Pubmed du 07/09/19

dimanche 8 septembre 2019

1. Burgette JM, Rezaie A. Association between Autism Spectrum Disorder and Caregiver-Reported Dental Caries in Children. JDR clinical and translational research. 2019 : 2380084419875441.

INTRODUCTION : There is evidence that dental caries is both increased and decreased in children with autism spectrum disorder (ASD). OBJECTIVES : This study examined the association between ASD and the probability of a child having caregiver-reported dental caries based on a nationally representative sample. We hypothesized that when compared with children without ASD, children with ASD would have greater odds of dental caries. METHODS : We performed a cross-sectional analysis of the 2016 National Survey of Children’s Health. Caregivers reported whether a health provider informed them that their children had ASD and "decayed teeth or cavities" during the past 12 mo. We used logistic regression controlling for child characteristics (age, sex, race/ethnicity, insurance, preventive dental use) and family characteristics (education and federal poverty level). RESULTS : Among the 45,155 children in our sample, 1,228 (2.5%) had ASD. The prevalence of caregiver-reported dental caries was 14.7% in children with ASD and 9.5% in children without ASD. The odds of having caregiver-reported child dental caries (adjusted odds ratio = 1.4, 95% CI = 1.2 to 1.7) was greater among children with ASD than children without ASD when controlling for the aforementioned covariates. CONCLUSION : Using a nationally representative sample, we found that children with ASD had significantly greater odds of having caregiver-reported dental caries as compared with children without ASD. Families can be educated on the increased odds of having dental caries in children with ASD. Moreover, this finding highlights a need for oral health services and policies to prevent and treat dental caries, which are tailored to the increasing number of American children with ASD. KNOWLEDGE TRANSFER STATEMENT : The results of this study support the need for policy makers, clinicians, and families to improve oral health services that prevent and treat dental caries in the increasing number of American children with autism spectrum disorder.

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2. Dempsey EE, Moore C, Johnson SA, Stewart SH, Smith IM. Morality in autism spectrum disorder : A systematic review. Development and psychopathology. 2019 : 1-17.

Moral reasoning and decision making help guide behavior and facilitate interpersonal relationships. Accounts of morality that position commonsense psychology as the foundation of moral development, (i.e., rationalist theories) have dominated research in morality in autism spectrum disorder (ASD). Given the well-documented differences in commonsense psychology among autistic individuals, researchers have investigated whether the development and execution of moral judgement and reasoning differs in this population compared with neurotypical individuals. In light of the diverse findings of investigations of moral development and reasoning in ASD, a summation and critical evaluation of the literature could help make sense of what is known about this important social-cognitive skill in ASD. To that end, we conducted a systematic review of the literature investigating moral decision making among autistic children and adults. Our search identified 29 studies. In this review, we synthesize the research in the area and provide suggestions for future research. Such research could include the application of an alternative theoretical framework to studying morality in autism spectrum disorder that does not assume a deficits-based perspective.

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3. DiCriscio AS, Hu Y, Troiani V. Brief Report : Pupillometry, Visual Perception, and ASD Features in a Task-Switching Paradigm. J Autism Dev Disord. 2019.

We assessed the association between dynamic changes in pupil response in the context of visual perception and quantitative measures of the autism phenotype in healthy adults. Using Navon stimuli in a task-switching paradigm, participants were instructed to identify global or local information based on a cue. Multiple pupil response trajectories across conditions were identified. We combined trajectory patterns for global and local conditions and used data-driven methods to identify three distinct pupil trajectory sub-groups. We report higher scores on quantitative measures of autism features in individuals who demonstrated an increased change in pupil diameter across both conditions. Results demonstrate the use of individualized pupil response trajectories in order to quantitatively characterize visual perception associated with the broader autism phenotype (BAP).

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4. Drobnyk W, Rocco K, Davidson S, Bruce S, Zhang F, Soumerai SB. Sensory Integration and Functional Reaching in Children With Rett Syndrome/Rett-Related Disorders. Clinical medicine insights Pediatrics. 2019 ; 13 : 1179556519871952.

