1. Attanasio M, Mazza M, Le Donne I, Nigri A, Valenti M. Salience Network in Autism: preliminary results on functional connectivity analysis in resting state. Eur Arch Psychiatry Clin Neurosci. 2024.

The literature suggests that alterations in functional connectivity (FC) of the Salience Network (SN) may contribute to the manifestation of some clinical features of Autism Spectrum Disorder (ASD). The SN plays a key role in integrating external sensory information with internal emotional and bodily information. An atypical FC of this network could explain some symptomatic features of ASD such as difficulties in self-awareness and emotion processing and provide new insights into the neurobiological basis of autism. Using the Autism Brain Imaging Data Exchange II we investigated the resting-state FC of core regions of SN and its association with autism symptomatology in 29 individuals with ASD compared with 29 typically developing (TD) individuals. In ASD compared to TD individuals, seed-based connectivity analysis showed a reduced FC between the rostral prefrontal cortex and left cerebellum and an increased FC between the right supramarginal gyrus and the regions of the middle temporal gyrus and angular gyrus. Finally, we found that the clinical features of ASD are mainly associated with an atypical FC of the anterior insula and the involvement of dysfunctional mechanisms for emotional and social information processing. These findings expand the knowledge about the differences in the FC of SN between ASD and TD, highlighting atypical FC between structures that play key roles in social cognition and complex cognitive processes. Such anomalies could explain difficulties in processing salient stimuli, especially those of a socio-affective nature, with an impact on emotional and behavioral regulation.

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2. Ezedinma U, Jones E, Ring A, Miller S, Ladhams A, Fjaagesund S, Downer T, Campbell G, Oprescu F. Short report on a distinct electroencephalogram endophenotype for MTHFR gene variation co-occurring in autism spectrum disorder. Autism. 2024: 13623613241305721.

Methylenetetrahydrofolate reductase mutations refer to genetic variations in the methylenetetrahydrofolate reductase enzyme, which plays an important role in folate metabolism. Folate is essential for neural development and signalling. Children with autism spectrum disorder have atypical neural signals compared with control. This study used a non-invasive method to identify a distinct neural signal that may be useful in future screening for methylenetetrahydrofolate reductase mutation in children with autism spectrum disorder. Given that the underlying causes of autism spectrum disorder have multiple genetic factors and often require subjective assessment, this study introduces a potential non-invasive screening method for methylenetetrahydrofolate reductase gene mutation. This method could provide valuable biomarkers for screening and personalised treatments, offering hope for improved risk stratification and bespoke nutritional support and supplements to mitigate the impact on affected individuals and their descendants.

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3. Huntjens A, van den Bosch LW, Sizoo B, Kerkhof A, Smit F, van der Gaag M. Secondary effects of dialectical behaviour therapy on social functioning, quality of life, and autism traits in autistic adults with suicidality. Autism. 2024: 13623613241302875.

Dialectical behaviour therapy is a comprehensive treatment that helps individuals improve distress tolerance, mindfulness, interpersonal effectiveness and emotion regulation. It is commonly used to assist those experiencing self-harm and suicidal thoughts or behaviours. Despite its broad application, our understanding of how dialectical behaviour therapy impacts autistic individuals with suicidal behaviour remains limited. This study compared dialectical behaviour therapy with treatment as usual in 123 autistic adults experiencing suicidal behaviours. Participants were recruited from six mental health centres, with 63 receiving dialectical behaviour therapy and 60 receiving treatment as usual. The study assessed outcomes such as social functioning, quality of life and specific autism traits over 12 months. Findings revealed that dialectical behaviour therapy led to significant improvements in social functioning and quality of life compared to treatment as usual, though there were no effects on autism traits. These improvements suggest that dialectical behaviour therapy holds promise as an effective treatment for autistic individuals grappling with suicidal behaviour. The findings strongly support the broader implementation of dialectical behaviour therapy in mental health centres, especially given the limited treatment options available for autistic individuals with suicidal tendencies.

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4. Lampinen LA, Zheng S, Olson L, Bishop SL. Brief Report: Psychometric Properties of the Brief Problem Monitor-Parent (BPM-P) 6-18 in a Sample of Children Referred to an Autism Specialty Clinic. J Autism Dev Disord. 2024.

Detection and monitoring of emotional and behavior problems is a critical part of clinical care for children diagnosed with autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs), as well as a common focus of research. The Child Behavior Checklist (CBCL) is a well-established caregiver-report instrument that is used for screening and monitoring of emotional and behavior problems in individuals diagnosed with ASD and NDDs. However, it has over 100 items and can be time-consuming to complete. The Brief Problem Monitor Parent Report (BPM-P; Achenbach et al. 2011) includes a subset of the CBCL items and is intended for monitoring emotional and behavior problems. However, its validity has not been examined in ASD or NDD samples. Data from 302 children ages 6-18 years whose caregivers had completed the CBCL were drawn from a clinical research databank. Confirmatory factor analysis of the BPM-P three-factor structure had mixed findings. All BPM-P scales had acceptable internal consistency, and agreement between the BPM-P cutoffs and the corresponding CBCL clinical cutoffs was acceptable for the broad problem scales. The Attention scale demonstrated high sensitivity, but poor specificity. Results provide initial evidence that the BPM-P may be a useful alternative to the CBCL, producing comparable information for broad problems, while requiring much less time from caregivers. BPM-P users may want to consider the Attention scale separately due to poor specificity compared to the CBCL. These results will need to be replicated using larger samples and independent administrations of the BPM-P and the CBCL.

