Pubmed du 09/05/18

mercredi 9 mai 2018

1. Abdulamir HA, Abdul-Rasheed OF, Abdulghani EA. Serotonin and serotonin transporter levels in autistic children. Saudi medical journal. 2018 ; 39(5) : 487-94.

OBJECTIVES : To assess the possible correlation between serotonin and serotonin transporter (SERT) with the autism severity and investigate the association between these parameters in autistic children to assess their possible role for diagnosis of autism severity. METHODS : A comparative cross-sectional study was carried out in the Chemistry and Biochemistry Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq while the samples were taken from 60 male autistic children recruited to the Department of Pediatrics at Al-Sader Hospital, Baghdad, Iraq between November 2014 amd April 2015. Levels of serotonin and serotonin transporters (SERT) were determined in 60 male autistic Iraqi patients classified into mild, moderate and severe (20 for each). These levels were compared with those of 26 healthy control children. Results : Levels of serotonin and SERT were significantly increased in autistic children than that of gender and age-matched controls. Serotonin levels were 80.63+/- 21.83 ng/ml in mild, 100.39+/-23.07 ng/ml moderate, and 188.7+/-31.72 ng/ml severe autistic patients. Serotonin transporter levels were 10.13+/-4.51 ng/ml in mild, 13.15+/-4.71 ng/ml moderate, and 16.32+/-6.7 ng/ml in severe autistic patients. The increase of both serotonin and SERT levels were associated with severity of autism. Receiver operating characteristic (ROC) analysis can be used for diagnostic and prognostic purposes. CONCLUSIONS : High serotonin and SERT levels may indicate that these biomarkers have a role in the autism pathogenesis and support the possibility of using serotonin and SERT to diagnose autism severity.

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2. Bae SM, Hong JY. The Wnt Signaling Pathway and Related Therapeutic Drugs in Autism Spectrum Disorder. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology. 2018 ; 16(2) : 129-35.

Autism spectrum disorder (ASD) is a series of neurodevelopmental disorder with a large genetic component. However, the pathogenic genes and molecular mechanisms of ASD have not been clearly defined. Recent technological advancements, such as next-generation sequencing, have led to the identification of certain loci that is responsible for the pathophysiology of ASD. Three functional pathways, such as chromatin remodeling, Wnt signaling and mitochondrial dysfunction are potentially involved in ASD. In this review, we will focus on recent studies of the involvement of Wnt signaling pathway components in ASD pathophysiology and related drugs used in ASD treatment.

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3. Bileviciute-Ljungar I, Maroti D, Bejerot S. Patients with chronic fatigue syndrome do not score higher on the autism-spectrum quotient than healthy controls : Comparison with autism spectrum disorder. Scandinavian journal of psychology. 2018.

Clinically, there is an overlap of several symptoms of chronic fatigue syndrome (CFS) and autism spectrum disorder (ASD), including fatigue ; brain "fog" ; cognitive impairments ; increased sensitivity to sound, light, and odour ; increased pain and tenderness ; and impaired emotional contact. Adults with CFS (n = 59) or ASD (n = 50) and healthy controls (HC ; n = 53) were assessed with the Autism-Spectrum Quotient (AQ) in a cross-sectional study. Non-parametric analysis was used to compare AQ scores among the groups. Univariate analysis of variance (ANCOVA) was used to identify if age, sex, or diagnostic group influenced the differences in scores. Patients with ASD scored significantly higher on the AQ than the CFS group and the HC group. No differences in AQ scores were found between the CFS and HC groups. AQ results were influenced by the diagnostic group but not by age or sex, according to ANCOVA. Despite clinical observations of symptom overlap between ASD and CFS, adult patients with CFS report few autistic traits in the self-report instrument, the AQ. The choice of instrument to assess autistic traits may influence the results.

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4. Bolourian Y, Zeedyk SM, Blacher J. Autism and the University Experience : Narratives from Students with Neurodevelopmental Disorders. J Autism Dev Disord. 2018.

