1. Au-Yeung SK, Kaakinen JK, Liversedge SP, Benson V. {{Would Adults with Autism be less likely to Bury the Survivors? An Eye Movement Study of Anomalous Text Reading}}. {Q J Exp Psychol (Hove)};2017 (Apr 24):1-27.
In a single eye movement experiment we investigated the effects of context on the time course of local and global anomaly processing during reading in adults with Autism Spectrum Disorder (ASD). In one condition short paragraph texts contained anomalous target words. Detection of the anomaly was only possible through evaluation of word meaning in relation to the global context of the whole paragraph (Passage Level Anomalies). In another condition the anomaly could be detected via computation of a local thematic violation within a single sentence embedded in the paragraph (Sentence Level Anomalies). For the sentence level anomalies the ASD group, in contrast with the typically developing (TD) group, showed early detection of the anomaly as indexed by regressive eye movements from the critical target word upon fixation. Conversely, for the passage level anomalies, and in contrast with the ASD group, the TD group showed early detection of the anomaly, with increased regressive eye movements once the critical word had been fixated. The reversal of the pattern of regression path data for the two groups, for the sentence and passage level anomalies, is discussed in relation to cognitive accounts of ASD.
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2. Barkaia A, Stokes TF, Mikiashvili T. {{Intercontinental telehealth coaching of therapists to improve verbalizations by children with autism}}. {J Appl Behav Anal};2017 (Apr 24)
This study examined the effects of intercontinental telehealth coaching on the mastery of therapists’ skills and improvements in verbalizations by children with autism, testing whether telehealth can be a solution for underserved communities in developing countries such as Georgia-Sakartvelo in Eastern Europe. Three therapists delivering and three children with autism receiving early-intervention services from the nongovernmental organization Children of Georgia in Tbilisi participated. Experimenters provided coaching from Virginia, USA to therapists in Georgia-Sakartvelo. Observers in Georgia-Sakartvelo and in Virginia conducted the behavioral observations. We used inexpensive communications technology to provide the coaching and a multiple-baseline design across participants to evaluate the effects of the intervention. Therapists demonstrated improvements in two classes of behaviors: correct command sequences and positive consequences. The children demonstrated improvements with echoics and mands. The study demonstrated that telehealth can be a good model for delivering early-intervention services to children with autism in underserved and distant regions of the world.
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3. Bent S, Ailarov A, Dang KT, Widjaja F, Lawton BL, Hendren RL. {{Open-Label Trial of Vitamin D3 Supplementation in Children with Autism Spectrum Disorder}}. {J Altern Complement Med};2017 (Feb 16)
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4. Carlisi CO, Norman L, Murphy CM, Christakou A, Chantiluke K, Giampietro V, Simmons A, Brammer M, Murphy DG, Mataix-Cols D, Rubia K. {{Comparison of neural substrates of temporal discounting between youth with autism spectrum disorder and with obsessive-compulsive disorder}}. {Psychol Med};2017 (Apr 24):1-15.
BACKGROUND: Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) share abnormalities in hot executive functions such as reward-based decision-making, as measured in the temporal discounting task (TD). No studies, however, have directly compared these disorders to investigate common/distinct neural profiles underlying such abnormalities. We wanted to test whether reward-based decision-making is a shared transdiagnostic feature of both disorders with similar neurofunctional substrates or whether it is a shared phenotype with disorder-differential neurofunctional underpinnings. METHODS: Age and IQ-matched boys with ASD (N = 20), with OCD (N = 20) and 20 healthy controls, performed an individually-adjusted functional magnetic resonance imaging (fMRI) TD task. Brain activation and performance were compared between groups. RESULTS: Boys with ASD showed greater choice-impulsivity than OCD and control boys. Whole-brain between-group comparison revealed shared reductions in ASD and OCD relative to control boys for delayed-immediate choices in right ventromedial/lateral orbitofrontal cortex extending into medial/inferior prefrontal cortex, and in cerebellum, posterior cingulate and precuneus. For immediate-delayed choices, patients relative to controls showed reduced activation in anterior cingulate/ventromedial prefrontal cortex reaching into left caudate, which, at a trend level, was more decreased in ASD than OCD patients, and in bilateral temporal and inferior parietal regions. CONCLUSIONS: This first fMRI comparison between youth with ASD and with OCD, using a reward-based decision-making task, shows predominantly shared neurofunctional abnormalities during TD in key ventromedial, orbital- and inferior fronto-striatal, temporo-parietal and cerebellar regions of temporal foresight and reward processing, suggesting trans-diagnostic neurofunctional deficits.
