1. Al-Maweri SA, Halboub ES, Al-Soneidar WA, Al-Sufyani GA. {{Oral lesions and dental status of autistic children in Yemen: A case-control study}}. {J Int Soc Prev Community Dent}. 2014; 4(Suppl 3): S199-203.
PURPOSE: This study aimed to assess the prevalence of oral lesions among children with autism in Sana’a City, Yemen, and to evaluate their dental status. PATIENTS AND METHODS: This case-control study included 42 children with autism, aged between 5 and 16 years, and 84 age- and gender-matched healthy children as controls. Oral lesions were assessed based on standardized criteria according to the World Health Organization (WHO) recommendations. Dental caries, gingival health, and oral hygiene status were assessed using dmft/DMFT index, Gingival Index (GI), and Plaque Index (PI), respectively. Chi-square test and Mann-Whitney’s test were used to compare the groups. RESULTS: Compared to controls, children with autism revealed higher proportion of fistulae (9.5% vs. 2.4%), ulcerative lesions (7.1% vs. 1.2%), gingival hyperplasia (4.8% vs. 0.0%), and cheilitis (4.8% vs. 2.4%); however, the differences were not statistically significant. The mean dmft score was significantly higher in children with autism than in controls (5.23 vs. 4.06; P < 0.001). Moreover, children with autism revealed poorer oral hygiene than controls, and the majority had gingivitis. CONCLUSIONS: Children with autism in Yemen have high prevalence of oral soft tissue lesions, caries, and gingivitis. Therefore, proper oral health education programs should be initiated and directed toward this special section of the society.
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2. Anna C, Edyta SS, Jolanta W, Ewa F, Barbara C, Malgorzata MD, Tomasz C, Marta B, Elzbieta K. {{Influence of candidate polymorphisms on the dipeptidyl peptidase IV and mu-opioid receptor genes expression in aspect of the beta-casomorphin-7 modulation functions in autism}}. {Peptides}. 2015.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with population prevalence of approximately 60 – 70 per 10 000. Data shows that both opioid system function enhancement and opiate administration can result in autistic-like symptoms. Cow milk opioid peptides, including beta-casomorphin-7 (BCM7, Tyr-Pro-Phe-Pro-Gly-Pro-Ile), effect the mu-opioid receptor (MOR) and are subjected to degradation resulting from the proline dipeptidyl peptidase IV (DPPIV, EC 3.4.14.5) enzyme activity. The presence of MOR and DPPIV activity are crucial factors determining biological activity of BCM7 in the human body. Our study examined the effect of beta-casomorphin-7 on the MOR and DPPIV genes expression according to specific point mutations in these genes. In addition, we investigated frequency of A118G SNP in the MOR gene and rs7608798 of the DPPIV (A/G) gene in healthy and autistic children. Our research indicated correlation in DPPIV gene expression under the influence of BCM7 and hydrolyzed milk between healthy and ASD-affected children with genotype GG (p<0.0001). We also observed increased MOR gene expression in healthy children with genotype AG at polymorphic site A118G under influence of BCM7 and hydrolyzed milk. The G allele frequency was 0.09 in MOR gene and 0.68 in the DPPIV gene. But our results suggest no association between presence of the alleles G and A at position rs7608798 in DPPIV gene nor alleles A and G at position A118G of the MOR and increased incidence of ASD. Our studies emphasize the compulsion for genetic analysis in correlation with genetic factors affecting development and enhancement of autism symptoms.
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3. Bener A, Khattab AO, Al-Dabbagh MM. {{Is high prevalence of Vitamin D deficiency evidence for autism disorder?: In a highly endogamous population}}. {J Pediatr Neurosci}. 2014; 9(3): 227-33.
