1. Abou-Donia MB, Suliman HB, Siniscalco D, Antonucci N, ElKafrawy P. {{De novo Blood Biomarkers in Autism: Autoantibodies against Neuronal and Glial Proteins}}. {Behav Sci (Basel)}. 2019; 9(5).
Autism spectrum disorders (ASDs) are the most common neurodevelopmental disorders with unidentified etiology. The behavioral manifestations of ASD may be a consequence of genetic and/or environmental pathology in neurodevelopmental processes. In this limited study, we assayed autoantibodies to a panel of vital neuronal and glial proteins in the sera of 40 subjects (10 children with ASD and their mothers along with 10 healthy controls, age-matched children and their mothers). Serum samples were screened using Western Blot analysis to measure immunoglobulin (IgG) reactivity against a panel of 9 neuronal proteins commonly associated with neuronal degeneration: neurofilament triplet proteins (NFP), tubulin, microtubule-associated proteins (tau), microtubule-associated protein-2 (MAP-2), myelin basic protein (MBP), myelin-associated glycoprotein (MAG), alpha-synuclein (SNCA) and astrocytes proteins such as glial fibrillary acidic protein (GFAP) and S100B protein. Our data show that the levels of circulating IgG class autoantibodies against the nine proteins were significantly elevated in ASD children. Mothers of ASD children exhibited increased levels of autoantibodies against all panel of tested proteins except for S100B and tubulin compared to age-matched healthy control children and their mothers. Control children and their mothers showed low and insignificant levels of autoantibodies to neuronal and glial proteins. These results strongly support the importance of anti-neuronal and glial protein autoantibodies biomarker in screening for ASD children and further confirm the importance of the involvement of the maternal immune system as an index that should be considered in fetal in utero environmental exposures. More studies are needed using larger cohort to verify these results and understand the importance of the presence of such autoantibodies in children with autism and their mothers, both as biomarkers and their role in the mechanism of action of autism and perhaps in its treatment.
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2. Alon R. {{Social support and post-crisis growth among mothers of children with autism spectrum disorder and mothers of children with down syndrome}}. {Res Dev Disabil}. 2019; 90: 22-30.
BACKGROUND: Raising a child with special needs challenges mothers in complicated ways, yet, alongside these difficulties, there is evidence for maternal post-crisis growth. Social support is one element that may contribute to growth. AIMS: This study explores the relationship between social support and post-crisis growth, examines type of disability as a mediating variable between support and growth, and, looks at the relations between subtypes of support and growth. METHODS & PROCEDURES: Participants included 99 mothers of children with Autism Spectrum Disorder (ASD) and 119 mothers of children with Down Syndrome (DS). Mothers completed three self-report questionnaires: demographic, Multidimensional Scale of Perceived Social Support, and the Stress-Related Growth Scale. RESULTS: Social support was found to predict maternal post-crisis growth with type of disability serving as a mediating variable between them, such that social support contributes to post-crisis growth only among mothers of children with ASD. In addition, results revealed various correlations between types of support and types of growth. CONCLUSIONS & IMPLICATIONS: The findings indicate that compared to DS, characteristics of ASD may contribute to less maternal post-crisis growth, and that social support serves as an important predictor for growth in this group. Finding ways to increase social support for mothers of children with ASD thus gains additional importance.
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3. Azad GF, Singh V, Kalb L, Pinkett-Davis M, Landa R. {{Child and Family Characteristics that Predict Autism Spectrum Disorder Specialty Clinic Appointment Attendance and Alignment with Providers}}. {J Autism Dev Disord}. 2019.
We examined factors contributing to initial appointment attendance, alignment between parents’ pre-visit and clinicians’ diagnostic impressions, and family commitment to follow-ups at an autism spectrum disorder (ASD) specialty clinic. Sample sizes were n = 6558 (initial), n = 1430 (alignment), and n = 1353 (follow-up). Parents completed surveys and clinicians provided their ASD diagnostic impressions. When children were not receiving intervention, families were less likely to keep their initial appointment. Families residing long distances and having older children were less likely to keep their initial and follow-up appointments. African American families were less likely to keep their initial appointment and expressed initial doubts with providers about the diagnosis. Findings suggest that some children are not getting diagnostic clarity or accessing timely services.
