Pubmed du 1/07/09

vendredi 3 juillet 2009

1. Akdemir D, Pehlivanturk B, Unal F, Ozusta S. [Comparison of attachment-related social behaviors in autistic disorder and developmental disability.]. Turk Psikiyatri Derg ;2009 (Summer) ;20(2):105-117.Otistik Bozukluk ve Gelisim Geriliginde Baglanmaya Yonelik Sosyal Davranislarin Karsilastirilmasi.

OBJECTIVE : This study examined social behaviors related to attachment in children with autistic disorder and the differences in these behaviors from those observed in developmentally disabled children. Additionally, we aimed to investigate the relationship between attachment behaviors and clinical variables, such as age, cognitive development, severity of autism, language development, and mothers’ attachment styles. METHOD : The study group consisted of 19 children with autistic disorder (mean age : 37.9 +/- 6.8 months) and the control group consisted of 18 developmentally disabled children without autistic disorder that were matched with respect to age, gender, and cognitive development. The Childhood Autism Rating Scale (CARS) was administered to all the children by two child psychiatrists. Mothers completed the Relationships Scale Questionnaire (RSQ). Cognitive development of the children was assessed with the Stanford-Binet intelligence scale. Attachment behaviors of the children were evaluated with a modified Strange Situation Procedure (SSP). RESULTS : Attachment behaviors in the children with autistic disorder and in the children with developmental disabilities were similar. In contrast to the developmentally disabled group, the children with autistic disorder stayed closer toward their mothers compared with their responses to strangers. In the autistic disorder group, attachment behaviors were not associated with age, intelligence quotient, or mothers’ attachment styles ; however, a significant relationship between the severity of autism and the presence of speech was observed. CONCLUSION : Parents’ understanding of the attachment needs and the attachment behaviors of their autistic children in the early stages of the disorder may lead to more secure attachment relationships and improved social development.

2. Al-Gadani Y, El-Ansary A, Attas O, Al-Ayadhi L. Metabolic biomarkers related to oxidative stress and antioxidant status in Saudi autistic children. Clin Biochem ;2009 (Jul) ;42(10-11):1032-1040.

OBJECTIVE : Measurement of oxidative stress and antioxidant-related parameters (enzymatic and non-enzymatic) in Saudi autistic children. DESIGN AND METHODS : 30 autistic children (22 males and 8 females) aged 3-15 years (25/30 of these were below 8 years old), and 30 healthy children as control group were included in this study. Levels of lipid peroxides, vitamin E, vitamin C, glutathione together with enzymatic activities of glutathione peroxidase (GSH-Px), and catalase were determined in plasma while superoxide dismutase (SOD was measured in red blood cells of both groups. RESULTS : Lipid peroxidation was found to be significantly higher in autistic compared to control Saudi children. On the other hand, vitamin E and glutathione were remarkably lower in autistic patients while vitamin C shows non-significant lower values. Regarding the enzymatic antioxidants, both glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were significantly higher in autistic compared to control while catalase recorded more or less similar activities in both groups. CONCLUSION : Saudi autistic children are under H(2)O(2) stress due to GSH depletion, over expression of SOD together with the unchanged catalase enzyme. This could be helpful in the early diagnosis of young autistic patients and suggesting the possibility of antioxidant supplementation for the early intervention with autistic children.

3. Al-Mosalem OA, El-Ansary A, Attas O, Al-Ayadhi L. Metabolic biomarkers related to energy metabolism in Saudi autistic children. Clin Biochem ;2009 (Jul) ;42(10-11):949-957.

OBJECTIVES : Energy metabolism is usually manipulated in many neurodegenerative diseases. Autism is considered a definable systemic disorder resulting in a number of diverse factors that may affect the brain development and functions both pre and post natal. The increased prevalence of autism will have enormous future public implications and has stimulated intense research into potential etiologic factors. This study aims to establish a connection between autism and the deterioration accompanied it, especially in the brain cognitive areas through a postulation of energy manipulation. MATERIALS AND METHODS : The biochemical changes in activities of enzymes and pathways that participate in the production of ATP as the most important high-energy compound needed by the human brain were measured in Saudi autistic children. Na(+)/K(+)ATPase, ectonucleotidases (NTPDases) (ADPase and ATPase) and creatine kinase (CK), were assessed in plasma of 30 Saudi autistic patients and compared to 30 age-matching control samples. In addition, adenosine mono, di and trinucleotides (ATP, ADP, and AMP) were measured calorimetrically in the red blood cells of both groups and the adenylate energy charge (AEC) was calculated. Moreover, lactate concentration in plasma of both groups was monitored. RESULTS : The obtained data recorded 148.77% and 72.35% higher activities of Na(+)/K(+)ATPase and CK respectively in autistic patients which prove the impairment of energy metabolism in these children compared to age and sex matching healthy controls. While ADPase was significantly higher in autistic patients, ATPase were non-significantly elevated compared to control. In spite of the significant increase of Na(+)/K(+)ATPase activity in autistic patients, there was no significant difference in the levels of ATP, ADP, and AMP in both groups and the calculated AEC values were 0.814+/-0.094 and 0.806+/-0.081 for autistic and control groups respectively. The unchanged AEC value in autistic patients was easily correlated with the induced activity of CK and ADPase as two enzymes playing a critical role in the stabilization of AEC. Lactate as an important energy metabolite for the brain was significantly higher in autistic patients compared to control showing about 40% increase. CONCLUSION : The present study confirmed the impairment of energy metabolism in Saudi autistic patients which could be correlated to the oxidative stress previously recorded in the same investigated samples. The identification of biochemical markers related to autism would be advantageous for earlier clinical diagnosis and intervention.

4. Anderson BM, Schnetz-Boutaud NC, Bartlett J, Wotawa AM, Wright HH, Abramson RK, Cuccaro ML, Gilbert JR, Pericak-Vance MA, Haines JL. Examination of association of genes in the serotonin system to autism. Neurogenetics ;2009 (Jul) ;10(3):209-216.

Autism is characterized as one of the pervasive developmental disorders, a spectrum of often severe behavioral and cognitive disturbances of early development. The high heritability of autism has driven multiple efforts to identify genetic variation that increases autism susceptibility. Numerous studies have suggested that variation in peripheral and central metabolism of serotonin (5-hydroxytryptamine) may play a role in the pathophysiology of autism. We screened 403 autism families for 45 single nucleotide polymorphisms in ten serotonin pathway candidate genes. Although genome-wide linkage scans in autism have provided support for linkage to various loci located within the serotonin pathway, our study does not provide strong evidence for linkage to any specific gene within the pathway. The most significant association (p = 0.0002 ; p = 0.02 after correcting for multiple comparisons) was found at rs1150220 (HTR3A) located on chromosome 11 ( approximately 113 Mb). To test specifically for multilocus effects, multifactor dimensionality reduction was employed, and a significant two-way interaction (p value = 0.01) was found between rs10830962, near MTNR1B (chromosome11 ; 92,338,075 bp), and rs1007631, near SLC7A5 (chromosome16 ; 86,413,596 bp). These data suggest that variation within genes on the serotonin pathway, particularly HTR3A, may have modest effects on autism risk.