AIM: To determine the association between Vitamin D and autism, and the difference in level of Vitamin D in autism children and control. DESIGN: Case-control study conducted between June 2011 and May 2013, among autism at the Hamad Medical Corporation and controls at the School Health Clinics and Primary Health Care Clinics. SUBJECTS AND METHODS: A total of 254 cases and 254 controls. The Autism Diagnostic Observation Schedule-Generic is a semi-structured, standardized assessment of social interaction, communication, play and imaginative use of materials for individuals suspected of having autism spectrum disorders. Data on clinical manifestations and laboratory, family history, body mass index (BMI) and clinical biochemistry variables including serum 25-hydroxy Vitamin D, calcium, phosphorus and magnesium were obtained. Univariate and multivariate statistical analyzes were performed. RESULTS: Of the total number of 508 children surveyed, 254 of autism and 254 of healthy children were contacted. The mean age (+/- standard deviation, in years) for autism versus control children was 5.51 +/- 1.58 versus 5.76 +/- 1.56. There were statistically significant differences between autism and healthy children control subjects with respect to educational level of mother (P = 0.016); occupation of mother (P = 0.005); BMI (P < 0.001); consanguinity (P = 0.015); exposure to sun (P = 0.002) and walking time per day <60 min (P < 0.001). The mean value of Vitamin D in autism children was much lower than the normal value, and there was a significant difference found in the mean values of Vitamin D between autism (18.39 +/- 8.2 with median 18) and versus control children (21.59 +/- 8.4) (P < 0.0001) and with median 21 (P = 0.004). Besides mean values of calcium, phosphorous, magnesium, glucose, potassium and alkaline phosphate were statistically significant higher in control healthy children compared to autism children (P < 0.001). Multivariate logistic regression analysis revealed that the mean serum Vitamin D level, calcium, consanguinity, BMI, physical activity, child order, and ferritin, were considered as the main factors associated with autism. Of total 254 of autism children, 14.2% had severe Vitamin D deficiency (<10 ng/ml), 43.7% had moderate insufficient levels (between 10 and 20 ng/ml), 28.3% had mild insufficient levels (between 20 and 30 ng/ml), and only 13.8% of autism had sufficient levels (>30 ng/ml). Similarly, of the total 254 of healthy children 8.3% had severe Vitamin D deficiency (<10 ng/ml), 37% had moderate insufficient levels (between 10 and 20 ng/ml), 37.4% had mild insufficient levels (between 20 and 30 ng/ml), and only 17.3% had sufficient levels (>30 ng/ml). Furthermore, there was statistically significant differences between autism and control subjects with respect to the serum level of Vitamin D (P = 0.023). CONCLUSION: The present study revealed that Vitamin D deficiency was higher in autism children compared to healthy children and supplementing infants with Vitamin D might be a safe and more effective strategy for reducing the risk of autism.
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4. Bilbo SD, Nevison CD, Parker W. {{A model for the induction of autism in the ecosystem of the human body: the anatomy of a modern pandemic?}}. {Microb Ecol Health Dis}. 2015; 26: 26253.
BACKGROUND: The field of autism research is currently divided based on a fundamental question regarding the nature of autism: Some are convinced that autism is a pandemic of modern culture, with environmental factors at the roots. Others are convinced that the disease is not pandemic in nature, but rather that it has been with humanity for millennia, with its biological and neurological underpinnings just now being understood. OBJECTIVE: In this review, two lines of reasoning are examined which suggest that autism is indeed a pandemic of modern culture. First, given the widely appreciated derailment of immune function by modern culture, evidence that autism is strongly associated with aberrant immune function is examined. Second, evidence is reviewed indicating that autism is associated with ‘triggers’ that are, for the most part, a construct of modern culture. In light of this reasoning, current epidemiological evidence regarding the incidence of autism, including the role of changing awareness and diagnostic criteria, is examined. Finally, the potential role of the microbial flora (the microbiome) in the pathogenesis of autism is discussed, with the view that the microbial flora is a subset of the life associated with the human body, and that the entire human biome, including both the microbial flora and the fauna, has been radically destabilized by modern culture. CONCLUSIONS: It is suggested that the unequivocal way to resolve the debate regarding the pandemic nature of autism is to perform an experiment: monitor the prevalence of autism after normalizing immune function in a Western population using readily available approaches that address the well-known factors underlying the immune dysfunction in that population.
