1. Åker TH, Johnson MS. {{Interviewing alleged victims with mild and moderate intellectual disabilities and autism: A field study of police-investigated cases of physical and sexual abuse in a Norwegian national sample}}. {J Intellect Disabil Res};2020 (Aug 24)
BACKGROUND: People with intellectual disabilities (IDs) or autism are at great risk of being victims of physical and sexual abuse. This study uses transcriptions of real-life investigative interviews to examine the interview techniques (e.g. question type) used in investigative interviews of these groups of alleged victims. METHODS: A national sample of transcribed investigative interviews (N = 96) of alleged victims with mild ID (n = 48, age 5-70 years old), moderate ID (n = 18, age 14-43 years old) and autism (n = 16, age 5-50 years old) was analysed. RESULTS: The study shows a preponderance of alleged sexual offences (70.7%) and reveals that open-ended questions account for only 2.6% of the total number of questions asked. The interviewers relied heavily on yes/no (53.4%) and directive questions (32.2%). Suggestive questions (8.6%) were frequently used. CONCLUSIONS: The use of question type varied considerably within and across the diagnostic group. The study reveals the need for a more in-depth analysis of variables that influence investigative interviews of people with cognitive impairments.
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2. Andersson M, Tangen Ä, Farde L, Bölte S, Halldin C, Borg J, Lundberg J. {{Serotonin transporter availability in adults with autism-a positron emission tomography study}}. {Mol Psychiatry};2020 (Aug 26)
Impairments in social interaction and communication, in combination with restricted, repetitive behaviors and interests, define the neurodevelopmental diagnosis of autism spectrum disorder (ASD). The biological underpinnings of ASD are not well known, but the hypothesis of serotonin (5-HT) involvement in the neurodevelopment of ASD is one of the longest standing. Reuptake through the 5-HT transporter (5-HTT) is the main pathway decreasing extracellular 5-HT in the brain and a marker for the 5-HT system, but in vivo investigations of the 5-HTT and the 5-HT system in ASD are scarce and so far inconclusive. To quantify possible alterations in the 5-HT system in ASD, we used positron emission tomography and the radioligand [(11)C]MADAM to measure 5-HTT availability in the brain of 15 adults with ASD and 15 controls. Moreover, we examined correlations between regional 5-HTT availability and behavioral phenotype assessments regarding ASD core symptoms. In the ASD group, we found significantly lower 5-HTT availability in total gray matter, brainstem, and 9 of 18 examined subregions of gray matter. In addition, several correlations between regional 5-HTT availability and social cognitive test performance were found. The results confirm the hypothesis that 5-HTT availability is lower in the brain of adult individuals with ASD, and are consistent with the theory of 5-HT involvement in ASD neurodevelopment. The findings endorse the central role of 5-HT in the physiology of ASD, and confirm the need for a continued investigation of the 5-HT system in order to disentangle the biology of ASD.
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3. Boutrus M, Gilani Z, Maybery MT, Alvares GA, Tan DW, Eastwood PR, Mian A, Whitehouse AJO. {{Brief Report: Facial Asymmetry and Autistic-Like Traits in the General Population}}. {J Autism Dev Disord};2020 (Aug 26)
Atypical facial morphology, particularly increased facial asymmetry, has been identified in some individuals with Autism Spectrum Conditions (ASC). Many cognitive, behavioural and biological features associated with ASC also occur on a continuum in the general population. The aim of the present study was to examine subthreshold levels of autistic traits and facial morphology in non-autistic individuals. Facial asymmetry was measured using three-dimensional facial photogrammetry, and the Autism-spectrum Quotient was used to measure autistic-like traits in a community-ascertained sample of young adults (n = 289). After accounting for covariates, there were no significant associations observed between autistic-like traits and facial asymmetry, suggesting that any potential facial morphology differences linked to ASC may be limited to the clinical condition.