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5. Delobel-Ayoub M, Klapouszczak D, van Bakel MME, Horridge K, Sigurdardottir S, Himmelmann K, Arnaud C. {{Prevalence and characteristics of autism spectrum disorders in children with cerebral palsy}}. {Dev Med Child Neurol};2017 (Apr 25)
AIM: To evaluate the prevalence of co-occurring autism spectrum disorders (ASDs) among children with cerebral palsy (CP), and to describe their characteristics. METHOD: The data of 1225 CP cases from four population-based registers (Iceland, Sweden, and two in France) and one population-based surveillance programme (North East England, UK) participating in the Surveillance of Cerebral Palsy in Europe Network (SCPE) were analysed. The ASD diagnoses were systematically recorded using category F84 of the International Classification of Diseases, 10th Revision. The registers provided data on children born between 1995 and 2006, while the cross-sectional survey in the UK concerned children aged 0 to 19 years, registered in 2010. RESULTS: Among the children with CP, 107 had an associated diagnosis of ASD – i.e., 8.7% of the study population (95% confidence interval 7.2-10.5). This proportion varied across centres from 4.0% to 16.7% but was independent of CP prevalence. Male sex, co-occurring epilepsy, intellectual disability, and better walking ability were associated with the coexistence of ASD. INTERPRETATION: Our findings support the need for a multidisciplinary approach to management of children with CP to adequately identify and address all facets of presentation, including ASD.
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6. Demetriou EA, Lampit A, Quintana DS, Naismith SL, Song YJC, Pye JE, Hickie I, Guastella AJ. {{Autism spectrum disorders: a meta-analysis of executive function}}. {Mol Psychiatry};2017 (Apr 25)
Evidence of executive dysfunction in autism spectrum disorders (ASD) across development remains mixed and establishing its role is critical for guiding diagnosis and intervention. The primary objectives of this meta-analysis is to analyse executive function (EF) performance in ASD, the fractionation across EF subdomains, the clinical utility of EF measures and the influence of multiple moderators (for example, age, gender, diagnosis, measure characteristics). The Embase, Medline and PsychINFO databases were searched to identify peer-reviewed studies published since the inclusion of Autism in DSM-III (1980) up to end of June 2016 that compared EF in ASD with neurotypical controls. A random-effects model was used and moderators were tested using subgroup analysis. The primary outcome measure was Hedges’ g effect size for EF and moderator factors. Clinical sensitivity was determined by the overlap percentage statistic (OL%). Results were reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 235 studies comprising 14 081 participants were included (N, ASD=6816, Control=7265). A moderate overall effect size for reduced EF (Hedges’ g=0.48, 95% confidence interval (CI) 0.43-0.53) was found with similar effect sizes across each domain. The majority of moderator comparisons were not significant although the overall effect of executive dysfunction has gradually reduced since the introduction of ASD. Only a small number of EF measures achieved clinical sensitivity. This study confirms a broad executive dysfunction in ASD that is relatively stable across development. The fractionation of executive dysfunction into individual subdomains was not supported, nor was diagnostic sensitivity. Development of feasible EF measures focussing on clinical sensitivity for diagnosis and treatment studies should be a priority.Molecular Psychiatry advance online publication, 25 April 2017; doi:10.1038/mp.2017.75.