5. Anderson GM. Conceptualizing autism : the role for emergence. J Am Acad Child Adolesc Psychiatry ;2009 (Jul) ;48(7):688-691.

6. Crane L, Goddard L, Pring L. Specific and general autobiographical knowledge in adults with autism spectrum disorders : the role of personal goals. Memory ;2009 (Jul) ;17(5):557-576.

Autobiographical knowledge is stored hierarchically, at both specific and general levels of representation. It has also been proposed that the self is the structure around which autobiographical memories are organised. The current series of studies assessed whether the autobiographical memory difficulties observed in adults with autism spectrum disorders (ASD) could be due to problems in using the self as an effective memory cue. A series of cueing paradigms were used to assess the accessibility of both specific and general autobiographical knowledge relating to (i) currently pursued goals (either high or low in self-concordance) and (ii) goals that participants were not currently pursuing. Results demonstrated that while event-specific knowledge was impaired in the ASD group, general event knowledge appeared relatively intact. Moreover, while both event-specific and general event knowledge were organised around goals of the self in control participants, a corresponding relationship was only observed for general event knowledge in the ASD group.

7. David FJ, Baranek GT, Giuliani CA, Mercer VS, Poe MD, Thorpe DE. A pilot study : coordination of precision grip in children and adolescents with high functioning autism. Pediatr Phys Ther ;2009 (Summer) ;21(2):205-211.

PURPOSE : This pilot study compared temporal coordination during a precision grip task between 13 children and adolescents with autism spectrum disorders (ASD) who were high functioning and 13 peers with typical development. METHODS : Temporal coordination between grip and load forces was measured using latency between onset of grip and load forces, grip force at onset of load force, peak grip force (PGF), and time to PGF. RESULTS : Compared with peers with typical development, participants with ASD demonstrated prolonged latency between grip and load forces, elevated grip force at onset of load force, and increased movement variability. PGF and time to PGF were not significantly different between the 2 groups. CONCLUSIONS : These findings indicate temporal dyscoordination in participants with ASD. The findings also enhance our understanding of motor coordination deficits in persons with ASD and have theoretical as well as clinical implications.

8. Emck C, Bosscher R, Beek P, Doreleijers T. Gross motor performance and self-perceived motor competence in children with emotional, behavioural, and pervasive developmental disorders : a review. Dev Med Child Neurol ;2009 (Jul) ;51(7):501-517.

AIMS : Motor performance and self-perceived motor competence have a great impact on the psychosocial development of children in general. In this review, empirical studies of gross motor performance and self-perception of motor competence in children with emotional (depression and anxiety), behavioural, and pervasive developmental disorders are scrutinized, with the objective of identifying specific motor characteristics that may be relevant to clinical practice. METHOD : A systematic search of studies published between 1997 and 2007 was performed using nine search engines. RESULTS : Children in all three categories (emotional, behavioural, and pervasive developmental disorders) exhibit poor gross motor performance and problematic self-perception of motor competence, with certain indications of disorder-specific characteristics. In particular, children with emotional disorders have balance problems and self-perceived motor incompetence ; children with behavioural disorders show poor ball skills and tend to overestimate their motor performance ; children with pervasive developmental disorders demonstrate poor gross motor performance and self-perceived motor incompetence. As a result, children with developmental and emotional disorders are restricted in participating in games and play, which may lead to inactive lifestyles and further disruption of their psychosocial and physical development. INTERPRETATION : Motor problems need more, to some extent disorder-specific, attention in clinical practice than has been provided to date.

9. Estes A, Munson J, Dawson G, Koehler E, Zhou XH, Abbott R. Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism ;2009 (Jul) ;13(4):375-387.

Parents of children with developmental disabilities, particularly autism spectrum disorders (ASDs), are at risk for high levels of distress. The factors contributing to this are unclear. This study investigated how child characteristics influence maternal parenting stress and psychological distress. Participants consisted of mothers and developmental-age matched preschool-aged children with ASD (N = 51) and developmental delay without autism (DD) ( N = 22). Evidence for higher levels of parenting stress and psychological distress was found in mothers in the ASD group compared to the DD group. Children’s problem behavior was associated with increased parenting stress and psychological distress in mothers in the ASD and DD groups. This relationship was stronger in the DD group. Daily living skills were not related to parenting stress or psychological distress. Results suggest clinical services aiming to support parents should include a focus on reducing problem behaviors in children with developmental disabilities.

10. Freitag CM, Agelopoulos K, Huy E, Rothermundt M, Krakowitzky P, Meyer J, Deckert J, von Gontard A, Hohoff C. Adenosine A(2A) receptor gene (ADORA2A) variants may increase autistic symptoms and anxiety in autism spectrum disorder. Eur Child Adolesc Psychiatry ;2009 (Jun 30)

Autism spectrum disorders (ASDs) are heterogeneous disorders presenting with increased rates of anxiety. The adenosine A(2A) receptor gene (ADORA2A) is associated with panic disorder and is located on chromosome 22q11.23. Its gene product, the adenosine A(2A) receptor, is strongly expressed in the caudate nucleus, which also is involved in ASD. As autistic symptoms are increased in individuals with 22q11.2 deletion syndrome, and large 22q11.2 deletions and duplications have been observed in ASD individuals, in this study, 98 individuals with ASD and 234 control individuals were genotyped for eight single-nucleotide polymorphisms in ADORA2A. Nominal association with the disorder was observed for rs2236624-CC, and phenotypic variability in ASD symptoms was influenced by rs3761422, rs5751876 and rs35320474. In addition, association of ADORA2A variants with anxiety was replicated for individuals with ASD. Findings point toward a possible mediating role of ADORA2A variants on phenotypic expression in ASD that need to be replicated in a larger sample.

11. Gaigg SB, Bowler DM. Illusory memories of emotionally charged words in autism spectrum disorder : further evidence for atypical emotion processing outside the social domain. J Autism Dev Disord ;2009 (Jul) ;39(7):1031-1038.

Recent evidence suggests that individuals with ASD may not accumulate distinct representations of emotional information throughout development. On the basis of this observation we predicted that such individuals would not be any less likely to falsely remember emotionally significant as compared to neutral words when such illusory memories are induced by asking participants to study lists of words that are orthographically associated to these words. Our findings showed that typical participants are far less likely to experience illusory memories of emotionally charged as compared to neutral words. Individuals with ASD, on the other hand, did not exhibit this emotional modulation of false memories. We discuss this finding in relation to the role of emotional processing atypicalities in ASD.