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4. Bachmann CJ, Hofer J, Kamp-Becker I, Kupper C, Poustka L, Roepke S, Roessner V, Stroth S, Wolff N, Hoffmann F. {{Internalised stigma in adults with autism: A German multi-center survey}}. {Psychiatry Res}. 2019; 276: 94-9.
The aim of this study was to evaluate the extent of internalised stigma and possible predictors in adults with a diagnosis of autism spectrum disorder (ASD). We measured internalised stigma in a sample of 149 adults with ASD and an IQ >/=70 (79.2% male, mean age 31.8 years), using the Brief Version of the Internalized Stigma of Mental Illness Scale (ISMI-10). The mean ISMI-10 score was 1.93 (SD=0.57), with 15.4% of participants reporting moderate or severe internalised stigma. Moderate or severe stigma was more frequent in persons aged >/=35 years (OR: 4.36), and in individuals with low educational level (OR: 6.00). IQ, sex and ASD diagnostic subtype (ICD-10) did not influence stigma severity. Compared to other mental disorders, the level of internalised stigma in adults with ASD without intellectual disability appears to be lower.
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5. DiCriscio AS, Hu Y, Troiani V. {{Brief Report: Visual Perception, Task-Induced Pupil Response Trajectories and ASD Features in Children}}. {J Autism Dev Disord}. 2019.
We applied a trajectory-based analysis to eye tracking data in order to quantify individualized patterns of pupil response in the context of global-local processing that may be associated with autism spectrum disorder (ASD) features. Multiple pupil response trajectories across both global and local conditions were identified. Using the combined trajectory patterns for global and local conditions for each individual, we were able to identify three groups based on trajectory group membership that were thought to reflect perceptual strategy. Results indicated that the proportion of children with ASD was significantly greater in the group demonstrating a local-focus response. This research presents a novel analytic approach to the objective characterization of individualized pupil response patterns that are associated with ASD features.
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6. Ismail S, Senna AA, Behiry EG, Ashaat EA, Zaki MS, Ashaat NA, Salah DM. {{Study of C677T variant of methylene tetrahydrofolate reductase gene in autistic spectrum disorder Egyptian children}}. {Am J Med Genet B Neuropsychiatr Genet}. 2019.
BACKGROUND: Autism spectrum disorders (ASD) is a heterogeneous neurodevelopmental disease, various articles reported that dysfunctional folate-methionine pathway enzymes might assume a paramount part in the pathophysiology of autism. Methylene tetrahydrofolate reductase (MTHFR) is a basic catalyst for this pathway, also MTHFR gene C677T variant accounted as a risk factor of autism. OBJECTIVE: The present study aimed to investigate the association of MTHFR gene rs1801133(C677T) variant among Egyptian autistic children. METHODS: The study included 78 autistic children, and 80 matched healthy control children. Full clinical and radiological examinations were conducted. MTHFR genetic variant, rs1801133(C677T) was studied by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods followed by direct sequencing technique. RESULTS: MTHFR (C677T) allele frequency was found to be higher significantly in ASD cases compared with nonautistic children. Also, we had a higher distribution of combined CT + TT genotypes among autistic patients with consanguinity and family history of psychological disease. In Gastrointestinal tract (GIT) and sleep disorders showed a higher distribution of hetero CT genotype as well as combined CT + TT genotypes. CONCLUSION: This study demonstrated a role of MTHFR gene (C667T) variant with the increased risk for ASD.
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7. Kirsten TB, Casarin RC, Bernardi MM, Felicio LF. {{Pioglitazone abolishes cognition impairments as well as BDNF and neurotensin disturbances in a rat model of autism}}. {Biology open}. 2019.
