Pubmed du 17/03/20

mardi 17 mars 2020

1. Cheng W, Zhou S, Zhou J, Wang X. Identification of a robust non-coding RNA signature in diagnosing autism spectrum disorder by cross-validation of microarray data from peripheral blood samples. Medicine. 2020 ; 99(11) : e19484.

Novel molecular signatures are needed to improve the early and accurate diagnosis of autism spectrum disorder (ASD), and indicate physicians to provide timely intervention. This study aimed to identify a robust blood non-coding RNA (ncRNA) signature in diagnosing ASD. One hundred eighty six blood samples in the microarray dataset were randomly divided into the training set (n = 112) and validation set (n = 72). Then, the microarray probe expression profile was re-annotated into the expression profile of 4143 ncRNAs though probe sequence mapping. In the training set, least absolute shrinkage and selection operator (LASSO) penalized generalized linear model was adopted to identify the 20-ncRNA signature, and a diagnostic score was calculated for each sample according to the ncRNA expression levels and the model coefficients. The score demonstrated an excellent diagnostic ability for ASD in the training set (area under receiver operating characteristic curve [AUC] = 0.96), validation set (AUC = 0.97) and the overall (AUC = 0.96). Moreover, the blood samples of 23 ASD patients and 23 age- and gender-matched controls were collected as the external validation set, in which the signature also showed a good diagnostic ability for ASD (AUC = 0.96). In subgroup analysis, the signature was also robust when considering the potential confounders of sex, age, and disease subtypes. In comparison with a 55-gene signature deriving from the same dataset, the ncRNA signature showed an obviously better diagnostic ability (AUC : 0.96 vs 0.68, P < .001). In conclusion, this study identified a robust blood ncRNA signature in diagnosing ASD, which might help improve the diagnostic accuracy for ASD in clinical practice.

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2. Costa AP, Loor C, Steffgen G. Suicidality in Adults with Autism Spectrum Disorder : The Role of Depressive Symptomatology, Alexithymia, and Antidepressants. J Autism Dev Disord. 2020.

People with autism spectrum disorder (ASD) have an increased risk of suicidality. However, the risk factors remain under-investigated. This study explored factors that increase suicidality risk in ASD. Through an online survey, 150 adults with ASD were compared to 189 control adults. Autistic traits, depressive symptomatology, alexithymia, and antidepressant intake were assessed on their contribution predicting suicidality. Among people with ASD, 63% scored above the cutoff for high suicidality risk. Increased autistic traits, depressive symptomatology, and antidepressant intake significantly predicted suicidality. Furthermore, among those with high levels of autistic traits, the risk of suicidality was increased if they also had high levels of alexithymia. These results highlight the importance of considering depression, antidepressants, and alexithymia to prevent suicidality in ASD.

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3. da Silveira de Mattos B, Soares MSP, Spohr L, Pedra NS, Teixeira FC, de Souza AA, Stefanello FM, Baldissarelli J, Gamaro GD, Spanevello RM. Quercetin prevents alterations of behavioral parameters, delta-aminolevulinic dehydratase activity and oxidative damage in brain of rats in a prenatal model of autism. Int J Dev Neurosci. 2020.

Autism is a neuropathology characterized by behavioral disorders. Considering that oxidative stress is involved in the pathophysiology of this disease, we evaluated the effects of quercetin, a flavonoid with antioxidant and neuroprotective properties, in an experimental model of autism induced by valproic acid (VPA). Twelve pregnant female rats were divided into four groups (control, quercetin, VPA, VPA+quercetin). Quercetin (50 mg/kg) was administered orally to the animals from gestational days 6.5 to 18.5, and VPA (800 mg/kg) was administered orally in a single dosage on gestational day 12.5. Behavioral tests such as open field, social interaction, and tail flick nociceptive assays were performed on pups between 30 and 40 days old, after which the animals were euthanized. Cerebral cortex, hippocampus, striatum, and cerebellum were collected for evaluation of oxidative stress parameters. The pups exposed to VPA during the gestational period showed reduced weight gain, increased latency in the open field and tail flick tests, reduced time of social interaction, accompanied by changes in oxidative stress parameters mainly in the hippocampus and striatum. Prenatal treatment with quercetin prevented the behavioral changes and damage caused by oxidative stress, possibly due to its antioxidant action. Our findings demonstrated that quercetin has neuroprotective effects in an animal model of autism, suggesting that this natural molecule could be an important therapeutic agent for treatment of autism spectrum disorders.