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4. Broder-Fingert S, Mateo C, Zuckerman KE. {{Structural Racism and Autism}}. {Pediatrics};2020 (Aug 24)
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5. Constantino JN, Abbacchi AM, Saulnier C, Klaiman C, Mandell DS, Zhang Y, Hawks Z, Bates J, Klin A, Shattuck P, Molholm S, Fitzgerald R, Roux A, Lowe JK, Geschwind DH. {{Timing of the Diagnosis of Autism in African American Children}}. {Pediatrics};2020 (Aug 24)
OBJECTIVES: African American (AA) children affected by autism spectrum disorder (ASD) experience delays in diagnosis and obstacles to service access, as well as a disproportionate burden of intellectual disability (ID) as documented in surveillance data recently published by the US Centers for Disease Control and Prevention. Our objective in this study was to analyze data from the largest-available repository of diagnostic and phenotypic information on AA children with ASD, and to explore the wide variation in outcome within the cohort as a function of sociodemographic risk and specific obstacles to service access for the purpose of informing a national approach to resolution of these disparities. METHODS: Parents of 584 AA children with autism consecutively enrolled in the Autism Genetic Resource Exchange across 4 US data collection sites completed event history calendar interviews of the diagnostic odysseys for their children with ASD. These data were examined in relation to developmental outcomes of the children with autism and their unaffected siblings. RESULTS: The average age of ASD diagnosis was 64.9 months (±49.6), on average 42.3 months (±45.1) after parents’ first concerns about their children’s development. The relationship between timing of diagnosis and ASD severity was complex, and ID comorbidity was not predicted in a straightforward manner by familial factors associated with cognitive variation in the general population. CONCLUSIONS: These findings document significant opportunity to expedite diagnosis, the need to further understand causes of ID comorbidity, and the necessity to identify effective approaches to the resolution of disparities in severity-of-outcome for AA children with autism.
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6. Costilla R, Kemper KE, Byrne EM, Porto-Neto LR, Carvalheiro R, Purfield DC, Doyle JL, Berry DP, Moore SS, Wray NR, Hayes BJ. {{Genetic control of temperament traits across species: association of autism spectrum disorder risk genes with cattle temperament}}. {Genet Sel Evol};2020 (Aug 26);52(1):51.
BACKGROUND: Temperament traits are of high importance across species. In humans, temperament or personality traits correlate with psychological traits and psychiatric disorders. In cattle, they impact animal welfare, product quality and human safety, and are therefore of direct commercial importance. We hypothesized that genetic factors that contribute to variation in temperament among individuals within a species will be shared between humans and cattle. Using imputed whole-genome sequence data from 9223 beef cattle from three cohorts, a series of genome-wide association studies was undertaken on cattle flight time, a temperament phenotype measured as the time taken for an animal to cover a short-fixed distance after release from an enclosure. We also investigated the association of cattle temperament with polymorphisms in bovine orthologs of risk genes for neuroticism, schizophrenia, autism spectrum disorders (ASD), and developmental delay disorders in humans. RESULTS: Variants with the strongest associations were located in the bovine orthologous region that is involved in several behavioural and cognitive disorders in humans. These variants were also partially validated in independent cattle cohorts. Genes in these regions (BARHL2, NDN, SNRPN, MAGEL2, ABCA12, KIFAP3, TOPAZ1, FZD3, UBE3A, and GABRA5) were enriched for the GO term neuron migration and were differentially expressed in brain and pituitary tissues in humans. Moreover, variants within 100 kb of ASD susceptibility genes were associated with cattle temperament and explained 6.5% of the total additive genetic variance in the largest cattle cohort. The ASD genes with the most significant associations were GABRB3 and CUL3. Using the same 100 kb window, a weak association was found with polymorphisms in schizophrenia risk genes and no association with polymorphisms in neuroticism and developmental delay disorders risk genes. CONCLUSIONS: Our analysis showed that genes identified in a meta-analysis of cattle temperament contribute to neuron development functions and are differentially expressed in human brain tissues. Furthermore, some ASD susceptibility genes are associated with cattle temperament. These findings provide evidence that genetic control of temperament might be shared between humans and cattle and highlight the potential for future analyses to leverage results between species.