5. Casanova MF, Sokhadze E, Opris I, Wang Y, Li X. {{Autism Spectrum Disorders: Linking Neuropathological Findings to Treatment with Transcranial Magnetic Stimulation}}. {Acta Paediatr}. 2015.
Postmortem studies in autism spectrum disorder (ASD) individuals indicate the presence of abnormalities within the peripheral neuropil space (PNS) of cortical minicolumns. The geometrical orientation of inhibitory elements within the PNS suggests using repetitive transcranial magnetic stimulation (rTMS) to up-regulate their activity. Several rTMS trials in ASD have shown marked improvements in motor symptomatology, attention, and perceptual binding. CONCLUSION: rTMS is the first therapeutic attempt at ASD aimed at correcting some of its core pathology. This article is protected by copyright. All rights reserved.
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6. Chien HY, Lin HY, Lai MC, Gau SS, Tseng WY. {{Hyperconnectivity of the Right Posterior Temporo-parietal Junction Predicts Social Difficulties in Boys with Autism Spectrum Disorder}}. {Autism Res}. 2015.
The posterior right temporo-parietal junction (pRTPJ) is a key brain region representing other’s mental status. Despite reports of atypical activation at pRTPJ during mentalizing in individuals with autism spectrum disorder (ASD), the intrinsic functional connectivity (iFC) of the pRTPJ remains under-investigated. We examined whether boys with ASD show altered resting-state iFC of the pRTPJ, and whether atypical iFC of the pRTPJ is associated with social deficits in ASD in a sample of 40 boys with high-functioning ASD (aged 9-17 years, mean age, 12.38 +/- 2.17; mean IQ, 105.60 +/- 16.06) and 42 typically developing (TD) boys (aged 9-17 years, mean age, 11.64 +/- 2.71; mean IQ, 111.29 +/- 13.45). Both groups received resting-state fMRI assessment after imaging data quality control for in-scanner head motion and spatial coverage. Seed-based approach was used to investigate iFC of the pRTPJ. TD and ASD boys demonstrated a resting-state pRTPJ iFC pattern comparable to the known spatial involvement of the default-mode network. Boys with ASD showed pRTPJ hyperconnectivity relative to TD boys in the right ventral occipito-temporal cortex. This atypically increased iFC in the ASD group was positively correlated with social deficits assessed by the Chinese version of the Autism Diagnostic Interview-Revised and the Social Responsive Scale. Our findings provide empirical support for functional « dysconnectivity, » that is, atypical functional integration among brain regions, as an integral component of the atypical neurobiology of ASD. Autism Res 2015. (c) 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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7. Coster WJ, Kramer JM, Tian F, Dooley M, Liljenquist K, Kao YC, Ni P. {{Evaluating the appropriateness of a new computer-administered measure of adaptive function for children and youth with autism spectrum disorders}}. {Autism}. 2015.
The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test is an alternative method for describing the adaptive function of children and youth with disabilities using a computer-administered assessment. This study evaluated the performance of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test with a national sample of children and youth with autism spectrum disorders aged 3-21 years. Parents (n = 365) completed an online survey that included demographics, the Social Communication Questionnaire, and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test Social/Cognitive, Daily Activities, and Responsibility domains. Item response theory analysis confirmed items in each domain fit a unidimensional model and few items misfit. A large number of items in the Social/Cognitive domain showed differential item functioning, indicating a unique order of item difficulty in this population in this domain. Differences in item difficulty estimates were addressed through a parameter linking (equating) process. Simulations supported the accuracy and precision of the Computer Adaptive Test. Results suggest that the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test, as modified for autism spectrum disorder, is an efficient and sound assessment for this population.