12. Gardener H, Spiegelman D, Buka SL. Prenatal risk factors for autism : comprehensive meta-analysis. Br J Psychiatry ;2009 (Jul) ;195(1):7-14.

BACKGROUND : The aetiology of autism is unknown, although prenatal exposures have been the focus of epidemiological research for over 40 years. AIMS : To provide the first quantitative review and meta-analysis of the association between maternal pregnancy complications and pregnancy-related factors and risk of autism. METHOD : PubMed, Embase and PsycINFO databases were searched for epidemiological studies that examined the association between pregnancy-related factors and autism. Forty studies were eligible for inclusion in the meta-analysis. Summary effect estimates were calculated for factors examined in multiple studies. RESULTS : Over 50 prenatal factors have been examined. The factors associated with autism risk in the meta-analysis were advanced parental age at birth, maternal prenatal medication use, bleeding, gestational diabetes, being first born v. third or later, and having a mother born abroad. The factors with the strongest evidence against a role in autism risk included previous fetal loss and maternal hypertension, proteinuria, pre-eclampsia and swelling. CONCLUSIONS : There is insufficient evidence to implicate any one prenatal factor in autism aetiology, although there is some evidence to suggest that exposure to pregnancy complications may increase the risk.

13. Genuis SJ, Bouchard TP. Celiac Disease Presenting as Autism. J Child Neurol ;2009 (Jun 29)

Gluten-restricted diets have become increasingly popular among parents seeking treatment for children diagnosed with autism. Some of the reported response to celiac diets in children with autism may be related to amelioration of nutritional deficiency resulting from undiagnosed gluten sensitivity and consequent malabsorption. A case is presented of a 5-year-old boy diagnosed with severe autism at a specialty clinic for autistic spectrum disorders. After initial investigation suggested underlying celiac disease and varied nutrient deficiencies, a gluten-free diet was instituted along with dietary and supplemental measures to secure nutritional sufficiency. The patient’s gastrointestinal symptoms rapidly resolved, and signs and symptoms suggestive of autism progressively abated. This case is an example of a common malabsorption syndrome associated with central nervous system dysfunction and suggests that in some contexts, nutritional deficiency may be a determinant of developmental delay. It is recommended that all children with neurodevelopmental problems be assessed for nutritional deficiency and malabsorption syndromes.

14. Glazebrook C, Gonzalez D, Hansen S, Elliott D. The role of vision for online control of manual aiming movements in persons with autism spectrum disorders. Autism ;2009 (Jul) ;13(4):411-433.

Recent studies suggest motor skills are not entirely spared in individuals with an autism spectrum disorder (ASD). Previous reports demonstrated that young adults with ASD were able to land accurately on a target despite increased temporal and spatial variability during their movement. This study explored how a group of adolescents and young adults with an ASD used vision and proprioception to land successfully on one of two targets. Participants performed eye movements and/or manual reaching movements, either with or without vision. Although eye movements were executed in a similar timeframe, participants with ASD took longer to plan and execute manual reaching movements. They also exhibited significantly greater variability during eye and hand movements, but were able to land on the target regardless of the vision condition. In general, individuals with autism used vision and proprioception. However, they took considerably more time to perform movements that required greater visual-proprioceptive integration.

15. Golnik AE, Ireland M. Complementary alternative medicine for children with autism : a physician survey. J Autism Dev Disord ;2009 (Jul) ;39(7):996-1005.

Previous studies suggest over half of children with autism are using complementary alternative medicine (CAM). In this study, physicians responded (n = 539, 19% response rate) to a survey regarding CAM use in children with autism. Physicians encouraged multi-vitamins (49%), essential fatty acids (25%), melatonin (25%) and probiotics (19%) and discouraged withholding immunizations (76%), chelation (61%), anti-infectives (57%), delaying immunizations (55%) and secretin (43%). Physicians encouraging CAM were more likely to desire CAM training, inquire about CAM use, be female, be younger, and report greater autism visits, autism education and CAM knowledge. Physicians were more likely to desire CAM training, inquire about CAM and view CAM as a challenge for children with autism compared to children with other neurodevelopmental and chronic/complex conditions.

16. Goodlin-Jones B, Schwichtenberg AJ, Iosif AM, Tang K, Liu J, Anders TF. Six-Month Persistence of Sleep Problems in Young Children With Autism, Developmental Delay, and Typical Development. J Am Acad Child Adolesc Psychiatry ;2009 (Jun 26)

OBJECTIVE :: This study examined the persistence of sleep problems in preschool children with autism and two matched comparison groups : children with developmental delay without autism and typically developing children. Sleep problems were defined subjectively by parent report, by the Children’s Sleep Habits Questionnaire (CSHQ), and objectively by quantitative Research Diagnostic Criteria (RDC) derived from actigraphic recordings. METHOD :: Children were studied on three occasions, each separated by a 3-month interval. At each assessment, the children were recorded actigraphically for 1 week, and parents completed sleep-wake diaries and the CSHQ. Descriptive statistics and odds ratios were used to assess the occurrence and stability of sleep problems within children and across groups and to explore how actigraph- and CSHQ-defined sleep problems affect parental sleep problem reports. RESULTS :: Parent reports of a generic sleep problem were more prevalent than RDC- and CSHQ-defined sleep problems, especially for children with neurodevelopmental disorders. For all groups, objectively measured sleep problems were rarely persistent during the 6-month period. The children in both neurodevelopmental groups, however, had more sleep problems on one or two occasions, using actigraph and the CSHQ, than typically developing children. CONCLUSIONS :: Objective and subjective measures of sleep problems in preschool-aged children produce different results. In a community sample, the rate of actigraph- and CSHQ-defined sleep problems in children with autism did not differ from rates for typically developing children, although the parent report of a generic sleep problem was significantly greater.

17. Grezes J, Wicker B, Berthoz S, de Gelder B. A failure to grasp the affective meaning of actions in autism spectrum disorder subjects. Neuropsychologia ;2009 (Jul) ;47(8-9):1816-1825.

The ability to grasp emotional messages in everyday gestures and respond to them is at the core of successful social communication. The hypothesis that abnormalities in socio-emotional behavior in people with autism are linked to a failure to grasp emotional significance conveyed by gestures was explored. We measured brain activity using fMRI during perception of fearful or neutral actions and showed that whereas similar activation of brain regions known to play a role in action perception was revealed in both autistics and controls, autistics failed to activate amygdala, inferior frontal gyrus and premotor cortex when viewing gestures expressing fear. Our results support the notion that dysfunctions in this network may contribute significantly to the characteristic communicative impairments documented in autism.

18. Grinker RR, Leventhal BL. Estimating the incidence of autism. Epidemiology ;2009 (Jul) ;20(4):622-623 ; author reply 623-624.

19. Guttmann-Steinmetz S, Gadow KD, Devincent CJ. Oppositional defiant and conduct disorder behaviors in boys with autism spectrum disorder with and without attention-deficit hyperactivity disorder versus several comparison samples. J Autism Dev Disord ;2009 (Jul) ;39(7):976-985.