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7. Dawson M, Fletcher-Watson S. {{Commentary: What conflicts of interest tell us about autism intervention research-a commentary on Bottema-Beutel et al. (2020)}}. {J Child Psychol Psychiatry};2020 (Aug 26)
Bottema-Beutel, Crowley, Sandbank, and Woynaroski (Journal of Child Psychology and Psychiatry, 2020) have performed a Herculean and invaluable task in their investigation of conflicts of interest (COIs) in nonpharmacological early autism intervention research. Drawing on a meta-analysis of 150 articles reporting group designs, they found COIs in 105 (70%), only 6 (5.7%) of which had fully accurate COI statements. Most reports had no COI statements, but among the 48 (32%) which did, the majority of those declaring no COIs had detectable COIs (23 of 30; 77%). Thus, COI reporting in the literature examined is routinely missing, misleading, and/or incomplete; accurate reporting is the exception rather than the rule. That 120 of the 150 reports were published in 2010 or later, compared to 6 pre-2000, tells us this is not about practices confined to decades past. Instead, it reflects and is a telling indictment of established standards in autism intervention research.
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8. Dirks B, Romero C, Voorhies W, Kupis L, Nomi JS, Dajani DR, Odriozola P, Burrows CA, Beaumont AL, Cardona SM, Parlade MV, Alessandri M, Britton JC, Uddin LQ. {{Neural Responses to a Putative Set-shifting Task in Children with Autism Spectrum Disorder}}. {Autism Res};2020 (Aug 25)
While much progress has been made toward understanding the neurobiology of social and communication deficits associated with autism spectrum disorder (ASD), less is known regarding the neurobiological basis of restricted and repetitive behaviors (RRBs) central to the ASD diagnosis. Symptom severity for RRBs in ASD is associated with cognitive inflexibility. Thus, understanding the neural mechanisms underlying cognitive inflexibility in ASD is critical for tailoring therapies to treat this understudied yet pervasive symptom. Here we used a set-shifting paradigm adopted from the developmental cognitive neuroscience literature involving flexible switching between stimulus categories to examine task performance and neural responses in children with ASD. Behaviorally, we found little evidence for group differences in performance on the set-shifting task. Compared with typically developing children, children with ASD exhibited greater activation of the parahippocampal gyrus during performance on trials requiring switching. These findings suggest that children with ASD may need to recruit memory-based neural systems to a greater degree when learning to flexibly associate stimuli with responses. LAY SUMMARY: Children with autism often struggle to behave in a flexible way when faced with unexpected challenges. We examined brain responses during a task thought to involve flexible thinking and found that compared with typically developing children, those with autism relied more on brain areas involved in learning and memory to complete the task. This study helps us to understand what types of cognitive tasks are best suited for exploring the neural basis of cognitive flexibility in children with autism.
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9. Finnegan EG, Asaro-Saddler K, Zajic MC. {{Production and comprehension of pronouns in individuals with autism: A meta-analysis and systematic review}}. {Autism};2020 (Aug 25):1362361320949103.
This research compared pronoun use in individuals with autism and typically developing peers. Meta-analysis and systematic review of 20 selected articles were used to determine whether significant differences existed in the use of pronouns overall as well as in personal, ambiguous, possessive, reflexive, and clitic pronoun usage. Summary effects indicated significant differences between individuals with autism and their typically developing peers in the use of pronouns overall as well as in ambiguous, clitic, and reflexive pronoun usage, but not in personal and possessive pronoun usage. Results indicate wide variation in the way individuals with autism use pronouns. Since individual outcomes appear to be moderated by multiple factors, including cognitive ability, first language, and overall language development, it is recommended these be considered in assessment and treatment.
