Pubmed du 23/11/20

Pubmed du jour

2020-11-23 12:03:50

1. Arvind B, Kothari SS. {{Combination of F-ASO and TMT: Is Natural History of All ASD With Severe PAH Altered?}}. {JACC Cardiovascular interventions}. 2020; 13(22): 2708.

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2. Ayhan AB, Beyazıt U, Topuz Ş, Tunay Ç Z, Abbas MN, Yılmaz S. {{Autism Spectrum Disorder and Genetic Testing: Parents’ Attitudes-Data from Turkish Sample}}. {J Autism Dev Disord}. 2020.

We aimed to examine the opinions of parents’ having a child with ASD, on genetic testing, in a Turkish sample. 951 parents’ attitudes towards genetic testing were included. 89.1% of the parents did not take a genetic test during pregnancy. 87.6% of the parents agreed to take a genetic test if it could explain the cause of ASDs. 93% agreed to take a genetic test, if it would help to have a better treatment in the future. 63.8% of the participants would approve the storage of their DNA samples for the future studies. 94.8% considered being informed about the purpose of taking DNA material for the early diagnosis and 84.2% considered being suggested genetic tests for early diagnosis as important.

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3. Bonfim TA, Giacon-Arruda BCC, Hermes-Uliana C, Galera SAF, Marcheti MA. {{Family experiences in discovering Autism Spectrum Disorder: implications for family nursing}}. {Revista brasileira de enfermagem}. 2020; 73(s6): e20190489.

OBJECTIVES: to describe the family’s experience in the process of discovering the diagnosis and initiation of treatment of children with Autism Spectrum Disorder. METHODS: this qualitative and descriptive study interviewed nine relatives of eight children on autism spectrum. They were inserted in health services, public education, and Association of Parents and Friends of The Exceptional of cities in the countryside of the Center-West. Data were collected through open interviews from July to September 2017. Data was submitted to thematic analysis. RESULTS: at the beginning, the family was difficult to perceive the first atypical signs presented by the children. Families experience situations of vulnerability, since support networks are insufficient. The school played a significant role in recognizing unexpected behaviors. FINAL CONSIDERATIONS: support, offered by nurses, health professionals, school and social support devices, is important to family and children in this trajectory.

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4. Busti Ceccarelli S, Ferrante C, Gazzola E, Marzocchi GM, Nobile M, Molteni M, Crippa A. {{Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder: A 10-Year Narrative Review}}. {Children (Basel, Switzerland)}. 2020; 7(11).

In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have critical implications for subsequent cognitive and social development. Nevertheless, this area of development is particularly underexamined in the autism-related context, and early intervention programs commonly focus on the core symptoms of the condition. In the present work, we review and discuss the findings from recent studies that investigated the effect of interventions regarding fundamental motor skills in autistic children. Although the limited nature of the literature prevents researchers from drawing definitive conclusions, the results from the studies discussed here demonstrated potentially significant improvements in the motor abilities of autistic children after the interventions. Only a subset of the reviewed studies explored possible changes in the sociocommunicative domain after the motor skills improvements, and they had not concordant, although promising, conclusions. Overall, in consideration of the well-documented motor impairment people with the condition, the present findings highlight the importance of including motor skills training within the rehabilitation programs designed for autistic children. Furthermore, this narrative review encourages future interventional trials to consider motor skills as a possible target for reducing activity limitations and participation restrictions of autistic children.

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5. Chen JY, Strodl E, Wu CA, Huang LH, Yin XN, Wen GM, Sun DL, Xian DX, Chen YJ, Yang GY, Chen WQ. {{Screen time and autistic-like behaviors among preschool children in China}}. {Psychology, health & medicine}. 2020: 1-14.

