1. AM DM, Olson HA, Johnson KT, Nishith S, Frosch IR, Gabrieli JDE. Personal interests amplify engagement of language regions in the brains of children with and without autism. bioRxiv;2023 (Mar 23)

Behavioral investigations have found that personal interests can profoundly influence language-relevant behaviors; however, the influence of personal interest on language processing in the brain is unknown. We measured brain activation via functional magnetic resonance imaging (fMRI) in 20 children while they listened to personalized narratives written about their specific interests, as well as to non-personalized narratives about a neutral topic. Multiple cortical language regions, as well as select cortical and subcortical regions associated with reward and salience, exhibited greater activation for personally-interesting than neutral narratives. There was also more overlap in activation patterns across individuals for their personally-interesting narratives than neutral narratives, despite the personalized narratives being unique to each individual. These results replicated in a group of 15 children with autism, a condition characterized by both specific interests and difficulties with communication, suggesting that personally-interesting narratives may impact neural language processing even amidst challenges with language and social communication. These findings reveal that engagement with topics that are personally interesting can significantly affect activation in the neocortical and subcortical regions that subserve language, reward, and salience in the brains of children.

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2. Buac M, Ibarra G, Torres R, Onal S, Gladfelter A, Wang Z. The Urgent Need for Neuroscience Research to Consider Culture when Assessing the Development of Gait in Autistic Children: A Scoping Review. J Integr Neurosci;2023 (Mar 23);22(2):51.

BACKGROUND: Over the last decade, there has been a steady increase in the number of children diagnosed with autism spectrum disorder (ASD) on a global scale, impacting all racial and cultural groups. This increase in the diagnostic rate has prompted investigation into a myriad of factors that may serve as early signs of ASD. One of these factors includes the biomechanics of gait, or the manner of walking. Although ASD is a spectrum, many autistic children experience differences in gross motor function, including gait. It has been documented that gait is also impacted by racial and cultural background. Given that ASD is equally prevalent across all cultural backgrounds, it is urgent that studies assessing gait in autistic children consider the impact of cultural factors on children’s development of gait. The purpose of the present scoping review was to assess whether recent empirical research studies focusing on gait in autistic children have taken culture into account. METHODS: To do so, we conducted a scoping review following PRISMA guidelines using a keyword searching with the terms autism, OR autism spectrum disorder, OR ASD, OR autis, AND gait OR walking in the following databases: CINAHL, ERIC (EBSCO), Medline, ProQuest Nursing & Allied Health Source, PsychInfo, PubMed, and Scopus. Articles were considered for review if they met all six of the following inclusionary criteria: (1) included participants with a diagnosis of autism spectrum disorder (ASD), (2) directly measured gait or walking, (3) the article was a primary study, (4) the article was written in English, (5) participants included children up to age 18, and (6) the article was published between 2014 and 2022. RESULTS: A total of 43 articles met eligibility criteria but none of the articles took culture into account in the data analysis process. CONCLUSIONS: There is an urgent need for neuroscience research to consider cultural factors when assessing gait characteristics of autistic children. This would allow for more culturally responsive and equitable assessment and intervention planning for all autistic children.

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3. Chen S, Fan M, Lee BK, Dalman C, Karlsson H, Gardner RM. Rates of maternal weight gain over the course of pregnancy and offspring risk of neurodevelopmental disorders. BMC Med;2023 (Mar 23);21(1):108.