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10. Gandhi A, Zhou D, Alaimo J, Chon E, Fountain MD, Elsea SH. {{Composite Sleep Problems Observed Across Smith-Magenis Syndrome, MBD5-Associated Neurodevelopmental Disorder, Pitt-Hopkins Syndrome, and ASD}}. {J Autism Dev Disord};2020 (Aug 26)
Caregivers of preschool and elementary school age children with Smith-Magenis syndrome (SMS), MBD5-associated neurodevelopmental disorder (MAND), and Pitt-Hopkins syndrome (PTHS) were surveyed to assess sleep disturbance and to identify disorder-specific sleep problems. Because of overlapping features of these rare genetic neurodevelopmental syndromes, data were compared to reports of sleep disturbance in children with autism spectrum disorder (ASD). While similarities were observed with ASD, specific concerns between disorders differed, including mean nighttime sleep duration, daytime sleepiness, night wakings, parasomnias, restless sleep, and bedwetting. Overall, sleep disturbance in PTHS is significant but less severe than in SMS and MAND. The complexity of these conditions and the challenges of underlying sleep disturbance indicate the need for more support, education, and ongoing management of sleep for these individuals.
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11. Grossi E, Terruzzi V. {{Exceptionally high COVID-19 viral load and very long duration of shedding in a young pauci-symptomatic child with autism resident in an Italian nursing home}}. {J Infect};2020 (Aug 22)
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12. Hanai F, Narama M, Tamakoshi K. {{The Self of Adolescents with Autism Spectrum Disorder or Attention Deficit Hyperactivity Disorder: A Qualitative Study}}. {J Autism Dev Disord};2020 (Aug 24)
Self-development is a central developmental issue in adolescence, there are few studies describing the experiences related to the self in adolescents with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD). We conducted semi-structural interviews with 14 adolescents with ASD and three with ADHD to describe the self. As a result of inductive continuous comparison analysis, three concepts « Interest in self and self-realization », « Intentionality and self-transformation », « Unrealized/unnoticed self » were generated. It was suggested that the characteristic perceptions may tend to have difficulty realizing subjective selves.Otherwise, most adolescents realized various sense of self through interaction with others. Nurses should know adolescents’ inner world and share their emotions related to their self-recognition in order to provide care that meets important youth developmental needs.
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13. Huang ZA, Zhang J, Zhu Z, Wu EQ, Tan KC. {{Identification of Autistic Risk Candidate Genes and Toxic Chemicals via Multilabel Learning}}. {IEEE Trans Neural Netw Learn Syst};2020 (Aug 25);Pp
As a group of complex neurodevelopmental disorders, autism spectrum disorder (ASD) has been reported to have a high overall prevalence, showing an unprecedented spurt since 2000. Due to the unclear pathomechanism of ASD, it is challenging to diagnose individuals with ASD merely based on clinical observations. Without additional support of biochemical markers, the difficulty of diagnosis could impact therapeutic decisions and, therefore, lead to delayed treatments. Recently, accumulating evidence have shown that both genetic abnormalities and chemical toxicants play important roles in the onset of ASD. In this work, a new multilabel classification (MLC) model is proposed to identify the autistic risk genes and toxic chemicals on a large-scale data set. We first construct the feature matrices and partially labeled networks for autistic risk genes and toxic chemicals from multiple heterogeneous biological databases. Based on both global and local measure metrics, the simulation experiments demonstrate that the proposed model achieves superior classification performance in comparison with the other state-of-the-art MLC methods. Through manual validation with existing studies, 60% and 50% out of the top-20 predicted risk genes are confirmed to have associations with ASD and autistic disorder, respectively. To the best of our knowledge, this is the first computational tool to identify ASD-related risk genes and toxic chemicals, which could lead to better therapeutic decisions of ASD.
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14. McCrae CS, Chan WS, Curtis AF, Nair N, Deroche CB, Munoz M, Takamatsu S, McLean D, Davenport M, Muckerman JE, Takahashi N, McCann D, McGovney K, Sahota P, Mazurek MO. {{Telehealth cognitive behavioral therapy for insomnia in children with autism spectrum disorder: A pilot examining feasibility, satisfaction, and preliminary findings}}. {Autism};2020 (Aug 25):1362361320949078.
