1. {{Corrections: Prevalence of long-term health conditions in adults with autism: observational study of a whole country population}}. {BMJ Open};2019 (Feb 22);8(11):e023945corr023941.
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2. Adams D, Clark M, Simpson K. {{The Relationship Between Child Anxiety and the Quality of Life of Children, and Parents of Children, on the Autism Spectrum}}. {J Autism Dev Disord};2019 (Feb 25)
Children on the autism spectrum experience high rates of anxiety but little is known about the impact of anxiety on child or parent quality of life (QoL). This study aimed to investigate the relationship between anxiety, autism characteristics, and QoL in children and their parents. Sixty-four parents of children on the spectrum completed questionnaires on their child’s autism characteristics, anxiety symptomatology, and both child (PedsQL) and parent QoL (WHOQoL-BREF). Parents of children with elevated anxiety reported lower child and parent QoL. Regression models highlight specific anxiety subscales as predictive of PedsQL school and emotional functioning but not of parent QoL. Anxiety symptomatology may be a significant factor contributing to specific aspects of QoL for children on the spectrum.
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3. Doshi PK, Hegde A, Desai A. {{Nucleus Accumbens (NAc) DBS for obsessive compulsive disorder and aggression in an autistic patient: a case report and hypothesis of the role of NAc in autism and co-morbid symptoms}}. {World Neurosurg};2019 (Feb 21)
BACKGROUND: Autism spectrum disorder (ASD) is a set of developmental disorders characterized by lack of social interaction, verbal and non-verbal communication in the first 3 years of life. It is also associated with several co-morbidities, including epilepsy, aggression, self-mutilating behaviour and obsessive-compulsive behaviour. In some cases this can turn in to obsessive compulsive disorder (OCD). Nucleus accumbens (NAc) plays a key role in reward circuitry and is also involved in the control of OCD and aggression. CASE DESCRIPTION: A 42 years old Autistic lady suffering from OCD and aggression was offered NAc DBS for her comorbidities of OCD and aggression. NAc was targeted using standard stereotactic methods and the postoperative scans confirmed the position of the active electrode to be within the NAc. The patient had a significant relief of her symptoms. At one-year follow-up the Yale-Brown obsessive-compulsive scale (YBOCS) score for OCD, excluding the item 1-5 of YBOCS, improved from 19 to 5. Her Hamilton depression and anxiety scores similarly improved from 20 to 15 and from 30 to 18. Social communication questionnaire – current for autism score improved from 26 to16, the subscores for reciprocal social interaction improved from 13 to 8, for the communication from 5 to 4 and for the restricted, repetitive and stereotyped patterns of behaviour 6 to 3. CONCLUSION: This case reports illustrates the role of NAc in OCD and aggression in an autistic patient. We have discussed the role of NAc as a target to explain the above outcome in this paper.
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4. Fuller EA, Kaiser AP. {{The Effects of Early Intervention on Social Communication Outcomes for Children with Autism Spectrum Disorder: A Meta-analysis}}. {J Autism Dev Disord};2019 (Feb 25)
This meta-analysis examined the effects of early interventions on social communication outcomes for young children with autism spectrum disorder. A systematic review of the literature included 1442 children (mean age 3.55 years) across 29 studies. The overall effect size of intervention on social communication outcomes was significant (g = 0.36). The age of the participants was related to the treatment effect size on social communication outcomes, with maximum benefits occurring at age 3.81 years. Results did not differ significantly depending on the person implementing the intervention. However, significantly larger effect sizes were observed in studies with context-bound outcome measures. The findings of this meta-analysis highlight the need for further research examining specific components of interventions associated with greater and more generalized gains.
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5. Greene RK, Zheng S, Kinard JL, Mosner MG, Wiesen CA, Kennedy DP, Dichter GS. {{Social and Nonsocial Visual Prediction Errors in Autism Spectrum Disorder}}. {Autism Res};2019 (Feb 25)
Impaired predictive coding has been proposed as a framework to explain discrepancies between expectations and outcomes in autism spectrum disorder (ASD) that may contribute to core symptoms of the disorder. However, no eye tracking study has directly addressed this framework in the context of visual predictions of social and nonsocial stimuli. The current study used eye tracking to examine violations of learned visual associations of both social and nonsocial stimuli. Twenty-six adolescents with ASD and 18 typically developing control (TDC) adolescents completed an outcome expectation eye tracking task in which predictive cues correctly (80% of trials) or incorrectly (20% of trials) indicated the location (left or right) of forthcoming social or nonsocial stimuli. During violation trials, individuals with ASD focused their gaze relatively more often on stimuli presented on locations that violated the learned association and less often on locations that corresponded with the learned association. This finding was not moderated by stimulus type (i.e., social vs. nonsocial). Additionally, participants who looked at incorrectly predicted locations more often had significantly greater ASD symptom severity. These results are consistent with theories that characterize ASD as a disorder of prediction and have potential implications for understanding symptoms related to prediction errors in individuals with ASD. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) exhibit impairments making predictions that may impact learning. In this study, we used eye tracking methodology and found that individuals with ASD were less likely to look at the predicted location when a visual routine was violated. This pattern was evident for both social and nonsocial images and was associated with greater ASD symptom severity. These findings provide additional support for predictive challenges in ASD.