We compared disruptive behaviors in boys with either autism spectrum disorder (ASD) plus ADHD (n = 74), chronic multiple tic disorder plus ADHD (n = 47), ADHD Only (n = 59), or ASD Only (n = 107). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 including parent- (n = 168) and teacher-rated (n = 173) community controls. Parents rated children in the three ADHD groups comparably for each symptom of oppositional defiant disorder (ODD) and conduct disorder. Teacher ratings indicated that the ASD + ADHD group evidenced a unique pattern of ODD symptom severity, differentiating them from the other ADHD groups, and from the ASD Only group. The clinical features of ASD appear to influence co-morbid, DSM-IV-defined ODD, with implications for nosology.

20. Henderson HA, Zahka NE, Kojkowski NM, Inge AP, Schwartz CB, Hileman CM, Coman DC, Mundy PC. Self-referenced memory, social cognition, and symptom presentation in autism. J Child Psychol Psychiatry ;2009 (Jul) ;50(7):853-861.

BACKGROUND : We examined performance on a self-referenced memory (SRM) task for higher-functioning children with autism (HFA) and a matched comparison group. SRM performance was examined in relation to symptom severity and social cognitive tests of mentalizing. METHOD : Sixty-two children (31 HFA, 31 comparison ; 8-16 years) completed a SRM task in which they read a list of words and decided whether the word described something about them, something about Harry Potter, or contained a certain number of letters. They then identified words that were familiar from a longer list. Dependent measures were memory performance (d’) in each of the three encoding conditions as well as a self-memory bias score (d’ self-d’ other). Children completed The Strange Stories Task and The Children’s Eyes Test as measures of social cognition. Parents completed the SCQ and ASSQ as measures of symptom severity. RESULTS : Children in the comparison sample showed the standard SRM effect in which they recognized significantly more self-referenced words relative to words in the other-referenced and letter conditions. In contrast, HFA children showed comparable rates of recognition for self- and other-referenced words. For all children, SRM performance improved with age and enhanced SRM performance was related to lower levels of social problems. These associations were not accounted for by performance on the mentalizing tasks. CONCLUSIONS : Children with HFA did not show the standard enhanced processing of self- vs. other-relevant information. Individual differences in the tendency to preferentially process self-relevant information may be associated with social cognitive processes that serve to modify the expression of social symptoms in children with autism.

21. Jovanovic-Privrodski JD, Kavecan, II, Obrenovic MR, Buonadonna LA, Bukvic NM. Autism and hypoplastic corpus callosum in a case of monocentric marker chromosome 15. Pediatr Neurol ;2009 (Jul) ;41(1):65-67.

An 8-year-old boy was diagnosed with autism, along with development delay, seizures, and hypoplastic corpus callosum. His karyotype was 47, XY, +mar.ish (15) (D15Z1+, SNRPN+, GABRB3+, PML-(de novo ?). The supernumerary marker chromosome 15 with euchromatin was monosatellited and monocentric. Although autism, seizures, and mental and developmental retardation are not rare in association with a dicentric, bisatellited supernumerary marker chromosome 15, the present case is novel for a monocentric, monosatellited supernumerary marker chromosome 15 and the additional feature of hypoplastic corpus callosum. The present case provides support for the hypotheses that additional copies of different segments of proximal 15q are related to autism and to malformations of corpus callosum.

22. Kim J, Wigram T, Gold C. Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy. Autism ;2009 (Jul) ;13(4):389-409.

Through behavioural analysis, this study investigated the social-motivational aspects of musical interaction between the child and the therapist in improvisational music therapy by measuring emotional, motivational and interpersonal responsiveness in children with autism during joint engagement episodes. The randomized controlled study (n = 10) employed a single subject comparison design in two different conditions, improvisational music therapy and toy play sessions, and DVD analysis of sessions. Improvisational music therapy produced markedly more and longer events of ;joy’, ;emotional synchronicity’ and ;initiation of engagement’ behaviours in the children than toy play sessions. In response to the therapist’s interpersonal demands, ;compliant (positive) responses’ were observed more in music therapy than in toy play sessions, and ;no responses’ were twice as frequent in toy play sessions as in music therapy. The results of this exploratory study found significant evidence supporting the value of music therapy in promoting social, emotional and motivational development in children with autism.

23. Kleinhans NM, Richards T, Weaver KE, Liang O, Dawson G, Aylward E. Brief report : biochemical correlates of clinical impairment in high functioning autism and Asperger’s disorder. J Autism Dev Disord ;2009 (Jul) ;39(7):1079-1086.

Amygdala dysfunction has been proposed as a critical contributor to social impairment in autism spectrum disorders (ASD). The current study investigated biochemical abnormalities in the amygdala in 20 high functioning adults with autistic disorder or Asperger’s disorder and 19 typically developing adults matched on age and IQ. Magnetic resonance spectroscopy was used to measure N-acetyl aspartate (NAA), creatine/phosphocreatine (Cre), choline/choline containing compounds (Cho), and Myoinositol (mI) in the right and left amygdala. There were no significant between-group differences in any of the metabolites. However, NAA and Cre levels were significantly correlated to clinical ratings on the Autism Diagnostic Interview-Revised. This suggests that altered metabolite levels in the amygdala may be associated with a more severe early developmental course in ASD.

24. Landry O, Mitchell PL, Burack JA. Orienting of visual attention among persons with autism spectrum disorders : reading versus responding to symbolic cues. J Child Psychol Psychiatry ;2009 (Jul) ;50(7):862-870.

BACKGROUND : Are persons with autism spectrum disorders (ASD) slower than typically developing individuals to read the meaning of a symbolic cue in a visual orienting paradigm ? METHODS : Participants with ASD (n = 18) and performance mental age (PMA) matched typically developing children (n = 16) completed two endogenous orienting conditions in which the cue exposure time and response preparation time were manipulated within a consistent series of cue-target stimulus onset asynchronies (SOAs). RESULTS : Participants with ASD displayed facilitation effects at all SOAs, whereas typically developing children displayed facilitation effects only at shorter SOAs. The magnitude of the facilitation effect was greater for the group with ASD at 400ms SOA. Both groups showed similar effects of condition, with similar patterns of facilitation in both conditions. CONCLUSION : Persons with ASD were not slower to read the symbolic cue, as the effect was elicited by brief cues within longer SOAs before target onset. The participants with ASD were also less efficient in using the predictability of the cues to guide responding. The difficulties of participants with ASD on endogenous orienting occur at the response selection level, not the perceptual level.

25. Lintas C, Sacco R, Garbett K, Mirnics K, Militerni R, Bravaccio C, Curatolo P, Manzi B, Schneider C, Melmed R, Elia M, Pascucci T, Puglisi-Allegra S, Reichelt KL, Persico AM. Involvement of the PRKCB1 gene in autistic disorder : significant genetic association and reduced neocortical gene expression. Mol Psychiatry ;2009 (Jul) ;14(7):705-718.