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8. Davis T, Clifton D, Papadopoulos C. {{Identifying autism early: The Toddlers at Risk of Autism Clinic model}}. {J Paediatr Child Health}. 2015.
AIM: This paper describes the Toddlers at Risk of Autism Clinic (TRAC), which utilises the Social Attention and Communication Study (SACS) and/or Autism Detection in Early Childhood (ADEC) play-based assessments to facilitate the early diagnosis of autism. METHODS: A retrospective audit was conducted of all 42 children assessed over a 3-year period in the TRAC. A semi-structured interview and play-based assessment (SACS and ADEC) were used to aid experienced clinicians in diagnosing autism. Intervention was recommended, and families were routinely followed up. Analysis was conducted on the tools used, the outcomes of assessment, diagnosis and stability of diagnosis on follow-up. RESULTS: During this period, 35 boys and 7 girls were assessed, with a mean age of 25 months. The average waiting time for clinic was 11.6 weeks. Twenty-five patients were diagnosed with autism; 90.5% of toddlers given an initial diagnosis retained that diagnosis at follow-up. Out of the 17 children who were not diagnosed with autism in the TRAC, one child was later diagnosed with autism. CONCLUSION: Experienced clinicians can use the SACS and/or ADEC to assist with a Diagnostic and Statistical Manual diagnosis of autism in toddlers.
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9. Eussen ML, Louwerse A, Herba CM, Van Gool AR, Verheij F, Verhulst FC, Greaves-Lord K. {{Childhood Facial Recognition Predicts Adolescent Symptom Severity in Autism Spectrum Disorder}}. {Autism Res}. 2015.
Limited accuracy and speed in facial recognition (FR) and in the identification of facial emotions (IFE) have been shown in autism spectrum disorders (ASD). This study aimed at evaluating the predictive value of atypicalities in FR and IFE for future symptom severity in children with ASD. Therefore we performed a seven-year follow-up study in 87 children with ASD. FR and IFE were assessed in childhood (T1: age 6-12) using the Amsterdam Neuropsychological Tasks (ANT). Symptom severity was assessed using the Autism Diagnostic Observation Schedule (ADOS) in childhood and again seven years later during adolescence (T2: age 12-19). Multiple regression analyses were performed to investigate whether FR and IFE in childhood predicted ASD symptom severity in adolescence, while controlling for ASD symptom severity in childhood. We found that more accurate FR significantly predicted lower adolescent ASD symptom severity scores (DeltaR2 = .09), even when controlling for childhood ASD symptom severity. IFE was not a significant predictor of ASD symptom severity in adolescence. From these results it can be concluded, that in children with ASD the accuracy of FR in childhood is a relevant predictor of ASD symptom severity in adolescence. Test results on FR in children with ASD may have prognostic value regarding later symptom severity. Autism Res 2015. (c) 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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10. Gaigg SB, Bowler DM, Ecker C, Calvo-Merino B, Murphy DG. {{Episodic Recollection Difficulties in ASD Result from Atypical Relational Encoding: Behavioral and Neural Evidence}}. {Autism Res}. 2015.
Memory functioning in Autism Spectrum Disorder (ASD) is characterized by impairments in the encoding of relational but not item information and difficulties in the recollection of contextually rich episodic memories but not in the retrieval of relatively context-free memories through processes of familiarity. The neural underpinnings of this profile and the extent to which encoding difficulties contribute to retrieval difficulties in ASD remain unclear. Using a paradigm developed by Addis and McAndrews [2006; Neuroimage, 33, 1194-1206] we asked adults with and without a diagnosis of ASD to study word-triplets during functional Magnetic Resonance Imaging (fMRI) scanning that varied in the number of category relations amongst component words. Performance at test confirmed attenuated recollection in the context of preserved familiarity based retrieval in ASD. The results also showed that recollection but not familiarity based retrieval increases as a function of category relations in word triads for both groups, indicating a close link between the encoding of relational information and recollection. This link was further supported by the imaging results, where blood oxygen level dependent (BOLD) signal responses in overlapping regions of the inferior prefrontal cortex were sensitive to the relational encoding manipulation as well as the contrast between recollection versus familiarity based retrieval. Interestingly, however, there was no evidence of prefrontal signal differentiation for this latter contrast in the ASD group for whom signal changes in a left hippocampal region were also marginally attenuated. Together, these observations suggest that attenuated levels of episodic recollection in ASD are, at least in part, attributable to anomalies in relational encoding processes. Autism Res 2015. (c) 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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11. Hagerman PJ, Hagerman RJ. {{Fragile X-associated tremor/ataxia syndrome}}. {Ann N Y Acad Sci}. 2015.
