Pubmed du 20/02/21
1. Al-Saleh I, Elkhatib R, Alrushud N, Alnuwaysir H, Alnemer M, Aldhalaan H, Shoukri M, McWalter P, Alkhenizan A. Potential health risks of maternal phthalate exposure during the first trimester – The Saudi Early Autism and Environment Study (SEAES). Environmental research. 2021 : 110882.
Phthalates are the most ubiquitous contaminants that we are exposed to daily due to their wide use as plasticizers in various consumer products. A few studies have suggested that in utero exposure to phthalates can disturb fetal growth and development in humans, because phthalates can interfere with endocrine function. We collected spot urine samples from 291 pregnant women in their first trimester (9.8 ± 2.3 gestational weeks) recruited in an ongoing prospective cohort study in Saudi Arabia. A second urine sample was collected within 1-7 d after enrollment. The aims of this study were to : (1) assess the extent of exposure to phthalates during the first trimester and (2) estimate the risk from single and cumulative exposures to phthalates. Most phthalate metabolites’ urinary levels were high, several-fold higher than those reported in relevant studies from other countries. The highest median levels of monoethyl phthalate, mono-n-butyl phthalate (MnBP), mono-iso-butyl phthalate (MiBP), and mono-(2-ethylhexyl) phthalate (MEHP) in μg/l (μg/g creatinine) were 245.62 (197.23), 114.26 (99.45), 39.59 (34.02), and 23.51 (19.92), respectively. The MEHP levels were highest among three di(2-ethylhexyl) phthalate (DEHP) metabolites. %MEHP(4), the ratio of MEHP to four di(2-ethylhexyl) phthalate metabolites (∑(4)DEHP), was 44%, indicating interindividual differences in metabolism and excretion. The hazard quotient (HQ) of individual phthalates estimated based on the reference dose (RfD) of the U.S. Environmental Protection Agency indicated that 58% (volume-based) and 37% (creatinine-based) of the women were at risk of exposure to ∑(4)DEHP (HQ>1). Based on the tolerable daily intake (TDI) from the European Food Safety Authority, 35/12% (volume-/creatinine-based data) of the women were at risk of exposure to two dibutyl phthalate (∑DBP) metabolites (MiBP and MnBP). The cumulative risk was assessed using the hazard index (HI), the sum of HQs of all phthalates. The percentages of women (volume-/creatinine-based data) at health risks with an HI >1 were 64/40% and 42/22% based on RfD and TDI, respectively. In view of these indices for assessing risk, our results for the anti-androgenic effects of exposing pregnant women to ∑(4)DEHP and ∑DBP early during pregnancy are alarming.
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2. Avino T, Hutsler JJ. Supernumerary neurons within the cerebral cortical subplate in autism spectrum disorders. Brain Res. 2021 ; 1760 : 147350.
Autism spectrum disorders (ASDs) involve alterations to cortical connectivity that manifest as reduced coordinated activity between cortical regions. The neurons of the cortical subplate are a major contributor to establishing thalamocortical, corticothalamic and corticocortical long-range connections and only a subset of this cell population survives into adulthood. Previous reports of an indistinct gray-white matter boundary in subjects with ASD suggest that the adjacent subplate may also show organizational abnormalities. Frozen human postmortem tissue samples from the parietal lobe (BA7) were used to evaluate white-matter neuron densities adjacent to layer VI with an antibody to NeuN. In addition, fixed postmortem tissue samples from frontal (BA9), parietal (BA7) and temporal lobe (BA21) locations, were stained with a Golgi-Kopsch procedure, and used to examine the morphology of these neuronal profiles. Relative to control cases, ASD subjects showed a large average density increase of NeuN-positive profiles of 44.7 percent. The morphologies of these neurons were consistent with subplate cells of the fusiform, polymorphic and pyramidal cell types. Lower ratios of fusiform to other cell types are found early in development and although adult ASD subjects showed consistently lower ratios, these differences were not significant. The increased number of retained subplate profiles, along with cell type ratios redolent of earlier developmental stages, suggests either an abnormal initial population or a partial failure of the apoptosis seen in neurotypical development. These results indicate abnormalities within a neuron population that plays multiple roles in the developing and mature cerebral cortex, including the establishment of long-range cortical connections.