Screen time is becoming increasingly common in daily life. Early and excessive screen use has raised growing concerns for children’s neuropsychological development. The purpose of this study was to evaluate the association between exposure to screen time in early life and the presence of autistic-like behaviors among preschool children. 29,461 child-caregiver dyads at kindergartens in Longhua New District of Shenzhen, China, were enrolled in this cross-sectional study. Information concerning socio-demographic characteristics, frequency and duration of children’s electronic screen exposure for each year since birth, and autistic-like behaviors (measured by the Autism Behavior Checklist) were collected using a self-administered structured questionnaire completed by the primary caregivers. A series of logistic regression models assessed the association between screen time and autistic-like behaviors. Results indicated that younger initial age, longer daily screen time and longer cumulative years of screen exposure since birth were associated with the presence of autistic-like behaviors at preschool age. The risk was enhanced with the increase of both daily screen time and cumulative years of screen exposure during preschool period. Moreover, the cross-over analysis indicated that the first three years following birth might be a sensitive period for children when screen exposure increases the risk of experiencing autistic-like behaviors. In conclusion, our study implied that screen exposure in early life might increase the occurrence of autistic-like behaviors among preschoolers. These findings support the need for early interventions into preschoolers’ screen use, however longitudinal studies are necessary to further confirm the causal relationship between early screen time and the incidence of later autistic-like behaviors among preschool children.

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6. Chen S, Zhao S, Dalman C, Karlsson H, Gardner R. {{Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention-deficit/hyperactivity disorder and intellectual disability}}. {International journal of epidemiology}. 2020.

BACKGROUND: Maternal diabetes has been associated with a risk of neurodevelopmental disorders (NDDs) in offspring, though the common co-occurrence of autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and intellectual disability (ID) is rarely considered, nor is the potential for confounding by shared familial factors (e.g. genetics). METHODS: This population-based cohort study used data from Psychiatry Sweden, a linkage of Swedish national registers, to follow 2 369 680 individuals born from 1987 to 2010. We used population-averaged logit models to examine the association between exposure to maternal type 1 diabetes mellitus (T1DM), pre-gestational type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM), and odds of NDDs in offspring. Subgroup analysis was then performed to investigate the timings of GDM diagnosis during pregnancy and its effect on the odds of NDDs in offspring. We compared these results to models considering paternal lifetime T1DM and T2DM as exposures. RESULTS: Overall, 45 678 individuals (1.93%) were diagnosed with ASD, 20 823 (0.88%) with ID and 102 018 (4.31%) with ADHD. All types of maternal diabetes were associated with odds of NDDs, with T2DM most strongly associated with any diagnosis of ASD (odds ratioadjusted 1.37, 95% confidence interval 1.03-1.84), ID (2.09, 1.53-2.87) and ADHD (1.43, 1.16-1.77). Considering common co-morbid groups, the associations were strongest between maternal diabetes and diagnostic combinations that included ID. Paternal T1DM and T2DM diagnoses were also associated with offspring NDDs, but these associations were weaker than those with maternal diabetes. Diagnosis of GDM between 27 and 30 weeks of gestation was generally associated with the greatest risk of NDDs in offspring, with the strongest associations for outcomes that included ID. CONCLUSION: The association of maternal diabetes with NDDs in offspring varies depending on the co-morbid presentation of the NDDs, with the greatest odds associated with outcomes that included ID. Results of paternal-comparison studies suggest that the above associations are likely to be partly confounded by shared familial factors, such as genetic liability.

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7. Garcia JM, Lawrence S, Brazendale K, Leahy N, Fukuda D. {{Brief report: The impact of the COVID-19 pandemic on health behaviors in adolescents with Autism Spectrum Disorder}}. {Disability and health journal}. 2020: 101021.

BACKGROUND: There is concern that the COVID-19 pandemic may negatively affect health behaviors in youth, especially youth diagnosed with Autism Spectrum Disorder (ASD). OBJECTIVE: The purpose of this paper was to examine changes in physical activity, screen-time, and sleep in adolescents with ASD due to the COVID-19 pandemic. METHODS: Nine adolescents with ASD completed surveys measuring physical activity, screen-time, and sleep duration prior to and during the pandemic. RESULTS: A significant decrease in days of physical activity (4.17 vs 2.27; p = 0.0006), and a significant increase in hours of both weekday (3.69 vs 6.25; p = 0.007) and weekend screen-time (5.94 vs. 7.39; p = 0.004) was observed during the pandemic. No changes regarding sleep duration was observed. CONCLUSIONS: Although preliminary, results suggest that physical activity and screen-time may be negatively affected by the COVID-19 outbreak in youth with ASD. The development of interventions to promote health behaviors in ASD populations during long periods of less-structured time (quarantine) should be considered.