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6. Grove J, Ripke S, Als TD, Mattheisen M, Walters RK, Won H, Pallesen J, Agerbo E, Andreassen OA, Anney R, Awashti S, Belliveau R, Bettella F, Buxbaum JD, Bybjerg-Grauholm J, Baekvad-Hansen M, Cerrato F, Chambert K, Christensen JH, Churchhouse C, Dellenvall K, Demontis D, De Rubeis S, Devlin B, Djurovic S, Dumont AL, Goldstein JI, Hansen CS, Hauberg ME, Hollegaard MV, Hope S, Howrigan DP, Huang H, Hultman CM, Klei L, Maller J, Martin J, Martin AR, Moran JL, Nyegaard M, Naerland T, Palmer DS, Palotie A, Pedersen CB, Pedersen MG, dPoterba T, Poulsen JB, Pourcain BS, Qvist P, Rehnstrom K, Reichenberg A, Reichert J, Robinson EB, Roeder K, Roussos P, Saemundsen E, Sandin S, Satterstrom FK, Davey Smith G, Stefansson H, Steinberg S, Stevens CR, Sullivan PF, Turley P, Walters GB, Xu X, Stefansson K, Geschwind DH, Nordentoft M, Hougaard DM, Werge T, Mors O, Mortensen PB, Neale BM, Daly MJ, Borglum AD. {{Identification of common genetic risk variants for autism spectrum disorder}}. {Nat Genet};2019 (Mar);51(3):431-444.
Autism spectrum disorder (ASD) is a highly heritable and heterogeneous group of neurodevelopmental phenotypes diagnosed in more than 1% of children. Common genetic variants contribute substantially to ASD susceptibility, but to date no individual variants have been robustly associated with ASD. With a marked sample-size increase from a unique Danish population resource, we report a genome-wide association meta-analysis of 18,381 individuals with ASD and 27,969 controls that identified five genome-wide-significant loci. Leveraging GWAS results from three phenotypes with significantly overlapping genetic architectures (schizophrenia, major depression, and educational attainment), we identified seven additional loci shared with other traits at equally strict significance levels. Dissecting the polygenic architecture, we found both quantitative and qualitative polygenic heterogeneity across ASD subtypes. These results highlight biological insights, particularly relating to neuronal function and corticogenesis, and establish that GWAS performed at scale will be much more productive in the near term in ASD.
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7. Hwang YIJ, Srasuebkul P, Foley KR, Arnold S, Trollor JN. {{Mortality and cause of death of Australians on the autism spectrum}}. {Autism Res};2019 (Feb 25)
Focused investigations regarding mortality rates, risk factors, and cause of death in autistic populations remain scarce. The present study used large linked datasets spanning 2001-2015 to report the rates and risk factors for mortality and cause of death in individuals on the autism spectrum (n = 35,929 age range 5-64) with and without concurrent intellectual disability (ID) in New South Wales, Australia. Mortality rates for those on the autism spectrum were 2.06 times that of the general population. Concurrent ID, epilepsy, mental health conditions, and chronic physical health conditions were associated with a higher risk of death for those on the spectrum, whereas demographic variables such as gender and socioeconomic status were not. A differing profile of top causes of death was found for autistic individuals relative to the general population, with « nervous system and sense disorders » and « injury and poisoning » being the top-ranked causes for those on the spectrum. The findings alert the need for health promotion and management of concurrent physical and mental health conditions for those on the autism spectrum. There is also a need for better identification, diagnosis, and documentation of older adults on the autism spectrum. Autism Res 2019, 9999: 1-10. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Rates of death are higher for autistic individuals compared to the general population. There is higher risk of death for autistic individuals who have additional mental and physical health conditions. The leading causes of death for autistic individuals with and without ID are « nervous system and sense disorders », which includes epilepsy and « injury and poisoning », respectively. To minimize risk of death, it is important to manage the mental and physical health individuals on the autism spectrum and to better understand the circumstances surrounding preventable deaths for this population.
