Pubmed du 07/03/20

samedi 7 mars 2020

1. Buchmuller BC, Kosel B, Summerer D. Complete Profiling of Methyl-CpG-Binding Domains for Combinations of Cytosine Modifications at CpG Dinucleotides Reveals Differential Read-out in Normal and Rett-Associated States. Sci Rep ;2020 (Mar 4) ;10(1):4053.

5-Methylcytosine (mC) exists in CpG dinucleotides of mammalian DNA and plays key roles in chromatin regulation during development and disease. As a main regulatory pathway, fully methylated CpG are recognized by methyl-CpG-binding domain (MBD) proteins that act in concert with chromatin remodelers, histone deacetylases and methyltransferases to trigger transcriptional downregulation. In turn, MBD mutations can alter CpG binding, and in case of the MBD protein MeCP2 can cause the neurological disorder Rett syndrome (RTT). An additional layer of complexity in CpG recognition is added by ten-eleven-translocation (TET) dioxygenases that oxidize mC to 5-hydroxymethyl-, 5-formyl- and 5-carboxylcytosine, giving rise to fifteen possible combinations of cytosine modifications in the two CpG strands. We report a comprehensive, comparative interaction analysis of the human MBD proteins MeCP2, MBD1, MBD2, MBD3, and MBD4 with all CpG combinations and observe individual preferences of each MBD for distinct combinations. In addition, we profile four MeCP2 RTT mutants and reveal that although interactions to methylated CpGs are similarly affected by the mutations, interactions to oxidized mC combinations are differentially affected. These findings argue for a complex interplay between local TET activity/processivity and CpG recognition by MBDs, with potential consequences for the transcriptional landscape in normal and RTT states.

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2. Chojnicka I, Wawer A. Social language in autism spectrum disorder : A computational analysis of sentiment and linguistic abstraction. PLoS One ;2020 ;15(3):e0229985.

Individuals with autism spectrum disorder (ASD) demonstrate impairments with pragmatic (social) language, including narrative skills and conversational abilities. We aimed to quantitatively characterize narrative performance in ASD using natural language processing techniques : sentiment and language abstraction analyses based on the Linguistic Category Model. Individuals with ASD and with typical development matched for age, gender, ethnicity, and verbal and nonverbal intelligence quotients produced language samples during two standardized tasks from the Autism Diagnostic Observation Schedule, Second Edition assessment : Telling a Story from a Book and Description of a Picture. Only the narratives produced during the Book Task differed between ASD and control groups in terms of emotional polarity and language abstraction. Participants with typical development used words with positive sentiment more often in comparison to individuals with ASD. In the case of words with negative sentiment, the differences were marginally significant (participants with typical development used words with negative sentiment more often). The Book Task narratives of individuals with ASD were also characterized by a lower level of language abstraction than narratives of peers with typical development. Linguistic abstraction was strongly positively correlated with a higher number of words with emotional polarity. Neither linguistic abstraction nor emotional polarity correlated with participants’ age or verbal and nonverbal IQ. The results support the promise of sentiment and language abstraction analyses as a useful tool for the quantitative, fully automated assessment of narrative abilities among individuals with ASD.

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3. Drimalla H, Scheffer T, Landwehr N, Baskow I, Roepke S, Behnia B, Dziobek I. Towards the automatic detection of social biomarkers in autism spectrum disorder : introducing the simulated interaction task (SIT). NPJ Digit Med ;2020 ;3:25.

Social interaction deficits are evident in many psychiatric conditions and specifically in autism spectrum disorder (ASD), but hard to assess objectively. We present a digital tool to automatically quantify biomarkers of social interaction deficits : the simulated interaction task (SIT), which entails a standardized 7-min simulated dialog via video and the automated analysis of facial expressions, gaze behavior, and voice characteristics. In a study with 37 adults with ASD without intellectual disability and 43 healthy controls, we show the potential of the tool as a diagnostic instrument and for better description of ASD-associated social phenotypes. Using machine-learning tools, we detected individuals with ASD with an accuracy of 73%, sensitivity of 67%, and specificity of 79%, based on their facial expressions and vocal characteristics alone. Especially reduced social smiling and facial mimicry as well as a higher voice fundamental frequency and harmony-to-noise-ratio were characteristic for individuals with ASD. The time-effective and cost-effective computer-based analysis outperformed a majority vote and performed equal to clinical expert ratings.