Insomnia is common in children with autism. Cognitive behavioral treatment for childhood insomnia (CBT-CI) may improve sleep and functioning in children with autism and their parents, but typical delivery involving multiple office visits can make it difficult for some children to get this treatment. This pilot study tested telehealth delivery of CBT-CI using computers, which allowed children and their parents to get the treatment at home. This pilot shows therapists that parents and children were able to use telehealth CBT-CI to improve child and parent sleep, child behavior and arousal, and parent fatigue. Parents found telehealth CBT-CI helpful, age-appropriate, and autism-friendly. Telehealth CBT-CI holds promise for treating insomnia in school-aged children with autism and deserves further testing.
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15. Mikrani R, Li C, Naveed M, Li C, Baig M, Zhang Q, Wang Y, Peng J, Zhao L, Zhou X. {{Pharmacokinetic Advantage of ASD Device Promote Drug Absorption through the Epicardium}}. {Pharm Res};2020 (Aug 24);37(9):173.
PURPOSE: Due to low therapeutic efficacy and severe adverse reaction of systemic administration for coronary heart disease (CHD) therapy, we designed a novel local target delivery system, called Active hydraulic ventricular Support Drug delivery system (ASD). This study aims to investigate the potential advantages of ASD compared to intrapericardial (IPC) injection and factors affecting drug absorption through epicardium. METHODS: Liposoluble, water soluble and viscous solutions of cyanine 5 (Cy5) fluorescent dye were delivered individually through ASD and IPC in Sprague-Dawley (SD) rats and then tissues were isolated and observed by in vivo imaging system. Atria and ventricles of the heart were taken for the paraffin section and observed under a fluorescence microscope. RESULTS: The fluorescence intensity of Cy5 injected by ASD distributed in the heart was significantly higher than IPC injection. Whereas, the fluorescence signal spread in other tissues such as lung, liver, spleen, and kidney of ASD groups was much weaker. Moreover, when choosing liposoluble and viscous Cy5, the intensity of the heart turned stronger and fluorescence dye distributed in other tissues was lesser. CONCLUSIONS: The application of ASD device may provide a promising route of drug delivery for CHD. Furthermore, increasing viscosity of the solution and liposolublity of the drug was beneficial to facilitate drug absorption through the epicardium.
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16. Molnar-Szakacs I, Kupis L, Uddin LQ. {{Neuroimaging Markers of Risk and Pathways to Resilience in Autism Spectrum Disorder}}. {Biol Psychiatry Cogn Neurosci Neuroimaging};2020 (Jul 6)
Autism spectrum disorder is a complex, heterogeneous neurodevelopmental condition of largely unknown etiology. This heterogeneity of symptom presentation, combined with high rates of comorbidity with other developmental disorders and a lack of reliable biomarkers, makes diagnosing and evaluating life outcomes for individuals with autism spectrum disorder a challenge. We review the growing literature on neuroimaging-based biomarkers of risk for the development of autism and explore evidence for resilience in some autistic individuals. The current literature suggests that neuroimaging during early infancy, in combination with prebirth and early genetic studies, is a promising tool for identifying biomarkers of risk, while studies of gene expression and DNA methylation have provided some key insights into mechanisms of resilience. With genetics and the environment contributing to both risk for the development of autism spectrum disorder and conditions for resilience, additional studies are needed to understand how risk and resilience interact mechanistically, whereby factors of risk may engender conditions for adaptation. Future studies should prioritize longitudinal designs in global cohorts, with the involvement of the autism community as partners in research to help identify domains of functioning that hold value and importance to the community.