Protein kinase C enzymes play an important role in signal transduction, regulation of gene expression and control of cell division and differentiation. The fsI and betaII isoenzymes result from the alternative splicing of the PKCbeta gene (PRKCB1), previously found to be associated with autism. We performed a family-based association study in 229 simplex and 5 multiplex families, and a postmortem study of PRKCB1 gene expression in temporocortical gray matter (BA41/42) of 11 autistic patients and controls. PRKCB1 gene haplotypes are significantly associated with autism (P<0.05) and have the autistic endophenotype of enhanced oligopeptiduria (P<0.05). Temporocortical PRKCB1 gene expression was reduced on average by 35 and 31% for the PRKCB1-1 and PRKCB1-2 isoforms (P<0.01 and <0.05, respectively) according to qPCR. Protein amounts measured for the PKCbetaII isoform were similarly decreased by 35% (P=0.05). Decreased gene expression characterized patients carrying the ’normal’ PRKCB1 alleles, whereas patients homozygous for the autism-associated alleles displayed mRNA levels comparable to those of controls. Whole genome expression analysis unveiled a partial disruption in the coordinated expression of PKCbeta-driven genes, including several cytokines. These results confirm the association between autism and PRKCB1 gene variants, point toward PKCbeta roles in altered epithelial permeability, demonstrate a significant downregulation of brain PRKCB1 gene expression in autism and suggest that it could represent a compensatory adjustment aimed at limiting an ongoing dysreactive immune process. Altogether, these data underscore potential PKCbeta roles in autism pathogenesis and spur interest in the identification and functional characterization of PRKCB1 gene variants conferring autism vulnerability.

26. 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.

27. Mazur-Kolecka B, Cohen IL, Jenkins EC, Flory M, Merz G, Ted Brown W, Frackowiak J. Sera from children with autism alter proliferation of human neuronal progenitor cells exposed to oxidation. Neurotox Res ;2009 (Jul) ;16(1):87-95.

Altered brain development during embryogenesis and early postnatal life has been hypothesized to be responsible for the abnormal behaviors of people with autism. The specific genetic background that alters vulnerability to some environmental insults has been suggested in the etiology of autism ; however, the specific pathomechanisms have not been identified. Recently, we showed that sera from children with autism alter the maturation of human neuronal progenitor cells (NPCs) in culture. Results suggest that pre-programmed neurogenesis, i.e., neuronal proliferation, migration, differentiation, growth, and circuit organization, can be affected differently by factors present in autistic sera. In this report, we tested the effect of autistic sera on the vulnerability of NPCs to oxidative stress-a recognized risk factor of autism. We found that mild oxidative stress reduced proliferation of differentiating NPCs but not immature NPCs. This decrease of proliferation was less prominent in cultures treated with sera from children with autism than from age-matched controls. These results suggest that altered response of NPCs to oxidative stress may play a role in the etiology of autism.

28. Milne E, Griffiths H, Buckley D, Scope A. Vision in children and adolescents with autistic spectrum disorder : evidence for reduced convergence. J Autism Dev Disord ;2009 (Jul) ;39(7):965-975.

Evidence of atypical perception in individuals with ASD is mainly based on self report, parental questionnaires or psychophysical/cognitive paradigms. There have been relatively few attempts to establish whether binocular vision is enhanced, intact or abnormal in those with ASD. To address this, we screened visual function in 51 individuals with autistic spectrum disorder and 44 typically developing individuals by measuring visual acuity, stereoacuity, convergence, divergence, ocular motility, incidence of strabismus and integrity of the optokinetic response. The data suggest that many aspects of vision, including visual acuity, are unaffected in ASD, but that convergence is an aspect of visual function that merits further research in those with ASD.

29. Monge Galindo L, Escosa Garcia L, Garcia Sanchez N, Ruiz-Lazaro PM. [Hyperprolactinemia in a child diagnosed with Asperger syndrome and hyperkinetic disorder treated with risperidone.]. An Pediatr (Barc) ;2009 (Jul) ;71(1):86-87.Hiperprolactinemia en nino con sindrome de Asperger y trastorno hipercinetico tratado con risperidona.

30. Nakatani J, Tamada K, Hatanaka F, Ise S, Ohta H, Inoue K, Tomonaga S, Watanabe Y, Chung YJ, Banerjee R, Iwamoto K, Kato T, Okazawa M, Yamauchi K, Tanda K, Takao K, Miyakawa T, Bradley A, Takumi T. Abnormal behavior in a chromosome-engineered mouse model for human 15q11-13 duplication seen in autism. Cell ;2009 (Jun 26) ;137(7):1235-1246.

Substantial evidence suggests that chromosomal abnormalities contribute to the risk of autism. The duplication of human chromosome 15q11-13 is known to be the most frequent cytogenetic abnormality in autism. We have modeled this genetic change in mice by using chromosome engineering to generate a 6.3 Mb duplication of the conserved linkage group on mouse chromosome 7. Mice with a paternal duplication display poor social interaction, behavioral inflexibility, abnormal ultrasonic vocalizations, and correlates of anxiety. An increased MBII52 snoRNA within the duplicated region, affecting the serotonin 2c receptor (5-HT2cR), correlates with altered intracellular Ca(2+) responses elicited by a 5-HT2cR agonist in neurons of mice with a paternal duplication. This chromosome-engineered mouse model for autism seems to replicate various aspects of human autistic phenotypes and validates the relevance of the human chromosome abnormality. This model will facilitate forward genetics of developmental brain disorders and serve as an invaluable tool for therapeutic development.

31. Neville B. A regional database for autism spectrum disorders. Arch Dis Child ;2009 (Jul) ;94(7):562.

32. Niklasson L, Rasmussen P, Oskarsdottir S, Gillberg C. Autism, ADHD, mental retardation and behavior problems in 100 individuals with 22q11 deletion syndrome. Res Dev Disabil ;2009 (Jul-Aug) ;30(4):763-773.

This study assessed the prevalence and type of associated neuropsychiatric problems in children and adults with 22q11 deletion syndrome. One-hundred consecutively referred individuals with 22q11 deletion syndrome were given in-depth neuropsychiatric assessments and questionnaires screens. Autism spectrum disorders (ASDs) and/or attention deficit/hyperactivity disorder (ADHD) were diagnosed in 44 cases. ASD was diagnosed in 23 cases of whom only 5 had autistic disorder. ADHD was diagnosed in 30 individuals. In nine of these cases with ASD or ADHD there was a combination of these diagnoses. Mental retardation (MR) with or without ASD/ADHD was diagnosed in 51 individuals. ASD, ADHD, and/or MR were present in 67 cases. Females had higher IQ than males. The results of this study showed that the vast majority of all individuals with 22q11 deletion syndrome have behavior and/or learning problems and more than 40% meet criteria for either ASD, ADHD or both. Neuropsychiatric and neuropsychological evaluations are indicated as parts of the routine clinical assessment of individuals with 22q11 deletion syndrome.