We have shown that exposure of rats to lipopolysaccharide (LPS) during gestation induces autistic-like behaviors in the juvenile offspring and pioglitazone post-treatment corrects social and communication deficits. The first objective of the present study was to evaluate the cognition of the rats, because this is also a behavioral sphere committed in autism. Second, biomarkers related to pioglitazone pathways and autism were studied to try to understand their mechanisms. We used our rat model of autism and pioglitazone were administered daily to these young offspring. T-maze spontaneous alternations test, plasma levels of brain-derived neurotrophic factor (BDNF), beta-endorphin, neurotensin, oxytocin, and substance P were studied. Exposure of rats to LPS during gestation induced cognitive deficits in the young offspring, elevated BDNF levels, and decreased neurotensin levels. Daily postnatal pioglitazone treatment abolished cognition impairments as well as BDNF and neurotensin disturbances. Together with our previous studies, we suggested pioglitazone as a candidate for the treatment of autism, because it improved the responses of the three most typical autistic-like behaviors. BDNF and neurotensin appeared to be related with the autistic-like behaviors as well as should be considered for therapeutic purposes/pathway.
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8. Laxman DJ, Taylor JL, DaWalt LS, Greenberg JS, Mailick MR. {{Loss in Services Precedes High School Exit for Teens with Autism Spectrum Disorder: A Longitudinal Study}}. {Autism Res}. 2019.
The present longitudinal study investigated changes in service receipt and unmet service needs spanning 14 years before and after high school exit in a large community-based sample of individuals with autism spectrum disorder (ASD) (n = 204), of whom 59% had co-occurring intellectual disability (ID). Using multilevel models, potential discontinuity of service patterns at the point of high school exit was examined, as well as the rate of change in services received and needed during the high school years and into the post-high school period. Differences between those with and without ID were probed. Study findings indicated that overall, sample members experienced a reduction in receipt of services during high school, particularly for those without co-occurring ID. After high school exit, sample members experienced a decline in services received; for those without ID, there was a continuous rate of loss of services after leaving high school but for those with ID, there was a sharp decline in services received. Unmet service needs increased right after high school exit for both those with and without ID. These patterns reflect loss of entitlement for services that accompanies high school exit, and the limited availability of adult services for individuals with ASD. This study documented not only the post-high school service cliff that has been the subject of much concern, but also that the loss of services begins long before high school exit and that subgroups of the population with ASD are particularly vulnerable. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this research, we studied changes in the number of services received before and after high school exit in a large sample of individuals with autism spectrum disorder (ASD). With each passing year during high school, individuals with ASD received fewer services. At the time of high school exit, there was a sharp drop in the number of services received, particularly for those with co-occurring intellectual disability. This study found not only that there is a post-high school service cliff, but also that the loss of services begins long before high school exit.
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9. Matta SM, Hill-Yardin EL, Crack PJ. {{The influence of neuroinflammation in Autism Spectrum Disorder}}. {Brain, behavior, and immunity}. 2019.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by deficits in social communication and restricted or repetitive behaviours. The clinical presentation of ASD is highly variable and diagnosis is based on the presence of impaired social communication and repetitive and/or restricted behaviours. Although the precise pathophysiologies underlying ASD are unclear, growing evidence supports a role for dysregulated neuroinflammation. The potential involvement of microglia and astrocytes reactive to inflammatory stimuli in ASD has generated much interest due to their varied roles including in mounting an immune response and regulating synaptic function. Increased numbers of reactive microglial and astrocytes in both ASD postmortem tissue and animal models have been reported. Whether dysregulation of glial subtypes exacerbates alterations in neural connectivity in the brain of autistic patients is not well explored. A role for the gut-brain axis involving microbial-immune-neuronal cross talk is also a growing area of neuroinflammation research. Greater understanding of these interactions under patho/physiological conditions and the identification of consistent immune profile abnormalities can potentially lead to more reliable diagnostic measures and treatments in ASD.