BACKGROUND: Previous studies have suggested that gestational weight gain (GWG) outside an optimal range increases the risks of neurodevelopmental disorders (NDDs) in offspring including autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit/hyperactivity disorder (ADHD). The sequential development of the fetal brain suggests that its vulnerability may vary depending on the timing of exposure. Therefore, we aimed to investigate the associations of not only gestational age-standardized total GWG (GWG z-scores) but also the rate of GWG (RGWG) in the second and third trimesters with risks of NDDs in offspring. METHODS: In this population-based cohort study, we used maternal weight data from antenatal care records collected for 57,822 children born to 53,516 mothers between 2007 and 2010 in the Stockholm Youth Cohort. Children were followed from 2 years of age to December 31, 2016. GWG z-scores and RGWG (kg/week) in the second and third trimesters were considered as continuous variables in cox regression models, clustered on maternal identification numbers. Nonlinear relationships were accommodated using restricted cubic splines with 3 knots. RGWG were also categorized according to the 2009 US Institute of Medicine (IOM) guidelines for optimal GWG. According to the IOM guidelines, the optimal rate of GWG for the second and third trimesters for underweight, normal weight, overweight, and obese categories were 0.44-0.58, 0.35-0.50, 0.23-0.33, and 0.17-0.27 kg/week, respectively. RESULTS: During a mean follow-up of 5.4 years (until children were on average 7.4 years old), 2205 (3.8%) children were diagnosed with NDDs, of which 1119 (1.9%) received a diagnosis of ASD, 1353 (2.3%) ADHD, and 270 (0.5%) ID. We observed a J-shaped association between total GWG z-score and offspring risk of NDDs, with higher total GWG (GWG z-score = 2) associated with 19% increased risk of any NDD (95% CI = 3-37%) and lower total GWG (GWG z-score = - 2) associated with 12% increased risk of any NDDs (95% CI = 2-23%), compared to the reference (GWG z-score = 0). In the second trimester, lower RGWG (0.25 kg/week) was associated with a 9% increased risk of any NDD diagnosis (95% CI = 4-15%) compared to the median of 0.57 kg/week, with no apparent relationship between higher RGWG and risk of NDDs. In the third trimester, there was no apparent association between lower RGWG and risk of NDDs, though higher RGWG (1 kg/week) was associated with a 28% increased risk of NDD diagnosis (95% CI = 16-40%), compared to the median (0.51 kg/week). When considering categorized RGWG, we found that slow weight gain in the second trimester followed by rapid weight gain in the third trimester most significantly increased the risk of ADHD (HR(adjusted) = 1.55, 1.13-2.13) and ID (HR(adjusted) = 2.53, 1.15-5.55) in offspring. The main limitations of our study are the relatively few years for which detailed GWG data were available and the relatively short follow-up for the outcomes, limiting power to detect associations and misclassifying children who receive an NDD diagnosis later in childhood. CONCLUSIONS: The relationship between maternal weight gain and children’s risk of NDDs varied according to timing in pregnancy, with the greatest risks associated with slow weight gain in the second trimester and rapid weight gain in the third trimester.

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4. D’Incal CP, Van Rossem KE, De Man K, Konings A, Van Dijck A, Rizzuti L, Vitriolo A, Testa G, Gozes I, Vanden Berghe W, Kooy RF. Chromatin remodeler Activity-Dependent Neuroprotective Protein (ADNP) contributes to syndromic autism. Clin Epigenetics;2023 (Mar 21);15(1):45.

BACKGROUND: Individuals affected with autism often suffer additional co-morbidities such as intellectual disability. The genes contributing to autism cluster on a relatively limited number of cellular pathways, including chromatin remodeling. However, limited information is available on how mutations in single genes can result in such pleiotropic clinical features in affected individuals. In this review, we summarize available information on one of the most frequently mutated genes in syndromic autism the Activity-Dependent Neuroprotective Protein (ADNP). RESULTS: Heterozygous and predicted loss-of-function ADNP mutations in individuals inevitably result in the clinical presentation with the Helsmoortel-Van der Aa syndrome, a frequent form of syndromic autism. ADNP, a zinc finger DNA-binding protein has a role in chromatin remodeling: The protein is associated with the pericentromeric protein HP1, the SWI/SNF core complex protein BRG1, and other members of this chromatin remodeling complex and, in murine stem cells, with the chromodomain helicase CHD4 in a ChAHP complex. ADNP has recently been shown to possess R-loop processing activity. In addition, many additional functions, for instance, in association with cytoskeletal proteins have been linked to ADNP. CONCLUSIONS: We here present an integrated evaluation of all current aspects of gene function and evaluate how abnormalities in chromatin remodeling might relate to the pleiotropic clinical presentation in individual »s » with Helsmoortel-Van der Aa syndrome.