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4. de Freitas D. The Use of Mental States in an Adult Diagnosed with Autism Spectrum Disorder on Socio-Comunicative and Dialogical Processes. Integrative psychological & behavioral science. 2020.

This work was developed based on the reaserching field named Cultural Psychology which takes into account transformative processes marked by relations/dialogues among I-Others-World in a cultural field that allows and/or restricts people’s possibilities for action. From this point of view, we propose a discussion about the socio-communicative capacity of a person diagnosed with Autism Spectrum Disorder (ASD), focusing on the dialogical capacity of human communication for an idiographic and qualitative analysis on the mental states use of words and attributions from reports collected from semi-structured interviews conducted with an adult person diagnosed with ASD and an adult woman who has no such diagnosis. The interviews focused on apprehending information on the participants’ understanding of the person diagnosed with ASD’s development, therapies carried out and its implications in the life of the person. Our results indicate that the person diagnosed with ASD has a significant deficit in the use of words, which accounts for mental states in socio-communicative processes compared to a person with a typical development. These data point to relevant impairments that the person diagnosed with ASD presents in dialogic processes.

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5. Forgeot d’Arc B, Devaine M, Daunizeau J. Social behavioural adaptation in Autism. PLoS computational biology. 2020 ; 16(3) : e1007700.

Autism is still diagnosed on the basis of subjective assessments of elusive notions such as interpersonal contact and social reciprocity. We propose to decompose reciprocal social interactions in their basic computational constituents. Specifically, we test the assumption that autistic individuals disregard information regarding the stakes of social interactions when adapting to others. We compared 24 adult autistic participants to 24 neurotypical (NT) participants engaging in a repeated dyadic competitive game against artificial agents with calibrated reciprocal adaptation capabilities. Critically, participants were framed to believe either that they were competing against somebody else or that they were playing a gambling game. Only the NT participants did alter their adaptation strategy when they held information regarding others’ competitive incentives, in which case they outperformed the AS group. Computational analyses of trial-by-trial choice sequences show that the behavioural repertoire of autistic people exhibits subnormal flexibility and mentalizing sophistication, especially when information regarding opponents’ incentives was available. These two computational phenotypes yield 79% diagnosis classification accuracy and explain 62% of the severity of social symptoms in autistic participants. Such computational decomposition of the autistic social phenotype may prove relevant for drawing novel diagnostic boundaries and guiding individualized clinical interventions in autism.

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6. Freitag CM, Jensen K, Teufel K, Luh M, Todorova A, Lalk C, Vllasaliu L. [Empirically based developmental and behavioral intervention programs targeting the core symptoms and language development in toddlers and preschool children with autism spectrum disorder]. Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie. 2020 : 1-18.

Empirically based developmental and behavioral intervention programs targeting the core symptoms and language development in toddlers and preschool children with autism spectrum disorder Abstract. This systematic review summarizes findings of articles included in the German AWMF-S3 clinical guideline on early intervention in autism spectrum disorders (ASD). We present the current state-of the art of evidence-based interventions for toddlers and preschool-aged children with ASD, specifically targeting the core symptoms and language development. We included studies on manualized developmental and behavioral interventions for children with ASD aged <7 years according to DSM-III(R), DSM-IV(TR), DSM-5, and ICD-10. The publication dates ranged from 1 January 2011 to 31 August 2018 or as included in the NICE-children guidelines. Studies were included by an iterative hierarchy : systematic review > randomized-controlled trial > clinically controlled trial. Outcome measures were core ASD symptoms and precursor abilities, or language abilities. The interventions were collated by (1) frequency and (2) approach. The studies focused on low-intensive interventions targeting parental synchrony, the child’s initiations, reciprocity, joint attention, play and imitation skills as well as comprehensive interventions. Improvement of core ASD symptoms regarding social communication was observed for low-intensive training of parental synchrony and child’s reciprocity as well as for low-intensive comprehensive developmental interventions implementing natural-learning paradigms. High-frequency discrete trial interventions did not improve social communication. Language abilities improved by comprehensive interventions. In conclusion, intervention recommendations are summarized.