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8. Landes SD, Turk MA, Lauer E. {{Recommendations for Accurately Reporting Intellectual and Developmental Disabilities on Death Certificates}}. {American journal of preventive medicine}. 2020; 59(6): 892-5.

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9. Li S, Yan C. {{Reply: Combination of F-ASO and TMT: Is Natural History of All ASD With Severe PAH Altered?}}. {JACC Cardiovascular interventions}. 2020; 13(22): 2708-9.

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10. Mussap M, Siracusano M, Noto A, Fattuoni C, Riccioni A, Rajula HSR, Fanos V, Curatolo P, Barberini L, Mazzone L. {{The Urine Metabolome of Young Autistic Children Correlates with Their Clinical Profile Severity}}. {Metabolites}. 2020; 10(11).

Autism diagnosis is moving from the identification of common inherited genetic variants to a systems biology approach. The aims of the study were to explore metabolic perturbations in autism, to investigate whether the severity of autism core symptoms may be associated with specific metabolic signatures; and to examine whether the urine metabolome discriminates severe from mild-to-moderate restricted, repetitive, and stereotyped behaviors. We enrolled 57 children aged 2-11 years; thirty-one with idiopathic autism and twenty-six neurotypical (NT), matched for age and ethnicity. The urine metabolome was investigated by gas chromatography-mass spectrometry (GC-MS). The urinary metabolome of autistic children was largely distinguishable from that of NT children; food selectivity induced further significant metabolic differences. Severe autism spectrum disorder core deficits were marked by high levels of metabolites resulting from diet, gut dysbiosis, oxidative stress, tryptophan metabolism, mitochondrial dysfunction. The hierarchical clustering algorithm generated two metabolic clusters in autistic children: 85-90% of children with mild-to-moderate abnormal behaviors fell in cluster II. Our results open up new perspectives for the more general understanding of the correlation between the clinical phenotype of autistic children and their urine metabolome. Adipic acid, palmitic acid, and 3-(3-hydroxyphenyl)-3-hydroxypropanoic acid can be proposed as candidate biomarkers of autism severity.

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11. Phan L, Tariq A, Lam G, Pang EW, Alain C. {{The Neurobiology of Semantic Processing in Autism Spectrum Disorder: An Activation Likelihood Estimation Analysis}}. {J Autism Dev Disord}. 2020.

Semantic processing impairments are present in a proportion of individuals with autism spectrum disorder (ASD). Despite the numerous imaging studies investigating this language domain in ASD, there is a lack of consensus regarding the brain structures showing abnormal pattern of activity. This meta-analysis aimed to identify neural activation patterns present during semantic processing in ASD. Findings reveal activation of areas associated with semantic processing and executive functions in ASD. However, the activation was less concise in comparison to controls and there was less activation in the right hemisphere and in areas associated with executive functions. This provides strong support for impaired semantic processing in ASD that is consistently associated with abnormal patterns of neural activity in the semantic network.

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12. Rhodus EK, Barber J, Abner EL, Bardach SH, Gibson A, Jicha GA. {{Comparison of behaviors characteristic of autism spectrum disorder behaviors and behavioral and psychiatric symptoms of dementia}}. {Aging & mental health}. 2020: 1-9.