Relatively limited research has been devoted to understanding the postsecondary experience from the students’ perspectives. In the current study, individual interviews were conducted with university students with autism spectrum disorder (n = 13) and students with Attention Deficit/Hyperactivity Disorder (n = 18) to investigate likely factors impeding meaningful postsecondary experiences. Through an iterative coding process, nine themes were identified, and direct narratives exemplifying each are included. Overall, both diagnostic groups reported significant social, emotional, and academic challenges within the university setting, although there were distinctions. Findings have direct applications to higher education initiatives, such as the development of programs to increase faculty awareness and to target the efforts of university disability centers in meeting the needs of students with neurodevelopmental disorders.

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5. Brookman-Frazee L, Stahmer AC. Effectiveness of a multi-level implementation strategy for ASD interventions : study protocol for two linked cluster randomized trials. Implementation science : IS. 2018 ; 13(1) : 66.

BACKGROUND : The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD : Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. METHODS : A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. Implementation outcomes including provider training completion, fidelity (coded by observers blind to group assignment) and child behavior change will be examined for 295 mental health providers, 295 teachers, and 590 children. DISCUSSION : This implementation intervention has the potential to increase quality of care for ASD in publicly funded settings by improving effectiveness of intervention implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services. TRIAL REGISTRATION : This study is registered with ( NCT03380078 ). Registered 20 December 2017, retrospectively registered.

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6. Reichow B, Hume K, Barton EE, Boyd BA. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2018 ; 5 : Cd009260.

BACKGROUND : The rising prevalence of autism spectrum disorders (ASD) increases the need for evidence-based behavioral treatments to lessen the impact of symptoms on children’s functioning. At present, there are no curative or psychopharmacological therapies to effectively treat all symptoms of the disorders. Early intensive behavioral intervention (EIBI) is a treatment based on the principles of applied behavior analysis. Delivered for multiple years at an intensity of 20 to 40 hours per week, it is one of the more well-established treatments for ASD. This is an update of a Cochrane review last published in 2012. OBJECTIVES : To systematically review the evidence for the effectiveness of EIBI in increasing functional behaviors and skills, decreasing autism severity, and improving intelligence and communication skills for young children with ASD. SEARCH METHODS : We searched CENTRAL, MEDLINE, Embase, 12 additional electronic databases and two trials registers in August 2017. We also checked references and contacted study authors to identify additional studies. SELECTION CRITERIA : Randomized control trials (RCTs), quasi-RCTs, and controlled clinical trials (CCTs) in which EIBI was compared to a no-treatment or treatment-as-usual control condition. Participants must have been less than six years of age at treatment onset and assigned to their study condition prior to commencing treatment. DATA COLLECTION AND ANALYSIS : We used standard methodological procedures expected by Cochrane.We synthesized the results of the five studies using a random-effects model of meta-analysis, with a mean difference (MD) effect size for outcomes assessed on identical scales, and a standardized mean difference (SMD) effect size (Hedges’ g) with small sample correction for outcomes measured on different scales. We rated the quality of the evidence using the GRADE approach. MAIN RESULTS : We included five studies (one RCT and four CCTs) with a total of 219 children : 116 children in the EIBI groups and 103 children in the generic, special education services groups. The age of the children ranged between 30.2 months and 42.5 months. Three of the five studies were conducted in the USA and two in the UK, with a treatment duration of 24 months to 36 months. All studies used a treatment-as-usual comparison group.Primary outcomesThere is low quality-evidence at post-treatment that EIBI improves adaptive behaviour (MD 9.58 (assessed using Vineland Adaptive Behavior Scale (VABS) Composite ; normative mean = 100, normative SD = 15), 95% confidence interval (CI) 5.57 to 13.60, P < 0.0001 ; 5 studies, 202 participants), and reduces autism symptom severity (SMD -0.34, 95% CI -0.79 to 0.11, P = 0.14 ; 2 studies, 81 participants ; lower values indicate positive effects) compared to treatment as usual.No adverse effects were reported across studies.Secondary outcomesThere is low-quality evidence at post-treatment that EIBI improves IQ (MD 15.44 (assessed using standardized IQ tests ; scale 0 to 100, normative SD = 15), 95% CI 9.29 to 21.59, P < 0.001 ; 5 studies, 202 participants) ; expressive (SMD 0.51, 95% CI 0.12 to 0.90, P = 0.01 ; 4 studies, 165 participants) and receptive (SMD 0.55, 95% CI 0.23 to 0.87, P = 0.001 ; 4 studies, 164 participants) language skills ; and problem behaviour (SMD -0.58, 95% CI -1.24 to 0.07, P = 0.08 ; 2 studies, 67 participants) compared to treatment as usual. AUTHORS’ CONCLUSIONS : There is weak evidence that EIBI may be an effective behavioral treatment for some children with ASD ; the strength of the evidence in this review is limited because it mostly comes from small studies that are not of the optimum design. Due to the inclusion of non-randomized studies, there is a high risk of bias and we rated the overall quality of evidence as ’low’ or ’very low’ using the GRADE system, meaning further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.It is important that providers of EIBI are aware of the current evidence and use clinical decision-making guidelines, such as seeking the family’s input and drawing upon prior clinical experience, when making recommendations to clients on the use EIBI. Additional studies using rigorous research designs are needed to make stronger conclusions about the effects of EIBI for children with ASD.