33. Norbury CF, Brock J, Cragg L, Einav S, Griffiths H, Nation K. Eye-movement patterns are associated with communicative competence in autistic spectrum disorders. J Child Psychol Psychiatry ;2009 (Jul) ;50(7):834-842.

BACKGROUND : Investigations using eye-tracking have reported reduced fixations to salient social cues such as eyes when participants with autism spectrum disorders (ASD) view social scenes. However, these studies have not distinguished different cognitive phenotypes. METHODS : The eye-movements of 28 teenagers with ASD and 18 typically developing peers were recorded as they watched videos of peers interacting in familiar situations. Within ASD, we contrasted the viewing patterns of those with and without language impairments. The proportion of time spent viewing eyes, mouths and other scene details was calculated, as was latency of first fixation to eyes. Finally, the association between viewing patterns and social-communicative competence was measured. RESULTS : Individuals with ASD and age-appropriate language abilities spent significantly less time viewing eyes and were slower to fixate the eyes than typically developing peers. In contrast, there were no differences in viewing patterns between those with language impairments and typically developing peers. Eye-movement patterns were not associated with social outcomes for either language phenotype. However, increased fixations to the mouth were associated with greater communicative competence across the autistic spectrum. CONCLUSIONS : Attention to both eyes and mouths is important for language development and communicative competence. Differences in fixation time to eyes may not be sufficient to disrupt social competence in daily interactions. A multiple cognitive deficit model of ASD, incorporating different language phenotypes, is advocated.

34. Orsmond GI, Seltzer MM. Adolescent siblings of individuals with an autism spectrum disorder : testing a diathesis-stress model of sibling well-being. J Autism Dev Disord ;2009 (Jul) ;39(7):1053-1065.

The purpose of this study was to test a diathesis-stress model of well-being for siblings who have a brother or sister with an autism spectrum disorder (ASD). Data were collected from 57 adolescents and their mothers. Sisters reported higher levels of depressive and anxiety symptoms than brothers. Having a family history of ASDs was associated with depressive, but not anxiety, symptoms. A high level of maternal depression was also associated with more depressive and anxiety symptoms. A diathesis-stress model was partially supported, primarily through the findings that sibling sub-threshold autism characteristics were associated with depressive and anxiety symptoms in siblings, but only in the presence of a high number of stressful life events.

35. Pandolfi V, Magyar CI, Dill CA. Confirmatory factor analysis of the child behavior checklist 1.5-5 in a sample of children with autism spectrum disorders. J Autism Dev Disord ;2009 (Jul) ;39(7):986-995.

Validity studies of measures for emotional and behavioral disorders (EBD) for use with preschool children with autism spectrum disorders (ASD) are lacking. The Child Behavior Checklist 1.5-5 (CBCL ; Achenbach and Rescorla, Manual for the ASEBA Preschool Forms & Profiles. VT : University of Vermont, Research Center for Children, Youth, and Families, Burlington, 2000), a widely used measure for EBD, contains several norm-referenced scales derived through factor analysis of data from the general pediatric population. In this study, confirmatory factor analysis of archival data evaluated the adequacy of the CBCL factor model in a well characterized sample of preschoolers with ASD (N = 128). Psychometric results supported the model and suggested that practitioners can use the CBCL to assess for EBD in young children with ASD in conjunction with other clinical data. This will increase the likelihood of accurate identification and EBD-specific intervention.

36. Perry A, Flanagan HE, Dunn Geier J, Freeman NL. Brief report : the Vineland Adaptive Behavior Scales in young children with autism spectrum disorders at different cognitive levels. J Autism Dev Disord ;2009 (Jul) ;39(7):1066-1078.

Vineland Adaptive Behavior Scales (VABS) data were examined in a large sample of young children with ASD (n = 290) of varying cognitive levels. IQ was higher than VABS composite score among high functioning children only ; the opposite pattern was found in lower IQ subgroups. Profile analysis of VABS domains across cognitive levels demonstrated different profiles in different subgroups. A characteristic "autism profile" was found for most subgroups for Age Equivalents but not Standard Scores. In a small set of matched pairs (n = 28) of children with autism versus MR, significantly different profiles were found, with Socialization and Communication lower in autism, but no differences were found between matched pairs of children with autism and PDD-NOS (n = 48). Correlations between age, cognitive level, and adaptive level were also reported, and regression analyses indicated that autism severity accounts for a modest amount of unique variance in Socialization and Daily Living Skills.

37. Philippe C, Amsallem D, Francannet C, Lambert L, Saunier A, Verneau F, Jonveaux P. Phenotypic variability in Rett syndrome associated with FOXG1 mutations in females. J Med Genet ;2009 (Jun 29)

BACKGROUND : The FOXG1 gene has been recently implicated in the congenital form of Rett syndrome (RTT). It encodes the Forkhead box protein G1, a winged-helix transcriptional repressor with expression restricted to testis and brain where it is critical for forebrain development. So far, only two point mutations in FOXG1 have been reported in females affected by the congenital form of RTT. AIM : To assess the implication of FOXG1 in the molecular aetiology of classical RTT syndrome and related disorders. METHODS : We screened the entire multi-exon coding sequence of FOXG1 for point mutations and large rearrangements in a cohort of 35 MECP2/CDKL5 mutation-negative female individuals including 31 classical and 4 congenital forms of RTT. RESULTS : We identified two different de novo heterozygous FOXG1 truncating mutations. The individual with the p.Trp308X mutation presented with a severe RTT-like neurodevelopment disorder, whereas the p.Tyr400X allele was associated with a classical clinical RTT presentation. CONCLUSIONS : These new cases give additional support to the genetic heterogeneity in RTT, and help to delineate the clinical spectrum in the FOXG1-related phenotypes. FOXG1 screening should be considered in the molecular diagnosis of RTT.

38. Pickles A, Simonoff E, Conti-Ramsden G, Falcaro M, Simkin Z, Charman T, Chandler S, Loucas T, Baird G. Loss of language in early development of autism and specific language impairment. J Child Psychol Psychiatry ;2009 (Jul) ;50(7):843-852.