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7. Freitag CM, Poustka L, Kamp-Becker I, Vogeley K, Tebartz van Elst L. [Transition in autism spectrum disorders]. Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie. 2020 : 1-3.

Transition in autism spectrum disorders Abstract. Children and adolescents with autism spectrum disorder (ASD) are regularly seen by child and adolescent psychiatrists. Many diagnostic and therapeutic interventions are available for this age group. However, ASD is a rather unknown disorder in adult services, including psychiatry - despite the chronic course and the individual need for diagnosis, intervention, and support also in adulthood. Transition from childhood into adulthood is a rather complex topic that includes the challenge of mastering education and employment. This article presents these transition-related aspects and recommendations to improve healthcare in Germany.

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8. Guo BQ, Ding SB, Li HB. Blood Biomarker Levels of Methylation Capacity in Autism Spectrum Disorder : A Systematic Review and Meta-analysis. Acta Psychiatr Scand. 2020.

OBJECTIVE : To compare the peripheral blood levels of methionine (Met), S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), and the SAM/SAH ratio (the most core and predictive indices of cellular methylation ability) between patients with autism spectrum disorder (ASD) and control subjects. METHODS : PubMed, EMBASE, PsycINFO, Web of Science, and Cochrane Library were searched from inception to August 2, 2019, without language restriction. The random-effects model was used to summarize effect sizes. RESULTS : We retrieved 1,493 records, of which 22 studies met inclusion criteria. Our overall analyses findings revealed that individuals with ASD had significantly decreased levels of Met (22 studies ; Hedges’ g = -0.62 ; 95% confidence interval [CI] : -0.89, -0.35), SAM (8 studies ; Hedges’ g = -0.60 ; 95% CI : -0.86, -0.34), and the SAM/SAH ratio (8 studies ; Hedges’ g = -0.98 ; 95% CI : -1.30, -0.66) and significantly increased levels of SAH (8 studies ; Hedges’ g = 0.69 ; 95% CI : 0.43, 0.94). The findings of the overall analyses were quite stable after being verified by sensitivity analyses and in agreement with the corresponding outcomes of subgroup analyses. Additionally, our results from meta-analytic techniques confirmed that the effect estimates of this meta-analysis did not originate from publication bias. CONCLUSION : Individuals with ASD have substantially aberrant peripheral blood levels of Met, SAM, SAH, and the SAM/SAH ratio, which supports the association between impaired methylation capacity and ASD. Therefore, further investigations into these indices as potential biomarkers for diagnosis and therapeutic targets of ASD are warranted.

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9. Huang T, Finestack L. Comparing Morphosyntactic Profiles of Children With Developmental Language Disorder or Language Disorder Associated With Autism Spectrum Disorder. American journal of speech-language pathology. 2020 : 1-18.