BACKGROUND: Similarities exist in behavioral expression of autism spectrum disorder (ASD) and Alzheimer’s disease and related dementias (ADRD). The purpose of this study was to assess presence of behavioral and psychiatric symptoms of dementia (BPSD) and ASD-like behaviors in adults with ADRD. METHODS: Using a cross-sectional design, data from University of Kentucky Alzheimer’s Disease Center participant cohort were used. Hierarchical linear regression was used to assess (1) the relationship between ASD-like behaviors (measured by the Gilliam Autism Rating Scale-Second Edition, GARS-2) and BPSD measured by the Neuropsychiatric Inventory (NPI), and (2) the relationship between ASD-like behaviors and dementia severity (measured by the Clinical Dementia Rating [CDR] sum of boxes), when controlling for BPSD. RESULTS: Complete data were available for 142 participants. Using α of 0.05, analyses identified ASD behaviors were significantly associated with BPSD severity ratings (r = 0.47; p < 0.001) and dementia severity (r = 0.46; p < 0.001). GARS-2 explained 6.1% (p < 0.001) of variance in CDR sum of boxes when controlling for NPI and other covariates. DISCUSSION: There is significant overlap in behaviors characteristic of ASD and BPSD as assessed by the NPI and GARS-2, despite the use of these instruments in disparate developmental vs. aging settings. ASD behaviors appear to not be solely present in early childhood as a manifestation of ASD but are also present in older adults with neurodegenerative cognitive impairment. Such associations warrant additional research into causation, assessment, and behavioral interventions to further enable new therapeutic approaches targeting ASD behaviors across the lifespan. Lien vers le texte intégral (Open Access ou abonnement)

13. Rosenbrock GJ, Mire SS, Kim HJ, Aguirre-Munoz Z. {{Exploring sociodemographic predictors of parents’ perceptions about their children’s autism and their families’ adjustment}}. {Res Dev Disabil}. 2020; 108: 103811.

BACKGROUND: Diagnostic and treatment disparities exist among sociodemographically diverse families with autism spectrum disorder (ASD). These disparities may be partially explained by the lack of information researchers and providers have regarding the unique experiences of diverse populations. AIMS: This study aimed to explore sociodemographic predictors of parents’ perceptions about their children’s ASD and families’ adjustment. METHODS: Hierarchical linear regression analyses were conducted to explore whether sociodemographic factors predicted aspects of parent’s perceptions and family adjustment among 363 parents of children and adolescents with ASD. RESULTS: Parents’ race/ethnicity, education level, and annual household income predicted their beliefs that they or treatment could be helpful in controlling their children’s ASD symptoms; their understanding of ASD; their experiences of emotional distress; their involvement in resources of support; and their families’ ability to manage stress. CONCLUSION: Our results demonstrate the importance of considering the complexity of families’ demographic characteristics when working to support families with ASD. Parents’ unique characteristics and experiences influence their perceptions about their children’s ASD diagnosis and their families’ ability to adjust to life raising children with ASD. Research extending this work is a critical step in dismantling ASD diagnostic and treatment disparities.

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14. Shillington A, Capal JK. {{Genetic testing in patients with nonsyndromic autism spectrum disorder and EEG abnormalities with or without epilepsy: Is exome trio-based testing the best clinical approach?}}. {Epilepsy Behav}. 2020: 107564.

OBJECTIVES: The association between autism spectrum disorder (ASD) and epilepsy is well-known. Abnormalities on electroencephalography (EEG) studies have been reported in patients with ASD without a history of seizures, and these patients have lower functional scores on adaptive measures than patients with ASD with normal EEG studies. The purpose of the study was to evaluate the genetic test approach in children with ASD and abnormal EEGs. METHODS: Data were collected from medical records at Cincinnati Children’s Hospital Medical Center (CCHMC) of a previously published cohort of patients with well-characterized ASD based on evaluation by Developmental Pediatrics. Patients were subdivided into two groups: ASD without epilepsy, but with abnormal EEG results, and ASD with epilepsy. EEG data were abstracted from reports. In this follow-up study, we analyzed genetic testing data, namely the proportion of this cohort that received genetic testing, and the specific type of genetic testing that was ordered to analyze if there were any differences between groups. RESULTS: Analysis was performed on 173 patients with ASD. Ninety-five patients had a diagnosis of epilepsy. Seventy-eight patients did not have a diagnosis of epilepsy but did have abnormal EEGs. In both groups, approximately three quarters of all subjects received routine neurodevelopmental genetic testing (77% versus 72% p = 0.15) without significant differences between groups. The ASD + epilepsy group was more likely to receive additional second-tier genetic testing outside of a routine neurodevelopmental workup (35% versus 15% p = 0.007). The ASD + epilepsy group was more likely to receive phenotype specific panels, most often an epilepsy gene panel of less than 250 genes (15% versus 3% p = 0.008). However, the ASD + epilepsy group was less likely to receive a genetic diagnosis from testing than the ASD + abnormal EEG group (9% versus 33%, p = 0.047). CONCLUSIONS: Patients with ASD along with a formal epilepsy diagnosis received more genetic testing; but had an overall lower diagnostic rate than patients with ASD with abnormal EEGs but without a formal epilepsy diagnosis. Patients in this cohort without a diagnosis of epilepsy were more likely to get broad trio-based exome testing instead of targeted epilepsy gene panel testing. A higher diagnostic rate was found in patients when a broad genetic test strategy was implemented.