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5. Galetta MS, Lorentz NA, Lan R, Chan C, Zabat MA, Raman T, Protopsaltis TS, Fischer CR. Reoperation Rates Due to ASD following Primary 1-2 level MIS vs. Open TLIF. Spine (Phila Pa 1976);2023 (Mar 23)

STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To investigate the effect of the approach of the TLIF (open vs. MIS) on reoperation rates due to ASD at 2 – 4 year follow up. SUMMARY OF BACKGROUND DATA: Adjacent segment degeneration (ASDeg) is a complication of lumbar fusion surgery which may progress to adjacent segment disease (ASD) and cause debilitating postoperative pain potentially requiring additional operative management for relief. Minimally invasive (MIS) transforaminal lumbar interbody fusion surgery (TLIF) has been introduced to minimize this complication but the impact on ASD incidence is unclear. METHODS: For a cohort of patients undergoing 1- or 2-level primary TLIF between 2013 and 2019, patient demographics and follow-up outcomes were collected and compared between patients who underwent open versus MIS TLIF using Mann Whitney U test, Fischer’s exact test, and binary logistic regression. RESULTS: 238 patients met inclusion criteria. There was a significant difference in revision rates due to ASD between MIS and open TLIFs at 2 (5.8% vs. 15.4%, P=0.021) and 3 (8% vs. 23.2%, P=0.03) year follow up, with open TLIFs demonstrating significantly higher revision rates. Surgical approach was the only independent predictor of reoperation rates at both 2 and 3 year follow ups (2-year P=0.009; 3-year P=0.011). CONCLUSION: Open TLIF was found to have a significantly higher rate of reoperation due to ASD compared to the MIS approach. Additionally, surgical approach (MIS vs. Open) appears to be an independent predictor of reoperation rates.

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6. George-Levi S, Laslo-Roth R, Ben Yaakov L. Vulnerability to loneliness among fathers of children with autism spectrum disorder: The role of interpersonal and familial resources. Fam Process;2023 (Mar 21):e12877.

Fathers of children with autism spectrum disorder (ASD) might be at increased risk of becoming lonely. In the current study, we explored the differences in loneliness between fathers of children with and without ASD and identified interpersonal and familial resources (social support, family cohesion, and family adaptability) that might be related to levels of loneliness. Using a cross-sectional design, 348 fathers (of 114 children with ASD and 234 without) completed a series of questionnaires. Fathers of children with ASD reported higher levels of loneliness and lower levels of social support and family cohesion. A moderated mediation model indicated that the interaction between social support and family cohesion mediated the association between ASD group (i.e., ASD vs. non-ASD) and fathers’ loneliness. Findings suggest the importance of interpersonal and familial resources (e.g., perceived social support and family cohesion) for family members at risk of loneliness.

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7. Griffin J, Gore N. ‘Different things at different times’: Wellbeing strategies and processes identified by parents of children who have an intellectual disability or who are autistic, or both. J Appl Res Intellect Disabil;2023 (Mar 23)

BACKGROUND: Most parents of children with an intellectual disability or who are autistic identify positives in their family life and their own wellbeing, in addition to reported mental health challenges. Several models and interventions have been developed in relation to parent carer wellbeing. Few studies have asked parent carers how they support their own wellbeing. METHOD: Adopting an interpretive phenomenological approach this study utilised semi-structured interviews. Seventeen parent carers were asked what supported their emotional wellbeing. Template Analysis was applied to develop themes. RESULTS: All participants identified factors that supported their wellbeing. Themes included strategies that countered stress (time for themselves, relaxation, ‘parking’ difficulties) and broader wellbeing strategies (finding meaningful life direction, greater understanding of child). An ongoing process of supporting wellbeing by ‘Reorienting and Finding Balance’ appeared central. CONCLUSIONS: Self-identified, multi-dimensional strategies benefit parents’ emotional wellbeing and should be considered in the context of support provided to families.