Purpose Previous cross-population comparisons suggest a considerable overlap in the morphosyntactic profiles of children with developmental language disorder (DLD) and children who experience language disorder associated with autism spectrum disorder (LD-ASD). The goal of this study was to further examine and compare the morphosyntactic profiles of the two populations using both standardized, norm-referenced assessments and language sample analysis. Method We used the Structured Photographic Expressive Language Test-Third Edition (Dawson et al., 2003) and the Index of Productive Syntax (in Applied Psycholinguistics, 11(1), 1990 by Scarborough) to compare the morphosyntactic profiles of 21 children with DLD (5 ;6-8 ;1 [years ;months]) and 15 children with LD-ASD (4 ;4-9 ;8). Results Overall, both groups’ morphosyntactic profiles were not significantly different based on the 26 structures assessed by the Structured Photographic Expressive Language Test-Third Edition. Chi-square analyses identified two structures on which the DLD group outperformed the LD-ASD group (i.e., participle and the conjunction "and"). Likewise, the groups’ morphosyntactic profiles were not significantly different based on the 56 items assessed by the Index of Productive Syntax. Analyses identified only one structure on which the DLD group outperformed the LD-ASD group (i.e., S8 : Infinitive) and four structures on which the LD-ASD group outperformed the DLD group (i.e., Q9 : Why/when/which, etc. ; Q6 : Wh-question with auxiliary, modal, or copula ; Q4 : Wh-question with verb ; and Q2 : Routine question). Conclusions Study results suggest that the morphosyntactic profiles of children with DLD and children with LD-ASD are not significantly different. Results also suggest potential weaknesses on forms that have not been the focus of previous studies. It is important for clinicians to assess each of these forms using both standardized assessments and language sample analysis to gain a full understanding of the language profiles of children with DLD or LD-ASD.

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10. Huntjens A, van den Bosch L, Sizoo B, Kerkhof A, Huibers MJH, van der Gaag M. The effect of dialectical behaviour therapy in autism spectrum patients with suicidality and/ or self-destructive behaviour (DIASS) : study protocol for a multicentre randomised controlled trial. BMC Psychiatry. 2020 ; 20(1) : 127.

BACKGROUND : Many persons with autism spectrum disorder (ASD) are treated in long-term specialised care. In this population, suicidal behaviour troubles patients, families, and specialists in the field because it is difficult to treat. At present, there is no documented effective therapy for suicidal behaviour in ASD (Autism Research 7:507-521, 2014 ; Crisis 35:301-309, 2014). Dialectical Behaviour Therapy (DBT) is an efficacious treatment programme for chronically suicidal and/or self-harm behaviour in patients with Borderline Personality Disorder (J Psychiatry 166:1365-1374, 2014 ; Linehan MM. Cognitive behavioural therapy of borderline personality disorder. 1993). This study will evaluate the efficacy of DBT in persons with ASD and suicidal/ self- destructive behaviour in a multicentre randomised controlled clinical trial. METHOD : One hundred twenty-eight persons with autism and suicidal and/or self-harming behaviour will be recruited from specialised mental healthcare services and randomised into two conditions : 1) the DBT condition in which the participants have weekly individual cognitive behavioural therapy sessions and a 2.5 h skills training group session twice per week during 6 months, and 2) the treatment as usual condition which consists of weekly individual therapy sessions of 30-45 min with a psychotherapist or social worker. Assessments will take place at baseline, at post-treatment (6 months), and after a follow-up period of 12 months. The mediators will also be assessed at 3 months. The primary outcome is the level of suicidal ideation and behaviour. The secondary outcomes are anxiety and social performance, depression, core symptoms of ASD, quality of life, and cost-utility. Emotion regulation and therapeutic alliance are hypothesised to mediate the effects on the primary outcome. DISCUSSION : The results from this study will provide an evaluation of the efficacy of DBT treatment in persons with ASD on suicidal and self-harming behaviour. The study is conducted in routine mental health services which enhances the generalisability of the study results to clinical practice. TRIAL REGISTRATION : ISRCTN96632579. Registered 1 May 2019. Retrospectively registered.

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11. Isabel Alvarez-Mora M, Santos C, Carreno-Gago L, Madrigal I, Isabel Tejada M, Martinez F, Izquierdo-Alvarez S, Garcia-Arumi E, Mila M, Rodriguez-Revenga L. Role of mitochondrial DNA variants in the development of fragile X-associated tremor/ataxia syndrome. Mitochondrion. 2020.

Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late-onset neurodegenerative disorder that appears in at least one-third of adult carriers of FMR1 premutation. Several studies have shown that mitochondrial dysfunction may play a role in neurodegenerative disorders. In order to assess whether mitochondrial DNA variants are involved in the risk of developing FXTAS we evaluated the frequency of mitochondrial haplogroups in 132 unrelated Spanish FMR1 premutation carriers. In addition, the entire mitogenome of 26 FMR1 premutation carriers was sequenced using massively parallel sequencing technologies to analyze mitochondrial DNA variants. Statistical analyses reveal a significant difference in the frequency of T haplogroup. Data analysis of mitochondrial DNA sequences evidence an association between FXTAS and the burden of heteroplasmic variants as well as their distribution. Our results suggest that haplogroup T might be a potential protective factor for FXTAS and that FXTAS individuals accumulate higher rates of heteroplasmic variants in compromised regions of the mitochondrial genome. These results may explain, in part, the role of mitochondrial DNA in the development of FXTAS.

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12. Kamga KK, De Vries J, Nguefack S, Munung SN, Wonkam A. Lived Experiences of Fragile X Syndrome Caregivers : A Scoping Review of Qualitative Studies. Frontiers in neurology. 2020 ; 11 : 128.

Fragile X Syndrome (FXS) is the most common x-linked monogenic cause of Intellectual Disability (ID) and Autism Spectrum Disorder (ASD). Taking care of children with ID is challenging and overwhelming due to the multiple facets of caregiving. This scoping review aimed at summarizing the qualitative literature on the experiences of families living with FXS, identify key themes and determine the gaps in the extant literature. We conducted a literature search in May 2019 using four databases ; PubMed, Web of Science, African-Wide-Information, and Scopus. The keywords used in our search strategy were associated with caregivers, lived experiences, FXS, and qualitative research. All English language articles with full-text reporting were included. Studies associated with other neurodevelopmental conditions and quantitative studies were excluded. We identified 12 out of 203 articles that described the lived experiences of families with FXS. Most articles originated from the United States of America and mothers were the main caregivers. We summarized our findings into four major themes which are ; grief experiences, challenges of living with FXS, coping mechanisms and the need to plan for future outcomes. This scoping review highlights the scarcity of qualitative FXS literature in the African population and frustrations endured by families with FXS due to the low knowledge of FXS by healthcare workers. More research is needed to evaluate the impact of living with FXS in males and fathers.

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13. Nadeem A, Ahmad SF, Al-Harbi NO, Alasmari AF, Al-Ayadhi LY, Alasmari F, Ibrahim KE, Attia SM, Bakheet SA. Upregulation of enzymatic antioxidants in CD4+ T cells of autistic children. Biochimie. 2020.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder which begins in early childhood and presents itself with characteristic symptoms such as repetitive behavioral patterns and problems in speech/social interactions. Adaptive immune system is thought to be involved in the etiology of ASD. T cells orchestrate amplification of inflammation through release of inflammatory mediators ; however, antioxidant defenses have not been evaluated in CD4+ T cells of ASD subjects. In this study we evaluated intracellular enzymatic antioxidant potential through measurement of major antioxidant enzymes (SOD, GPx, and GR) in ASD subjects and typically developing control (TDC) children and further assessed its role in modulation of inflammation. Our data reveal that there is an increase in antioxidant potential (SOD, GPx, GR) in CD4+ T cells of ASD subjects as compared to TDC children at both protein and activity level. Further, this antioxidant increase was associated with upregulated IL-17A levels in CD4+ T cells. This was corroborated by oxidant treatment in vitro. Pretreatment with oxidant, H2O2 led to attenuation of IL-17A levels along with increased oxidative stress in stimulated CD4+ T cells from ASD subjects. These data reveal that antioxidant play an essential role in modulation of inflammatory potential in CD4+ T cells of ASD subjects.

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14. Parr JR, Brice S, Welsh P, Ingham B, Le Couteur A, Evans G, Monaco A, Freeston M, Rodgers J. Treating anxiety in autistic adults : study protocol for the Personalised Anxiety Treatment-Autism (PAT-A(c)) pilot randomised controlled feasibility trial. Trials. 2020 ; 21(1) : 265.