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17. Moreno-Pérez FJ, Rodríguez-Ortiz IR, Tavares G, Saldaña D. {{Comprehending reflexive and clitic constructions in children with autism spectrum disorder and developmental language disorder}}. {Int J Lang Commun Disord};2020 (Aug 26)
BACKGROUND: It has been established that people with autism spectrum disorder (ASD) often have difficulties understanding spoken language. Understanding reflexive and clitic pronouns is vital to establishing reference-based inference, but it is as yet unclear whether such constructions pose specific difficulties for those with ASD. Pronoun interpretation seems be connected to the development of pragmatic abilities, and can therefore be considered a plausible marker in the differential diagnosis between ASD and developmental language disorder (DLD). AIMS: To establish whether or not there are differences between ASD and DLD in relation to their understanding of pronoun constructions (both reflexive and clitic). The working hypothesis was that although no differences were expected between groups in relation to automatic (online) pronoun processing, the comprehension of reflexive pronouns would constitute a diagnostic marker between the group with ASD and language disorder and the DLD group. METHODS & PROCEDURES: The study carried out two experiments with three clinical groups (two with ASD and different levels of language proficiency and one with DLD) and two control groups with typically developing people (with equivalent language levels), analysing their on- and offline processing in pronoun resolution tasks. The first experiment uses an online method (eye-tracking) to record pronoun processing in real time. The second uses an offline method to analyse comprehension accuracy. OUTCOMES & RESULTS: The results of the two experiments indicated no differences in the way in which the clinical and control groups resolved the tasks, but a shorter reaction time was observed only in the age-matched control group in comparison with the ASD group without language disorder in the first experiment, perhaps due to the fact that processing pronouns involves a greater cognitive load among the latter group. CONCLUSIONS & IMPLICATIONS: The comprehension of reflexive pronouns cannot be considered a diagnostic marker for distinguishing ASD from DLD. What this paper adds What is already known on the subject Previous studies have found that the performance of children with ASD in the comprehension of personal pronouns is equivalent to youngest control groups, but poorer regarding the interpretation of reflective pronouns. However, children with DLD do not usually have problems with the use of pronouns, which suggests that their pronoun processing is not affected. As pronoun interpretation seems be connected to the development of pragmatic abilities, it could be considered a plausible marker in the differential diagnosis between ASD and DLD. What this paper adds to existing knowledge This paper presents the results of two experiments involving pronoun processing by those with ASD (both with and without language disorder) and those with DLD. The design enables us to analyse the reflexive and clitic pronoun processing in people with ASD and DLD, regardless of their language proficiency. One experiment uses an eye-tracking methodology that allows us to obtain data about how the pronouns are processed in real time. It represents an attempt to identify language markers that may help distinguish between the two groups and adapt the interventions to the specific problems experienced by each one. What are the potential or actual clinical implications of this work? The results indicate that it is not possible to identify any specific impairment in pronoun processing among the clinical groups (ASD and DLD).
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18. Nguyen L, Jack S, Ketelaar M, Di Rezze B, Soper AK, Gorter JW. {{Understanding the essential components and experiences of youth with autism spectrum disorders in peer mentorship programs during the transition to adulthood: a qualitative meta-ethnography}}. {Child Care Health Dev};2020 (Aug 25)
BACKGROUND: Youth with an autism spectrum disorder (ASD) often require additional supports during the period of transition to from high school to post-secondary education or career paths. Peer mentorship programs create opportunities to support youth with ASD in identifying their personal, academic, and career goals after graduating from high school, however there is limited insight about the components of these programs that are valued by both participants and peer mentors and that are perceived to contribute to the overall success of a program in achieving their goals. Our objective was to identify, describe and synthesize the components of peer mentorship programs valued by youth with ASD and their peer mentors, as well as to document their experiences in these transitional support services. METHODS: A meta-ethnography was conducted to synthesize qualitative and mixed methods studies of PM programs for youth with ASD. A systematic search of seven databases yielded 142 non-duplicate articles. Data analysis and synthesis involved: 1) extraction of raw data; 2) extraction of study authors’ interpretations, followed by inductive coding; 3) synthesis of key themes; and 4) schematic diagram development to illustrate the relationship of themes. RESULTS: 10 studies of PM programs from Canada (2), United States (4), Australia (3), and United Kingdom (1) were included. Extracted data reflected experiences of 131 mentees and 82 mentors. The essential program components identified were: 1) mentorship; 2) skill building; 3) peer group; and 4) facilitating transition. SIGNIFICANCE: Peer mentorship characterized by clear communication and connection between mentors and mentees was valuable to the success of the program. Peer mentors played an essential role to facilitate the positive experiences that mentees had with program components, including interactions with peer groups. Successful PM programs created a safe environment for mentees to practice skills, and help mentees gain confidence to expand their roles to take leadership in their learning.