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8. Gupta M, Gupta N, Moll J, Ramar D. Buspirone for Comorbid Anxiety in Autism. Prim Care Companion CNS Disord;2023 (Mar 16);25(2)

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9. Harris E. Trofinetide Receives FDA Approval as First Drug for Rett Syndrome. JAMA;2023 (Mar 22)

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10. Jones SC. Advice for autistic people considering a career in academia. Autism;2023 (Mar 23):13623613231161882.

One of the recognised strengths of autistic people is their ability to absorb and retain large amounts of information; autistic children and adolescents are often described as ‘little professors’. So, is the life of a university researcher or teacher the ideal career for an autistic person? In this study, 37 autistic people working in universities and colleges provide advice to young people considering a future career as an academic. They emphasise the importance of understanding the complexities and requirements of the role, understanding and valuing yourself and your strengths, and finding the right people to work with and learn from. They also discuss the importance of maintaining a balance between work and well-being, and between caution and passion. The life of an academic can be ideally suited to an autistic person, but it can also be very challenging.

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11. Kitamura S, Matsuoka K, Takahashi M, Hiroaki Y, Ishida R, Kishimoto N, Yasuno F, Yasuda Y, Hashimoto R, Miyasaka T, Kichikawa K, Kishimoto T, Makinodan M. Association of adverse childhood experience-related increase in neurite density with sensory over-responsivity in autism spectrum disorder: A neurite orientation dispersion and density imaging study. J Psychiatr Res;2023 (Mar 23);161:316-323.

Sensory over-responsivity (SOR) causes social and daily distress in individuals with autism spectrum disorder (ASD). Compared to typically developed (TD) individuals, ASD individuals are at higher risk of adverse childhood experiences (ACEs), which induce abnormal neuronal development. However, whether or how ACEs are associated with abnormal neural development and SOR in ASD remains to be determined. Forty-five individuals with ASD and 43 TD individuals underwent T1-weighted and neurite orientation dispersion and density imaging; the axonal and dendritic densities were defined as the neurite density index (NDI). Voxel-based analyses were performed to explore the brain regions associated with SOR. The relationships between severity of ACEs and SOR, and NDI in the brain regions were examined. ASD individuals showed a significantly positive association between SOR severity and NDI in the right superior temporal gyrus (STG), which was not found in TD individuals. Severity of ACEs correlated significantly with that of SOR and NDI in the right STG in ASD; ASD individuals having severe SOR showed significantly higher NDI in the right STG than those with mild SOR and TD individuals. In individuals with ASD, NDI in the right STG, but not ACEs, could predict the severity of SOR, which was not shown in TD subjects. Our findings suggest that severe ACEs are involved in excessive neurite density in the right STG in ASD. ACE-associated excessive neurite density in the right STG is critical for SOR in ASD, which may be a therapeutic target in the future.

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12. Klusek J, Will E, Moser C, Hills K, Thurman AJ, Abbeduto L, Roberts JE. Correction to: Predictors, Parental Views, and Concordance Across Diagnostic Sources of Autism in Male Youth with Fragile X Syndrome: Clinical Best Estimate and Community Diagnoses. Res Child Adolesc Psychopathol;2023 (Mar 23)

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13. Liu G, Chen Y, Ou P, Huang L, Qian Q, Wang Y, He HG, Hu R. Effects of Parent-Child Sandplay Therapy for preschool children with autism spectrum disorder and their mothers: A randomized controlled trial. J Pediatr Nurs;2023 (Mar 20);71:6-13.