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15. Terloyeva D, Frey AJ, Park BY, Kauffman EM, Mathew L, Bostwick A, Varner EL, Lee BK, Croen LA, Fallin MD, Hertz-Picciotto I, Newschaffer CJ, Lyall K, Snyder NW. {{Meconium androgens are correlated with ASD-related phenotypic traits in early childhood in a familial enriched risk cohort}}. {Mol Autism}. 2020; 11(1): 93.

BACKGROUND: Prenatal exposure to increased androgens has been suggested as a risk factor for autism spectrum disorder (ASD). This hypothesis has been examined by measurement of steroids in amniotic fluid, cord blood, saliva, and blood with mixed results. METHODS: To provide an orthogonal measure of fetal exposure, this study used meconium, the first stool of a newborn, to measure prenatal androgen exposure from infants in the Early Autism Risk Longitudinal Investigation (EARLI). EARLI is a familial-enriched risk cohort that enrolled pregnant mothers who already had a child with an ASD diagnosis. In the younger child, we investigated the association between meconium unconjugated (u) and total (t) concentrations of major androgens testosterone (T), dehydroepiandrosterone (DHEA), and androstenedione (A4), and ASD-related traits at 12 and 36 months of age. Traits were measured at 12 months with Autism Observation Scale for Infants (AOSI) and at 36 months with total score on the Social Responsiveness Scale (SRS). One hundred and seventy children had meconium and AOSI, 140 had meconium and SRS, and 137 had meconium and both AOSI and SRS. RESULTS: Separate robust linear regressions between each of the log-transformed androgens and log-transformed SRS scores revealed three-way interaction between sex of the child, sex of the proband, and testosterone concentration. In the adjusted analyses, t-T, u-A4, and u-DHEA (P ≤ 0.01) were positively associated with AOSI scores, while u-T (P = 0.004) and u-DHEA (P = 0.007) were positively associated with SRS total score among females with female probands (n = 10). Additionally, higher concentrations of u-T (P = 0.01) and t-T (P = 0.01) predicted higher SRS total score in males with male probands (n = 63). Limitations Since we explored three-way interactions, this resulted in a limited sample size for some analyses. This study was from an enriched-risk cohort which may limit generalizability, and this study used ASD-assessment scales as outcomes instead of diagnostic categories. Additionally, the novel use of meconium in this study limits the ability to compare the results in this cohort to others due to the paucity of research on meconium. CONCLUSIONS: This study supports the utility of meconium for studies of endogenous fetal metabolism and suggests the sex of older siblings with autism should be considered as a biological variable in relevant studies.

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16. Vettori S, Van der Donck S, Nys J, Moors P, Van Wesemael T, Steyaert J, Rossion B, Dzhelyova M, Boets B. {{Combined frequency-tagging EEG and eye-tracking measures provide no support for the « excess mouth/diminished eye attention » hypothesis in autism}}. {Mol Autism}. 2020; 11(1): 94.