Background : The loss of functional hand skills is a primary characteristic of Rett syndrome. Stereotypies, dyspraxia, and other sensory processing issues severely limit the individual’s ability to reach toward and sustain grasp on objects. This loss of functional reach and grasp severely limits their ability to participate in self-help, play, and school-related activities. We proposed that Ayres Sensory Integration (ASI) treatment would improve sensory processing and motor planning, which would lay the sensory-motor groundwork for improving grasp of objects, an important first step in developing functional hand use. Objective : We examined effects of ASI treatment on rate of reaching and grasping for children with Rett syndrome/Rett-related disorders. Methods : We used an interrupted time series design to measure changes in outcome variables occurring after intervention initiation and cessation. We analyzed daily video observations during baseline, intervention, and post-intervention periods, over a span of 7 months. Results : During baseline, rate of grasping declined moderately. There was a 15% increase in grasping from the end of baseline to end of the post-intervention period. There was no significant change in rate of reaching. Conclusions : This study provides preliminary data showing very small improvements in hand grasp of children with Rett syndrome following ASI treatment ; larger studies in diverse settings are needed to establish the effectiveness of this approach. This study shows that an interrupted time series research design provides a valid template for evaluating interventions for children with rare disorders.

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5. Gubbiotti M, Elisei S, Bedetti C, Marchiafava M, Giannantoni A. Urinary and bowel disfunction in autism spectrum disorder : a prospective, observational study. Psychiatria Danubina. 2019 ; 31(Suppl 3) : 475-8.

BACKGROUND : Vesico- sphincter and bowel dysfunction have been frequently detected in Autism spectrum disorder (ASD) patients, but to date no consistent information exist on adults affected by the disease. We evaluated the prevalence and types of bladder and bowel disfunction (BBD) in young and adult patients affected by ASD. SUBJECTS AND METHODS : Twenty- seven adults and 20 children/teens with ASD and a matched group of typically developing subjects were enrolled. Daily pads use and episodes of urinary incontinence (UI) were recorded in a 3- day voiding diary. Patients underwent also the measurement of post-void urinary residual volume and 3- day bowel diary. In addition, type and duration of the pharmacological agents assumed by the patients were accurately recorded. RESULTS : Any type of UI was observed in 85.1% of adults and in 90% of children/teens. In adults, nocturnal enuresis (NE, 62.9%) and diurnal intermittent UI (37%) were the most frequently observed bladder dysfunction while in children/ teens were NE (75%) and diurnal continuous UI (40%). In all patients was demonstrated a significant relationship between urinary symptoms and pharmacological agents, particularly NE and clotiapine (p<0.004) and periciazine (p<0.008). CONCLUSIONS : Young and adult patients with ASD present with a high prevalence of BBD and concomitant antipsychotic medications could to play a contribution in induction and/or maintaining of BBD.

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6. Hine JF, Allin J, Allman A, Black M, Browning B, Ramsey B, Swanson A, Warren ZE, Zawoyski A, Allen W. Increasing Access to Autism Spectrum Disorder Diagnostic Consultation in Rural and Underserved Communities : Streamlined Evaluation Within Primary Care. J Dev Behav Pediatr. 2019.

OBJECTIVE : Preliminary feasibility and clinical utility research has demonstrated that implementation of a streamlined diagnostic model embedded within primary care (PC) clinics promotes early identification of young children with autism spectrum disorder (ASD). Use of this model results in dramatically reduced waits for diagnostic consultation, high levels of family/provider satisfaction, and reductions in referrals to overtaxed tertiary diagnostic centers. The current study extends this work by providing data before/after implementation of a streamlined model across a diverse range of PC clinics that provide health care to rural and underserved communities. METHODS : The streamlined assessment involved record/history review, diagnostic interview, standard rating scales, and an interactive screening tool. Eighty children between the ages of 19 and 47 months were seen across 5 different clinics. Data were collected through chart review. RESULTS : Implementation of streamlined model resulted in a significant decrease in latency to diagnostic conclusion from a mean of 144.7 to 49.9 days. Children were likely to experience a greater reduction in wait times if they were a PC patient versus a non-PC patient. CONCLUSION : Results show significant reduction in wait times for ASD diagnostic decisions across both PC and non-PC patients. By reducing waits and identifying concerns more efficiently, we may increase the ability of families to access early intervention and support services.

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7. Iakoucheva LM, Muotri AR, Sebat J. Getting to the Cores of Autism. Cell. 2019 ; 178(6) : 1287-98.