PURPOSE: To evaluate the effects of the Parent-Child Sandplay Therapy (PCST) Program on autism behaviors, social responsiveness and sleep quality among preschool children with autism spectrum disorder (ASD), and their mothers’ parenting stress. DESIGN AND METHODS: A prospective, randomized controlled, parallel-group trial was employed. Fifty-two child-mother dyads were randomly assigned to an intervention group (n = 26) or a control group (n = 26) from February 2017 to February 2019. The intervention group was treated with a 20-week PCST Program plus an Applied Behavior Analysis-based program (ABA-based program), whereas the control group received only the ABA-based program. Outcome measures included the Autism Behavior Checklist total scores, Social Responsiveness Scale scores, Children’s Sleep Habits Questionnaire scores, and Parenting Stress Index-Short Form scores, measured at baseline, post-intervention (20 weeks after baseline) and follow-up assessments (32 weeks after baseline). RESULTS: Finally, 43 dyads completed the study. The linear mixed model analysis resulted in a significant group*time interaction effect of ABC score (Est = 2.027, t = 3.277; p < 0.01), SRS score (Est = 3.377, t = 6.095; p < 0.01), PSI-SF score (Est = 3.873, t = 4.253, p < 0.01), and CSHQ score (Est = 3.158, t = 6.485; p < 0.05). CONCLUSION: Our findings suggested that the PCST Program could potentially improve social interaction and sleep quality of preschool children with ASD while decreasing parenting stress. PRACTICE IMPLICATIONS: The PCST Program was found to be a feasible and a promising treatment for children with mild-to-moderate ASD as well as for their parents. It was a nurse-led program, which could be integrated into the usual nursing care of children with autism spectrum disorder in special education schools. TRIAL REGISTRATION: Chinese Clinical Trials Registry, ChiCTR2100047699.

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14. Maniram J, Oosthuizen F, Karrim SBS. An Overview of Pharmacotherapy in the Management of Children with Autism Spectrum Disorder at a Public Hospital in KwaZulu-Natal. Child Psychiatry Hum Dev;2023 (Mar 22)

This study presents an overview of prescribing patterns and provides insight into the current management practice for the core symptoms and comorbidities of ASD in children. A quantitative retrospective study was conducted at a public hospital in KwaZulu-Natal, South Africa by reviewing patient files of children diagnosed with ASD and meeting the inclusion criteria for the study. A descriptive analysis of data was done to identify treatment trends and patient therapeutic outcomes. A total of 181 children met the inclusion criteria of the study. Risperidone was the most frequently prescribed drug (88%) for the management of comorbidities and/or core symptoms of ASD. Drugs prescribed to manage ASD comorbidities included methylphenidate, melatonin, sodium valproate, risperidone, oxybutynin, carbamazepine, and others. Except for risperidone, there were no additional drugs that targeted the core symptoms of ASD. Non-pharmacological therapies were often used collaboratively with medication to manage ASD symptoms. In 41% of patients, there were improvements in their symptoms.

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15. Miner S, McVoy M, Damato E. Evaluation of the Relationship of Sleep Disturbances to Severity and Common Behaviors in Autism Spectrum Disorder. Res Sq;2023 (Mar 23)

Background : Autism spectrum disorder (ASD) is one of the most puzzling disorders of childhood. Recent research of comorbidities that accompany ASD and are commonly attributed to the diagnosis, indicate that they may contribute to the severity of behavioral symptoms of the disorder. Disturbed sleep in all children can decrease cognition, decrease focus, increase performance problems, and alter mood and behavior. Children with ASD experience an increased sensitivity to disturbed sleep that may increase the severity of the disorder. Disturbed sleep patterns, such as increased sleep latency, nighttime waking and early arousal, have been identified in up to 80% of children with ASD. This study explored the relationship of disturbed sleep and the severity of the core ASD symptoms. Methods : Actigraphy and an accompanying sleep diary captured disturbed sleep patterns in 24 children, ages 6-12, with ASD. Participants wore a GT3X actigraphy monitor for 7 nights to collect data on patterns of disturbed sleep. Parents completed a sleep diary and the Autism Spectrum Rating Scale (ASRS) questionnaire. A descriptive analysis was used to report the characteristics of nighttime sleep and sleep efficiency as well as sleep disturbances. Pearson’s r determined the relationships between the number of sleep disturbances and the severity of ASD behavioral scores and diagnostic severity (determined by the ASRS). Results : Of the 24 study participants, almost 92% had one or more sleep disturbances. A positive correlation was present between the number of sleep disturbances and the severity of delays in social and communication symptoms. A moderate effect size was found between the number of sleep disturbances and unusual behaviors in ASD suggests a possible, unanticipated, inverse relationship. Conclusions : Exploring the relationship of disturbed sleep to behavior and symptom severity in children with ASD can provide an understanding of how poor sleep influences ASD symptoms. This study identified distinct differences in ASD symptom severity between and within individual participants and found unique, and unexpected, symptom patterns. This finding supports the need, in research and treatment, to identify comorbidities and symptoms that contribute to individual behavioral profiles and phenotypes of the disorder.