BACKGROUND: Scanning faces is important for social interactions. Difficulty with the social use of eye contact constitutes one of the clinical symptoms of autism spectrum disorder (ASD). It has been suggested that individuals with ASD look less at the eyes and more at the mouth than typically developing (TD) individuals, possibly due to gaze aversion or gaze indifference. However, eye-tracking evidence for this hypothesis is mixed. While gaze patterns convey information about overt orienting processes, it is unclear how this is manifested at the neural level and how relative covert attention to the eyes and mouth of faces might be affected in ASD. METHODS: We used frequency-tagging EEG in combination with eye tracking, while participants watched fast flickering faces for 1-min stimulation sequences. The upper and lower halves of the faces were presented at 6 Hz and 7.5 Hz or vice versa in different stimulation sequences, allowing to objectively disentangle the neural saliency of the eyes versus mouth region of a perceived face. We tested 21 boys with ASD (8-12 years old) and 21 TD control boys, matched for age and IQ. RESULTS: Both groups looked longer at the eyes than the mouth, without any group difference in relative fixation duration to these features. TD boys looked significantly more to the nose, while the ASD boys looked more outside the face. EEG neural saliency data partly followed this pattern: neural responses to the upper or lower face half were not different between groups, but in the TD group, neural responses to the lower face halves were larger than responses to the upper part. Face exploration dynamics showed that TD individuals mostly maintained fixations within the same facial region, whereas individuals with ASD switched more often between the face parts. LIMITATIONS: Replication in large and independent samples may be needed to validate exploratory results. CONCLUSIONS: Combined eye-tracking and frequency-tagged neural responses show no support for the excess mouth/diminished eye gaze hypothesis in ASD. The more exploratory face scanning style observed in ASD might be related to their increased feature-based face processing style.

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17. Yoshida K, Koyama E, Zai CC, Beitchman JH, Kennedy JL, Lunsky Y, Desarkar P, Müller DJ. {{Pharmacogenomic Studies in Intellectual Disabilities and Autism Spectrum Disorder: A Systematic Review: Études Pharmacogénomiques en Déficiences Intellectuelles et Trouble du Spectre de L’autisme: Une Revue Systématique}}. {Can J Psychiatry}. 2020: 706743720971950.

BACKGROUND: Individuals with intellectual disability (ID) and autism spectrum disorder (ASD) often receive psychotropic medications such as antipsychotics and antidepressants to treat aberrant behaviors and mood symptoms, frequently resulting in polypharmacy and drug-related adverse effects. Pharmacogenomic (PGx) studies with ASD and/or ID (ASD/ID) have been scarce despite the promise of optimizing treatment outcomes. We reviewed the literature on PGx studies with antipsychotics and antidepressants (e.g., treatment response and adverse effects) in ASD/ID. METHODS: We performed a systematic review using MEDLINE, Embase, and PsycINFO, including peer-reviewed original articles in English referring to PGx in the treatment of ASD/ID in any age groups (e.g., treatment response and adverse effects). RESULTS: A total of 28 PGx studies using mostly candidate gene approaches were identified across age groups. Notably, only 3 studies included adults with ASD/ID while the other 25 studies focused specifically on children/adolescents with ASD/ID. Twelve studies primarily investigated treatment response, of which 5 and 6 studies included patients treated with antipsychotics and antidepressants, respectively. Most interesting results for response were reported for 2 sets of candidate gene studies, namely: (1) The DRD3 Ser9Gly (rs6280) polymorphism was examined in patients treated with risperidone in 3 studies, 2 of which reported an association with risperidone treatment response and (2) the SLC6A4 5-HTTLPR polymorphism and treatment response to antidepressants which was investigated in 4 studies, 3 of which reported significant associations. In regard to side effects, 9 of 15 studies focused on hyperprolactinemia in patients treated with risperidone. Among them, 7 and 5 studies examined the impact of CYP2D6 and DRD2 Taq1A polymorphisms, respectively, yielding mostly negative study findings. CONCLUSIONS: There is limited data available on PGx in individuals with ASD/ID and in particular in adults. Given the potential for PGx testing in improving treatment outcomes, additional PGx studies for psychotropic treatment in ASD/ID across age groups are warranted.