The genetic architecture of autism spectrum disorder (ASD) is itself a diverse allelic spectrum that consists of rare de novo or inherited variants in hundreds of genes and common polygenic risk at thousands of loci. ASD susceptibility genes are interconnected at the level of transcriptional and protein networks, and many function as genetic regulators of neurodevelopment or synaptic proteins that regulate neural activity. So that the core underlying neuropathologies can be further elucidated, we emphasize the importance of first defining subtypes of ASD on the basis of the phenotypic signatures of genes in model systems and humans.

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8. Kong X, Liu J, Cetinbas M, Sadreyev R, Koh M, Huang H, Adeseye A, He P, Zhu J, Russell H, Hobbie C, Liu K, Onderdonk AB. New and Preliminary Evidence on Altered Oral and Gut Microbiota in Individuals with Autism Spectrum Disorder (ASD) : Implications for ASD Diagnosis and Subtyping Based on Microbial Biomarkers. Nutrients. 2019 ; 11(9).

Autism Spectrum Disorder (ASD) is a complex neurological and developmental disorder characterized by behavioral and social impairments as well as multiple co-occurring conditions, such as gastrointestinal abnormalities, dental/periodontal diseases, and allergies. The etiology of ASD likely involves interaction between genetic and environmental factors. Recent studies suggest that oral and gut microbiome play important roles in the pathogenesis of inflammation, immune dysfunction, and disruption of the gut-brain axis, which may contribute to ASD pathophysiology. The majority of previous studies used unrelated neurotypical individuals as controls, and they focused on the gut microbiome, with little attention paid to the oral flora. In this pilot study, we used a first degree-relative matched design combined with high fidelity 16S rRNA (ribosomal RNA) gene amplicon sequencing in order to characterize the oral and gut microbiotas of patients with ASD compared to neurotypical individuals, and explored the utility of microbiome markers for ASD diagnosis and subtyping of clinical comorbid conditions. Additionally, we aimed to develop microbiome biomarkers to monitor responses to a subsequent clinical trial using probiotics supplementation. We identified distinct features of gut and salivary microbiota that differed between ASD patients and neurotypical controls. We next explored the utility of some differentially enriched markers for ASD diagnosis and examined the association between the oral and gut microbiomes using network analysis. Due to the tremendous clinical heterogeneity of the ASD population, we explored the relationship between microbiome and clinical indices as an attempt to extract microbiome signatures assocociated with clinical subtypes, including allergies, abdominal pain, and abnormal dietary habits. The diagnosis of ASD currently relies on psychological testing with potentially high subjectivity. Given the emerging role that the oral and gut microbiome plays in systemic diseases, our study will provide preliminary evidence for developing microbial markers that can be used to diagnose or guide treatment of ASD and comorbid conditions. These preliminary results also serve as a starting point to test whether altering the oral and gut microbiome could improve co-morbid conditions in patients with ASD and further modify the core symptoms of ASD.

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9. Kuter B, Guler N. Caries experience, oral disorders, oral hygiene practices and socio-demographic characteristics of autistic children. European journal of paediatric dentistry : official journal of European Academy of Paediatric Dentistry. 2019 ; 20(3) : 237-41.

AIM : The aim of the present study was to comparatively evaluate the oral health status and influential factors, brushing, developmental and orthodontic disorders, bruxism, drug intake, sweet eating habits, sociodemographic factors and lifestyles of autistic and healthy children. Participants in this study were greater in number compared to the previous studies investigating the same phenomenon. Furthermore, it was a more comprehensive study than other studies in the literature in terms of number of variables included. METHODS : The study was carried out with a total of 407 participants, 285 autistic (test group) and 122 healthy children (control group). The ages ranged from 5 to 16. A total of 407 children were examined. DMFT, dmft, plaque index, dental trauma, oral symptoms, developmental and orthodontic disorders of these children were recorded. Participants were also asked to fill a two-part questionnaire. The first part included questions related to the child’s and parents’ demographics such as the child’s age, gender, number of siblings, the mother’s and father’s age, education, occupation and income. The second part included questions related to systemic diseases, drug intake, the dental history of children and their parents, brushing and nutrition habits. RESULTS : The results from the inferential statistics showed that both DMFT and dmft indices values of the autistic children were lower than those of the healthy children. Caries prevalence of the autistic children was lower compared to the control group. There was also no difference in the plaque index values between the two groups. Drooling of saliva of the autistic children was higher than that of the healthy children. The results showed statistically significant differences between the two groups regarding bruxism, deep-palate and tongue thrusting, though no statistically significant differences were found between the two groups regarding open bite. However, significant differences were observed in terms of dental crowding between the two groups in that the healthy children had more dental crowding than the autistic children. CONCLUSION : One of the main findings of the study was observed in relation to caries prevalence in that autistics had lower caries prevalence values than controls. Another main finding was that no statistically significant differences were found in terms of plaque index values when the groups were compared. When the findings related to deep palate, open bite and dental crowding were examined, it was seen that deep palate was higher but dental crowding was lower in the autistic children. However, in this study there were no statistically significant differences between the two groups in terms of open bite.