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19. Pehlivanidis A, Papanikolaou K, Mantas V, Kalantzi E, Korobili K, Xenaki LA, Vassiliou G, Papageorgiou C. {{Lifetime co-occurring psychiatric disorders in newly diagnosed adults with attention deficit hyperactivity disorder (ADHD) or/and autism spectrum disorder (ASD)}}. {BMC Psychiatry};2020 (Aug 26);20(1):423.
BACKGROUND: Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. METHODS: The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. RESULTS: At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). CONCLUSIONS: Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
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20. Rodrigues R, Lai MC, Beswick A, Gorman DA, Anagnostou E, Szatmari P, Anderson KK, Ameis SH. {{Practitioner Review: Pharmacological treatment of attention-deficit/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta-analysis}}. {J Child Psychol Psychiatry};2020 (Aug 26)
BACKGROUND: Clinically significant attention-deficit/hyperactivity disorder (ADHD) symptoms are common and impairing in children and youth with autism spectrum disorder(ASD). The aim of this systematic review and meta-analysis was to (a) evaluate the efficacy and safety of pharmacotherapy for the treatment of ADHD symptoms in ASD and (b) distil findings for clinical translation. METHODS: We searched electronic databases and clinical trial registries (1992 onwards). We selected randomized controlled trials conducted in participants <25 years of age, diagnosed with ASD that evaluated ADHD outcomes (hyperactivity/impulsivity and inattention) following treatment with stimulants (methylphenidate or amphetamines), atomoxetine, alpha-2 adrenergic receptor agonists, antipsychotics, tricyclic antidepressants, bupropion, modafinil, venlafaxine, or a combination, in comparison with placebo, any of the listed medications, or behavioral therapies. Data were pooled using a random-effects model. RESULTS: Twenty-five studies (4 methylphenidate, 4 atomoxetine, 1 guanfacine, 14 antipsychotic, 1 venlafaxine, and 1 tianeptine) were included. Methylphenidate reduced hyperactivity (parent-rated: standardized mean difference [SMD] = -.63, 95%CI = -.95,-.30; teacher-rated: SMD = -.81, 95%CI = -1.43,-.19) and inattention (parent-rated: SMD = -.36, 95%CI = -.64,-.07; teacher-rated: SMD = -.30, 95%CI = -.49,-.11). Atomoxetine reduced inattention (parent-rated: SMD = -.54, 95%CI = -.98,-.09; teacher/investigator-rated: SMD = -0.38, 95%CI = -0.75, -0.01) and parent-rated hyperactivity (parent-rated: SMD = -.49, 95%CI = -.76,-.23; teacher-rated: SMD = -.43, 95%CI = -.92, .06). Indirect evidence for significant reductions in hyperactivity with second-generation antipsychotics was also found. Quality of evidence for all interventions was low/very low. Methylphenidate was associated with a nonsignificant elevated risk of dropout due to adverse events. CONCLUSIONS: Direct pooled evidence supports the efficacy and tolerability of methylphenidate or atomoxetine for treatment of ADHD symptoms in children and youth with ASD. The current review highlights the efficacy of standard ADHD pharmacotherapy for treatment of ADHD symptoms in children and youth with ASD. Consideration of the benefits weighed against the limitations of safety/efficacy data and lack of data evaluating long-term continuation is undertaken to help guide clinical decision-making regarding treatment of co-occurring ADHD symptoms in children and youth with ASD. Lien vers le texte intégral (Open Access ou abonnement)
21. Siafis S, Çıray O, Schneider-Thoma J, Bighelli I, Krause M, Rodolico A, Ceraso A, Deste G, Huhn M, Fraguas D, Mavridis D, Charman T, Murphy DG, Parellada M, Arango C, Leucht S. {{Placebo response in pharmacological and dietary supplement trials of autism spectrum disorder (ASD): systematic review and meta-regression analysis}}. {Mol Autism};2020 (Aug 26);11(1):66.
