Perfil de personalidad en el trastorno del espectro autista mediante el Inventario Multifásico de Personalidad de Minnesota / Personality profiles in autism spectrum disorder obtained with the Minnesota Multiphasic Personality Inventory (MMPI)

Desde la publicación de DSM-5, se ha vuelto más importante llevar a cabo un diagnóstico diferencial para distinguir a las personas con TEA de los trastornos de personalidad del grupo C. El objetivo de la presente investigación fue identificar un perfil de personalidad de sujetos con trastorno del espectro autista (TEA) utilizando el Inventario de Personalidad Multifásico de Minnesota (MMPI) para llevar a cabo dicho diagnóstico diferencial. La muestra del estudio consistió en un total de 178 sujetos divididos en cuatro grupos de comparación. El grupo TEA obtuvo un perfil de personalidad MMPI con un código característico 2-0 que era específico para esta muestra de personas con TEA leve, y puntuaciones más altas en las escalas 6, 7 y 8 en relación con las otras puntuaciones de la escala. Se identificó un perfil de personalidad MMPI específico para los sujetos con TEA que diferenció a este grupo de los otros grupos estudiados. (AU)

Since the publication of DSM-5, it has become more important to carry out a differential diagnosis to distinguish people with autism spectrum disorder (ASD) from cluster C personality disorders. The aim of the present research study was to identify a personality profile of adults with ASD using the Minnesota Multiphasic Personality Inventory (MMPI) in order to carry out this differential diagnosis. The study sample consisted of a total of 178 subjects divided into four groups for comparison purposes. The ASD group obtained a MMPI personality profile with a characteristic 2-0 code that was specific to this sample of people with mild ASD, and higher scores in scales 6, 7 and 8 relative to the other scale scores. A specific MMPI personality profile was identified for ASD subjects, which differentiated this group from the other groups studied. (AU)

Docosahexaenoic and Eicosapentaenoic Intervention Modifies Plasma and Erythrocyte Omega-3 Fatty Acid Profiles But Not the Clinical Course of Children With Autism Spectrum Disorder: A Randomized Control Trial.

Background: The pathogenesis of autism spectrum disorder (ASD) is under investigation and one of the main alterations relates to the metabolic and inflammatory system dysfunctions. Indeed, based on a possible deficit of omega-3 fatty acids (FAs) of patients with ASD and looking for an anti-inflammatory effect, dietary supplements with omega-3 fatty acids have been proposed. We aimed to evaluate differences in plasma and erythrocyte FA profiles and plasma cytokines in patients with infantile ASD after supplementation with docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids or placebo and both compared at baseline with a reference healthy group. Methods: A double-blind, randomized placebo-controlled intervention with DHA/EPA for 6 months was carried out in 54 children between 2 and 6 years diagnosed with ASD. They were selected and randomly assigned into two groups: 19 children received 800 mg/day of DHA and 25 mg/day of EPA, or placebo. In addition, another reference group of 59 healthy children of the same age was included. Plasma lipids and cytokines, and FA profiles in plasma and erythrocytes were measured at baseline and after 6 months of treatment in ASD children, and at baseline in the reference group. Results: There were no differences in demographic, anthropometric characteristics, and omega-3 intake between the healthy reference group and the ASD children at baseline. Children with ASD showed the higher plasma percentages of palmitic acid and total saturated FA and lower total omega-6 polyunsaturated FA (PUFA) compared with healthy children. An increased level of DHA and reduced EPA level in erythrocytes were detected in the ASD group vs. the reference group. After 6 months of treatment, the ASD group that received DHA enriched product significantly increased the plasma and erythrocyte percentages of DHA, but no differences were observed in the clinical test scores and other parameters as plasma cytokines between the two groups of ASD related to the intervention. Conclusion: Spanish children with ASD exhibit an appropriate omega-3 FA status in plasma and erythrocytes. Neither a clinical improvement of ASD children nor a better anti-inflammatory or fatty acid state has been found after an intervention with DHA/EPA for 6 months. So, the prescription of n-3 LC-PUFA and other dietary supplements in ASD should be only indicated after a confirmed alteration of FA metabolism or omega-3 LC-PUFA deficiency evaluated by specific erythrocyte FA. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03620097].

