1. Chandan S, Mohan BP, Khan SR, Kassab LL, Ponnada S, Ofosu A, Bhat I, Singh S, Adler DG. {{Efficacy and safety of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD): A systematic review and meta-analysis of 714 patients}}. {Endoscopy international open}. 2020; 8(11): E1664-e72.
Background and study aims Endoscopic ultrasound guided pancreatic duct drainage (EUS-PDD) is a minimal-invasive therapeutic option to surgery and in patients with failed endoscopic retrograde pancreatography (ERP). The aim of this review was to quantitatively appraise the clinical outcomes of EUS-PDD by meta-analysis methods. Methods We searched multiple databases from inception through March 2020 to identify studies that reported on EUS-PDD. Pooled rates of technical success, successful drainage of pancreatic duct, clinical success, and adverse events were calculated. Study heterogeneity was assessed using I (2) % and 95 % prediction interval. Results A total of 22 studies (714 patients) were included. The pooled rate of technical success in EUS-PDD was 84.8 % (95 % CI 79.1-89.2). The pooled rate of successful PD drained by EUS-PDD was 77.5 % (95 % CI 63.1-87.4). The pooled rate of clinical success of EUS-PDD was 89.2 % (95 % CI 82.1-93.7). The pooled rate of all adverse events was 18.1 % (95 % CI 14.2-22.9). On sub-group analysis, the pooled technical success and clinical success of EUS-PDD from Japanese data were considerably superior (91.2 %, 83-95.6 & 92.5 %, 83.9-96.7, respectively). The pooled rate of post EUS-PDD acute pancreatitis was 6.6 % (95 % CI 4.5-9.4), bleeding was 4.1 % (95 % CI 2.7-6.2), perforation and/or pneumoperitoneum was 3.1 % (95 % CI 1.9-5), pancreatic leak and/or pancreatic fluid collection was 2.3 % (95 % CI 1.4-4), and infection was 2.8 % (95 % CI 1.7-4.6). Conclusion EUS-PDD demonstrates high technical success and clinical success rates with acceptable adverse events. Technical success was especially high for anastomotic strictures.
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2. Guidotti L, Musetti A, Barbieri GL, Ballocchi I, Corsano P. {{Conflicting and harmonious sibling relationships of children and adolescent siblings of children with Autism Spectrum Disorder}}. {Child Care Health Dev}. 2020.
BACKGROUND: The presence of a child with Autism Spectrum Disorder (ASD) could have a strong psychological and emotional impact on typical development (TD) siblings, with different ways of adjustment and perception of fraternal relationships. In this study we aimed to investigate the experience of the TD siblings of children with ASD combining both quantitative and qualitative methodologies. METHOD: An explanatory sequential design was employed. Forty-four TD siblings of children with ASD, aged from 6 to 17 years old, participated in the study. Each participant completed the Sibling Relationship Inventory that investigated warmth, rivalry and conflict in sibling relationships. Moreover, in order to thoroughly evaluate the participants’ perception of their sibling relationship, they were asked to draw themselves with their sibling with ASD in a condition of harmony and conflict. The drawings were collected and coded using the well-validated Pictorial Assessment of Interpersonal Relationships. Quantitative and qualitative analyses were conducted. RESULTS: In general, TD siblings showed affection for their siblings with ASD. However, males showed more conflict than females. Quantitative analyses of the drawings showed high levels of Similarity between the siblings, despite the disability. In drawings in conditions of harmony, greater Cohesion emerged and in situations of conflict greater Distancing. Content analysis of the drawings showed that the conflict is represented mainly at home and the siblings often show opposite emotions, with TD siblings experiencing negative emotions. Moreover, adolescent TD siblings displayed more annoyance, shame and embarrassment than child TD siblings. CONCLUSIONS: It is important to combine quantitative and qualitative tools to understand the experience of TD siblings in detail. In particular, drawing is a useful tool for providing quantitative and qualitative information, supplying rich and detailed information that can be well integrated with the results coming from quantitative tools.
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3. Jokiranta-Olkoniemi E, Gyllenberg D, Sucksdorff D, Suominen A, Kronström K, Chudal R, Sourander A. {{Risk for Premature Mortality and Intentional Self-harm in Autism Spectrum Disorders}}. {J Autism Dev Disord}. 2020.