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4. Egorova O, Myte R, Schneede J, Hagglof B, Bolte S, Domellof E, Ivars A’roch B, Elgh F, Ueland PM, Silfverdal SA. Maternal blood folate status during early pregnancy and occurrence of autism spectrum disorder in offspring : a study of 62 serum biomarkers. Mol Autism ;2020 (Jan 16) ;11(1):7.

BACKGROUND : Autism spectrum disorder (ASD) evolves from an interplay between genetic and environmental factors during prenatal development. Since identifying maternal biomarkers associated with ASD risk in offspring during early pregnancy might result in new strategies for intervention, we investigated maternal metabolic biomarkers in relation to occurrence of ASD in offspring using both univariate logistic regression and multivariate network analysis. METHODS : Serum samples from 100 women with an offspring diagnosed with ASD and 100 matched control women with typically developing offspring were collected at week 14 of pregnancy. Concentrations of 62 metabolic biomarkers were determined, including amino acids, vitamins (A, B, D, E, and K), and biomarkers related to folate (vitamin B9) metabolism, lifestyle factors, as well as C-reactive protein (CRP), the kynurenine-tryptophan ratio (KTR), and neopterin as markers of inflammation and immune activation. RESULTS : We found weak evidence for a positive association between higher maternal serum concentrations of folate and increased occurrence of ASD (OR per 1 SD increase : 1.70, 95% CI 1.22-2.37, FDR adjusted P = 0.07). Multivariate network analysis confirmed expected internal biochemical relations between the biomarkers. Neither inflammation markers nor vitamin D3 levels, all hypothesized to be involved in ASD etiology, displayed associations with ASD occurrence in the offspring. CONCLUSIONS : Our findings suggest that high maternal serum folate status during early pregnancy may be associated with the occurrence of ASD in offspring. No inference about physiological mechanisms behind this observation can be made at the present time because blood folate levels may have complex relations with nutritional intake, the cellular folate status and status of other B-vitamins. Therefore, further investigations, which may clarify the potential role and mechanisms of maternal blood folate status in ASD risk and the interplay with other potential risk factors, in larger materials are warranted.

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5. Ekici B. Combination of Steroid and Flavonoid for the Treatment of Regressive Autism. J Neurosci Rural Pract ;2020 (Jan) ;11(1):216-218.

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6. Failla MD, Bryant LK, Heflin BH, Mash LE, Schauder K, Davis S, Gerdes MB, Weitlauf A, Rogers BP, Cascio CJ. Neural Correlates of Cardiac Interoceptive Focus Across Development : Implications for Social Symptoms in Autism Spectrum Disorder. Autism Res ;2020 (Mar 5)

Interoception involves the processing of sensory information relevant to physiological functioning and is integral to building self-awareness, emotional states, and modulating social behaviors. With the role of interoception in emotional processing and social functioning, there is growing interest in characterizing interoception in autism spectrum disorder (ASD), yet, there are mixed results regarding cardiac interoceptive accuracy in ASD. In this study, we explored the neural basis of cardiac interoception using an fMRI heartbeat-counting task in order to assess neural correlates of primary interoception. We predicted that interoceptive-specific response in the insula, a "hub" for interoception, would be related to ASD symptomatology. We investigated the relationship of insula responses during cardiac interoceptive focus and a self/caregiver-reported autism-related symptom scale (Social Responsiveness Scale-2 (SRS)). Participants included 46 individuals with autism spectrum disorder (ASD) (age 8-54, mean = 19.43 +/- 10.68 years) and 54 individuals with typical development for comparison (TC, age 8-53, mean = 21.43 +/- 10.41 years). We found no significant difference in cardiac interoceptive accuracy or neural response to cardiac interoception focus in ASD. Several insula subdivisions had a curvilinear relationship to age, peaking in early adulthood. Interoceptive-specific insula response was associated with adult self-report SRS scores ; this association differed by diagnostic group and was not present for caregiver-reported scores. This work suggests that (a) there is no global deficit in cardiac interoception in ASD, but integrating interoceptive cues with social information may distinguish individuals with ASD, and (b) there is a developmental trajectory for interoceptive processing in the insula that may be relevant for socio-emotional health. LAY SUMMARY : We use internal sensory information from the body, such as signals from the heart, to understand our emotional response to the external world. We measured how accurately people with autism feel their heartbeat and how the brain responds to this type of information. We found no differences between the autism and comparison groups in how the brain senses heartbeats, or in how accurately people feel their heartbeats. However, for people with autism, brain responses while sensing heartbeats were related to social difficulties. This work suggests people with autism may use internal and external information in a different way. (c) 2020 International Society for Autism Research, Wiley Periodicals, Inc.