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10. Leiva-Garcia B, Planells E, Planells Del Pozo P, Molina-Lopez J. Association Between Feeding Problems and Oral Health Status in Children with Autism Spectrum Disorder. J Autism Dev Disord. 2019.

A number of studies have been made of mealtime behavioral problems and food selectivity in patients with autism spectrum disorder (ASD), though not from a multidisciplinary perspective where diet and dental care are investigated in children with ASD. In the present study, the parents of 55 children with ASD and 91 children with typical development (TD) between 6 and 18 years of age completed the Brief Assessment of Mealtime Behavior in Children (BAMBIC) and a food consumption frequency questionnaire. A pediatric dentist performed an oral exploration of the participants according to the criteria of the World Health Organization (WHO). Food rejection and limited food variety were associated to an increased prevalence of malocclusion and altered Community Periodontal Index scores in children with ASD.

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11. Leyden J, Fung L, Frick S. Autism and toe-walking : are they related ? Trends and treatment patterns between 2005 and 2016. Journal of children’s orthopaedics. 2019 ; 13(4) : 340-5.

Purpose : This study quantified toe-walking trends and treatment decisions in patients with autism spectrum disorder (ASD) in the United States between 2005 and 2016 using a large national private-payer database. Methods : A retrospective database review was performed on paediatric patients with ASD, and for International Classification of Diseases-9/10 diagnosis codes for toe-walking. Patients were filtered based on treatment type by Current Procedural Terminology (CPT) code. Continued toe-walking rates were assessed for each patient population and treatment group. A Pearson’s chi-squared test was used to evaluate differences in group characteristics. Results : Of 2 221 009 paediatric patients in the database, 5739 patients had a diagnosis of ASD, and 8.4% of patients with ASD also had a diagnosis of toe-walking (n = 484). For typically developing children in the database, 0.47% of patients had a diagnosis of persistent toe-walking. In all, 59.3% of ASD patients underwent physical therapy, 7.4% serial casting and 3.3% surgical correction, compared with 38.1%, 3.6% and 1.2% of normally developing children, respectively (chi-square 6.4031 ; p < 0.040699). Without intervention, 63.6% of patients with ASD continued to toe-walk within ten years of their diagnosis, with 19.3% of patients without ASD (chi-square 82.9762 ; p < 0.0001). Conclusion : This study supports the association between a greater prevalence of toe-walking in children with ASD. We showed that patients with ASD and toe-walking receive surgical correction at nearly triple the rate of children without ASD who toe-walk. The continued rate of toe-walking is comparable between treatment groups as well as between ASD and typically developing children. Typically developing children have higher rates of toe-walking resolution without intervention than children with ASD. Level of evidence : Level II.

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12. Margoni F, Guglielmetti G, Surian L. Brief Report : Young Children with Autism Can Generate Intent-Based Moral Judgments. J Autism Dev Disord. 2019.

Past research suggested that, due to difficulties in mentalistic reasoning, individuals with autism tend to base their moral judgments on the outcome of agents’ actions rather than on agents’ intentions. In a novel task, aimed at reducing the processing demands required to represent intentions and generate a judgment, autistic children were presented with agents that accidentally harmed or attempted but failed to harm others and were asked to judge those agents. Most of the times, children blamed the character who attempted to harm and exculpated the accidental wrongdoer, suggesting that they generated intent-based moral judgments. These findings suggest that processing limitations rather than lack of conceptual competence explain the poor performance reported in previous research on moral judgment in autism.