To examine the risk for premature mortality and intentional self-harm in autism spectrum disorders (ASD). Based on a national birth cohort. Children born in 1987-2005, diagnosed with ASD by 2007 (n = 4695) were matched with four non-ASD subjects (n = 18,450) and followed until 2015 for mortality and intentional self-harm. The risk among ASD subjects was elevated only for natural cause of death. The risk for intentional self-harm was increased in the unadjusted analyses, but decreased to non-significant after adjusting for comorbid psychiatric disorders. ASD subjects are at increased risk for premature mortality due to natural causes of death. While ASD subjects die of suicide and present with more self-harm, the association is explained by comorbid psychiatric disorders.
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4. Kozono N, Okamura A, Honda S, Matsumoto M, Mihara T. {{Gamma power abnormalities in a Fmr1-targeted transgenic rat model of fragile X syndrome}}. {Sci Rep}. 2020; 10(1): 18799.
Fragile X syndrome (FXS) is characteristically displayed intellectual disability, hyperactivity, anxiety, and abnormal sensory processing. Electroencephalography (EEG) abnormalities are also observed in subjects with FXS, with many researchers paying attention to these as biomarkers. Despite intensive preclinical research using Fmr1 knock out (KO) mice, an effective treatment for FXS has yet to be developed. Here, we examined Fmr1-targeted transgenic rats (Fmr1-KO rats) as an alternative preclinical model of FXS. We characterized the EEG phenotypes of Fmr1-KO rats by measuring basal EEG power and auditory steady state response (ASSR) to click trains of stimuli at a frequency of 10-80 Hz. Fmr1-KO rats exhibited reduced basal alpha power and enhanced gamma power, and these rats showed enhanced locomotor activity in novel environment. While ASSR clearly peaked at around 40 Hz, both inter-trial coherence (ITC) and event-related spectral perturbation (ERSP) were significantly reduced at the gamma frequency band in Fmr1-KO rats. Fmr1-KO rats showed gamma power abnormalities and behavioral hyperactivity that were consistent with observations reported in mouse models and subjects with FXS. These results suggest that gamma power abnormalities are a translatable biomarker among species and demonstrate the utility of Fmr1-KO rats for investigating drugs for the treatment of FXS.
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5. Li H, Liu H, Chen X, Zhang J, Tong G, Sun Y. {{Association of food hypersensitivity in children with the risk of autism spectrum disorder: a meta-analysis}}. {European journal of pediatrics}. 2020.
This meta-analysis was performed to clarify the association between food hypersensitivity in children and autism spectrum disorder (ASD) in detail. Relevant studies published in 8 databases before March 2020 were retrieved and screened according to established inclusion criteria. The odds ratio (OR) with the 95% confidence interval (CI) was pooled to estimate the effect. Subgroup analyses were performed in terms of publication year, study design, location, sample size, definition of food hypersensitivity, definition of ASD, and study quality score. Furthermore, we stratified studies by participant sex and age to perform a more detailed analysis. This meta-analysis included 12 published articles with 434,809 subjects. A significant association was observed between food hypersensitivity and the risk of ASD (OR = 2.792, 95% CI: 2.081-3.746). The risk of ASD among girls and subjects younger than 12 with food hypersensitivity may be greater than that among boys and those older than 12. The results of sensitivity analysis and publication bias analysis show that the association is relatively stable.Conclusion: Our results showed a positive association between food hypersensitivity and autism spectrum disorder, and girls and subjects younger than 12 may be more sensitive to this association. The role of food hypersensitivity in the onset of ASD deserves more attention. What is Known: • Food hypersensitivity is a term used to describe food allergies and food intolerance. • ASD is a group of neurodevelopmental disorders that are characterized by deficits in social interaction, repetitive or stereotypic behavior, and verbal communication disorder. • The prevalence rates of ASD and food hypersensitivity in the developed world are increasing. What is New: • In this work, we reviewed and analyzed the available data and studies and found a positive association between food hypersensitivity and ASD. • Girls and children younger than 12 may be more sensitive to have ASD than boys and children older than 12.
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6. Li Y, Mache MA, Todd TA. {{Automated identification of postural control for children with autism spectrum disorder using a machine learning approach}}. {Journal of biomechanics}. 2020; 113: 110073.