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late-onset neurodegenerative disorder that affects some but not all carriers of small, noncoding CGG-repeat expansions (55-200 repeats; premutation) within the fragile X gene (FMR1). Principal features of FXTAS include intention tremor, cerebellar ataxia, Parkinsonism, memory and executive function deficits, autonomic dysfunction, brain atrophy with white matter disease, and cognitive decline. Although FXTAS was originally considered to be confined to the premutation range, rare individuals with a gray zone (45-54 repeats) or an unmethylated full mutation (>200 repeats) allele have now been described, the constant feature of the disorder remaining the requirement for FMR1 expression, in contradistinction to the gene silencing mechanism of fragile X syndrome. Although transcriptional activity is required for FXTAS pathogenesis, the specific trigger(s) for FXTAS pathogenesis remains elusive, highlighting the need for more research in this area. This need is underscored by recent neuroimaging findings of changes in the central nervous system that consistently appear well before the onset of clinical symptoms, thus creating an opportunity to delay or prevent the appearance of FXTAS.
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12. LaFlamme B. {{Genetic modules for autism}}. {Nat Genet}. 2015; 47(2): 105.
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13. Mikita N, Hollocks MJ, Papadopoulos AS, Aslani A, Harrison S, Leibenluft E, Simonoff E, Stringaris A. {{Irritability in boys with autism spectrum disorders: an investigation of physiological reactivity}}. {J Child Psychol Psychiatry}. 2015.
BACKGROUND: Irritability in people with autism spectrum disorders (ASD) is common and impairing, yet its mechanisms remain understudied. We investigated symptom reporting and mechanisms of irritability in ASD, focusing on the relation between irritability and physiological stress responses. METHODS: Forty-seven unmedicated boys with high-functioning ASD (hfASD) and 23 typically developing boys aged 10-16 years completed a psychosocial stress test. Changes in cortisol, heart rate and heart rate variability throughout the test were recorded. Self- and parent-reported measures of irritability were obtained. Irritability symptom reporting in the hfASD group was compared to two groups of boys without ASD: highly irritable boys (severe mood dysregulation, SMD; n = 40) and healthy-control boys (HC; n = 30). RESULTS: Boys with hfASD scored significantly higher on irritability than HC boys, and they reported a pattern of irritability symptoms closely resembling that of boys with SMD. The internal consistency of irritability in hfASD was high by parent- and self-report. Although boys with hfASD showed significant stress-induced changes in cortisol and heart rate, those who rated themselves as highly irritable had lower cortisol levels throughout the test compared to those low on irritability. Participants rated as highly irritable by their parents showed blunted cortisol and heart rate responses to stress. The effects of irritability on heart rate, but not cortisol, were accounted for by trait anxiety. CONCLUSIONS: Irritability can be measured reliably in hfASD and is associated with distinct biological responses to stress.
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14. Osipowicz K, Bosenbark DD, Patrick KE. {{Cortical Changes Across the Autism Lifespan}}. {Autism Res}. 2015.