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8. Lammert CR, Lukens JR. {{Modeling Autism-Related Disorders in Mice with Maternal Immune Activation (MIA)}}. {Methods Mol Biol};2019;1960:227-236.
Autism spectrum disorder (ASD) has emerged as one of the most prevalent and poorly understood disorders of our time. The etiology of autism currently remains poorly understood; however, emerging clinical and experimental evidence suggests central roles for maternal immune activation (MIA) during pregnancy in ASD. In particular, children whose mothers suffered from an infectious disease or other inflammatory conditions during pregnancy are at a substantially higher risk of developing ASD. It has been shown that MIA-induced ASD can be modeled by treating pregnant mice with the viral mimetic polyinosinic-polycytidylic acid (PolyI:C) during key neurodevelopmental time points. In this paradigm, PolyI:C treatment induces systemic inflammatory responses that model MIA during viral infections. Offspring from PolyI:C-treated mothers develop many of the defining features of ASD including defects in social interactions, communicative impairments, and repetitive/stereotyped behaviors, as well as neuropathologies that are commonly observed in human ASD. While the early use of this emerging ASD model system has provided important initial insights into the involvement of gestational immune dysfunction in neurodevelopmental disorder pathogenesis, we have only just begun to scratch the surface in our understanding of how MIA affects brain maturation and contributes to neurodevelopmental disease. Here we describe best practices for how the PolyI:C model of MIA can be used to study autism-related disorders in mice.
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9. Li Y, Mache MA, Todd TA. {{Complexity of Center of Pressure in Postural Control for Children With Autism Spectrum Disorders Was Partially Compromised}}. {J Appl Biomech};2019 (Feb 25):1-6.
The purpose of this study was to compare the complexity of postural control between children with autism spectrum disorder (ASD) and typical developing children during altered visual and somatosensory conditions using the multiscale entropy. Eleven children with ASD and 11 typical developing children were tested during quiet standing under 4 conditions: (1) eyes open and standing on a stable surface, (2) eyes open and standing on a compliant surface, (3) eyes closed and standing on a stable surface, and (4) eyes closed and standing on a compliant surface. The center of pressure data were collected, and multiscale entropy and sway area of center of pressure were calculated. The ASD group exhibited lower complexity in mediolateral sway compared with typical developing children with a large effect size (partial eta(2) = .21). However, based on the different postural control modes, the anteroposterior sway complexity did not demonstrate a similar decrease for children with ASD. The altered visual or somatosensory conditions alone did not significantly affect the postural sway complexity. The authors concluded that the complexity of postural control for children with ASD was partially compromised. Reduced mediolateral sway complexity could potentially increase the risks of fall.
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10. Pequegnat B, Monteiro MA. {{Carbohydrate Scaffolds for the Study of the Autism-associated Bacterium, Clostridium bolteae}}. {Curr Med Chem};2019 (Feb 25)
A large number of children in the autism spectrum disorder suffer from gastrointestinal (GI) conditions, such as constipation and diarrhea. Clostridium bolteae is part of a set of pathogens being regularly detected in the stool samples of hosts affected by GI and autism symptoms. Accompanying studies have pointed to the possibility that such microbes affect behaviour through the production of neurotoxic metabolites in a so-called, gut-brain connection. As an extension of our Clostridium difficile polysaccharide (PS)-based vaccine research, we engaged in the discovery of C. bolteae surface carbohydrates. So far, studies revealed that C. bolteae produces a specific immunogenic PS capsule comprised of disaccharide repeating blocks of mannose (Manp) and rhamnose (Rhap) units: alpha-D-Manp-(1–>[-4)-beta-D-Rhap-(1–>3)-alpha-D-Manp-(1–>]n. For vaccinology and further immunogenic experiments, a method to produce C. bolteae PS conjugates has been developed, along with the chemical syntheses of the PS non-reducing end linkage, with D-Rha or L-Rha, alpha-D-Manp-(1–>4)-beta-D-Rhap-(1–>O(CH2)5NH2 and alpha-D-Manp-(1–>4)-beta-L-Rhap-(1–>O(CH2)5NH2, equipped with an aminopentyl linker at the reducing end for conjugation purposes. The discovery of C. bolteae PS immunogen opens the door to the creation of non-evasive diagnostic tools to evaluate the frequency and role of this microbe in autistic subjects and to a vaccine to reduce colonization levels in the GI tract, thus impeding the concentration of neurotoxins.