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7. Vermaat LEW, van der Miesen AIR, de Vries ALC, Steensma TD, Popma A, Cohen-Kettenis PT, Kreukels BPC. Self-Reported Autism Spectrum Disorder Symptoms Among Adults Referred to a Gender Identity Clinic. LGBT health. 2018.

PURPOSE : The purpose of this study was to (1) investigate autism spectrum disorder (ASD) symptoms in a sample of adults referred for gender dysphoria (GD) compared to typically developing (TD) populations, (2) see whether males assigned at birth with GD (MaBGDs) and females assigned at birth with GD (FaBGDs) differ in ASD symptom levels, (3) study the role of sexual orientation, and (4) investigate ASD symptoms’ correlation with GD symptoms. METHODS : The Autism-Spectrum Quotient (AQ) was used to measure ASD symptoms, and the Utrecht Gender Dysphoria Scale (UGDS) was used to measure the intensity of GD. Mean AQ scores of adults referred for GD (n = 326 ; 191 MaBGD and 135 FaBGD) were compared to three TD populations taken from the literature (n = 1316 ; 667 male and 644 female, 5 birth-assigned sex unknown). RESULTS : The mean AQ score in individuals referred for GD was similar to the TD samples. FaBGDs showed higher mean AQ scores than MaBGDs, and they had mean scores similar to TD individuals of the same experienced gender (TD males). After selecting individuals with an UGDS score indicative of GD, a positive association between ASD and GD symptoms was found. CONCLUSION : The co-occurrence of GD and ASD in adults may not be as prevalent as previously suggested. Attenuation of sex differences in ASD might explain FaBGDs’ and MaBGDs’ ASD symptoms’ similarity to those of TD individuals of the same experienced gender. Intensity of ASD symptoms might be correlated with intensity of GD symptoms, warranting further studies to elaborate on their potential co-occurrence.

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8. Wang M, Jegathesan T, Young E, Huber J, Minhas R. Raising Children with Autism Spectrum Disorders in Monolingual vs Bilingual Homes : A Scoping Review. J Dev Behav Pediatr. 2018.

BACKGROUND : Approximately 20% of children in Canada and the United States are raised in bilingual family homes. Current recommendations for typically developing children are to encourage and support bilingual exposure in the home ; however, there are no specific guidelines for families of children with autism spectrum disorders (ASDs), a disorder in which communication deficits are considered a hallmark feature. OBJECTIVE : The aim of this study is to present a scoping review of studies that compare cognitive, linguistic, and behavioral outcomes for children with ASDs raised in monolingual vs bilingual homes. METHODS : A systematic search of 6 databases for peer-reviewed literature and gray literature search through dissertation databases, conference archives, and reference lists of pertinent studies was conducted. RESULTS : Nine studies were included. No consistent differences were observed in the categories of core ASDs behaviors, cognitive function, or language. The studies suggest a potential bilingual advantage on nonverbal intelligence quotient scores, adaptive functioning, and expressive vocabulary. CONCLUSION : There is no evidence of a detrimental effect of raising children with ASDs in a bilingual home.

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