1. Bedford SA, Park MTM, Devenyi GA, Tullo S, Germann J, Patel R, Anagnostou E, Baron-Cohen S, Bullmore ET, Chura LR, Craig MC, Ecker C, Floris DL, Holt RJ, Lenroot R, Lerch JP, Lombardo MV, Murphy DGM, Raznahan A, Ruigrok ANV, Smith E, Spencer MD, Suckling J, Taylor MJ, Thurm A, Lai MC, Chakravarty MM. {{Large-scale analyses of the relationship between sex, age and intelligence quotient heterogeneity and cortical morphometry in autism spectrum disorder}}. {Mol Psychiatry}. 2019.
Significant heterogeneity across aetiologies, neurobiology and clinical phenotypes have been observed in individuals with autism spectrum disorder (ASD). Neuroimaging-based neuroanatomical studies of ASD have often reported inconsistent findings which may, in part, be attributable to an insufficient understanding of the relationship between factors influencing clinical heterogeneity and their relationship to brain anatomy. To this end, we performed a large-scale examination of cortical morphometry in ASD, with a specific focus on the impact of three potential sources of heterogeneity: sex, age and full-scale intelligence (FIQ). To examine these potentially subtle relationships, we amassed a large multi-site dataset that was carefully quality controlled (yielding a final sample of 1327 from the initial dataset of 3145 magnetic resonance images; 491 individuals with ASD). Using a meta-analytic technique to account for inter-site differences, we identified greater cortical thickness in individuals with ASD relative to controls, in regions previously implicated in ASD, including the superior temporal gyrus and inferior frontal sulcus. Greater cortical thickness was observed in sex specific regions; further, cortical thickness differences were observed to be greater in younger individuals and in those with lower FIQ, and to be related to overall clinical severity. This work serves as an important step towards parsing factors that influence neuroanatomical heterogeneity in ASD and is a potential step towards establishing individual-specific biomarkers.
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2. Hardan AY, Hendren RL, Aman MG, Robb A, Melmed RD, Andersen KA, Luchini R, Rahman R, Ali S, Jia XD, Mallick M, Lateiner JE, Palmer RH, Graham SM. {{Efficacy and safety of memantine in children with autism spectrum disorder: Results from three phase 2 multicenter studies}}. {Autism}. 2019: 1362361318824103.
Three phase 2 trials were conducted to assess the efficacy and long-term safety of weight-based memantine extended release (ER) treatment in children with autism spectrum disorder. MEM-MD-91, a 50-week open-label trial, identified memantine extended-release treatment responders for enrollment into MEM-MD-68, a 12-week randomized, double-blind, placebo-controlled withdrawal trial. MEM-MD-69 was an open-label extension trial in which participants from MEM-MD-68, MEM-MD-91, and open-label trial MEM-MD-67 were treated 48 weeks with memantine extended release. In MEM-MD-91, 517 (59.6%) participants were confirmed Social Responsiveness Scale responders at week 12; mean Social Responsiveness Scale total raw scores improved two to three times a minimal clinically important difference of 10 points. In MEM-MD-68, there was no difference between memantine and placebo on the primary efficacy parameter, the proportion of patients with a loss of therapeutic response (defined as 10-point increase from baseline in Social Responsiveness Scale total raw score). MEM-MD-69 exploratory analyses revealed mean standard deviation improvement in Social Responsiveness Scale total raw score of 32.4 (26.4) from baseline of the first lead-in study. No new safety concerns were evident. While the a priori-defined efficacy results of the double-blind trial were not achieved, the considerable improvements in mean Social Responsiveness Scale scores from baseline in the open-label trials were presumed to be clinically important.
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3. Morie KP, Jackson S, Zhai ZW, Potenza MN, Dritschel B. {{Mood Disorders in High-Functioning Autism: The Importance of Alexithymia and Emotional Regulation}}. {J Autism Dev Disord}. 2019.