It is unclear whether postural sway characteristics could be used as diagnostic biomarkers for autism spectrum disorder (ASD). The purpose of this study was to develop and validate an automated identification of postural control patterns in children with ASD using a machine learning approach. 50 children aged 5-12 years old were recruited and assigned into two groups: ASD (n = 25) and typically developing groups (n = 25). Participants were instructed to stand barefoot on two feet and maintain a stationary stance for 20 s during two conditions: (1) eyes open and (2) eyes closed. The center of pressure (COP) data were collected using a force plate. COP variables were computed, including linear displacement, total distance, sway area, and complexity. Six supervised machine learning classifiers were trained to classify the ASD postural control based on these COP variables. All machine learning classifiers successfully identified ASD postural control patterns based on the COP features with high accuracy rates (>0.800). The naïve Bayes method was the optimal means to identify ASD postural control with the highest accuracy rate (0.900), specificity (1.000), precision (1.000), F1 score (0.898) and satisfactory sensitivity (0.826). By increasing the sample size and analyzing more data/features of postural control, a better classification performance would be expected. The use of computer-aided machine learning to assess COP data is efficient, accurate, with minimum human intervention and thus, could benefit the diagnosis of ASD.
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7. McDonnell CG, Speidel R, Lawson M, Valentino K. {{Reminiscing and Autobiographical Memory in ASD: Mother-Child Conversations About Emotional Events and How Preschool-Aged Children Recall the Past}}. {J Autism Dev Disord}. 2020.
Autobiographical memory (AM) is a socially-relevant cognitive skill. Little is known regarding AM during early childhood in ASD. Parent-child reminiscing conversations predict AM in non-ASD populations but have rarely been examined in autism. To address this gap, 17 preschool-aged children (ages 4-6 years) with ASD and 21 children without ASD matched on age, sex, and expressive language completed assessments of AM, executive functioning, self-related variables, and a parent-child reminiscing task. Children with ASD had less specific AM, which related to theory of mind, self-concept, and working memory. AM specificity also related to child observed autism traits. Mothers of children with ASD made more closed-ended and off-topic utterances during reminiscing, although only maternal open-ended elaborations predicted better AM in ASD.
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8. Miron O, Delgado RE, Delgado CF, Simpson EA, Yu KH, Gutierrez A, Zeng G, Gerstenberger JN, Kohane IS. {{Prolonged Auditory Brainstem Response in Universal Hearing Screening of Newborns with Autism Spectrum Disorder}}. {Autism Res}. 2020.
Previous studies report prolonged auditory brainstem response (ABR) in children and adults with autism spectrum disorder (ASD). Despite its promise as a biomarker, it is unclear whether healthy newborns who later develop ASD also show ABR abnormalities. In the current study, we extracted ABR data on 139,154 newborns from their Universal Newborn Hearing Screening, including 321 newborns who were later diagnosed with ASD. We found that the ASD newborns had significant prolongations of their ABR phase and V-negative latency compared with the non-ASD newborns. Newborns in the ASD group also exhibited greater variance in their latencies compared to previous studies in older ASD samples, likely due in part to the low intensity of the ABR stimulus. These findings suggest that newborns display neurophysiological variation associated with ASD at birth. Future studies with higher-intensity stimulus ABRs may allow more accurate predictions of ASD risk, which could augment the universal ABR test that currently screens millions of newborns worldwide. LAY SUMMARY: Children with autism spectrum disorder (ASD) have slow brain responses to sounds. We examined these brain responses from newborns’ hearing tests and found that newborns who were later diagnosed with autism also had slower brain responses to sounds. Future studies might use these findings to better predict autism risk, with a hearing test that is already used on millions of newborns worldwide.
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9. Myers L, Karp SM, Dietrich MS, Looman WS, Lutenbacher M. {{Family-Centered Care: How Close Do We Get When Talking to Parents of Children Undergoing Diagnosis for Autism Spectrum Disorders?}}. {J Autism Dev Disord}. 2020.
Autism spectrum disorder (ASD) affects 1:59 children, yet little is known about parents’ perceptions of family-centered care (FCC) during the diagnostic process leading up to diagnosis. This mixed-methods study explored key elements of FCC from 31 parents of children recently diagnosed with ASD using parallel qualitative and quantitative measures. Parents rated highly their receipt of FCC and discussed ways providers demonstrated FCC. However, the majority of parents indicated that the period when their child was undergoing diagnosis was stressful and reported symptoms of depression and anxiety. The study points to ways in which health care providers can enhance FCC provided to families when a child is undergoing ASD diagnosis.
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10. Pitzianti M, Fagioli S, Pontis M, Pasini A. {{Attention Deficits Influence the Development of Motor Abnormalities in High Functioning Autism}}. {Child Psychiatry Hum Dev}. 2020.