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10. Micheletti M, McCracken C, Constantino JN, Mandell D, Jones W, Klin A. {{Research Review: Outcomes of 24- to 36-month-old children with autism spectrum disorder vary by ascertainment strategy: a systematic review and meta-analysis}}. {J Child Psychol Psychiatry}. 2019.
BACKGROUND: Despite widespread recommendations for early surveillance of risk for autism spectrum disorder (ASD), no research to date has shown that early surveillance leads to better clinical outcomes. Preliminary research has suggested that children with ASD ascertained via prospective follow-up have better outcomes than those ascertained via community referral. Because prospective studies include early surveillance, by comparing outcomes of children with ASD across ascertainment strategies, we may gain insight into the effects of early surveillance relative to its absence. METHODS: A systematic review was conducted to identify studies reporting outcomes of 24- to 36-month-olds with ASD ascertained via prospective follow-up, community referral, or universal screening. A meta-analysis using a random effects model was used to calculate overall effect size estimates for developmental level and symptom severity across ascertainment cohorts. RESULTS: Eleven prospective, ten community referral, and eight universal screening studies were identified, reporting on 1,658 toddlers with ASD. We found no differences in outcomes between community referral and universal screening studies. Relative to both, prospective studies reported significantly higher developmental levels and lower symptom severities. CONCLUSIONS: Outcomes of young children with ASD ascertained via prospective follow-up are better than those of children with ASD recruited via community referral or universal screening. Although we discuss why sampling bias is not likely the driving force behind these findings, we cannot rule out the possibility that sampling bias contributes to the observed differences; future studies should probe the effects of sociodemographic variables on clinical outcomes as a function of ascertainment strategy. This limitation notwithstanding, our results raise the possibility that prospective follow-up may confer a ‘surveillance effect’ that contributes to improved developmental and diagnostic outcomes in children with ASD. Future research should test this hypothesis and determine the specific mechanism by which surveillance may improve outcomes.
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11. Mouchati PR, Barry JM, Holmes GL. {{Functional brain connectivity in a rodent seizure model of autistic-like behavior}}. {Epilepsy Behav}. 2019; 95: 87-94.
OBJECTIVE: There is increasing evidence that Autism Spectrum Disorder (ASD) is a disorder of functional connectivity with both human and rodent studies demonstrating alterations in connectivity. Here, we hypothesized that early-life seizures (ELS) in rats would interrupt normal brain connectivity and result in autistic-like behavior (ALB). METHODS: Following 50 seizures, adult rats were tested in the social interaction and social novelty tests and then underwent qualitative and quantitative intracranial electroencephalography (EEG) monitoring in the medial prefrontal cortex (PFC) and the hippocampal subfields, CA3 and CA1. RESULTS: Rats with ELS showed deficits in social interaction and novelty, and compared with control, rats had marked increases in coherence within the hippocampus (CA3-CA1) and between the hippocampus and PFC during the awake and sleep states indicating hyperconnectivity. In addition, sleep spindle density was significantly reduced in rats with ELS. There were no differences in voltage correlations and power spectral densities between the ELS and control rats in any bandwidths. CONCLUSION: Taken together, these findings indicate that ELS can result in ALB and alter functional connectivity as measured by coherence and sleep spindle density. These findings implicate altered connectivity as a robust neural signature for ALB following ELS.
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12. Park SH, Demetriou EA, Pepper KL, Song YJC, Thomas EE, Hickie IB, Glozier N, Guastella AJ. {{Validation of the 36-item and 12-item self-report World Health Organization Disability Assessment Schedule II (WHODAS-II) in individuals with autism spectrum disorder}}. {Autism Res}. 2019.