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18. Yoshimura S, Kobayashi K, Ueno T, Miyagi T, Oishi N, Murai T, Fujiwara H. {{Autistic traits are associated with the functional connectivity of between-but not within-attention systems in the general population}}. {BMC neuroscience}. 2020; 21(1): 49.

BACKGROUND: Previous studies have demonstrated that individuals with autism spectrum disorder (ASD) exhibit dysfunction in the three attention systems (i.e., alerting, orienting, and executive control) as well as atypical relationships among these systems. Additionally, other studies have reported that individuals with subclinical but high levels of autistic traits show similar attentional tendencies to those observed in ASD. Based on these findings, it was hypothesized that autistic traits would affect the functions and relationships of the three attention systems in a general population. Resting-state functional magnetic resonance imaging (fMRI) was performed in 119 healthy adults to investigate relationships between autistic traits and within- and between-system functional connectivity (FC) among the three attention systems. Twenty-six regions of interest that were defined as components of the three attention systems by a previous task-based fMRI study were examined in terms of within- and between-system FC. We assessed autistic traits using the Autism-Spectrum Quotient. RESULTS: Correlational analyses revealed that autistic traits were significantly correlated with between-system FC, but not with within-system FC. CONCLUSIONS: Our results imply that a high autistic trait level, even when subclinical, is associated with the way the three attention systems interact.

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19. Yule S, Wanik J, Holm EM, Bruder MB, Shanley E, Sherman CQ, Fitterman M, Lerner J, Marcello M, Parenchuck N, Roman-White C, Ziff M. {{Nutritional Deficiency Disease Secondary to ARFID Symptoms Associated with Autism and the Broad Autism Phenotype: A Qualitative Systematic Review of Case Reports and Case Series}}. {Journal of the Academy of Nutrition and Dietetics}. 2020.

BACKGROUND: The demographics, weight statuses, and dietary patterns of people with autism or the broad autism phenotype who experience a severe nutrient deficiency disease due to symptoms of avoidant/restrictive food intake disorder have not been well established. OBJECTIVE: The primary objective of this review was to examine the relationship between the demographics, weight statuses, dietary patterns, and nutrient deficiency diseases that characterize the most severe manifestations of avoidant/restrictive food intake disorder symptomology associated with autism or the broad autism phenotype. METHODS: A systematic review of English and non-English articles published up to August 29, 2019, on the Scopus, PubMed, and Cumulative Index to Nursing and Allied Health Literature Plus electronic databases was conducted. Additional cases were identified through the reference list of all included articles. The search terms used were « autis(∗) AND (deficiency OR scurvy) ». Only case reports or case series in which a person of any age who had been identified as having a formal diagnosis of autism or autism symptoms and a disease of nutritional deficiency due to self-imposed dietary restrictions were included. Data were independently extracted by 8 authors using predefined data fields. RESULTS: A total of 76 cases (patients were aged 2.5 to 17 years) from 63 articles that were published from 1993 through 2019 were found. More than 85% cases (65 of 76 patients) were from articles published in the past 10 years. The largest percentage of published cases (69.7% [53 of 76]) involved scurvy, a vitamin C deficiency. The second-largest percentage of published cases (17.1% [13 of 76]) involved eye disorders secondary to vitamin A deficiency. Other primary nutrient deficiencies reported were thiamin, vitamin B-12, and vitamin D. In 62.9% (22 of 35) of the patients for which a body mass index or a weight percentile for age was provided, the patient was within normal weight parameters, per Centers for Disease Control weight status categories. CONCLUSIONS: Based on the 63 articles extracted for this systematic review, nutritional deficiency diseases related to inadequate intakes of vitamin A, thiamin, vitamin B-12, vitamin C, and vitamin D were found in individuals with autism and the broad autism phenotype who had severe self-imposed dietary restrictions. When weight information was provided, most of the youth in these cases were not reported to be underweight. Individuals of any weight who present with symptoms of avoidant/restrictive food intake disorder can benefit from early and frequent screening for adequacy of micronutrient intake, regardless of whether they have a clinical diagnosis of autism.

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