BACKGROUND : Several authors have highlighted areas of overlap in symptoms and impairment among children with autism spectrum disorder (ASD) and children with specific language impairment (SLI). By contrast, loss of language and broadly defined regression have been reported as relatively specific to autism. We compare the incidence of language loss and language progression of children with autism and SLI. METHODS : We used two complementary studies : the Special Needs and Autism Project (SNAP) and the Manchester Language Study (MLS) involving children with SLI. This yielded a combined sample of 368 children (305 males and 63 females) assessed in late childhood for autism, history of language loss, epilepsy, language abilities and nonverbal IQ. RESULTS : language loss occurred in just 1% of children with SLI but in 15% of children classified as having autism or autism spectrum disorder. Loss was more common among children with autism rather than milder ASD and is much less frequently reported when language development is delayed. For children who lost language skills before their first phrases, the phrased speech milestone was postponed but long-term language skills were not significantly lower than children with autism but without loss. For the few who experienced language loss after acquiring phrased speech, subsequent cognitive performance is more uncertain. CONCLUSIONS : Language loss is highly specific to ASD. The underlying developmental abnormality may be more prevalent than raw data might suggest, its possible presence being hidden for children whose language development is delayed.

39. Poljac E, Simon S, Ringlever L, Kalcik D, Groen WB, Buitelaar JK, Bekkering H. Impaired task switching performance in children with dyslexia but not in children with autism. Q J Exp Psychol (Colchester) ;2009 (Jun 25):1-16.

Problems with cognitive control in both autism and dyslexia have already been reported in different studies. The present study specifically examined task-switching performance in children with autism and dyslexia. For this purpose, a multiple-trial paradigm was used with cues for colour- and shape-matching tasks presented before a run of trials. The cue could imply a task switch (when the cue changed the task) or a task repetition (when the cue did not change the task). Both reaction times and error rates were measured for switching, restarting, and general task performance. Participants were children with autism (24) and with dyslexia (25) and healthy controls (27) with normal IQ and ages from 12 to 18 years. The main finding was that while similar switching performance was observed between children with autism and the healthy controls, children with dyslexia showed a significant switch-specific delay relative to both healthy controls and children with autism. Furthermore, no deficit in restarting performance was observed for any of the two patient groups. Finally, additional evidence is provided for a more general deficit in information processing in dyslexia. Our data suggest that children with autism are able to switch between tasks in a similar way as do normally developing children as long as the tasks are unambiguously specified. Furthermore, the data imply switch-specific deficits in dyslexia additionally to the deficits in general information processing already reported in the literature. The implications of our data are further discussed in relation to the interpretation of the Wisconsin Card Sorting Test.

40. Ramachandran R, Mitchell P, Ropar D. Do individuals with autism spectrum disorders infer traits from behavior ? J Child Psychol Psychiatry ;2009 (Jul) ;50(7):871-878.

BACKGROUND : Traits and mental states are considered to be inter-related parts of theory of mind. Attribution research demonstrates the influential role played by traits in social cognition. However, there has been little investigation into how individuals with autism spectrum disorders (ASD) understand traits. METHOD : The ability of individuals with ASD to infer traits from descriptions of behavior was investigated by asking participants to read trait-implying sentences and then to choose one of two words that best related to the sentence. RESULTS : In Experiment 1, individuals with ASD performed similarly to matched controls in being faster at choosing the trait in comparison to the semantic associate of one of the words in the sentence. The results from Experiments 1 and 2 provided converging evidence in suggesting that inferring traits from textual descriptions of behavior occurs with relatively little effort. The results of Experiment 3 suggested that making trait inferences took priority over inferring actions or making semantic connections between words. CONCLUSIONS : Individuals with ASD infer traits from descriptions of behavior effortlessly and spontaneously. The possibility of trait inference being a spared socio-cognitive function in autism is discussed.

41. Sahyoun CP, Soulieres I, Belliveau JW, Mottron L, Mody M. Cognitive differences in pictorial reasoning between high-functioning autism and Asperger’s syndrome. J Autism Dev Disord ;2009 (Jul) ;39(7):1014-1023.

We investigated linguistic and visuospatial processing during pictorial reasoning in high-functioning autism (HFA), Asperger’s syndrome (ASP), and age and IQ-matched typically developing participants (CTRL), using three conditions designed to differentially engage linguistic mediation or visuospatial processing (visuospatial, V ; semantic, S ; visuospatial + semantic, V + S). The three groups did not differ in accuracy, but showed different response time profiles. ASP and CTRL participants were fastest on V + S, amenable to both linguistic and nonlinguistic mediation, whereas HFA participants were equally fast on V and V + S, where visuospatial strategies were available, and slowest on S. HFA participants appeared to favor visuospatial over linguistic mediation. The results support the use of linguistic versus visuospatial tasks for characterizing subtypes on the autism spectrum.

42. Sandhu B, Steer C, Golding J, Emond A. The early stool patterns of young children with autistic spectrum disorder. Arch Dis Child ;2009 (Jul) ;94(7):497-500.

AIM : To investigate whether children with autistic spectrum disorder (ASD) have bowel symptoms consistent with underlying enterocolitis. METHODS : Information on children’s stool patterns and gut symptoms collected by questionnaire at 4 weeks and at 6, 18, 30 and 42 months of age were available for 12,984 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Data on the 78 children identified by local health and/or education systems to have special educational provision for ASD were compared with the 12,906 remaining children in the cohort. RESULTS : Comparison of the ASD and control group during the first 3.5 years of life showed no major differences in stool colour or consistency, or in frequency of diarrhoea, constipation, bloody stools or abdominal pain. The ASD children had similar stool frequency up to 18 months, but there was a trend for ASD children to pass more stools at 30 months (OR 3.73, 95% CI 1.11 to 12.6 ; p = 0.004) and at 42 months (OR 6.46, 95% CI 1.83 to 22.7 ; p<0.001), although only three children passed more than 4 stools/day. Repeating the analysis on only those cases diagnosed as having classical childhood autism resulted in very similar findings. CONCLUSIONS : During the first 42 months of life, ASD children had a stool pattern that was very similar to that of other children, apart from a slight increase in stool frequency at 30 and 42 months. There were no symptoms to support the hypothesis that ASD children had enterocolitis.

43. Sheppard E, Ropar D, Mitchell P. Perceiving the impossible : How individuals with autism copy paradoxical figures. Autism ;2009 (Jul) ;13(4):435-452.

Mottron and colleagues found that individuals with autism were less affected by geometric impossibility than comparison participants on a copying task. The current experiment sought to determine whether a local perceptual style could account for this. Participants with and without autism copied possible and impossible geometric figures. Geometric impossibility had a larger effect on drawing time for comparison participants than for those with autism. However, participants with autism did not use more localized drawing strategies. Strength of impossibility effect was associated with a global strategy amongst comparison participants but this relationship was not found amongst participants with autism. The findings suggest that differences in high-level conceptual processing may account for group differences in effects of impossibility.

44. Sheppard E, Ropar D, Mitchell P. Autism and dimensionality : differences between copying and drawing tasks. J Autism Dev Disord ;2009 (Jul) ;39(7):1039-1046.