BACKGROUND: Placebo response in autism spectrum disorder (ASD) might dilute drug-placebo differences and hinder drug development. Therefore, this meta-analysis investigated placebo response in core symptoms. METHODS: We searched ClinicalTrials.gov , CENTRAL, EMBASE, MEDLINE, PsycINFO, WHO-ICTRP (up to July 8, 2018), and PubMed (up to July 4, 2019) for randomized pharmacological and dietary supplement placebo-controlled trials (RCTs) with a minimum of seven days of treatment. Single-group meta-analyses were conducted using a random-effects model. Standardized mean changes (SMC) of core symptoms in placebo arms were the primary outcomes and placebo positive response rates were a secondary outcome. Predictors of placebo response were investigated with meta-regression analyses. The protocol was registered with PROSPERO ID CRD42019125317 . RESULTS: Eighty-six RCTs with 2360 participants on placebo were included in our analysis (87% in children/adolescents). The majority of trials were small, single-center with a duration of 8-12 weeks and published after 2009. Placebo response in social-communication difficulties was SMC = - 0.32, 95% CI [- 0.39, - 0.25], in repetitive behaviors - 0.23[- 0.32, - 0.15] and in scales measuring overall core symptoms - 0.36 [- 0.46, - 0.26]. Overall, 19%, 95% CI [16-22%] of participants were at least much improved with placebo. Caregiver (vs. clinician) ratings, lower risk of bias, flexible-dosing, larger sample sizes and number of sites, less recent publication year, baseline levels of irritability, and the use of a threshold of core symptoms at inclusion were associated with larger placebo response in at least a core symptom domain. LIMITATIONS: About 40% of the trials had an apparent focus on core symptoms. Investigation of the differential impact of predictors on placebo and drug response was impeded by the use of diverse experimental interventions with essentially different mechanisms of action. An individual-participant-data meta-analysis could allow for a more fine-grained analysis and provide more informative answers. CONCLUSIONS: Placebo response in ASD was substantial and predicted by design- and participant-related factors, which could inform the design of future trials in order to improve the detection of efficacy in core symptoms. Potential solutions could be the minimization and careful selection of study sites as well as rigorous participant enrollment and the use of measurements of change not solely dependent on caregivers.
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22. van Leeuwen TM, Neufeld J, Hughes J, Ward J. {{Synaesthesia and autism: Different developmental outcomes from overlapping mechanisms?}}. {Cogn Neuropsychol};2020 (Aug 26):1-17.
Synaesthesia, a mixing of the senses, is more common in individuals with autism. Here, we review the evidence for the association between synaesthesia and autism with regard to their genetic background, brain connectivity, perception, cognitive mechanisms and their contribution to exceptional talents. Currently, the overlap between synaesthesia and autism is established most convincingly at the level of alterations in sensory sensitivity and perception, with synaesthetes showing autism-like profiles of sensory sensitivity and a bias towards details in perception. Shared features may include a predominance of local over global connectivity in the brain. When autism and synaesthesia co-occur in the same individual, the chance of developing heightened cognitive and memory abilities is increased. We discuss how the same theoretical models could potentially explain both conditions. Given the evidence, we believe the phenotypical overlap between autism and synaesthesia has been established clearly enough to invite future research to confirm overlapping mechanisms.