Although it is widely accepted that autism spectrum disorder (ASD) involves neuroanatomical abnormalities and atypical neurodevelopmental patterns, there is little consensus regarding the precise pattern of neuroanatomical differences or how these differences relate to autism symptomology. Furthermore, there is limited research related to neuroanatomical correlates of autism symptomology in individuals with ASD and the studies that do exist primarily include small samples. This study was the first to investigate gray matter (GM) changes throughout the ASD lifespan, using voxel-based morphometry to determine whether significant differences exist in the GM volumes of a large sample of individuals with ASD compared to age- and IQ-matched typical controls. We examined GM volume across the lifespan in 531 individuals diagnosed with ASD and 571 neurotypical controls, aged 7-64. We compared groups and correlated GM with age and autism severity in the ASD group. Findings suggest bilateral decreased GM volume for individuals with ASD in regions extending from the thalamus to the cerebellum, anterior medial temporal lobes, and orbitofrontal regions. Higher autism severity was associated with decreased GM volumes in prefrontal cortex, inferior parietal and temporal regions, and temporal poles. Similar relationships were found between GM volume and age. ASD diagnosis and severity were not associated with increased GM volumes in any region. Autism Res 2015. (c) 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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15. Ota M, Stewart ME, Petrou AM, Dickie C. {{Lexical Effects on Children’s Speech Processing: Individual Differences Reflected in the Autism-Spectrum Quotient (AQ)}}. {J Speech Lang Hear Res}. 2015.
Purpose: To examine whether children exhibit the same relationship that adults show between the lexical influence on phoneme identification and individual variation on the Autism-Spectrum Quotient (AQ). Method: Data from 62 4- to 7-year-olds with no diagnosis of autism were analyzed. The main task involved identification of the initial sound in pairs of voice-onset time continua with a real word on one end and a nonword on the other (e.g., gift-kift, giss-kiss). Participants were also given the children’s version of the Autism-Spectrum Quotient (AQ-child) and a second instrument related to autistic-like traits, the Social Responsiveness Scale (SRS). Results: The lexical shift was related to the AQ (particularly to its attention switching subscale), but not to the SRS. Conclusions: The size of lexical effects on children’s speech perception can be predicted by AQ scores but not necessarily by other measures of autistic-like traits. The results indicate that speech perception in children manifests individual differences along some general dimension of cognitive style reflected in the AQ, possibly in relation to local/global information processing.
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16. Piochon C, Kloth AD, Grasselli G, Titley HK, Nakayama H, Hashimoto K, Wan V, Simmons DH, Eissa T, Nakatani J, Cherskov A, Miyazaki T, Watanabe M, Takumi T, Kano M, Wang SS, Hansel C. {{Corrigendum: Cerebellar plasticity and motor learning deficits in a copy-number variation mouse model of autism}}. {Nat Commun}. 2015; 6: 6014.
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17. Pokorny JJ, Hatt NV, Colombi C, Vivanti G, Rogers SJ, Rivera SM. {{The Action Observation System when Observing Hand Actions in Autism and Typical Development}}. {Autism Res}. 2015.
Social impairments in individuals with autism spectrum disorders (ASD) may be in part due to difficulty perceiving and recognizing the actions of others. Evidence from imitation studies, which involves both observation and execution of an action, suggests differences, in individuals with ASD, between the ability to imitate goal-directed actions involving objects (transitive actions) and the ability to imitate actions that do not involve objects (intransitive actions). In the present study, we examined whether there were differences in how ASD adolescents encoded transitive and intransitive actions compared to typically developing (TD) adolescents, by having participants view videos of a hand reaching across a screen toward an object or to where an object would be while functional magnetic resonance images were collected. Analyses focused on areas within the action observation network (AON), which is activated during the observation of actions performed by others. We hypothesized that the AON would differentiate transitive from intransitive actions only in the ASD group. However, results revealed that object presence modulated activity in the right inferior frontal gyrus and supramarginal gyrus of the TD group, a differentiation that was not seen in the ASD group. Furthermore, there were no significant group differences between the TD and ASD groups in any of the conditions. This suggests that there is not a global deficit of the AON in individuals with ASD while observing transitive and intransitive actions. Autism Res 2015. (c) 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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18. Posar A, Visconti P. {{To what extent do environmental factors contribute to the occurrence of autism spectrum disorders?}}. {J Pediatr Neurosci}. 2014; 9(3): 297-8.