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5. Lee R, Clough S. Autism spectrum condition: an update for dental practitioners – Part 1. Br Dent J. 2024; 237(11): 850-6.

Autism spectrum condition is a complex neurodevelopmental condition that poses lifelong challenges. The first part of this two-part series aims to update dental practitioners on the correct language used in society, the prevalent comorbidities associated with autism, the barriers that hinder dental care provision and current legislation. The paper aims to update clinicians on their understanding of autism and allow clinicians to make necessary steps to provide reasonable adjustments to enhance care accessibility to individuals with autism.

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6. Schiff LD, Hester AOD, Benevides T. Providing Effective Medical Care to Autistic People. N Engl J Med. 2024; 391(24): 2281-3.

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7. Stillesjö S, Hjärtström H, Johansson AM, Rudolfsson T, Säfström D, Domellöf E. Action execution and observation in autistic adults: A systematic review of fMRI studies. Autism Res. 2024.

Motor impairments are common in individuals with autism spectrum disorder (ASD) although less is known about the neural mechanisms related to such difficulties. This review provides an outline of functional magnetic resonance imaging (fMRI) findings associated with execution and observation of naturalistic actions in autistic adults. Summarized outcomes revealed that adults with ASD recruit similar brain regions as neurotypical adults during action execution and during action observation, although with a difference in direction and/or magnitude. For action execution, this included higher and lower activity bilaterally in the precentral cortex, the parietal cortex, the inferior frontal gyrus (IFG), the middle temporal gyrus (MTG), the occipital cortex, and the cerebellum. For action observation, differences mainly concerned both higher and lower activity in bilateral IFG and right precentral gyrus, and lower activity in MTG. Activity overlaps between action execution and observation highlight atypical recruitment of IFG, MTG, precentral, and parieto-occipital regions in ASD. The results show atypical recruitment of brain regions subserving motor planning and/or predictive control in ASD. Atypical brain activations during action observation, and the pattern of activity overlaps, indicate an association with difficulties in understanding others’ actions and intentions.

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8. Zhang E, Snyder M, Alduraidi W, Kaiser E, Hunley S, Wright L, Swinburne Romine R, Nelson EL, Cheak-Zamora N. Health care transition for autistic adolescents and young adults: A pilot rural and urban comparison survey study. Autism. 2024: 13623613241304495.

Autistic adolescents and young adults in rural areas face significant challenges in health care transition compared to their urban counterparts. Health care transition, the process of moving from pediatric to adult health care, is crucial for the long-term health outcomes of adolescents and young adults. Previous research indicates rural adolescents and young adults often have greater unmet medical and financial needs, affecting their transition experiences, but there was no study focusing on rural autistic adolescents and young adults’ health care transition experiences. This pilot study provides a comparative analysis of the health care transition experiences of rural and urban autistic adolescents and young adults. Ninety-six urban and 84 rural participants (14-25 years old) participated in the study. Their average age was 19.67 years. Just over half of the participants had completed the transition to adult care, typically reporting finishing this process at around 18 years old. A majority had limited discussions with their doctors about transitioning, and those who had discussions often started these conversations late. It also reveals that the responses completed by or with parents of autistic adolescents and young adults tend to indicate that the adolescents and young adults would not make future medical decisions or are uncertain about it. The findings underscore the necessity for targeted support for autistic adolescents and young adults during their health care transition process, regardless of their residence. There is a clear need for targeted health care transition interventions for adolescents and young adults, parents, and health care providers to ensure autistic adolescents and young adults and their families receive adequate support during the health care transition process.

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9. Zoltowski AR, Convery CA, Eyoh E, Plump E, Sullivan M, Arumalla ER, Quinde-Zlibut JM, Keceli-Kaysili B, Lewis B, Cascio CJ. Sensory Processing and Anxiety: Within and Beyond the Autism Spectrum. Curr Top Behav Neurosci. 2024.

In this article, we briefly overview how the expression, measurement, and treatment of anxiety in autism may be different from the general population. We review the literature on links between sensory processing differences and anxiety, which show transdiagnostic patterns but are an especially prominent feature of anxiety in autism. Specifically, we focus on how the sense of interoception, i.e., how we perceive sensory information from within our bodies, contributes to anxiety in autism. We present new findings integrating multimodal interoceptive measures and total anxiety symptoms in a sample of n = 38 non-autistic and n = 43 autistic individuals, ages 8-55 years. Using principal components analysis, we found two components relating to interoceptive confusion (i.e., self-reported ability to localize and interpret interoceptive cues): one component that closely relates to anxiety symptoms and one component that is distinct from anxiety. Interoceptive perception (i.e., performance on a lab-based task) was uniformly related to interoceptive confusion when distinguished from anxiety but showed complex relations with total anxiety symptoms. Combined, these findings suggest meaningful subtypes of interoceptive difficulties and their interrelationship with anxiety. We present conclusions and future directions for consideration of individual differences, toward creating a personalized understanding of anxiety-interoception links.

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