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16. Orm S, Dean M, Fletcher-Watson S, Nordahl-Hansen A. Short report: Autistic adults’ recommendations on how to improve autistic portrayals in TV-series and movies. Res Dev Disabil;2023 (Mar 20);136:104484.

BACKGROUND: TV-series and movies are important sources of knowledge about autism for the general public. AIMS: This study’s purpose was to elicit autistic adults’ opinions on portrayals of autistic characters in film and television productions and how this can be improved. METHODS AND PROCEDURE: In this study, we examined the recommendations of autistic adults (n = 798, M(age) = 30.3, 48% female) and non-autistic adults (n = 1463, M(age) = 35.0, 62% female) from 90 countries on how film and television productions can improve autistic portrayals. OUTCOMES AND RESULTS: Autistic adults rated three improvement factors as most important: (1) Appointing autistic writers, (2) Having an autistic consultant, and (3) Representing greater diversity in autistic characters. Compared to the non-autistic groups, autistic adults rated « Appointing autistic writers » as more important. Autistic participants also endorsed « Having an autism-expert consultant » and « Making the character display all relevant diagnostic criteria » significantly less than non-autistic groups. CONCLUSIONS AND IMPLICATIONS: Participants strongly endorsed that autistic adults should to a much larger extent be included as writers, consultants and actors to enhance the making of autistic characters in film and TV.

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17. Scott SR, Millwood SN, Manczak EM. Adipocytokine correlates of childhood and adolescent mental health: A systematic review. Dev Psychobiol;2023 (Apr);65(3):e22379.

The objective of this systematic review was to determine the current state of the literature regarding how adipocytokines associate with mental health symptoms/disorders in youth. Findings summarized in this review suggested that in neurodevelopmental disorders, higher levels of leptin, ghrelin, resistin, and visfatin as well as lower levels of adiponectin, retinol-binding protein 4, and progranulin predicted increased risk for or were conflated with autism spectrum disorder. Adipocytokine correlates of attention-deficit hyperactivity disorder and related symptoms included higher apelin, higher leptin-to-adiponectin ratio, and lower adiponectin. Evidence from studies examining anxiety symptoms evinced mixed results regarding leptin, and one study suggested higher levels of ghrelin. Depressive symptoms correlated with higher leptin and ghrelin. Research examining posttraumatic stress symptoms found higher levels of ghrelin. In research examining broadband symptoms, conflicting results emerged for associations between internalizing symptoms (i.e., symptoms of emotional stress) and leptin in youth. Low levels of adiponectin and high levels of leptin predicted externalizing symptoms. Total symptom difficulties were associated with a higher leptin-to-adiponectin ratio. Our findings suggest that adipocytokines may be an important set of biomarkers to consider as underlying mechanisms contributing to developmental psychopathology.

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18. Ventura M, Innamorato F, Palmisano A, Cicinelli G, Nobile E, Manippa V, Keller R, Rivolta D. Investigating the impact of disposable surgical face-masks on face identity and emotion recognition in adults with autism spectrum disorder. Autism Res;2023 (Mar 23)