The World Health Organization Disability Assessment Schedule II (WHODAS-II) is one of the most widely used generic assessments for measuring disability levels in both clinical and nonclinical populations, with sound psychometrics that is also aligned with the International Classification of Functioning framework. However, its psychometric properties have not been explored extensively in individuals with autism spectrum disorder (ASD). This study examined the psychometric properties of the 36-item and 12-item Self-Report WHODAS-II from 109 individuals diagnosed with ASD and without intellectual disability (IQ >/= 70). Participants were consecutively recruited from the Brain and Mind Centre in New South Wales, Australia. The WHODAS-II showed adequate internal consistency for all domain scores (alpha = 0.78-0.97 for 36-item) and for the summary scale (alpha = 0.95 for 36-item; 0.86 for 12-item). All items also exhibited satisfactory correlations with their respective domain (r = 0.39-0.94 for 36-item) and summary scores (r = 0.42-0.71 for 36-item; 0.42-0.67 for 12-item), except item 4.5 « sexual activity » from the 36-item WHODAS-II (r = 0.19). Concurrent validity was shown by moderate correlations between similar constructs across the WHODAS-II and the World Health Organization Quality of Life BREF (Ps < 0.05). The second-order 7-factor model showed the best fit for the 36-item WHODAS-II, while the second-order 6-factor model demonstrated an acceptable fit for the 12-item WHODAS-II. The model fit could be improved with some modifications. The Schmid-Leiman transformation further confirmed the appropriateness of the second-order factor structure. Overall, the results indicated that the WHODAS-II is a viable generic self-report measure for disability in autistic individuals without ID. Autism Res 2019. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The majority of autistic people have a disability with a profound or severe limitation in their core activities. However, there is currently limited research identifying reliable and valid self-report measures for disability in the autistic population. This study examined the psychometric properties of the World Health Organization Disability Assessment Schedule II (WHODAS-II) from 109 autistic individuals without intellectual disability. Our results suggest that the WHODAS-II is a viable generic self-report measure for disability in autistic individuals. Lien vers le texte intégral (Open Access ou abonnement)
13. Pereira-Smith S, Boan A, Carpenter LA, Macias M, LaRosa A. {{Preventing elopement in children with autism spectrum disorder}}. {Autism Res}. 2019.
Reports of missing children with autism spectrum disorder (ASD) are common in the media, and elopement can lead to dire consequences. This study quantified the use of preventive measures that target elopement, plus identified child/family characteristics associated with elopement and the use of preventive measures. This cross-sectional study included 394 caregivers of children ages 2-17 years with ASD followed in an academic medical center’s Developmental-Behavioral Pediatrics clinic. Details about elopement, preventive measure use, and sociodemographic characteristics were assessed via an investigator-designed, parent advocate-approved questionnaire, while pertinent clinical factors were extracted from patients’ electronic health records. Two hundred and sixty-seven caregivers (68%) reported elopement by their child. Elopement risk was not associated with sociodemographic characteristics, nor with any specific comorbidity or neurobehavioral medication. Children with limited communication skills were more likely to have a history of elopement (OR 2.24, 95% CI 1.30-3.84; P = 0.004). The most common preventive measure used was lock(s) at top of doors (51%), while less than a quarter of families were using handicap permits, signs/visual markers, or tracking devices. Implementation of certain modifications was statistically associated with socioeconomic status and comorbidities of interest. In addition to supporting previous literature about the increased elopement risk in children with limited communication skills, this study is the first to reveal that caregiver use of numerous preventive measures varies widely. The associations noted with use of specific preventive measures can help guide recommendations for this dangerous comorbid symptom, and provide information needed for future studies to assess the efficacy of various preventive measures. Autism Res 2019, 00: 1-17. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Elopement, defined as leaving an area without permission and placing oneself in a potentially dangerous situation, is a behavior exhibited by many children with autism. There is little information about the use of various modifications that target elopement in the pediatric population. This study identifies child/family characteristics that were related to elopement and the use of modifications, and stresses the importance of counseling families of children with autism about elopement.
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14. Pierce K, Gazestani VH, Bacon E, Barnes CC, Cha D, Nalabolu S, Lopez L, Moore A, Pence-Stophaeros S, Courchesne E. {{Evaluation of the Diagnostic Stability of the Early Autism Spectrum Disorder Phenotype in the General Population Starting at 12 Months}}. {JAMA Pediatr}. 2019.