BACKGROUND : Anxiety is common in autistic adults and significantly limits everyday opportunities and quality of life. Evidence-based psychological therapies offered by mental health services often fail to meet the needs of autistic adults. The development of appropriate treatments for mental health conditions and, in particular, anxiety has been identified as a key priority by the autism community. The Personalised Anxiety Treatment-Autism (PAT-A(c)) trial aims to address this need by investigating the feasibility and acceptability of delivering an individualised psychological treatment for anxiety experienced by autistic adults. METHODS/DESIGN : This is a pilot randomised controlled feasibility trial. Up to 40 autistic adults with clinically diagnosed anxiety will be randomised into one of two groups (either the PAT-A(c) intervention or Current Clinical Services Plus two emotional literacy skills sessions). Before randomisation, participants will receive a detailed clinical assessment to inform formulation and guide anxiety treatment. As part of the baseline assessment participants will also identify two personally important ’target situations’ that cause significant anxiety and impact upon their daily life. Based upon the formulation and identified target situations, participants randomised to the PAT-A(c) intervention will receive up to 12 individualised, one-to-one therapy sessions. Initial emotional literacy training sessions will be followed by a bespoke, modular, needs-based treatment approach utilising one or more of the following approaches : Mindfulness, Coping with Uncertainty in Everyday Situations (CUES), social anxiety and graded exposure within Virtual Reality Environments. Participants in the control arm will receive two psycho-educational sessions focussing on understanding and describing emotions and be signposted to healthcare provision as required. Data will be collected through quantitative and qualitative methods. DISCUSSION : This feasibility pilot trial serves as the first stage in the development and evaluation of a manualised personalised, evidence-based psychological therapy treatment for anxiety in autistic adults. Study outcomes will be used to inform an application for a fully powered multi-site intervention trial of adults and young people. TRIAL REGISTRATION : ISRCTN, ID : 15881562. Retrospectively registered on 9 August 2019.

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15. Payne JM, Walsh KS, Pride NA, Haebich KM, Maier A, Chisholm A, Glad DM, Casnar CL, Rouel M, Lorenzo J, Del Castillo A, North KN, Klein-Tasman B. Social skills and autism spectrum disorder symptoms in children with neurofibromatosis type 1 : evidence for clinical trial outcomes. Dev Med Child Neurol. 2020.

AIM : We examined key features of two outcome measures for social dysfunction and autism spectrum disorder traits, the Social Responsiveness Scale, Second Edition (SRS-2) and the Social Skills Improvement System - Rating Scales (SSIS-RS), in children with neurofibromatosis type 1 (NF1). The aim of the study was to provide objective evidence as to which behavioural endpoint should be used in clinical trials. METHOD : Cross-sectional behavioural and demographic data were pooled from four paediatric NF1 tertiary referral centres in Australia and the United States (N=122 ; 65 males, 57 females ; mean age [SD] 9y 2mo [3y], range 3-15y). RESULTS : Distributions of SRS-2 and SSIS-RS scores were unimodal and both yielded deficits, with a higher proportion of severely impaired scores on the SRS-2 (16.4%) compared to the SSIS-RS (8.2%). Pearson’s product-moment correlations revealed that both questionnaires were highly related to each other (r=-0.72, p<0.001) and to measures of adaptive social functioning (both p<0.001). Both questionnaires were significantly related to attention-deficit/hyperactivity disorder symptoms, but only very weakly associated with intelligence. INTERPRETATION : The SRS-2 and SSIS-RS capture social dysfunction associated with NF1, suggesting both may be suitable choices for assessing social outcomes in this population in a clinical trial. However, careful thought needs to be given to the nature of the intervention when selecting either as a primary endpoint.

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16. Pome A, Binda P, Cicchini GM, Burr DC. Pupillometry correlates of visual priming, and their dependency on autistic traits. Journal of vision. 2020 ; 20(3) : 3.

