Pubmed du 03/06/09

jeudi 4 juin 2009

1. Gerrard S, Rugg G. Sensory Impairments and Autism : A Re-Examination of Causal Modelling. J Autism Dev Disord ;2009 (Jun 2)

2. Giovannini L, Jacomuzzi AC, Bruno N, Semenza C, Surian L. Distance perception in autism and typical development. Perception ;2009 ;38(3):429-441.

Children with autism and typically developing children walked blindfolded to a previously seen target (blindwalking task) and matched the frontal to the sagittal extent of a pattern formed by ropes on the ground (L-matching task). All participants were accurate in the blindwalking task. Children with autism were also very accurate in the matching task. By contrast, in the matching task typically developing children made substantial underestimations that were inversely correlated with age. These findings support models that posit independent representations for the egocentric distance to a target location and for the spatial extent to a target object relative to the other spatial extents. These latter representations involve a form of large-scale pattern perception that may mature more slowly than representations of egocentric distance and develop atypically in autism.

3. Johnson WG, Buyske S, Mars AE, Sreenath M, Stenroos ES, Williams TA, Stein R, Lambert GH. HLA-DR4 as a Risk Allele for Autism Acting in Mothers of Probands Possibly During Pregnancy. Arch Pediatr Adolesc Med ;2009 (Jun) ;163(6):542-546.

OBJECTIVES : To test whether HLA-DR4 acts in the mother, possibly during pregnancy, to contribute to the phenotype of autistic disorder in her fetus. DESIGN : Transmission disequilibrium testing in case mothers and maternal grandparents. SETTING : Previous studies have consistently shown increased frequency of HLA-DR4 in probands with autism and their mothers, but not their fathers. However, this has been documented only in case-control studies and not by a more direct study design to determine whether HLA-DR4 acts in mothers during pregnancy to contribute to autism in their affected offspring. PARTICIPANTS : We genotyped for HLA-DR alleles in members of 31 families with parents and maternal grandparents. Probands with autism were tested using the Autism Diagnostic Observation Schedule-Western Psychological Services and Autism Diagnostic Interview, Revised. There was 80% power to detect an odds ratio of 3.6. Participants were all families from New Jersey and were similar in number to earlier studies of autism and HLA-DR4. OUTCOME MEASURES : Analysis was by standard transmission disequilibrium testing. As a secondary test we examined the possibility of maternal imprinting. RESULTS : Significant transmission disequilibrium for HLA-DR4 was seen (odds ratio, 4.67 ; 95% confidence interval, 1.34-16.24 ; P = .008) for transmissions from maternal grandparents to mothers of probands, supporting a role for HLA-DR4 as an autism risk factor acting in mothers during pregnancy. Transmission disequilibrium was not seen for HLA-DR4 transmissions from parents to probands or from mothers to probands. CONCLUSIONS : The HLA-DR4 gene may act in mothers of children with autism during pregnancy to contribute to autism in their offspring. Further studies are required to confirm these findings.

4. King BH, Hollander E, Sikich L, McCracken JT, Scahill L, Bregman JD, Donnelly CL, Anagnostou E, Dukes K, Sullivan L, Hirtz D, Wagner A, Ritz L. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior : citalopram ineffective in children with autism. Arch Gen Psychiatry ;2009 (Jun) ;66(6):583-590.STAART Psychopharmacology Network

CONTEXT : Selective serotonin reuptake inhibitors are widely prescribed for children with autism spectrum disorders. OBJECTIVES : To determine the efficacy and safety of citalopram hydrobromide therapy for repetitive behavior in children with autism spectrum disorders. DESIGN : National Institutes of Health-sponsored randomized controlled trial. SETTING : Six academic centers, including Mount Sinai School of Medicine, North Shore-Long Island Jewish Health System, University of North Carolina at Chapel Hill, University of California at Los Angeles, Yale University, and Dartmouth Medical School. PARTICIPANTS : One hundred forty-nine volunteers 5 to 17 years old (mean [SD] age, 9.4 [3.1] years) were randomized to receive citalopram (n = 73) or placebo (n = 76). Participants had autistic spectrum disorders, Asperger disorder, or pervasive developmental disorder, not otherwise specified ; had illness severity ratings of at least moderate on the Clinical Global Impressions, Severity of Illness Scale ; and scored at least moderate on compulsive behaviors measured with the Children’s Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders. INTERVENTIONS : Twelve weeks of citalopram hydrobromide (10 mg/5 mL) or placebo. The mean (SD) maximum dosage of citalopram hydrobromide was 16.5 (6.5) mg/d by mouth (maximum, 20 mg/d). MAIN OUTCOME MEASURES : Positive response was defined by a score of much improved or very much improved on the Clinical Global Impressions, Improvement subscale. An important secondary outcome was the score on the Children’s Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders. Adverse events were systematically elicited using the Safety Monitoring Uniform Report Form. RESULTS : There was no significant difference in the rate of positive response on the Clinical Global Impressions, Improvement subscale between the citalopram-treated group (32.9%) and the placebo group (34.2%) (relative risk, 0.96 ; 95% confidence interval, 0.61-1.51 ; P > .99). There was no difference in score reduction on the Children’s Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders from baseline (mean [SD], -2.0 [3.4] points for the citalopram-treated group and -1.9 [2.5] points for the placebo group ; P = .81). Citalopram use was significantly more likely to be associated with adverse events, particularly increased energy level, impulsiveness, decreased concentration, hyperactivity, stereotypy, diarrhea, insomnia, and dry skin or pruritus. CONCLUSION : Results of this trial do not support the use of citalopram for the treatment of repetitive behavior in children and adolescents with autism spectrum disorders. Trial Registration Identifier : NCT00086645.

5. Koegel RL, Shirotova L, Koegel LK. Brief Report : Using Individualized Orienting Cues to Facilitate First-Word Acquisition in Non-Responders with Autism. J Autism Dev Disord ;2009 (Jun 2)

6. Martinez-Pedraza Fde L, Carter AS. Autism spectrum disorders in young children. Child Adolesc Psychiatr Clin N Am ;2009 (Jul) ;18(3):645-663.

Retrospective research studies, videotape analyses of children later diagnosed with autism spectrum disorders (ASD), and recent studies on younger siblings of children diagnosed with ASD, at high-risk of ASD, provide evidence of the early signs of ASD in children as young as 12 months. This article provides a review of early identification, diagnostic assessment, and treatment for young children (0-5 years old) with ASD. Several screening tools as well as comprehensive assessment measures are described. The authors also discuss how the family context is affected by the diagnosis, in terms of adaptation to the diagnosis and to treatment. Finally, the authors present a brief review of interventions for young children with ASD.

7. Selkirk CG, McCarthy Veach P, Lian F, Schimmenti L, Leroy BS. Parents’ Perceptions of Autism Spectrum Disorder Etiology and Recurrence Risk and Effects of their Perceptions on Family Planning : Recommendations for Genetic Counselors. J Genet Couns ;2009 (Jun 2)

8. Volkmar FR. Citalopram treatment in children with autism spectrum disorders and high levels of repetitive behavior. Arch Gen Psychiatry ;2009 (Jun) ;66(6):581-582.

9. Zetterstrom R. Autism’s false prophets : Bad science, risky medicine, and the search for a cure. Acta Paediatr ;2009 (May 25)


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