1. Bent S, Dang K, Widjaja F, Lawton B, Nazneen, Hendren RL. {{Examining Clinics for Children with Autism: The Autism Translating To Treatments (AT3) Study}}. {J Altern Complement Med}. 2017.
OBJECTIVES: Certain clinical providers specialize in providing complementary and integrative medicine (CIM) therapies for children with autism spectrum disorder (ASD). Because many of these providers and their patients/families have reported substantial improvement, the authors developed an online platform to carefully examine these clinical practices. The initial goal was to examine the feasibility of prospective data collection in this setting. The larger goals were to characterize the tests and treatments used in these clinics; examine associations between specific treatments, biomarkers, and improved outcomes; and identify promising treatments for future study. DESIGN: Prospective cohort study. SETTING: Four CIM clinics specializing in treating children with ASD. PATIENTS: Children with ASD age 2-8 years. INTERVENTIONS: The study protocol provided no interventions, but all interventions provided by the CIM clinical providers were recorded. OUTCOME MEASURES: Aberrant Behavior Checklist (ABC); Social Responsiveness Scale (SRS); and instruments that assessed sensory sensitivity, language, gastrointestinal (GI) symptoms, pediatric quality of life, and caregiver strain. RESULTS: Fourteen children were enrolled (mean age, 4.4 years). Over 3 months, the total behavior score (ABC) decreased (improved) from 110.8 to 103.8 (change, -7.0; 95% confidence interval [CI], -27.9 to 13.9), and the total social responsiveness score (SRS) decreased (improved) from 133.8 to 127.2 (change, -6.6; 95% CI, -30.5 to 17.3), but these changes were not statistically significant. Similarly, caregiver strain and pediatric quality of life decreased (improved) but by a nonsignificant amount. More severe GI symptoms and more severe ASD symptoms were associated with lower quality of life (p < 0.001). CONCLUSIONS: Barriers to successful data collection were identified. Despite these challenges, this study could confirm interesting associations between data elements, highlighting the future value of similar systems for improving evidence-based care in this population. Lien vers le texte intégral (Open Access ou abonnement)
2. Deschrijver E, Wiersema JR, Brass M. {{Disentangling Neural Sources of the Motor Interference Effect in High Functioning Autism: An EEG-Study}}. {J Autism Dev Disord}. 2017.
The role of imitation in autism spectrum disorder (ASD) is controversial. Researchers have argued that deficient control of self- and other-related motor representations (self-other distinction) might explain imitation difficulties. In a recent EEG study, we showed that control of imitation relies on high-level as well as on low-level cognitive processes. Here, we aimed to further our insights into control of imitation deficits in ASD. We focused on congruency effects in the P3 (high-level), the N190 and the readiness potential (RP; low-level). We predicted smaller congruency effects within the P3 in the ASD group. However, we found differences in the RP and not in the P3-component. Thus, high-level self-other distinction centred on motor actions may be preserved in ASD, while impairments are reflected during motor preparation.
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3. Feng C, Chen Y, Pan J, Yang A, Niu L, Min J, Meng X, Liao L, Zhang K, Shen L. {{Redox proteomic identification of carbonylated proteins in autism plasma: insight into oxidative stress and its related biomarkers in autism}}. {Clin Proteomics}. 2017; 14: 2.
BACKGROUND: Autism is a severe childhood neurological disorder with poorly understood etiology and pathology. Currently, there is no authentic laboratory test to confirm the diagnosis of autism. Oxidative damage may play a central role in the pathogenesis of autism. Present study is an effort to search for possible biomarkers of autism and further clarify the molecular changes associated with oxidative stress that occurs in the plasma of autistic children. METHODS: We performed redox proteomics analysis to compare carbonylated proteins in the plasma of autistic subjects and healthy controls. Immunoprecipitation and Western blot analysis were used to validate carbonylated proteins identified by the redox proteomics. RESULTS: Protein carbonylation levels in two proteins, complement component C8 alpha chain and Ig kappa chain C were found to be significantly increased in autistic patients compared with controls. These two proteins were successfully validated via immunoprecipitation and Western blot analysis. CONCLUSIONS: The results further highlight the role of oxidative stress in the pathogenesis of autism and provide some information for the diagnosis and/or monitoring of autism.
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4. Horvath A, Lukasik J, Szajewska H. {{omega-3 Fatty Acid Supplementation Does Not Affect Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis}}. {J Nutr}. 2017.