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19. Szatmari P, Georgiades S, Duku E, Bennett TA, Bryson S, Fombonne E, Mirenda P, Roberts W, Smith IM, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Elsabbagh M, Thompson A. {{Developmental Trajectories of Symptom Severity and Adaptive Functioning in an Inception Cohort of Preschool Children With Autism Spectrum Disorder}}. {JAMA Psychiatry}. 2015.
Importance: Symptom severity and adaptive functioning are fundamental domains of the autism spectrum disorder (ASD) phenotype. To date, the longitudinal association between these 2 domains has not been examined. Objective: To describe the developmental trajectories of autistic symptom severity and adaptive functioning in a large inception cohort of preschool children with ASD. Design, Setting, and Participants: The sample consisted of 421 newly diagnosed preschool children with ASD 2 to 4 years old (355 boys; mean age at study enrollment, 39.87 months) participating in a large Canadian multisite longitudinal study (Pathways in ASD Study). Prospective data collected at 4 points from time of diagnosis to age 6 years were used to track the developmental trajectories of children. Main Outcomes and Measures: Autistic symptom severity was indexed using the Autism Diagnostic Observation Schedule. Adaptive functioning was indexed using the Vineland Adaptive Behavior Scales, Second Edition. Results: Two distinct trajectory groups provided the best fit to the autistic symptom severity data. Group 1 (11.4% of the sample) had less severe symptoms and an improving trajectory (P < .05), whereas group 2 (88.6% of the sample) had more severe symptoms and a stable trajectory. Three distinct trajectory groups provided the best fit to the adaptive functioning data. Group 1 (29.2% of the sample) showed lower functioning and a worsening trajectory, group 2 (49.9% of the sample) had moderate functioning and a stable trajectory, and group 3 (20.9% of the sample) had higher functioning and an improving trajectory (P < .05). Cross-trajectory overlap between the autistic symptom severity and adaptive functioning groups was low (phi = 0.13, P < .05). Sex was a significant predictor of autistic symptom severity group membership and age at diagnosis, and language and cognitive scores at baseline predicted membership in adaptive functioning trajectories. Trajectories of both symptom severity and adaptive functioning predicted several different outcomes at age 6 years. Conclusions and Relevance: Findings confirm the heterogeneous nature of developmental trajectories in ASD. Change in adaptive functioning suggests that improvement is possible in roughly 20% of the sample. Autistic symptom severity appears to be more stable, with roughly 11% of the sample showing a marked decrease in symptom severity. During the preschool years, there appears to be only a small amount of « yoking » of developmental trajectories in autistic symptom severity and adaptive functioning. It is imperative that a flexible suite of interventions that target both autistic symptom severity and adaptive functioning should be implemented and tailored to each child’s strengths and difficulties.
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20. Toh MC, Allen-Vercoe E. {{The human gut microbiota with reference to autism spectrum disorder: considering the whole as more than a sum of its parts}}. {Microb Ecol Health Dis}. 2015; 26: 26309.
The human gut microbiota is a complex microbial ecosystem that contributes an important component towards the health of its host. This highly complex ecosystem has been underestimated in its importance until recently, when a realization of the enormous scope of gut microbiota function has been (and continues to be) revealed. One of the more striking of these discoveries is the finding that the gut microbiota and the brain are connected, and thus there is potential for the microbiota in the gut to influence behavior and mental health. In this short review, we outline the link between brain and gut microbiota and urge the reader to consider the gut microbiota as an ecosystem ‘organ’ rather than just as a collection of microbes filling a niche, using the hypothesized role of the gut microbiota in autism spectrum disorder to illustrate the concept.