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7. Hudry K, Pellicano E, Uljarevic M, Whitehouse AJO. Setting the research agenda to secure the wellbeing of autistic people. Lancet Neurol ;2020 (Mar 3)

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8. Lai MC, Anagnostou E, Wiznitzer M, Allison C, Baron-Cohen S. Evidence-based support for autistic people across the lifespan : maximising potential, minimising barriers, and optimising the person-environment fit. Lancet Neurol ;2020 (Mar 3)

Autism is both a medical condition that gives rise to disability and an example of human variation that is characterised by neurological and cognitive differences. The goal of evidence-based intervention and support is to alleviate distress, improve adaptation, and promote wellbeing. Support should be collaborative, with autistic individuals, families, and service providers taking a shared decision-making approach to maximise the individual’s potential, minimise barriers, and optimise the person-environment fit. Comprehensive, naturalistic early intervention with active caregiver involvement can facilitate early social communication, adaptive functioning, and cognitive development ; targeted intervention can help to enhance social skills and aspects of cognition. Augmentative and alternative communication interventions show preliminary evidence of benefit in minimising communication barriers. Co-occurring health issues, such as epilepsy and other neurodevelopmental disorders, sleep problems, and mental health challenges, should be treated in a timely fashion. The creation of autism-friendly contexts is best achieved by supporting families, reducing stigma, enhancing peer understanding, promoting inclusion in education, the community, and at work, and through advocacy.

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9. Leven Y, Wiegand F, Wilken B. Sleep Quality in Children and Adults with Rett Syndrome. Neuropediatrics ;2020 (Mar 6)

BACKGROUND : Over 80% of individuals suffering from Rett syndrome (RTT) are affected over their life period by sleeping disorders. Little is known about the impact of those on the quality of life and a clinical approach to the treatment of sleep disturbances is lacking. AIMS : Primary aim was to assess sleep quality in children and adults. Secondary aim was to assess behavioral disorders and their relationship to sleep quality. The medication taken by the subjects was also included. METHODS : Sleep quality and medication were assessed using the sleeping questionnaire for children with neurological and other complex diseases (SNAKE). Behavioral disorders were assessed by the Rett Syndrome Behavior Questionnaire (RSBQ). Questionnaires were sent to the 700 members of the Elternhilfe fur Kinder mit Rett Syndrom in Deutschland e.V. (Rett Aid) of which 287 were included. Questionnaires were filled out by the primary caregivers. RESULTS : Sleep quality was rated as very good to good by over 60% of caregivers in contrast to data available in the literature. Behavioral disorders related to regression such as loss of acquired hand skills (p = 0.046) and isolation (p = 0.002) were found to be associated with sleep quality. Melatonin showed a significant association (p = 0.007) with sleep quality. CONCLUSION : Our study showed sleep dysfunction to be less prevalent in RTT-affected individuals than evidence from past studies has suggested. Nevertheless, this remains a subjective assessment of sleep quality and therefore the need to find objective, disorder-specific parameters that measure sleep quality in RTT patients persists.

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10. London EB, Yoo JH, Fethke ED, Zimmerman-Bier B. The Safety and Effectiveness of High-Dose Propranolol as a Treatment for Challenging Behaviors in Individuals With Autism Spectrum Disorders. J Clin Psychopharmacol ;2020 (Mar/Apr) ;40(2):122-129.

PURPOSE/BACKGROUND : Individuals with autism spectrum disorders present with social communication deficits and a rigid adherence to sameness. Along with these symptoms, many individuals also present with severe challenging behaviors that place themselves as well as their families and communities at risk for injury. For these individuals, new and effective treatments are acutely needed. Propranolol has been used worldwide for over 50 years. Its primary indication is for hypertension, but there is evidence that, at higher doses, propranolol inhibits rage and anger through its effects on the central nervous system. This effect has been demonstrated in a variety of neuropsychiatric disorders. METHODS/PROCEDURES : Here, we present 46 retrospective analyses of clinical cases that were followed by a psychiatrist. Propranolol was prescribed as an add-on to the patients’ existing medications. The doses ranged from 120 to 960 mg per day (mean = 462 mg). FINDINGS/RESULTS : Thirty-nine (85%) of 46 patients were found to be much improved or very much improved on the physician-rated Clinical Global Impression Improvement scale. There were few side effects noted, with only 2 subjects unable to tolerate the propranolol. IMPLICATIONS/CONCLUSIONS : It appears that high-dose propranolol can be given safely with minimal adverse cardiovascular problems, provided that close clinical monitoring is maintained. A more rigorous clinical trial is needed to elucidate and verify its clinical utility, clinical practice parameters, and the effects of propranolol as a monotherapy versus as an add-on to the patient’s existing medication regimen.

