Associations between executive function and attention abilities and language and social communication skills in young autistic children.

LAY ABSTRACT: Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in executive function and attention abilities relate to social abilities and communication/language in 180 young autistic children. Data were gathered via caregiver report (questionnaires/interviews) and an assessment of vocabulary skills. The ability to sustain attention to a dynamic video was measured via eye tracking. We found that children with higher levels of executive function skills demonstrated lower levels of social pragmatic problems, a measure of having difficulties in social contexts. Furthermore, children who were able to sustain their attention longer to the video displayed higher levels of expressive language. Our results emphasize the importance of executive function and attention skills across multiple areas of functioning in autistic children, in particular those that involve language and social communication.

Observations from a prospective small cohort study suggest that CGRP genes contribute to acute posttraumatic headache burden after concussion.

Introduction: Post-traumatic headache (PTH) is commonly reported after concussion. Calcitonin gene-related peptide (CGRP) is implicated in the pathogenesis of migraine. We explored how single nucleotide polymorphisms (SNPs) from CGRP-alpha (CALCA) and the receptor activity modifying protein-1 (RAMP1) related to headache burden during the first week after concussion. Methods: A prospective study was performed in 34 collegiate athletes who sustained a concussion. Participants completed the symptom evaluation checklist from the SCAT3 within 48 h of injury (V1), and again 4 (V2) and 7 (V3) days after injury. For each visit, the self-reported score (0-6) for headache, pressure in head, blurred vision, and sensitivity to light/noise were reported and summed to calculate the headache burden. A saliva sample was obtained and genotyped for CALCA (rs3781719) and RAMP1 (rs10185142). RAMP1 (TT, TC, CC) and CALCA (AA, AG, GG) were dichotomized (A+, A- and T+, T-, respectively), and concatenated (T+A+, T+A-, T-A+, T-A-) for analyses. Results: Headache Burden at Visit 1 was greatest in T+A+ compared to T-A+, and trended toward a significant difference with T+A-. Repeated-measures ANOVA revealed the presence of significant visit main effects (p < 0.001, η2 = 0.404), but the group (p = 0.055) and interaction effects only trended (p = 0.094). Pearson's χ2-tests revealed that 88% of those with return-to play (RTP) exclusions ≥15 days had PTH with multi-sensory symptoms (PTH+SENS) as compared to 35% in those with RTP < 14 day. Conclusion: Knowledge of RAMP1 and CALCA genotypes appear to improve an understanding the presenting features and magnitude of headache burden after concussion injury.

Use of Mayer wave activity to demonstrate aberrant cardiovascular autonomic control following sports concussion injury.

Dysregulation of cardiovascular autonomic control is gaining recognition as a prevailing consequence of concussion injury. Characterizing the presence of autonomic dysfunction in concussed persons is inconsistent and conventional metrics of autonomic function cannot differentiate the presence/absence of injury. Mayer wave (MW) activity originates through baroreflex adjustments to blood pressure (BP) oscillations that appear in the low-frequency (LF: 0.04-0.15 Hz) band of the BP and heart rate (HR) power spectrum after a fast Fourier transform. We prospectively explored MW activity (∼0.1 Hz) in 19 concussed and 19 noninjured athletes for 5 min while seated at rest within 48 h and 1 week of injury. MW activity was derived from the LF band of continuous digital electrocardiogram and beat-to-beat BP signals (LFHR, LF-SBP, MWHR, and MW-SBP, respectively); a proportion between MWBP and MWHR was computed (cMW). At 48 h, the concussion group had a significantly lower MWBP and cMW than controls; these differences were gone by 1 week. MWHR, LFHR, and LF-SBP were not different between groups at either visit. Attenuated sympathetic vasomotor tone was present and the central autonomic mechanisms regulating MW activity to the heart and peripheral vasculature became transiently discordant early after concussion with apparent resolution by 1 week.

Preliminary Evidence for a Window of Increased Vulnerability to Sustain a Concussion in Females: A Brief Report.

A difference exists between sexes for the incidence of concussion injuries and severity of post-injury outcomes with females having a higher incidence rate (in comparable sports) and experience more robust symptoms than males. The basis for this disparity has remained largely unresolved. Recent findings point to a potential biological mechanism that may be related to the menstrual cycle as an arbiter of post-injury outcomes. What has not been addressed, is whether the phase of menstrual cycle (inferred fluctuations of ovarian hormones) contributes to an increased vulnerability to sustain a concussion injury. This prospective, observational study sought to determine if concussions occurred at different frequencies throughout the phase of the menstrual cycle. Female athletes who sustained a concussion injury were queried three times over the 7-day study (e.g., within 48 h of injury, and 4 and 7 days after injury) to recall the number of days that have elapsed since the beginning of their most recent menstruation. Twenty female athletes enrolled after sustaining a concussion; 18 were eumenorrheic and 2 amenorrheic. Among eumenorrheic participants at the time of injury, 2 were in the follicular phase, 4 were in the early luteal phase and 9 were in the late luteal phase. Two athletes were injured on the first and 1 was injured on the second day of menstruation. The greatest number of concussions were sustained during the late luteal phase and during the first 2 days of menstruation. This 9-day window accounted for 2/3rd of the sustained concussions in our study.

Problematic Internet Use and Associated High-Risk Behavior in an Adolescent Clinical Sample: Results from a Survey of Psychiatrically Hospitalized Youth.

Problematic Internet use (PIU) is a growing clinical concern to clinicians working in adolescent mental health, with significant potential comorbidities like depression and substance use. No prior study has examined associations between PIU, high-risk behavior, and psychiatric diagnoses specifically in psychiatrically hospitalized adolescents. Here, we analyzed how PIU severity correlated with preadmission Internet habits, psychiatric symptoms, and high-risk behavior in this unique population. We hypothesized that as the severity of PIU increased, so would endorsement of mood symptoms, engagement in risky behaviors, and chances of having comorbid mood and aggression-related diagnoses. We performed a cross-sectional survey on an adolescent psychiatric inpatient unit in an urban community hospital in Massachusetts. Participants were 12-20 years old (n = 205), 62.0 percent female, and of diverse racial/ethnic backgrounds. Relationships between PIU, high-risk symptoms, diagnoses, and behaviors were performed both using chi-square tests and determining Pearson correlation coefficients. Two hundred five adolescents participated in the study. PIU severity was associated with being female (p < 0.005), sexting (p < 0.05), cyberbullying (p < 0.005), and increased suicidality within the last year (p < 0.05). Adolescents with aggressive and developmental disorders, but not depressive disorders, also had significantly higher PIU scores (p ≤ 0.05). In our sample of psychiatrically hospitalized adolescents, PIU severity was significantly associated with both serious psychiatric symptoms and high-risk behaviors, including those related to suicide. Our findings may improve safety assessments in this vulnerable adolescent population by identifying comorbid risks associated with problematic digital media use.