrumental in delineating trajectories of development in children with ASD. Structural neuroimaging has revealed ASD to be a disorder with general and regional brain enlargement, especially in the frontotemporal cortices, while functional neuroimaging studies have highlighted diminished connectivity, especially between frontal-posterior regions. The diverse and specific neuroimaging findings may represent potential neuroendophenotypes, and may offer opportunities to further understand the etiopathogenesis of ASD, predict treatment response, and lead to the development of new therapies.

[General and Specific Mechanisms of Visual Cognitive Function Impairment in People with FMRP Deficit].

The purpose of this article is to provide the overview of visual cognitive development in subjects with FMRP deficit. Description of fragile X mental retardation syndrome is presented in the article, that is the most common cause of inherited intellectual disability and one of the most prevalent genetic causes of autism spectrum disorder. The syndrome is associated with deficit of fragile X mental retardation protein following FMR1-gene mutation. Researches of static and dynamic object perception, face perception and oculomotor control are discussed in the article. The results obtained by subjects with FX syndrome are compared with ASD data, syndrome with closed behavioral phenotype. Several factors that underlie visual cognitive deficit are discussed in the article.

Excitatory/Inhibitory Balance and Circuit Homeostasis in Autism Spectrum Disorders.

Autism spectrum disorders (ASDs) and related neurological disorders are associated with mutations in many genes affecting the ratio between neuronal excitation and inhibition. However, understanding the impact of these mutations on network activity is complicated by the plasticity of these networks, making it difficult in many cases to separate initial deficits from homeostatic compensation. Here we explore the contrasting evidence for primary defects in inhibition or excitation in ASDs and attempt to integrate the findings in terms of the brain's ability to maintain functional homeostasis.