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11. Marijnissen GM, Zwittink RD, Kuijper EJ, van Furth EF. [Microbiome and psychiatry : autism as an example]. Tijdschr Psychiatr ;2020 ;62(2):131-140.

BACKGROUND : The microbiome plays an important role in medicine. In psychiatry, it is also useful to examine the microbiome in relation to the pathogenesis and treatment of psychopathology. Nowadays, during consultation, patients and their relatives more frequently ask questions regarding the microbiome, as well as microbiome-based therapies.
AIM : To give an overview of the current knowledge regarding the relationship between microbiome, behaviour and psychiatric disorders in general, and autism in particular.
METHOD : A narrative literature review based on searches in the PubMed and psycinfo databases with the keywords : microbiota, microbiome, microorganisms, mental disorders, psychiatric disorder, autism spectrum disorder, autistic disorder, autistic and autism.
RESULTS : The number of publications concerning the bidirectional relationship between gut microbiota composition and behavior is considerable. The composition of the gut microbiome affects human behavior via subtle, finely regulated, system biological bidirectional influence. Placebo-controlled research into the effects of microbiome interventions is currently limited.
CONCLUSION : It is too early to make definitive statements about the possibilities of diagnosis and therapy aimed at the microbiome in psychiatric disorders. Further scientific research is necessary. How microbiota play a crucial role in host biochemical homeostasis is, however, becoming increasingly clearer.

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12. Naguy A. Autism and Gender Dysphoria : Searching for the Holy Grail. Prim Care Companion CNS Disord ;2020 (Mar 5) ;22(2)

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13. Naidoo M, Singh S. A Dental Communication Board as an Oral Care Tool for Children with Autism Spectrum Disorder. J Autism Dev Disord ;2020 (Mar 5)

Children with autism spectrum disorder (ASD) sometimes display an inability for information sharing through functional verbal communication. This may interfere with professional oral care. These children tend to process visual information more efficiently than auditory information. Picture schedules can briefly suffice as visual cues serving a vital function in helping children with ASD to function in a particular setting such as an oral care environment. A visual communication implement such as a dental communication board was developed in this study to allow for a facilitated communication process between the patient with ASD and the oral care professional. This study entailed two main phases, namely the selection of symbols for the construction of a dental communication board and the small scale testing of the board in a clinical setting. This study incorporated a combination of a quantitative non-experimental descriptive survey combined with a concurrent mixed method survey design which retrieved data for both close-ended and open-ended questions from the same respondent. A quantitative survey questionnaire at a structured dental seminar presentation was employed for the first phase, and a combination of a quantitative and qualitative questionnaire was employed for the second phase of this study. Documented responses were collated and analyzed using frequency and thematic analysis. The most frequently selected symbols were retrieved after a frequency analysis and displayed on a color coded background to distinguish the various categories on the dental communication board. The thematic analysis resulted in the emergence of three main themes, namely the strengths of the board ; weakness of the board and suggestions. This study anticipates the incorporation of a dental communication board as a visual mode using graphic symbols to augment expressive and receptive language in an oral care environment to facilitate professional oral care for children with ASD.

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14. Pan X, Kaminga AC, Liu A. Progress in spatial information technology in autistic spectrum disorders. Zhong Nan Da Xue Xue Bao Yi Xue Ban ;2020 (Jan 28) ;45(1):85-90.

The pathogenesis of autistic spectrum disorders is complicated and the exact etiology and pathogenesis remain unclear. Major advances in spatial information technology have revealed the potential of spatial information technology as an effective tool in research and treatment for children with autistic spectrum disorders. However, there are too many fragmented research topics. According to recent reports on spatial information technology, there is no precedent for the application of spatial information technology in autistic spectrum disorders in China. Space information technology analysis for autistic spectrum disorders can be divided into the following steps : pre analysis, spatial clustering analysis, spatial model analysis, and interpretation of related results. It is hopeful that the space information technology can provide proposals for the future research on the pathogenesis of autistic spectrum disorders in our country.