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13. Miyake M, Maesaka F, Marugami N, Miyamoto T, Nakai Y, Ohnishi S, Gotoh D, Owari T, Hori S, Morizawa Y, Itami Y, Inoue T, Anai S, Torimoto K, Fujii T, Shimada K, Tanaka N, Fujimoto K. A Potential Application of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Combined with Photodynamic Diagnosis for the Detection of Bladder Carcinoma in Situ : Toward the Future ’MRI-PDD Fusion TURBT’. Diagnostics (Basel, Switzerland). 2019 ; 9(3).

The detection of carcinoma in situ (CIS) is essential for the management of high-risk non-muscle invasive bladder cancers. Here, we focused on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with photodynamic diagnosis (PDD) for the detection of CIS. A total of 45 patients undergoing pre-surgical DCE-MRI and PDD-assisted endoscopic surgery accompanied by biopsies of the eight segmentations were analyzed. Immunohistochemical analysis of the biopsies revealed hypervascularity of CIS lesions, a cause of strong submucosal contrast-enhancement. It was found that 56 (16.2%) of 344 biopsies had pathologically proven CIS. In the DCE-MRI, the overall sensitivity and specificity for detecting CIS were 48.2% and 81.9%, respectively. We set out two different combinations of PDD and DCE-MRI for detecting CIS. Combination 1 was positive when either the PDD or DCE-MRI were test-positive. Combination 2 was positive only when both PDD and DCE-MRI were test-positive. The overall sensitivity of combinations 1 and 2 were 75.0% and 37.5%, respectively (McNemar test, vs PDD alone ; p = 0.041 and p < 0.001, respectively). However, the specificity was 74.0% and 91.7%, respectively (vs PDD alone ; both p < 0.001). Our future goal is to establish ’MRI-PDD fusion transurethral resction of the bladder tumor (TURBT), which could be an effective therapeutic and diagnostic approach in the clinical management of high-risk disease.

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14. Sarda P, Butt D, Elnikety S, Fitzgerald C, Corbett S. Does Hyaluronan improve pain or function following Arthroscopic Subacromial decompression (ASD) surgery of Shoulder ? Results of a level 1 RCT. Indian journal of orthopaedics. 2019 ; 53(5) : 595-601.

Background : Sodium hyaluronate (hyaluronan) can be used as a synovial fluid substitute following arthroscopic surgery. In this study, we examined its effect on pain and function following arthroscopic subacromial arthroscopic decompression (ASAD). Methodology : A prospective, randomized, and single-blinded design was used (13/LO0427) to compare the effect of a single postprocedure subacromial instillation of 10 ml hyaluronan, against 10 ml saline control. All patients had interscalene block along with general anesthesia and followed standard postoperative rehabilitation protocol. A power calculation for a 6-point difference in Oxford Shoulder Score (OSS) indicated a minimum sample size of 44. Participants were assessed preoperatively, and at 12 weeks using the following outcome measures -Oxford Shoulder Score (OSS), visual analog score (VAS), European quality of life score (EUROQOL), and Disability of the arm, shoulder, and hand (DASH) scores. Results : 46 patients were included for analysis. Both groups showed a mean improvement in OSS of 9 points (P = 0.0001), DASH (10 points, P < 0.05), and EUROQOL (0.13, P < 0.05). No significant difference was observed between groups in any of the recorded outcomes. Apart from one case of frozen shoulder in each group, no other complications were noted. Conclusion : While both groups showed improved pain and function scores after ASAD, no significant difference was seen between groups receiving placebo or hyaluronan. The intervention is safe but, in this study, has not been shown to improve postoperative pain or function over ASAD alone. Level of evidence : I.

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15. Van der Hallen R, Manning C, Evers K, Wagemans J. Global Motion Perception in Autism Spectrum Disorder : A Meta-Analysis. J Autism Dev Disord. 2019.

Visual perception in individuals with autism spectrum disorder (ASD) is often debated in terms of enhanced local and impaired global perception. Deficits in global motion perception seem to support this characterization, although the evidence is inconsistent. We conducted a large meta-analysis on global motion, combining 48 articles on biological and coherent motion. Results provide evidence for a small global motion processing deficit in individuals with ASD compared to controls in both biological and coherent motion. This deficit appears to be present independent of the paradigm, task, dependent variable, age or IQ of the groups. Results indicate that individuals with ASD are less sensitive to these types of global motion, although the difference in neural mechanisms underlying this behavioral difference remains unclear.

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