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7. Donzelli A, Schivalocchi A, Battaggia A. {{Influenza Vaccination in the First Trimester of Pregnancy and Risk of Autism Spectrum Disorder}}. {JAMA Pediatr};2017 (Apr 24)
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8. Dy ABC, Tassone F, Eldeeb M, Salcedo-Arellano MJ, Tartaglia N, Hagerman R. {{Metformin as Targeted Treatment in Fragile X Syndrome}}. {Clin Genet};2017 (Apr 24)
Individuals with Fragile X Syndrome (FXS) may be affected by several comorbid conditions, both behavioral and medical. Growth findings suggest that they are at an increased risk for obesity and overeating. The Prader-Willi phenotype (PWP) of FXS occurs in less than 10% of patients but it is associated with severe hyperphagia, lack of satiation and morbid obesity. Metformin is a drug used in individuals with high risk for diabetes type 2, obesity or impaired glucose tolerance. It has had a strong safety profile in children and adults with type 2 diabetes and obesity. There are emerging studies in FXS animal models that demonstrate the effectiveness of metformin as targeted treatment for cognitive and behavioral concerns. To date, metformin has not been studied for their behavioral effects in individuals with FXS. Here we present seven cases of individuals with FXS who have been treated with metformin clinically. One case with impaired glucose tolerance, three cases with the PWP, two adults with obesity and/or behavioral problems and, a young child with FXS. These individuals were clinically treated with metformin and monitored for behavioral and metabolic changes.
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9. Foss-Feig JH, Adkinson BD, Ji JL, Yang G, Srihari VH, McPartland JC, Krystal JH, Murray JD, Anticevic A. {{Searching for Cross-Diagnostic Convergence: Neural Mechanisms Governing Excitation and Inhibition Balance in Schizophrenia and Autism Spectrum Disorders}}. {Biol Psychiatry};2017 (May 15);81(10):848-861.
Recent theoretical accounts have proposed excitation and inhibition (E/I) imbalance as a possible mechanistic, network-level hypothesis underlying neural and behavioral dysfunction across neurodevelopmental disorders, particularly autism spectrum disorder (ASD) and schizophrenia (SCZ). These two disorders share some overlap in their clinical presentation as well as convergence in their underlying genes and neurobiology. However, there are also clear points of dissociation in terms of phenotypes and putatively affected neural circuitry. We highlight emerging work from the clinical neuroscience literature examining neural correlates of E/I imbalance across children and adults with ASD and adults with both chronic and early-course SCZ. We discuss findings from diverse neuroimaging studies across distinct modalities, conducted with electroencephalography, magnetoencephalography, proton magnetic resonance spectroscopy, and functional magnetic resonance imaging, including effects observed both during task and at rest. Throughout this review, we discuss points of convergence and divergence in the ASD and SCZ literature, with a focus on disruptions in neural E/I balance. We also consider these findings in relation to predictions generated by theoretical neuroscience, particularly computational models predicting E/I imbalance across disorders. Finally, we discuss how human noninvasive neuroimaging can benefit from pharmacological challenge studies to reveal mechanisms in ASD and SCZ. Collectively, we attempt to shed light on shared and divergent neuroimaging effects across disorders with the goal of informing future research examining the mechanisms underlying the E/I imbalance hypothesis across neurodevelopmental disorders. We posit that such translational efforts are vital to facilitate development of neurobiologically informed treatment strategies across neuropsychiatric conditions.
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10. Hooker BS. {{Influenza Vaccination in the First Trimester of Pregnancy and Risk of Autism Spectrum Disorder}}. {JAMA Pediatr};2017 (Apr 24)
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11. Hourston S, Atchley R. {{Autism and Mind-Body Therapies: A Systematic Review}}. {J Altern Complement Med};2017 (Feb 22)
BACKGROUND: Mind-body therapies are often used by people with autism spectrum disorders (ASD). However, there has been little examination into which types of mind-body therapies have been investigated for people with ASD and for what purposes. A systematic review was conducted to evaluate the existing evidence for mind-body therapies for people with ASD, particularly to determine the types of mind-body therapies used and the outcomes that are targeted. METHODS: PubMed, PsychInfo, and Scopus were searched using terms for ASD and mind-body therapies. Sixteen studies were selected for review; these studies tested interventions using mindfulness, meditation, yoga, Nei Yang Gong, and acceptance commitment therapy. Most study outcomes targeted behavior, psychological symptoms, and quality of life for children and adults with ASD as well as their parents. RESULTS: There was little overlap between studies on the types of mind-body therapies used and associated outcomes, and only three of the studies were randomized controlled trials. Most studies were small and uncontrolled. Some studies modified the mind-body therapies to increase accessibility for people with ASD. CONCLUSION: The evidence for mind-body therapies for people with ASD is limited and would benefit from larger randomized controlled trials.