Dietary Patterns, Eating Behavior, and Nutrient Intakes of Spanish Preschool Children with Autism Spectrum Disorders.

Eating behavior problems are characteristic of children with autism spectrum disorders (ASD) with a highly restricted range of food choices, which may pose an associated risk of nutritional problems. Hence, detailed knowledge of the dietary patterns (DPs) and nutrient intakes of ASD patients is necessary to carry out intervention strategies if required. The present study aimed to determine the DPs and macro-and micronutrient intakes in a sample of Spanish preschool children with ASD compared to typically developing control children. Fifty-four children with ASD (two to six years of age) diagnosed with ASD according to the Diagnostic Manual-5 criteria), and a control group of 57 typically developing children of similar ages were recruited. A validated food frequency questionnaire was used, and the intake of energy and nutrients was estimated through three non-consecutive 24-h dietary registrations. DPs were assessed using principal component analysis and hierarchical clustering analysis. Children with ASD exhibited a DP characterized by high energy and fat intakes and a low intake of vegetables and fruits. Likewise, meat intake of any type, both lean and fatty, was associated with higher consumption of fish and dietary fat. Furthermore, the increased consumption of dairy products was associated with increased consumption of cereals and pasta. In addition, they had frequent consumption of manufactured products with poor nutritional quality, e.g., beverages, sweets, snacks and bakery products. The percentages of children with ASD complying with the adequacy of nutrient intakes were higher for energy, saturated fat, calcium, and vitamin C, and lower for iron, iodine, and vitamins of group B when compared with control children. In conclusion, this study emphasizes the need to assess the DPs and nutrient intakes of children with ASD to correct their alterations and discard some potential nutritional diseases.

Analysis of Global and Local DNA Methylation Patterns in Blood Samples of Patients With Autism Spectrum Disorder.

The goal of this investigation was to determine whether there are alterations in DNA methylation patterns in children with autism spectrum disorder (ASD). Material and Methods: Controlled prospective observational case-control study. Within the ASD group, children were sub-classified based on the presence (AMR subgroup) or absence (ANMR subgroup) of neurodevelopmental regression during the first 2 years of life. We analyzed the global levels of DNA methylation, reflected in LINE-1, and the local DNA methylation pattern in two candidate genes, Neural Cell Adhesion Molecule (NCAM1) and Nerve Growth Factor (NGF) that, according to our previous studies, might be associated to an increased risk for ASD. For this purpose, we utilized blood samples from pediatric patients with ASD (n = 53) and their corresponding controls (n = 45). Results: We observed a slight decrease in methylation levels of LINE-1 in the ASD group, compared to the control group. One of the CpG in LINE-1 (GenBank accession no.X58075, nucleotide position 329) was the main responsible for such reduction, highly significant in the ASD subgroup of children with AMR (p < 0.05). Furthermore, we detected higher NCAM1 methylation levels in ASD children, compared to healthy children (p < 0.001). The data, moreover, showed higher NGF methylation levels in the AMR subgroup, compared to the control group and the ANMR subgroup. These results are consistent with our prior study, in which lower plasma levels of NCAM1 and higher levels of NGF were found in the ANMR subgroup, compared to the subgroup that comprised neurotypically developing children. Conclusions: We have provided new clues about the epigenetic changes that occur in ASD, and suggest two potential epigenetic biomarkers that would facilitate the diagnosis of the disorder. We similarly present with evidence of a clear differentiation in DNA methylation between the ASD subgroups, with or without mental regression.

Children With Autism Spectrum Disorder and Neurodevelopmental Regression Present a Severe Pattern After a Follow-Up at 24 Months.