Previous research suggests individuals with autism may be less influenced by a three-dimensional interpretation when copying line drawings (Sheppard et al. J Autism Dev Disord 37:1913-1924, 2007). The current research aimed to determine whether this reduced dimensionality effect extends to drawings of an actual object. Twenty-four children and adolescents with autism and 24 comparison participants copied one line drawing with no depth cues, line drawings with a three-dimensional interpretation, and drew a actual three-dimensional object. Participants with autism were less influenced by three-dimensionality on the copying tasks but were equally affected when drawing the actual object. This suggests that any advantage for three-dimensional drawing in non-savant individuals with autism is confined to situations when the individual copies a line drawing with depth cues.

45. Smith RA, Farnworth H, Wright B, Allgar V. Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders ? : A case control study. Autism ;2009 (Jul) ;13(4):343-355.

There is considerable controversy as to whether there is an association between bowel disorders and autism. Using a bowel symptom questionnaire we compared 51 children with autism spectrum disorder with control groups of 35 children from special school and 112 from mainstream school. There was a significant difference in the reporting of certain bowel symptoms (constipation, diarrhoea, flatulence) and food faddiness between the autism group and the mainstream school control group. There was no significant difference between the autism group and children in the special schools except for faddiness, which is an autism specific symptom and not a bowel symptom. This study confirms previously reported findings of an increase in bowel symptoms in children with autism. It would appear, however, that this is not specifically associated with autism as bowel symptoms were reported in similar frequency to a comparison group of children with other developmental and neurological disorders.

46. Smith T, Eikeseth S, Sallows GO, Graupner TD. Efficacy of applied behavior analysis in autism. J Pediatr ;2009 (Jul) ;155(1):151-152 ; author reply 152-153.

47. Tesink CM, Buitelaar JK, Petersson KM, van der Gaag RJ, Kan CC, Tendolkar I, Hagoort P. Neural correlates of pragmatic language comprehension in autism spectrum disorders. Brain ;2009 (Jul) ;132(Pt 7):1941-1952.

Difficulties with pragmatic aspects of communication are universal across individuals with autism spectrum disorders (ASDs). Here we focused on an aspect of pragmatic language comprehension that is relevant to social interaction in daily life : the integration of speaker characteristics inferred from the voice with the content of a message. Using functional magnetic resonance imaging (fMRI), we examined the neural correlates of the integration of voice-based inferences about the speaker’s age, gender or social background, and sentence content in adults with ASD and matched control participants. Relative to the control group, the ASD group showed increased activation in right inferior frontal gyrus (RIFG ; Brodmann area 47) for speaker-incongruent sentences compared to speaker-congruent sentences. Given that both groups performed behaviourally at a similar level on a debriefing interview outside the scanner, the increased activation in RIFG for the ASD group was interpreted as being compensatory in nature. It presumably reflects spill-over processing from the language dominant left hemisphere due to higher task demands faced by the participants with ASD when integrating speaker characteristics and the content of a spoken sentence. Furthermore, only the control group showed decreased activation for speaker-incongruent relative to speaker-congruent sentences in right ventral medial prefrontal cortex (vMPFC ; Brodmann area 10), including right anterior cingulate cortex (ACC ; Brodmann area 24/32). Since vMPFC is involved in self-referential processing related to judgments and inferences about self and others, the absence of such a modulation in vMPFC activation in the ASD group possibly points to atypical default self-referential mental activity in ASD. Our results show that in ASD compensatory mechanisms are necessary in implicit, low-level inferential processes in spoken language understanding. This indicates that pragmatic language problems in ASD are not restricted to high-level inferential processes, but encompass the most basic aspects of pragmatic language processing.

48. Ulay HT, Ertugrul A. [Neuroimaging findings in autism : a brief review.]. Turk Psikiyatri Derg ;2009 (Summer) ;20(2):164-174.Otizmde Beyin Goruntuleme Bulgulari : Bir Gozden Gecirme.

OBJECTIVE : Many structural and functional neuroimaging studies have investigated the neuroanatomical changes and possible pathophysiological pathways in autism. In this review the objective was to assess, with an integrative perspective, recent neuroimaging studies that have contributed to the explanation of the possible pathophysiological pathways in autism. METHOD : Relevant attainable studies published between 1997 and 2007 were included in this retrospective literature review. The PubMed search engine and the keywords, autism, autistic spectrum disorders, neuroimaging, computerized tomography, magnetic resonance imaging, functional magnetic resonance imaging, magnetic resonance spectroscopy, positron emission tomography, single photon emission computed tomography, and diffusion tensor imaging were used. RESULTS : Structural neuroimaging studies reported an increase in total cerebral volume, both in grey and white matter, mostly in the frontal, temporal and parietal lobes. These global volumetric changes are suggested to indicate a diffuse disturbance in neural networks during early development. In functional neuroimaging studies, activation abnormalities were observed in the temporal lobes and amygdala, which are involved in language and social cognition. An increase in visual activity cortex was also reported. CONCLUSION : Clinical observations and results from neuroimaging studies were gathered to hypothize and explain the pathophysiology of autism. Yet, it is still very early to conclude with certainty the neurobiological process responsible for autism.

49. Wachtel LE, Contrucci-Kuhn SA, Griffin M, Thompson A, Dhossche DM, Reti IM. ECT for self-injury in an autistic boy. Eur Child Adolesc Psychiatry ;2009 (Jul) ;18(7):458-463.

OBJECTIVE : Self-injurious behavior presents a significant challenge in autism, and first-line psychopharmacological and behavioral interventions have limited efficacy in some patients. These intractable cases may be responsive to electroconvulsive therapy. CLINICAL PICTURE : This article presents an eight-year-old boy with autism, mental retardation, prominent mood lability and a five-year history of extreme self-injurious behavior towards his head, averaging 109 self-injurious attempts hourly. The patient was at high risk for serious head trauma, and required usage of bilateral arm restraints and protective equipment (i.e., padding on shoulders, arms, and legs). All areas of daily functioning were profoundly impacted by dangerous self-injury. TREATMENT : Fifteen bilateral ECT treatments resulted in excellent mood stabilization and reduction of self-injury to 19 attempts hourly, and maintenance ECT was pursued. The patient was able to return to developmentally-appropriate educational and social activities. CONCLUSION : ECT should be considered in the treatment algorithm of refractory cases of severe self-injury in autism.

50. Wallace GL, Silvers JA, Martin A, Kenworthy LE. Brief Report : Further Evidence for Inner Speech Deficits in Autism Spectrum Disorders. J Autism Dev Disord ;2009 (Jun 30)

Recent research indicates that individuals with autism do not effectively use inner speech during the completion of cognitive tasks. We used Articulatory Suppression (AS) to interfere with inner speech during completion of alternate items from the Tower of London (TOL). AS detrimentally affected TOL performance among typically developing (TD) adolescents (n = 25), but did not significantly diminish performance among adolescents with high functioning (IQ > 80) autism spectrum disorders (n = 28). Moreover, the TD group’s TOL performance under AS was indistinguishable from the autism group’s impaired


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