Early attentional dysfunction is one of the most consistent findings in autism spectrum disorder (ASD), including the high functioning autism (HFA). There are no studies that assess how the atypical attentional processes affect the motor functioning in HFA. In this study, we evaluated attentional and motor functioning in a sample of 15 drug-naive patients with HFA and 15 healthy children (HC), and possible link between attentional dysfunction and motor impairment in HFA. Compared to HC, HFA group was seriously impaired in a considerable number of attentional processes and showed a greater number of motor abnormalities. Significant correlations between attention deficits and motor abnormalities were observed in HFA group. These preliminary findings suggest that deficit of attentional processes can be implied in motor abnormalities in HFA.
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11. Resciniti NV, Hong Y, McDermott S. {{Factors contributing to antihypertensive medication adherence among adults with intellectual and developmental disability}}. {Journal of intellectual disabilities : JOID}. 2020: 1744629520961958.
Adults with intellectual or developmental disabilities often have hypertension and mental illness, and are prescribed medications for treatment. This study examined psychotropic medication adherence as a mediator between the association of residence type and antihypertensive medication adherence for adults with intellectual or developmental disabilities. We used Medicaid data of adults with intellectual or developmental disabilities who had hypertension and prescribed antihypertensive medication (N = 1,201) to measure the direct effect, indirect effect, and total effect of residence type (home vs. supervised setting) and antihypertensive medication adherence, with a mediator of psychotropic medication adherence. The indirect effect of psychotropic medication adherence on antihypertensive medication adherence was 1.26 (OR = 1.26, CI: 1.08-1.52), holding residency constant. The direct effect of residential type on antihypertensive medication adherence was 3.75 (OR = 3.75, CI: 1.61-8.75). This association may be due to some features of having a mental illness or maybe the result of being prescribed more than one medication.
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12. Stockwell KM, Bottini S, Jaswal VK, Gillis JM. {{Brief Report: Social Behavior and Special Interests in the Stigmatization of Autistic College Students}}. {J Autism Dev Disord}. 2020.
Autistic people, by definition, differ in social behavior from non-autistic individuals. One characteristic common to many autistic people is a special interest in a particular topic-something spoken about with such frequency and intensity that it may be stigmatized by non-autistic peers. We investigated college students’ interest in interacting with peers described as behaving in ways characteristic of autism (or not), and additionally described as having a special interest (or not). As expected, autistic characters were more stigmatized, but autistic characters with a special interest were not more stigmatized than those without. Only among non-autistic characters was having a special interest associated with greater stigmatization. Findings give further insight into factors influencing the stigmatization of autistic college students.
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13. Vandewouw MM, Choi E, Hammill C, Arnold P, Schachar R, Lerch JP, Anagnostou E, Taylor MJ. {{Emotional face processing across neurodevelopmental disorders: a dynamic faces study in children with autism spectrum disorder, attention deficit hyperactivity disorder and obsessive-compulsive disorder}}. {Translational psychiatry}. 2020; 10(1): 375.
Autism spectrum disorder (ASD) is classically associated with poor face processing skills, yet evidence suggests that those with obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) also have difficulties understanding emotions. We determined the neural underpinnings of dynamic emotional face processing across these three clinical paediatric groups, including developmental trajectories, compared with typically developing (TD) controls. We studied 279 children, 5-19 years of age but 57 were excluded due to excessive motion in fMRI, leaving 222: 87 ASD, 44 ADHD, 42 OCD and 49 TD. Groups were sex- and age-matched. Dynamic faces (happy, angry) and dynamic flowers were presented in 18 pseudo-randomized blocks while fMRI data were collected with a 3T MRI. Group-by-age interactions and group difference contrasts were analysed for the faces vs. flowers and between happy and angry faces. TD children demonstrated different activity patterns across the four contrasts; these patterns were more limited and distinct for the NDDs. Processing happy and angry faces compared to flowers yielded similar activation in occipital regions in the NDDs compared to TDs. Processing happy compared to angry faces showed an age by group interaction in the superior frontal gyrus, increasing with age for ASD and OCD, decreasing for TDs. Children with ASD, ADHD and OCD differentiated less between dynamic faces and dynamic flowers, with most of the effects seen in the occipital and temporal regions, suggesting that emotional difficulties shared in NDDs may be partly attributed to shared atypical visual information processing.