BACKGROUND: Effective treatments for the core symptoms of autism spectrum disorder (ASD) are still lacking. OBJECTIVE: We aimed to update the data on the effectiveness of omega-3 (n-3) fatty acid (FA) supplementation as a treatment for ASD. METHODS: The Cochrane Library, MEDLINE, and EMBASE databases were systematically searched up until August 2016, with no language restrictions for randomized controlled trials (RCTs) comparing omega-3 FA supplementation with placebo or with no supplementation. Participants were children diagnosed with ASD. All functional outcome measures reported were considered. For dichotomous outcomes, the results for individual studies and pooled statistics were reported as RRs. Mean differences (MDs) were calculated for continuous outcomes. RESULTS: Five RCTs (183 participants) were included. With 4 exceptions, there were no statistically significant differences in ASD symptoms between groups measured by validated scales. Among studies that used the Aberrant Behavior Checklist, parents’ ratings indicated significant improvement in lethargy symptoms in the omega-3 FA group compared with the placebo group (2 RCTs) (pooled MD: 1.98; 95% CI: 0.32, 3.63). Among studies that used the Behavioral Assessment System for Children, parents’ ratings indicated significant worsening of both externalizing behavior (2 RCTs) (pooled MD: -6.22; 95% CI: -10.9, -1.59) and social skills (1 RCT) (MD: -7; 95% CI: -13.62, -0.38) in the omega-3 FA group compared with the placebo group. One RCT reported a significant improvement in the omega-3 FA group for the daily-living component of the Vineland Adaptive Behavior Scale (MD: 6.2; 95% CI: 0.37, 12.03). Adverse effects were similar in both groups. CONCLUSIONS: Because of the limited number of included studies and small sample sizes, no firm conclusions can be drawn. However, the limited data currently available suggest that omega-3 FA supplementation does not enhance the performance of children with ASD.
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5. Kheirouri S, Kalejahi P, Noorazar SG. {{Plasma levels of serotonin, gastrointestinal symptoms,and sleep problems in children with autism}}. {Turk J Med Sci}. 2016; 46(6): 1765-72.
BACKGROUND/AIM: Autism is a neurodevelopmental disorder identified with higher frequency of serotonin abnormalities and gastrointestinal (GI) and sleep problems. This study aimed to evaluate the plasma levels of serotonin, GI symptoms, and sleep problems, and their relationship with autism severity in children with autism. MATERIALS AND METHODS: Thirty-five children with autism and 31 healthy subjects were studied. GI problems, sleep disorders, and severity of disorder were assessed. Plasma serotonin was determined using ELISA. RESULTS: There was no significant association between GI problems and autism severity, but a significant positive correlation was seen between different indicators of sleep disorder and severity of autism. Plasma levels of serotonin were significantly higher in autistic children and a significant negative correlation was observed between plasma levels of serotonin and autism severity (r = -0.39, P = 0.02). CONCLUSION: Elevated plasma serotonin in autistic children and its negative correlation with disease severity may indicate involvement of the neurotransmitter in the neurophysiologic mechanism of autism.
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6. Laugeson EA. {{Disruptive behaviour may hinder the acquisition of daily living skills for youth with autism spectrum disorder}}. {Evid Based Ment Health}. 2017.
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7. Malhi P, Venkatesh L, Bharti B, Singhi P. {{Feeding Problems and Nutrient Intake in Children with and without Autism: A Comparative Study}}. {Indian J Pediatr}. 2017.
OBJECTIVE: To compare parent reported feeding difficulties and nutritional adequacy of children with Autism Spectrum Disorders (ASD) to an age and socio-economically matched group of typically developing children. METHODS: The scores on Children’s Eating Behavior Inventory (CEBI), three-day food records, anthropometric measures and adequacy of micro- and macro- nutrients were compared for 63 children diagnosed with ASD and 50 typically developing children enrolled from the department of pediatrics of a tertiary care teaching hospital from North India. RESULTS: The majority (79%) of the parents of ASD children reported some concern regarding their feeding behavior as compared to 64% of the parents of typically developing children. As compared to controls, ASD children had significantly higher CEBI scores (97.28 vs. 89.48, t = 3.15, P = 0.002) and more feeding problems (6.42 vs. 2.70, t = 3.74, P = 0.001). Relative to controls, ASD children consumed fewer number of food items (P = 0.022), particularly fruits (P = 0.004), vegetables (P = 0.011), and proteins (P = 0.015); had significantly lower daily intake of potassium (P = 0.001), copper (P = 0.007), and folate (P = 0.001). Although children with autism did not differ significantly from controls on intake of calories, height, weight, or body mass index, significantly greater proportion of ASD children failed to meet the estimated average requirement of thiamine (P = 0.039), vitamin C (P = 0.013), and copper (P = 0.005). CONCLUSIONS: The findings underscore the need for comprehensive assessment and empirically-supported interventions for eating problems and dietary deficiencies found in ASD children.