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12. Mahic M, Mjaaland S, Bovelstad HM, Gunnes N, Susser E, Bresnahan M, Oyen AS, Levin B, Che X, Hirtz D, Reichborn-Kjennerud T, Schjolberg S, Roth C, Magnus P, Stoltenberg C, Suren P, Hornig M, Lipkin WI. {{Correction for Mahic et al., « Maternal Immunoreactivity to Herpes Simplex Virus 2 and Risk of Autism Spectrum Disorder in Male Offspring »}}. {mSphere};2017 (Mar-Apr);2(2)
[This corrects the article DOI: 10.1128/mSphere.00016-17.].
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13. Parellada M, Pina-Camacho L, Moreno C, Aleman Y, Krebs MO, Desco M, Merchan-Naranjo J, Del Rey-Mejias A, Boada L, Llorente C, Moreno D, Arango C, Janssen J. {{Insular pathology in young people with high-functioning autism and first-episode psychosis}}. {Psychol Med};2017 (Apr 24):1-11.
BACKGROUND: Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions. METHODS: Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored. RESULTS: Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = -0.28, p = 0.041) and left posterior (r = -0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of ‘autistic-like’ symptoms (r = -0.30, p = 0.028). CONCLUSIONS: The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.
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14. Roi C, Bazzano A. {{Improvement in Excoriation (Skin-Picking) with use of Risperidone in a Patient with Developmental Disability}}. {Pediatr Rep};2017 (Mar 22);9(1):6946.
Patients with Autism Spectrum Disorder present with a heterogeneous mix of features beyond the core symptoms of the disorder. These features can be emotional, cognitive or behavioral. Behavioral symptoms often include self-injury, and this may take the form of repetitive skin-picking. The prevalence of skin-picking disorder in Autism is unknown. Skin-picking may lead to significant medical and psychosocial complications. Recent data suggest that behavioral interventions may be more effective than medications at reducing skin-picking in neurotypical patients. In this case, an 11-year-old male with intellectual disability and autistic spectrum disorder, with self-injurious skin-picking, was treated with risperidone with complete resolution of skin-picking symptoms. risperidone has been approved for irritability and aggression in Autistic spectrum disorder, and may be a valuable treatment option for skin-picking in pediatric patients with developmental disabilities.
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15. Schmeisser K, Parker JA. {{Worms on the spectrum – C. elegans models in autism research}}. {Exp Neurol};2017 (Apr 20)
The small non-parasitic nematode Caenorhabditis elegans is widely used in neuroscience thanks to its well-understood development and lineage of the nervous system. Furthermore, C. elegans has been used to model many human developmental and neurological conditions to better understand disease mechanisms and identify potential therapeutic strategies. Autism spectrum disorder (ASD) is the most prevalent of all neurodevelopmental disorders, and the C. elegans system may provide opportunities to learn more about this complex disorder. Since basic cell biology and biochemistry of the C. elegans nervous system is generally very similar to mammals, cellular or molecular phenotypes can be investigated, along with a repertoire of behaviours. For instance, worms have contributed greatly to the understanding of mechanisms underlying mutations in genes coding for synaptic proteins such as neuroligin and neurexin. Using worms to model neurodevelopmental disorders like ASD is an emerging topic that harbours great, untapped potential. This review summarizes the numerous contributions of C. elegans to the field of neurodevelopment and introduces the nematode system as a potential research tool to study essential roles of genes associated with ASD.