This study examined the presence of neurodevelopmental regression and its effects on the clinical manifestations and the severity of autism spectrum disorder (ASD) in a group of children with autism compared with those without neurodevelopmental regression at the time of initial classification and subsequently. Methods and Subjects: ASD patients were classified into two subgroups, neurodevelopmental regressive (AMR) and non-regressive (ANMR), using a questionnaire based on the Autism Diagnostic Interview-Revised test. The severity of ASD and neurodevelopment were assessed with the Childhood Autism Rating Scale Test-2, Strengths and Difficulties Questionnaire, and Pervasive Developmental Disorders Behavior Inventory Parent Ratings (PDDBI) and with the Battelle Developmental Inventory tests at the beginning of the study and after 24 months of follow-up. Fifty-two patients aged 2-6 years with ASD were included. Nineteen were classified with AMR, and 33 were classified with ANMR. Results: The AMR subgroup presented greater severity of autistic symptoms and higher autism scores. Additionally, they showed lower overall neurodevelopment. The AMR subgroup at 24 months had poorer scores on the Battelle Developmental Inventory test in the following areas: Total personal/social (p < 0.03), Total Motor (p < 0.04), Expressive (p < 0.01), and Battelle Total (p < 0.04). On the PDDBI test, the AMR subgroup had scores indicating significantly more severe ASD symptoms in the variables: ritual score (p < 0.038), social approach behaviors (p < 0.048), expressive language (p < 0.002), and autism score (p < 0.003). Conclusions: ASD patients exhibited a set of different neurological phenotypes. The AMR and ANMR subgroups presented different clinical manifestations and prognoses in terms of the severity of autistic symptoms and neurodevelopment.

Neurotoxicity by mercury is not associated with autism spectrum disorders in Spanish children.

BACKGROUND: The pathophysiological etiologies related with the development of Autism Spectrum Disorders (ASD) remain controversial. Different authors have studied neurotoxins such as mercury (Hg) and their relationship with ADS. The objective of this study was to assess the levels of Hg in hair in a group of ASD children (chronic exposure) and in urinary excretion (acute exposure), in comparison to a healthy group. METHODS: A case-control study was conducted in Spanish children. We compared 54 ASD children (aged 2-6) with no other associated pathology to a normally-developing control group (54 subjects). RESULTS: There were no differences in urine (p:0.631) and hair (p:1.000) samples percentages below the limits of detection between the control and the ASD groups, and also between patients in the regression ASD subgroup (AMR) (p:0.08) and the non-regression ASD subgroup (ANMR) (p:0.705). When the analysis was adjusted for age and sex, the differences between Hg levels maintained not significant. There were no correlations between Hg concentrations in the ASD group as a whole (p: 0.739), or when they were subdivided into ASD-AMR (p: 0.739) and ASD-ANMR (p: 0.363). CONCLUSIONS: The present study shows no evidence in our geographical area to support an association between mercury neurotoxicity and the etiopathogenesis of ASD.

Autism Spectrum Disorder (ASD) with and without Mental Regression is Associated with Changes in the Fecal Microbiota.

New microbiome sequencing technologies provide novel information about the potential interactions among intestinal microorganisms and the host in some neuropathologies as autism spectrum disorders (ASD). The microbiota⁻gut⁻brain axis is an emerging aspect in the generation of autistic behaviors; evidence from animal models suggests that intestinal microbial shifts may produce changes fitting the clinical picture of autism. The aim of the present study was to evaluate the fecal metagenomic profiles in children with ASD and compare them with healthy participants. This comparison allows us to ascertain how mental regression (an important variable in ASD) could influence the intestinal microbiota profile. For this reason, a subclassification in children with ASD by mental regression (AMR) and no mental regression (ANMR) phenotype was performed. The present report was a descriptive observational study. Forty-eight children aged 2⁻6 years with ASD were included: 30 with ANMR and 18 with AMR. In addition, a control group of 57 normally developing children was selected and matched to the ASD group by sex and age. Fecal samples were analyzed with a metagenomic approach using a next-generation sequencing platform. Several differences between children with ASD, compared with the healthy group, were detected. Namely, Actinobacteria and Proteobacteria at phylum level, as well as, Actinobacteria, Bacilli, Erysipelotrichi, and Gammaproteobacteria at class level were found at higher proportions in children with ASD. Additionally, Proteobacteria levels showed to be augmented exclusively in AMR children. Preliminary results, using a principal component analysis, showed differential patterns in children with ASD, ANMR and AMR, compared to healthy group, both for intestinal microbiota and food patterns. In this study, we report, higher levels of Actinobacteria, Proteobacteria and Bacilli, aside from Erysipelotrichi, and Gammaproteobacteria in children with ASD compared to healthy group. Furthermore, AMR children exhibited higher levels of Proteobacteria. Further analysis using these preliminary results and mixing metagenomic and other "omic" technologies are needed in larger cohorts of children with ASD to confirm these intestinal microbiota changes.