Importance: Universal early screening for autism spectrum disorder (ASD) in primary care is becoming increasingly common and is believed to be a pivotal step toward early treatment. However, the diagnostic stability of ASD in large cohorts from the general population, particularly in those younger than 18 months, is unknown. Changes in the phenotypic expression of ASD across early development compared with toddlers with other delays are also unknown. Objectives: To examine the diagnostic stability of ASD in a large cohort of toddlers starting at 12 months of age and to compare this stability with that of toddlers with other disorders, such as developmental delay. Design, Setting, and Participants: In this prospective cohort study performed from January 1, 2006, to December 31, 2018, a total of 2241 toddlers were referred from the general population through a universal screening program in primary care or community referral. Eligible toddlers received their first diagnostic evaluation between 12 and 36 months of age and had at least 1 subsequent evaluation. Exposures: Diagnosis was denoted after each evaluation visit as ASD, ASD features, language delay, developmental delay, other developmental issue, typical sibling of an ASD proband, or typical development. Main Outcomes and Measures: Diagnostic stability coefficients were calculated within 2-month age bands, and logistic regression models were used to explore the associations of sex, age, diagnosis at first visit, and interval between first and last diagnosis with stability. Toddlers with a non-ASD diagnosis at their first visit diagnosed with ASD at their last were designated as having late-identified ASD. Results: Among the 1269 toddlers included in the study (918 [72.3%] male; median age at first evaluation, 17.6 months [interquartile range, 14.0-24.4 months]; median age at final evaluation, 36.2 months [interquartile range, 33.4-40.9 months]), the overall diagnostic stability for ASD was 0.84 (95% CI, 0.80-0.87), which was higher than any other diagnostic group. Only 7 toddlers (1.8%) initially considered to have ASD transitioned into a final diagnosis of typical development. Diagnostic stability of ASD within the youngest age band (12-13 months) was lowest at 0.50 (95% CI, 0.32-0.69) but increased to 0.79 by 14 months and 0.83 by 16 months (age bands of 12 vs 14 and 16 years; odds ratio, 4.25; 95% CI, 1.59-11.74). A total of 105 toddlers (23.8%) were not designated as having ASD at their first visit but were identified at a later visit. Conclusions and Relevance: The findings suggest that an ASD diagnosis becomes stable starting at 14 months of age and overall is more stable than other diagnostic categories, including language or developmental delay. After a toddler is identified as having ASD, there may be a low chance that he or she will test within typical levels at 3 years of age. This finding opens the opportunity to test the impact of very early-age treatment of ASD.
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15. Raulston TJ, Hansen SG, Machalicek W, McIntyre LL, Carnett A. {{Interventions for Repetitive Behavior in Young Children with Autism: A Survey of Behavioral Practices}}. {J Autism Dev Disord}. 2019.
Children with autism spectrum disorder (ASD) display social-communication deficits and present with rigid and repetitive patterns of behavior and/or interests (RRBIs). Compared to interventions for social-communication skills, less attention has been given to RRBIs, especially with regard to interventions for young children. We surveyed 128 behavior analysts who implemented interventions for young children with ASD on their use of 16 practices and one assessment for the treatment of RRBIs. The majority of our sample perceived the practices to be effective in producing sustainable behavior change. Behavior analysts generally responded in the same way to items about reinforcement-based practices, punishment-based practices, and a group of commonly packaged antecedent and consequence-based package components. Implications and future directions are discussed.
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16. Srikantha P, Mohajeri MH. {{The Possible Role of the Microbiota-Gut-Brain-Axis in Autism Spectrum Disorder}}. {International journal of molecular sciences}. 2019; 20(9).