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16. Smith T, Iadarola S, Mandell DS, Harwood R, Kasari C. {{Community-Partnered Research with Urban School Districts that Serve Children with Autism Spectrum Disorder}}. {Acad Pediatr};2017 (Apr 25)
OBJECTIVE: To illustrate the process of community-partnered participatory research (CPPR) to develop and evaluate interventions for children with autism in urban school districts METHODS: We formed partnerships of school personnel, parents, and researchers to guide the project. We then conducted focus groups, key informant interviews, and town halls to explore how public schools currently serve students with autism. We used findings from these activities to adapt interventions for public schools. We then tested interventions in randomized clinical trials (RCTs). RESULTS: Community input indicated a particular need for interventions to improve children’s social interaction and instructional supports to promote their success throughout the day. Based on this input, we adapted two interventions: Remaking Recess for improving peer engagement during social times; and Schedules, Tools, and Activities for Transition (STAT) for facilitating successful transitions between activities throughout the daily routine. Results of the RCT of Remaking Recess are not yet available. The RCT of STAT involved 150 children and 56 teachers. Teachers reported high buy-in and increased their proficiency at implementing STAT; children with ASD reduced their disruptive behavior and made progress toward teacher-nominated goals. However, teachers’ implementation remained inconsistent, and children did not reliably improve in academic engagement or independence. CONCLUSIONS: The findings suggest that, although CPPR has limitations, it can assist in selecting interventions to address community priorities and produce some favorable outcomes for children with autism in public schools. An important next step is to evaluate the sustainability of the interventions introduced in this project.
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17. Wong H, Hoeffer C. {{Maternal IL-17A in autism}}. {Exp Neurol};2017 (Apr 25)
Although autism spectrum disorder (ASD) has a strong genetic basis, its etiology is complex, with several genetic factors likely to be involved as well as environmental factors. Immune dysregulation has gained significant attention as a causal mechanism in ASD pathogenesis. ASD has been associated with immune abnormalities in the brain and periphery, including inflammatory disorders and autoimmunity in not only the affected individuals but also their mothers. Prenatal exposure to maternal immune activation (MIA) has been implicated as an environmental risk factor for ASD. In support of this notion, animal models have shown that MIA results in offspring with behavioral, neurological, and immunological abnormalities similar to those observed in ASD. This raises the question of how MIA exposure can lead to ASD in susceptible individuals. Recent evidence points to a potential inflammation pathway linking MIA-associated ASD with the activity of T helper 17 (Th17) lymphocytes and their effector cytokine interleukin-17A (IL-17A). IL-17A has been implicated from human studies and elevated IL-17A levels in the blood have been found to correlate with phenotypic severity in a subset of ASD individuals. In MIA model mice, elevated IL-17A levels also have been observed. Additionally, antibody blockade to inhibit IL-17A signaling was found to prevent ASD-like behaviors in offspring exposed to MIA. Therefore, IL-17A dysregulation may play a causal role in the development of ASD. The source of increased IL-17A in the MIA mouse model was attributed to maternal Th17 cells because genetic removal of the transcription factor RORgammat to selectively inhibit Th17 differentiation in pregnant mice was able to prevent ASD-like behaviors in the offspring. Similar to ASD individuals, the MIA-exposed offspring also displayed cortical dysplasia which could be prevented by inhibition of IL-17A signaling in pregnant mice. This finding reveals one possible cellular mechanism through which ASD-related cognitive and behavioral deficits may emerge following maternal inflammation. IL-17A can exert strong effects on cell survival and differentiation and the activity of signal transduction cascades, which can have important consequences during cortical development on neural function. This review examines IL-17A signaling pathways in the context of both immunity and neural function that may contribute to the development of ASD associated with MIA.
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18. Zerbo O, Klein NP, Croen LA. {{Influenza Vaccination in the First Trimester of Pregnancy and Risk of Autism Spectrum Disorder-Reply}}. {JAMA Pediatr};2017 (Apr 24)