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8. Pantelis PC, Kennedy DP. {{Autism does not limit strategic thinking in the « beauty contest » game}}. {Cognition}. 2017; 160: 91-7.
A popular hypothesis in developmental psychology is that individuals with autism spectrum disorder (ASD) have a specific impairment or developmental delay in their ability to reason about other people’s mental processes, especially when this reasoning process is of a higher-order, recursive, or nested variety. One type of interpersonal interaction that involves this sort of complex reasoning about others’ minds is an economic game, and because economic games have been extensively modeled in behavioral economics, they provide a unique testbed for a quantitative and precise analysis of cognitive functioning in ASD. This study specifically asked whether ASD is associated with strategic depth in the economic game known as The Beauty Contest, in which all players submit a number from 0 to 100, and the winner is the player who submits the number closest to 2/3 of the mean of all numbers submitted. Unexpectedly, the distribution of responses among adult participants with ASD reflected a level of strategic reasoning at least as deep as that of their neurotypical peers, with the same proportion of participants with ASD being characterized as « higher order » strategic players. Thus, whatever mentalistic reasoning abilities are necessary for typical performance in the context of this economic game appear to be largely intact, and therefore unlikely to be fundamental to persistent social dysfunction in ASD.
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9. Scharkowski F, Frotscher M, Lutz D, Korte M, Michaelsen-Preusse K. {{Altered Connectivity and Synapse Maturation of the Hippocampal Mossy Fiber Pathway in a Mouse Model of the Fragile X Syndrome}}. {Cereb Cortex}. 2017.
The Fragile X syndrome (FXS) as the most common monogenetic cause of cognitive impairment and autism indicates how tightly the dysregulation of synapse development is linked to cognitive deficits. Symptoms of FXS include excessive adherence to patterns that point to compromised hippocampal network formation. Surprisingly, one of the most complex hippocampal synapses connecting the dentate gyrus (DG) to CA3 pyramidal neurons has not been analyzed in FXS yet. Intriguingly, we found altered synaptic function between DG and CA3 in a mouse model of FXS (fmr1 knockout [KO]) demonstrated by increased mossy fiber-dependent miniature excitatory postsynaptic current (mEPSC) frequency at CA3 pyramidal neurons together with increased connectivity between granule cells and CA3 neurons. This phenotype is accompanied by increased activity of fmr1 KO animals in the marble burying task, detecting repetitive and obsessive compulsive behavior. Spine apparatus development and insertion of AMPA receptors is enhanced at postsynaptic thorny excrescences (TEs) in fmr1 KO mice. We report age-dependent alterations in TE morphology and in the underlying actin dynamics possibly linked to a dysregulation in profilin1 expression. TEs form detonator synapses guiding CA3 network activity. Thus, alterations described here are likely to contribute substantially to the impairment in hippocampal function and therefore to the pathogenesis of FXS.
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10. Walsh C, Jones B, Schonwald A. {{Health Care Transition Planning Among Adolescents with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2017.
Improving the health care transition process for youth with autism spectrum disorder (ASD) is critically important. This study was designed to examine the overall national transition core outcome among youth with ASD and each of the component measures of health care transition planning. Fewer than 10% of youth with ASD meet the national transition core outcome. Among youth with ASD, there is greater disparity in health care transition planning for non-Hispanic black youth, youth with family income <400% of the federal poverty line, and youth with more severe activity limitation. Continued advocacy, research, and training efforts are needed to reduce disparities in receipt of health care transition planning services for youth with ASD. Lien vers le texte intégral (Open Access ou abonnement)
11. Whitehouse AJ. {{Elizabeth Usher Memorial Lecture: Rethinking the clinical pathway for autism spectrum disorder and challenging the status quo}}. {Int J Speech Lang Pathol}. 2017: 1-10.
Autism spectrum disorder (ASD) is typically diagnosed between 2 and 5 years of age, which is currently thought to be the earliest that the behavioural symptoms are able to be identified without ambiguity. A significant problem with this relatively « late » age of diagnosis is that by the time a child has been identified and diagnosed with ASD, many of the best opportunities for therapies to capitalise upon brain plasticity very early in development are not realised. This paper provides an overview of the benefits and drawbacks of the current clinical pathway that places primacy on a diagnostic assessment for triggering the commencement of therapy. The paper then presents an alternative clinical pathway – the identification and provision of therapy to infants at risk of ASD – and provides a critical review of current evidence supporting this model. The aim of the paper is to outline a vision for the future of early identification and intervention of individuals with ASD, and the research goals that need to be addressed to achieve this vision.