Children With Autism Spectrum Disorder With Regression Exhibit a Different Profile in Plasma Cytokines and Adhesion Molecules Compared to Children Without Such Regression.

Background: In the etiopathogenesis of autism spectrum disorder (ASD), it has been suggested that a proinflammatory condition, as well as an alteration in adhesion molecules in the early stages of neurodevelopment, may play a role in the pathophysiology of the disorder. This study set out to evaluate the plasma levels of certain inflammatory cytokines, adhesion molecules, and growth factors in a sample of pediatric patients with ASD and compare them to the levels in a control group of healthy children. Methods: Fifty-four children (45 males and nine females) aged 2-6, who were diagnosed with ASD, and a control group of 54 typically-developing children of similar ages were selected. The diagnosis of ASD was carried out in accordance with the DSM-5 criteria and the data obtained from a developmental semi-structured clinical interview and the ADOS evaluation test. Additional testing was carried out to identify the children's developmental level and severity of ASD symptomatology. Patients with ASD were further divided into two subgroups based on developmental parameters: ASD children with neurodevelopmental regression (AMR) and ASD children without neurodevelopmental regression (ANMR). Analyses of plasma molecules, such as cathepsin, IL1ß, IL6, IL8, MPO, RANTES, MCP, BDNF, PAI NCAM, sICAM, sVCAM and NGF, were performed. Results: Higher levels of NGF were observed in the ASD group compared with the levels in the control group (p < 0.05). However, in the analysis of the ASD subgroups, lower plasma levels of NCAM and higher levels of NGF were found in the group of ASD children without developmental regression compared to the levels in the group of typically-developing children. Conclusions: These results suggest differences that could be related to different pathophysiological mechanisms in ASD. There is not a specific profile for the expression of relevant plasma cytokines, adhesion molecules or growth factors in children with ASD compared with that in typically-developing children. However, in the ANMR and AMR subgroups, some of the adhesion molecules and neuronal growth factors show differences that may be related to synaptogenesis.

Aproximación al perfil de personalidad de adultos con trastorno del espectro autista mediante el MMPI-2: datos preliminares / Towards a personality profile of adults with autism spectrum disorder using MMPI-2: preliminary data

Introducción: La mayoría de estudios sobre personas con Trastornos del Espectro Autista (TEA) se centran en encontrar déficits en estas personas. La personalidad apenas ha recibido atención en este grupo de pacientes aunque con frecuencia una proporción de personas con TEA, aquellos que no tienen retraso mental, suelen confundirse con Trastornos de la Personalidad. El objetivo de este trabajo es conocer los rasgos de personalidad de un grupo de personas diagnosticadas con TEA y observar si existe un patrón de rasgos clínicos que se repita en los mismos. Material y método: Se utilizó para la evaluación de la personalidad el Inventario Multifásico de Personalidad de Minnesota (MMPI-2). Para conocer el Cociente Intelectual se recurrió a la Escala de Inteligencia Wechsler para Adultos (WAIS-III). Igualmente se utilizaron las Escala de Observación para el Diagnóstico de Autismo (ADOS) y la Entrevista para el Diagnóstico del Autismo revisada (ADIR) para confirmar el diagnóstico de TEA. Se evaluaron 10 personas adultas con trastorno del espectro autista (TEA) de manera individualizada. Igualmente se utilizó a un grupo control de 10 personas sin diagnóstico de salud mental. Resultados: Los resultados muestran puntuaciones elevadas en las escalas de validez L (mentira) y F (Incoherencia) y muy bajas en K (Factor Corrector). Igualmente se encuentran puntuaciones altas en las escalas clínicas 2 (Depresión) y 0 (Aislamiento Social) y en las escalas de contenido ANX (Ansiedad) SOD (Malestar Social) y OBS (Obsesividad) respecto al grupo control. Conclusiones: Los resultados manifiestan un perfil de personalidad que incluye un solapamiento de síntomas notable con las características del Síndrome de Asperger. El MMPI-2 se revela como una potencial prueba de cribaje para dicho trastorno (AU)