Individuals with autism spectrum disorder (ASD) often have co-morbid anxiety and depression. Alexithymia and emotion regulation difficulties are commonly seen in individuals with ASD and in mood disorders. We hypothesized that alexithymia and emotional regulation would mediate the relationship between autistic features and anxiety/depression symptom severity. We collected data about emotional regulation, alexithymia, autistic symptoms and depression/anxiety in a sample of 64 young adults with ASD. We constructed two serial multiple mediator models, using autistic features as the independent variable and anxiety/depression symptoms as outcome variables. The serial relationship between alexithymia and emotional regulation mediated associations between autistic features and depression and anxiety, separately. The findings suggest that targeting alexithymia may benefit therapies designed to alleviate mood disorders in ASD.
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4. Nik Adib NA, Ibrahim MI, Ab Rahman A, Bakar RS, Yahaya NA, Hussin S, Wan Mansor WNA. {{Perceived Stress among Caregivers of Children with Autism Spectrum Disorder: A State-Wide Study}}. {Int J Environ Res Public Health}. 2019; 16(8).
BACKGROUND: Caregivers of children with autism spectrum disorder (ASD) experience increased stress and more significant negative caregiving consequences than those with typically developing children. There is a lack of studies specifically focusing on stress among caregivers with ASD children in Asian countries. The current study examines levels of perceived stress and factors associated with it among caregivers in Kelantan, Malaysia. METHODS: In a cross-sectional study, the Malay version of the Perceived Stress Scale (PSS) was administered to 227 caregivers of children with ASD. The caregivers were recruited from ASD databases in four tertiary hospitals in Kelantan and a meeting was set up during the child’s follow-up in the clinic. Multiple linear regression analyses were applied to determine the predictors of perceived stress. RESULTS: The mean total perceived stress score was 20.84 (4.72). This was considered higher than average. Higher perceived stress was significantly predicted among caregivers who live far from the health institution, caregivers who do not own transportation to bring the child to the treatment center, and caregivers who have an ASD child with a learning disability. CONCLUSION: Caregivers of an ASD child perceived significant stress while taking care of their children. Institutions should alleviate the factors that were predicted to increase the caregivers’ perceived stress to improve the quality of the lives of children and ASD families as a whole.
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5. Siu AMH, Lin Z, Chung J. {{An evaluation of the TEACCH approach for teaching functional skills to adults with autism spectrum disorders and intellectual disabilities}}. {Res Dev Disabil}. 2019; 90: 14-21.
BACKGROUND: The Treatment & Education of Autistic and Communication Related Handicapped Children (TEACCH) approach has been widely adopted around the world, but most previous studies focus on applying it to teaching children with autism spectrum disorders (ASD) who have high functioning or without intellectual disabilities. AIMS: This study evaluated the application and effectiveness of a TEACCH approach in teaching functional skills to young adults with ASD who have mild to moderate intellectual disabilities. METHODS AND PROCEDURES: The study employed an experimental design which compared the training goal attainment of an experimental (n = 32) and a comparison (n = 31) group. We administered the TEACCH Transitional Assessment Profile (TTAP) to identify suitable areas of training and devised three individualized training goals for each participant using the goal attainment scaling (GAS) methodology. The experimental group participated in a standardized, individualized, 20-session training program based on the TEACCH approach, on top of their regular training in day activity centers. RESULTS: All the participants showed improvements in functional skills over the baseline, mid-program, and post-program assessments (F = 146.66, p < .001). The experimental group had significantly larger improvement in the GAS scores than the comparison group (F = 15.40, p < .001). There were no significant changes between the pre- and post-program TTAP scores of both groups. CONCLUSIONS AND IMPLICATIONS: The TEACCH approach is effective in teaching specific functional skills to young adults with ASD and mild to moderate intellectual disabilities. The clinical and research implications of the study are discussed. Lien vers le texte intégral (Open Access ou abonnement)
6. Trakoli A. {{Raising awareness of the health effects of environmental exposures}}. {BMJ (Clinical research ed)}. 2019; 365: l1878.