In paradigms of visual search where the search feature (say color) can change from trial to trials, responses are faster for trials where the search color is repeated than when it changes. This is a clear example of "priming" of attention. Here we test whether the priming effects can be revealed by pupillometry, and also whether they are related to autistic-like personality traits, as measured by the Autism-Spectrum Quotient (AQ). We repeated Maljkovic and Nakayama’s (1994) classic priming experiment, asking subjects to identify rapidly the shape of a singleton target defined by color. As expected, reaction times were faster when target color repeated, and the effect accumulated over several trials ; but the magnitude of the effect did not correlate with AQ. Reaction times were also faster when target position was repeated, again independent of AQ. Presentation of stimuli caused the pupil to dilate, and the magnitude of dilation was greater for switched than repeated trials. This effect did not accumulate over trials, and did not correlate with the reaction times difference, suggesting that the two indexes measure independent aspects of the priming phenomenon. Importantly, the amplitude of pupil modulation correlated negatively with AQ, and was significant only for those participants with low AQ. The results confirm that pupillometry can track perceptual and attentional processes, and furnish useful information unobtainable from standard psychophysics, including interesting dependencies on personality traits.

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17. Saure E, Laasonen M, Lepisto-Paisley T, Mikkola K, Algars M, Raevuori A. Characteristics of autism spectrum disorders are associated with longer duration of anorexia nervosa : A systematic review and meta-analysis. The International journal of eating disorders. 2020.

OBJECTIVE : Anorexia nervosa (AN) is associated with neuropsychological characteristics such as impairments in central coherence, cognitive flexibility, and emotion recognition. The same features also manifest in autism spectrum disorders (ASD) and have been suggested to be associated with illness prolongation in AN. The purpose of this meta-analysis was to examine whether pronounced neuropsychological characteristics related to ASD are associated with illness duration in AN. METHOD : Four databases (Medline, PsycINFO, Scopus, PubMed) were searched for eligible studies. Search terms were (a) "anorexia nervosa" and (b) "cognitive flexibility" or "set-shifting" or "central coherence" or "emotion recognition" or "theory of mind". The final sample consisted of 53 studies. Duration of AN was divided into three categories in order to investigate differences between the groups with varying illness duration. The meta-analysis was performed with Review Manager using a random-effects model. RESULTS : Deficits in central coherence, cognitive flexibility, and emotion recognition were pronounced among individuals with prolonged AN compared to those with shorter illness duration. DISCUSSION : A prolonged course of AN appears to be associated with underlying neuropsychological characteristics that are also distinctive to ASD. Neuropsychological impairments may lead to prolonged AN, and prolonged illness may contribute to the subsequent "neurological scar effect," further strengthening these impairments.

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18. Thompson C, McDonald J, Kidd T, Falkmer T, Bolte S, Girdler S. "I don’t want to be a patient" : Peer mentoring partnership fosters communication for autistic university students. Scandinavian journal of occupational therapy. 2020 : 1-16.

Background : Despite recognition of the benefits of post-school education in improving life outcomes for autistic adults their university completion rates remain low.Aim : To explore the experiences of undergraduate autistic university students participating in specialist peer mentoring (SPM) to identify active ingredients in the peer mentoring process and to examine the impact of SPM on social communication.Material and method : A total of 30 (8 female ; M age = 22.3 ; SD = 6.7) undergraduate autistic university students engaged in SPM participated in this study. A quantitative pre-test post-test design examined changes in autistic traits. In parallel, the experiences of participating in SPM were explored through semi-structured interviews.Results : Improvements were noted at post-test on the Social Responsiveness Scale-2 total score p = 0.02), and its Social Communication, (p = 0.03) and Social Motivation (p = 0.03) sub-scales. Four themes emerged from the interviews : Developing Partnership and Understanding, Modelling and Practising Communication, Psychological Support and Grading and Planning Skills.Conclusions : These results indicated that the mentor-mentee partnership was a crucial active ingredient of SPM. This partnership appeared to modify social cognition and motivation for autistic university students through modelling and practising communication.Significance : These results demonstrate that SPM can support participation at university for autistic university students.

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