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3. Bentenuto A, Perzolli S, Bertamini G, Venuti P, de Falco S. Paternal speech directed to young children with Autism Spectrum Disorders and typical development. Res Dev Disabil. 2021 ; 112 : 103886.
BACKGROUND : Few studies have investigated the characteristics of father language directed to typically developing children (TD), and father speech directed to children with Autism Spectrum Disorders (ASD) is largely under investigated. Considering the importance of involving fathers of children with ASD in research and clinical practice, the main purpose of this study was to investigate paternal speech directed to children with ASD compared to that of fathers of TD children. METHODS : To this aim, we coded multiple functional aspects of speech during 10-min naturalistic dyadic play interactions between fathers and their preschool children with ASD (n = 20) and with TD (n = 20). RESULTS : Results showed that fathers of children with ASD displayed a peculiar child-directed language that seems to reflect the effort to provide enhanced scaffolding and reduced demands while sustaining a challenging social interaction. Specifically, fathers of children with ASD used more descriptions, fewer questions in general but more questions about child internal states. Moreover, fathers adapted aspects of their information-salient speech to the severity of child impairments. CONCLUSIONS : Our findings support the importance to include fathers in early developmental intervention programs for children with ASD, by underlying fathers’ spontaneous adaptation to their children’s needs.
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4. Chetcuti L, Uljarević M, Ellis-Davies K, Hardan AY, Whitehouse AJO, Hedley D, Putnam S, Hudry K, Prior MR. Temperament in individuals with Autism Spectrum Disorder : A systematic review. Clinical psychology review. 2021 ; 85 : 101984.
The study of temperament in Autism Spectrum Disorder (ASD) has the potential to provide insight regarding variability in the onset, nature, and course of both core and co-morbid symptoms. The aim of this systematic review was to integrate existing findings concerning temperament in the context of ASD. Searches of Medline, PsychInfo and Scopus databases identified 64 relevant studies. As a group, children and adolescents with ASD appear to be temperamentally different from both typically developing and other clinical non-ASD groups, characterized by higher negative affectivity, lower surgency, and lower effortful control at a higher-order level. Consistent with research on typically developing children, correlational findings and emerging longitudinal evidence suggests that lower effortful control and higher negative affect are associated with increased internalizing and externalizing problems in ASD samples. Longitudinal studies suggest there may be temperamental differences between high familial risk infants who do and do not develop ASD from as early as 6-months of age. Limitations of existing research are highlighted, and possible directions for future research to capitalize on the potential afforded through the study of temperament in relation to ASD are discussed.
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5. Dierick F, Buisseret F, Eggermont S. Low-Cost Sensors and Biological Signals. Sensors (Basel, Switzerland). 2021 ; 21(4).
Low-cost sensors, i […].
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6. Giroux M, Pélissier-Simard L. Shedding light on autistic traits in struggling learners : A blind spot in medical education. Perspectives on medical education. 2021.
Some highly challenging, seemingly « unsolvable » situations that arise in medical education could be the result of autistic traits (AT) in learners. AT exist in physicians and learners, ranging from profiles compatible with DSM-5’s criteria for autism spectrum disorder (ASD) to more subtle manifestations of ASD’s « broader phenotype. » Often associated with strengths and talents, AT may nonetheless pose significant challenges for learning, teaching, and practising medicine. Since AT remain widely under-recognized and misunderstood by educators, clinicians, and affected individuals alike, they represent a blind spot in medical education. The use of a « neurodiversity lens » to examine challenging situations may help educators consider different pedagogical approaches to address those potentially stemming from AT.This paper aims to raise awareness and understanding of AT-related difficulties in struggling medical learners. To overcome the blind spot challenge and help develop this « neurodiversity lens, » we explore different angles. Beyond any diagnostic consideration, we offer a series of contextual examples, paralleled with explanatory concepts from the field of ASD. We also underline the role of context on functional impact and describe the often ill-defined pattern of challenges encountered, as well as the fertile grounds for interpersonal misunderstandings and disrespect. We propose historical, cultural, and clinical reasons likely contributing to the blind spot. Mindful of the potential risks of prejudice associated with identifying AT-related difficulties, we underline the necessity and feasibility of conciliating diversity and dignity with accountability standards for medical competence.