Introduction: The majority of studies into people with Autism Spectrum Disorders (ASD) focus on finding deficits in such people. Personality has scarcely received any attention in this group of patients, even though a proportion of people with ASD, those who have no mental delay, are often mistaken for people with Personality Disorders. The aim of this study is twofold: to identify the personality traits of a group of people diagnosed with ASD and also to determine whether there is a pattern of clinical traits in such a group. Material and methods: The Minnesota Multiphasic Personality Inventory (MMPI-2)was used to measure personality. The Wechsler Adult Intelligence Scale (WAIS-III) was used to determine intelligence quotient. To confirm the ASD diagnosis the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADIR) were used. Ten adults with Autism Spectrum Disorder (ASD) were individually evaluated. A control group of ten people with no mental health diagnosis was also used. Results: Results show higher scores in ASP patients than controls in L (lie) and F (incoherence) validity scales, 2 (Depression) and 0 (Social isolation) clinical scales and ANX (Anxiety), SOD (Social Discomfort) and OBS (Obsessiveness) content scales, and lower scores in K (correction) factor. Conclusions: Data obtained from this preliminary study show a personality profile similar to that of people with Asperger Syndrome. The MMPI-2 emerges as a test to be considered when diagnosing adults with this syndrome (AU)

Un test no-verbal de atribución social para niños y adolescentes con trastornos del espectro autista / A non-verbal test of social attribution for children and adolescents with Autism Spectrum Disorders

Aunque es un hecho ampliamente aceptado que las personas con un trastorno del espectro autista (TEA) exhiben un déficit generalizado en sus capacidades mentalistas, algunos individuos con autismo e inteligencia al menos promedio pasan con éxito los tests de la teoría de la mente (TM). Se cree que estas personas utilizan sus avanzadas habilidades cognitivas de razonamiento verbal para compensar por su capacidad disminuida de mentalizar y así aportar las respuestas correctas a las pruebas de la teoría de la mente en el laboratorio. Este estudio presenta un procedimiento para evaluar la capacidad de mentalización de niños y adolescentes con trastornos del espectro autista e inteligencia promedio a través de un test no-verbal de Atribución Social: el video de figuras geométricas animadas. En el estudio participaron 80 sujetos: 20 individuos varones con autismo y puntuaciones de CI y lenguaje al menos dentro de la banda promedio, 20 niños varones con un desarrollo normal con edades comprendidas entre los 8-9 años, 20 niños varones con desarrollo normal y edades entre 12- 13 años, y 20 adultos varones con ausencia de trastornos psiquiátricos y con una historia de desarrollo normal. Los resultados de la prueba indican una actuación significativamente inferior en el grupo clínico de sujetos con autismo y una correlación significativa entre su actuación en el test y el tiempo invertido en atribuir un significado a los movimientos de las figuras geométricas animadas. En los grupos de niños con un desarrollo normal, se observó una trayectoria de evolución en los resultados del test con una mejoría a partir del periodo de la infancia tardía, siguiendo la adolescencia y por último la etapa adulta. Este trabajo aporta datos que apoyan la existencia de un déficit en la capacidad de mentalización y aporta una base para futuras investigaciones de la naturaleza entre la relación entre la percepción del movimiento y las habilidades sociales

Although it is well established that people with Autism Spectrum Disorders experience a generalized difficulty in mentalising, some very able individuals do pass high level theory of mind (TOM) tasks. It is believed that the use of their well developed cognitive-verbal reasoning skills compensates for the lack of mentalising and facilitates the success on TOM tasks. This paper presents a procedure to test mentalising ability through a totally non-verbal Test of Social Attribution. Eighty subjects with high-functioning autism or Asperger Syndrome (ASD) (N=20) and with age appropriate IQ and language scores, normally developing children aged 8-9 (N=20) and 12-13 (N=20) and adults (N=20) participated in this study. The results indicate significantly lower performance in the clinical group and a significant correlation between their performance and the time invested in attributing meaning to the animations. In the normally developing groups, there was evidence of a developmental trend with performance improving from late childhood into adolescence and then adulthood. This study provides support for a deficit in mentalising, and provides a basis for further investigation of the nature of the relationship between movement perception and social abilities