With the outburst of the COVID-19 pandemic, disposable surgical face-masks (DSFMs) have been widely adopted as a preventive measure. DSFMs hide the bottom half of the face, thus making identity and emotion recognition very challenging, both in typical and atypical populations. Individuals with autism spectrum disorder (ASD) are often characterized by face processing deficits; thus, DSFMs could pose even a greater challenge for this population compared to typically development (TD) individuals. In this study, 48 ASDs of level 1 and 110 TDs underwent two tasks: (i) the Old-new face memory task, which assesses whether DSFMs affect face learning and recognition, and (ii) the Facial affect task, which explores DSFMs’ effect on emotion recognition. Results from the former show that, when faces were learned without DSFMs, identity recognition of masked faces decreased for both ASDs and TDs. In contrast, when faces were first learned with DSFMs, TDs but not ASDs benefited from a « context congruence » effect, that is, faces wearing DSFMs were better recognized if learned wearing DSFMs. In addition, results from the Facial affect task show that DSFMs negatively impacted specific emotion recognition in both TDs and ASDs, although differentially between the two groups. DSFMs negatively affected disgust, happiness and sadness recognition in TDs; in contrast, ASDs performance decreased for every emotion except anger. Overall, our study demonstrates a general, although different, disruptive effect on identity and emotion recognition both in ASD and TD population.

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19. Wamsley B, Bicks L, Cheng Y, Kawaguchi R, Quintero D, Grundman J, Liu J, Xiao S, Hawken N, Margolis M, Mazariegos S, Geschwind DH. Molecular cascades and cell-type specific signatures in ASD revealed by single cell genomics. bioRxiv;2023 (Mar 10)

Understanding how genetic variation exerts its effects on the human brain in health and disease has been greatly informed by functional genomic characterization. Studies over the last decade have demonstrated robust evidence of convergent transcriptional and epigenetic profiles in post-mortem cerebral cortex from individuals with Autism Spectrum Disorder (ASD). Here, we perform deep single nuclear (sn) RNAseq to elucidate changes in cell composition, cellular transcriptomes and putative candidate drivers associated with ASD, which we corroborate using snATAC-seq and spatial profiling. We find changes in cell state composition representing transitions from homeostatic to reactive profiles in microglia and astrocytes, a pattern extending to oligodendrocytes and blood brain barrier cells. We identify profound changes in differential expression involving thousands of genes across neuronal and glial subtypes, of which a substantial portion can be accounted for by specific transcription factor networks that are significantly enriched in common and rare genetic risk for ASD. These data, which are available as part of the PsychENCODE consortium, provide robust causal anchors and resultant molecular phenotypes for understanding ASD changes in human brain.

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20. Yeh TC, Chen MH, Bai YM, Tsai SJ, Hsu JW, Huang KL, Su TP, Chen TJ, Liang CS. Longitudinal follow-up of subsequent psychiatric comorbidities among children and adolescents with autism spectrum disorder. J Affect Disord;2023 (Mar 23);331:245-250.

BACKGROUND: The mental health of children and adolescents with autism spectrum disorder (ASD) is a concern of recent years. However, a large-scale longitudinal study investigating the risk and the time course of subsequent psychiatric comorbidities is still lacking. METHODS: Using the Taiwan National Health Insurance Research Database, 13,382 children and adolescents with ASD, and 53,528 age- and sex-matched non-ASD controls were enrolled between 2001 and 2009, and followed to the end of 2011. The adjusted hazard ratio (HR) with a corresponding 95 % confidence interval for psychiatric comorbidities among children and adolescents with ASD vs matched controls was estimated. The subjects who developed schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and obsessive-compulsive disorder (OCD) were identified during the follow-up. RESULTS: Children and adolescents with ASD compared with controls were more likely to be diagnosed with schizophrenia (19.21; 13.74, 26.88), bipolar disorder (17.59; 12.66, 24.44), depressive disorder (5.56; 4.72, 6.56), anxiety disorder (5.01; 4.49, 5.59), and OCD (16.12; 11.66, 22.30) later in life. The time course of subsequent psychiatric comorbidity showed that anxiety disorder occurred first, usually in late childhood, with psychotic and affective disorders proceeding in adolescence. Those with ASD and anxiety disorder had an additionally increased likelihood of developing subsequent psychiatric comorbidity compared with those with ASD only. LIMITATION: In claims data analysis, clinical parameters or possible confounders may not be fully captured. CONCLUSION: Patients with ASD are predisposed to the development of anxiety disorder in late childhood, as well as schizophrenia, bipolar disorder, depressive disorder, and OCD in adolescence.

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