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15. Patra S, Patro BK, Padhy SK. Symptom Recognition to Diagnosis : Pathway to Care for Autism in a Tertiary Care Medical Centre. J Neurosci Rural Pract ;2020 (Jan) ;11(1):164-169.

Objective There is no systematic report on pathway to care in autism from tertiary care medical centers of India. The present study was aimed to evaluate the pathways to care among parents of children with autism-seeking treatment at a tertiary care medical center. Methods Cross-sectional, observational study involving parents of 38 children with autism spectrum disorder diagnosed with INCLEN diagnostic tool. Pathway to care was assessed using World Health Organization Encounter Form. Statistical Analysis IBM Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis ; categorical variables were assessed using Chi-square test keeping statistical significance at 0.05%. Results A total of 74% parents reported going to a general practitioner and 13% reported going to a child psychiatrist as point of first contact. Among them, 71% parents reported seeking care with a child psychiatrist in a tertiary medical center at the fourth point of contact. Also, 84% parents believed in biomedical explanation of autism. Majority of parents sought for speech therapy and medicines for their child with autism which is in tune with their biomedical explanation. Parents were the first to identify developmental concerns, average age of symptom recognition being 2.2 years. Average age of intervention initiation was 40 months, 8 months prior to diagnosis of autism. Conclusions Early symptom recognition and initiation of interventions is encouraging. Despite having a biomedical explanation of autism and ability to recognize developmental concerns, there is a lag of 4 years in diagnosis and reaching a specialized child psychiatry setup. This lag is a cause of concern owing to the impact on access to evidence-based interventions.

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16. Shi BJ, Cao MQ, Jing J. [Research progress in restricted and repetitive behaviors in autism spectrum disorders]. Zhonghua Er Ke Za Zhi ;2020 (Mar 2) ;58(3):245-248.

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17. Stoddard J, Zik J, Mazefsky CA, DeChant B, Gabriels R. The Internal Structure of the Aberrant Behavior Checklist Irritability Subscale : Implications for Studies of Irritability in Treatment-Seeking Youth With Autism Spectrum Disorders. Behav Ther ;2020 (Mar) ;51(2):310-319.

Given the prominence of the Aberrant Behavior Checklist (ABC), Irritability Subscale (ABC-I), in treatment outcome studies, we conducted a critical examination of its internal consistency and relationship to other measures of irritability in 758 psychiatrically hospitalized youth with autism spectrum disorder. In exploratory and confirmation samples, we conducted factor and bifactor analyses to describe the internal structure of the ABC-I. Our results suggest that the ABC-I roughly represents a unidimensional construct of irritability, as indicated by a general factor in bifactor analysis. In addition to irritability, subordinate factors are presented that represent tantrums, verbal outbursts, self-harm, and negative affect. Notably, self-harm items explain a large proportion of variance independent of irritability. Therefore, their contribution in analyses of treatment effects should be considered. Further study or revision of the ABC-I may improve convergent validity with transdiagnostic formulations of irritability as well as prevent confound from self-harm in treatment studies for irritability in ASD.

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18. Tomoiaga D, Aguiar-Pulido V, Shrestha S, Feinstein P, Levy SE, Mason CE, Rosenfeld JA. Single-cell sperm transcriptomes and variants from fathers of children with and without autism spectrum disorder. NPJ Genom Med ;2020 ;5:14.

The human sperm is one of the smallest cells in the body, but also one of the most important, as it serves as the entire paternal genetic contribution to a child. Investigating RNA and mutations in sperm is especially relevant for diseases such as autism spectrum disorders (ASD), which have been correlated with advanced paternal age. Historically, studies have focused on the assessment of bulk sperm, wherein millions of individual sperm are present and only high-frequency variants can be detected. Using 10x Chromium single-cell sequencing technology, we assessed the transcriptome from >65,000 single spermatozoa across six sperm donors (scSperm-RNA-seq), including two who fathered multiple children with ASD and four fathers of neurotypical children. Using RNA-seq methods for differential expression and variant analysis, we found clusters of sperm mutations in each donor that are indicative of the sperm being produced by different stem cell pools. Finally, we have shown that genetic variations can be found in single sperm.