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11. Powell G, Jones CRG, Hedge C, Charman T, Happe F, Simonoff E, Sumner P. {{Face processing in autism spectrum disorder re-evaluated through diffusion models}}. {Neuropsychology};2019 (Feb 25)
OBJECTIVE: Research using cognitive or perceptual tasks in autism spectrum disorder (ASD) often relies on mean reaction time (RT) and accuracy derived from alternative-forced choice paradigms. However, these measures can confound differences in task-related processing efficiency with caution (i.e., preference for speed or accuracy). We examined whether computational models of decision-making allow these components to be isolated. METHOD: Using data from two face-processing tasks (face recognition and egocentric eye-gaze discrimination), we explored whether adolescents with ASD and wide-ranging intellectual ability differed from an age and IQ matched comparison group on model parameters that are thought to represent processing efficiency, caution, and perceptual encoding/motor output speed. RESULTS: We found evidence that autistic adolescents had lower processing efficiency and caution but did not differ from nonautistic adolescents in the time devoted to perceptual encoding/motor output. These results were more consistent across tasks when we only analyzed participants with IQ above 85. Cross-task correlations suggested that processing efficiency and caution parameters were relatively stable across individuals and tasks. Furthermore, logistic classification with model parameters improved discrimination between individuals with and without ASD relative to classification using mean RT and accuracy. Finally, previous research has found that ADHD symptoms are associated with lower processing efficiency, and we observed a similar relationship in our sample, but only for autistic adolescents. CONCLUSIONS: Together, these results suggest that models of decision-making could provide both better discriminability between autistic and nonautistic individuals on cognitive tasks and also a more specific understanding of the underlying mechanisms driving these differences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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12. Robison JE. {{Autism prevalence and outcomes in older adults}}. {Autism Res};2019 (Feb 25)
Recent studies of mortality, illness, and suicide among autistic adults paint an alarming picture. Autistic people appear to die much earlier than the general population, and they seem to be far more vulnerable to a surprising range of medical problems. Suicide and depression seem far more common than in the general population. If correct, that suggests an older autistic population in silent crisis, with few if any supports. If so, older autistic people should be a focus for public health and human service agencies. But is the picture complete? Autism researchers ask for answers, identifying problems and their scope. This article discusses the limitations of our adult autism knowledge, and the challenges we will face studying adults. Researching and ultimately serving older autistic adults presents a unique set of problems that have not yet been addressed by scientists or clinicians. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Public policy toward autistic people is driven by data. Most autism data to date have been derived from and about children, because autism tends to be identified and supported in the public school system. This has created a public perception of autism as a childhood problem. In fact, autism is a lifelong difference or disability, and recent studies suggest serious overlooked concerns for autistic adults. This commentary discusses how we have evaluated adult autism so far, limitations of our knowledge, and how we might evaluate adult needs going forward. The commentary makes a case for specific new adult prevalence and outcome studies to inform public policy.
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13. Shaia WE, Nichols HM, Dababnah S, Campion K, Garbarino N. {{Brief Report: Participation of Black and African-American Families in Autism Research}}. {J Autism Dev Disord};2019 (Feb 25)
Black and African-American families are underrepresented in research on autism spectrum disorder (ASD) and few studies have explored how to increase their involvement. To address this gap in the literature, this study explored the perspectives of 22 Black families raising children with ASD in order to identify facilitators and barriers to research participation; as well as suggestions to increase their involvement in ASD studies. Facilitators to research involvement included a desire to contribute to ASD research inclusive of Black families; to seek information and support for child and/or caregiver; and, to engage with culturally responsive research team members. Barriers to research involvement included stigma; denial, shame, and/or embarrassment; distrust of the research process; lack of time/interest; and research material inaccessibility or literacy issues.
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14. Spek AA, van Rijnsoever W, van Laarhoven L, Kiep M. {{Eating Problems in Men and Women with an Autism Spectrum Disorder}}. {J Autism Dev Disord};2019 (Feb 23)
The presence of eating problems was assessed in 53 males and 36 females with an autism spectrum disorder (ASD), with and without housing and residential support. The results were compared to a neurotypical group of 30 men and 38 women. The results indicate that men and especially women with ASD experience various eating problems. Women with ASD also recognized symptoms of an eating disorder. Hence, it is important to be aware of eating problems and symptoms of an eating disorder in adults with ASD, to ensure they receive the care they need.