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19. Wadhera T, Kakkar D. Multiplex temporal measures reflecting neural underpinnings of brain functional connectivity under cognitive load in Autism Spectrum Disorder. Neurol Res ;2020 (Mar 4):1-11.

Methods : Thirty individuals with ASD (11-18years) and thirty Typically Developing (TD) individuals (11-16years) were recruited to perform the mental task. The participants were instructed to flip the shown geometric images mentally and mark their response on a scale. The task-related multivariate EEG activations were analyzed using multiplex temporal Visibility Graphs (VGs) to compute local and global brain network functional connectivity dynamics.Results : With cognitive load (0-back to the 2-back task), the behavioral performance (d’ index and Reaction Time) has reduced in ASD. The brain network has become more segregated and less integrated, reflecting more involvement of intra-regions over inter-regions in ASD. The frequent rerouting in hubs measured by Eigenvector Centrality (EC) indicated the progression of brain trajectory towards ASD. Overall, the neural mechanisms involving hyperactive response in frontal regions, frequent rewiring, and strengthened brain connectivity as a result of learning-induced performance reflected the adaptation to cognitive demands in ASD.Discussion : The correlation between complex graph measures and behavioral domain further reflected that neural metrics could predict the behavioral performance of the individuals in the task. In the future, modeling functional connectivity-based markers have the potential to reflect the brain trajectory alterations, which can detect ASD even before the behavioral manifestations become apparent.

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20. Williamson IO, Elison JT, Wolff JJ, Runge CF. Cost-Effectiveness of MRI-Based Identification of Presymptomatic Autism in a High-Risk Population. Front Psychiatry ;2020 ;11:60.

Biological siblings of children with autism spectrum disorder (ASD) have increased risk of receiving an ASD diagnosis. In the U.S., most children with ASD are diagnosed after the optimal age to initiate early intervention which can reduce symptom severity and improve outcomes. Recent evidence suggests magnetic resonance imaging (MRI) in the first year of life can predict later diagnostic status in high-risk siblings. We investigated whether MRI-based screening is a cost-effective method for assigning early intervention. A hybrid decision tree/Markov model was used to evaluate two MRI-based screening strategies at 6 and 12 months of age. Primary outcomes were costs in U.S. dollars and quality-adjusted life years (QALYs). Results were reported as incremental cost-effectiveness ratios (ICERs). Costs were estimated from societal, health care, and educational perspectives. One-way and probabilistic sensitivity analyses were performed. From a societal perspective, the ICER for MRI-based screening at 6 months was $49,000 per QALY when compared to the status quo, implying that such screening is cost-effective at willingness-to-pay (WTP) thresholds of $50,000-$100,000 per QALY. From the health care and educational perspectives, the ICERs were larger at $99,000 and $76,000 per QALY, respectively. Sensitivity analysis identified that the parameters most influential in affecting cost-effectiveness were the prevalence of ASD and/or co-occurring intellectual disability. MRI specificity also has significant impacts which add to the uncertainty of the results. Future work is needed to determine the sensitivity and, in particular, the specificity of MRI with more certainty. Notably, the cost of the MRI-based screening had the least impact.

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21. Zeglam A, Al-Ksaik S. Hearing testing in autistic spectrum disorder : is it unnecessary in low and middle-income countries ?. East Mediterr Health J ;2020 (Feb 24) ;26(2):176-181.

Background : In low and middle-income countries where the health care is in a weakened state, spending money on unaffordable and probably unnecessary investigations might be substituted by a reliable, simple and more informative tool that can deal with the problem. Aims : To examine current medical practice of measuring auditory brainstem response for all children with autistic spectrum disorder, and assess the value of this test in these children and its applicability in low and middle-income countries such as Libya. Methods : We reviewed the medical records of all children with autistic spectrum disorder who presented to neurodevelopment clinics of Al-Khadra Teaching Hospital, Tripoli, Libya between January 2010 and December 2014. Results : In 71 of 2368 children with autistic spectrum disorder, the family were concerned about their children’s hearing and reaction to loud noises. Auditory brainstem response confirmed that 26 of these 71 children had sensorineural hearing loss. Conclusion : We consider auditory brainstem response measurement to be unnecessary in children with autistic spectrum disorder without clinical signs suggesting hearing impairment and without any parental concerns about hearing.

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