New research points to a possible link between autism spectrum disorder (ASD) and the gut microbiota as many autistic children have co-occurring gastrointestinal problems. This review focuses on specific alterations of gut microbiota mostly observed in autistic patients. Particularly, the mechanisms through which such alterations may trigger the production of the bacterial metabolites, or leaky gut in autistic people are described. Various altered metabolite levels were observed in the blood and urine of autistic children, many of which were of bacterial origin such as short chain fatty acids (SCFAs), indoles and lipopolysaccharides (LPS). A less integrative gut-blood-barrier is abundant in autistic individuals. This explains the leakage of bacterial metabolites into the patients, triggering new body responses or an altered metabolism. Some other co-occurring symptoms such as mitochondrial dysfunction, oxidative stress in cells, altered tight junctions in the blood-brain barrier and structural changes in the cortex, hippocampus, amygdala and cerebellum were also detected. Moreover, this paper suggests that ASD is associated with an unbalanced gut microbiota (dysbiosis). Although the cause-effect relationship between ASD and gut microbiota is not yet well established, the consumption of specific probiotics may represent a side-effect free tool to re-establish gut homeostasis and promote gut health. The diagnostic and therapeutic value of bacterial-derived compounds as new possible biomarkers, associated with perturbation in the phenylalanine metabolism, as well as potential therapeutic strategies will be discussed.
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17. Tordjman S, Celume MP, Denis L, Motillon T, Keromnes G. {{Reframing schizophrenia and autism as self-consciousness disorders associating a deficit of theory of mind and empathy with social communication impairments}}. {Neurosci Biobehav Rev}. 2019.
Prior observations and studies suggest self-consciousness disorders in schizophrenia and Autism Spectrum Disorder (ASD), two neurodevelopmental disorders sharing social communication impairments. First, the relationships between schizophrenia and autism are explored regarding social communication impairments. Then, self-consciousness disorders in schizophrenia and autism are described and discussed in relation with impairments of body self leading to impairments of self-other differentiation, a deficit of theory of mind and empathy, and their consequences on social communication. Also, neurological dysfunction involved possibly in self-consciousness disorders in schizophrenia and autism is presented. In conclusion, a new model is proposed integrating results of studies presented here and stating the existence of bodily self-consciousness disorders in schizophrenia and autism associated with altered/absent intermodal sensory integration (especially visual-kinesthetic-tactile integration). This would result in problems of self-other differentiation, leading in turn to a deficit of theory of mind and empathy as well as social communication impairments. This model opens new perspectives to understand better self-consciousness disorders and social communication impairments in schizophrenia and ASD and to develop therapeutic strategies.
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18. Weiner L, Flin A, Causin JB, Weibel S, Bertschy G. {{A case study of suicidality presenting as a restricted interest in autism Spectrum disorder}}. {BMC Psychiatry}. 2019; 19(1): 126.
BACKGROUND: Suicidality has been under-researched in autism spectrum disorders (ASD). Most studies have linked increased suicidality in ASD to psychiatric comorbidities such as depression. Here we investigated, from a neuropsychological and clinical standpoint, the relationship between core ASD symptoms, i.e., restricted behaviors and social and communication impairments, and the suicidal behaviors in an adult male individual with ASD, with no psychiatric comorbidities. CASE PRESENTATION: We report the case of a 21-year-old male with ASD who attempted suicide twice, in the absence of other psychiatric diagnoses. His behavior and communication skills were rigid. His suicidality was characterized by a rigid, detailed, and pervasive thinking pattern, akin to restricted interests. Consistently, from a neuropsychological standpoint, we found below-average planning and attention skills, and mind-reading skills were rigid and lacked spontaneity. CONCLUSIONS: Our case-study suggests that specific clinical and neuropsychological dimensions might be related to suicidal behaviors in ASD. Clinically, the repetitive and rigid suicide-oriented thinking of our patient was not part of a depressive episode. Instead, it followed a purely logical, inflexible, and pervasive reasoning pattern focused on a topic that fascinated him – i.e., suicide –, akin to restricted behaviors. From a neuropsychological standpoint, restrictive suicide-oriented thinking in our patient seems to be related to attention and executive anomalies that have been linked to repetitive and restricted behaviors in ASD. New tools need to be developed to assess persistent suicidal thoughts in this population, as they might be related to intrinsic features of ASD.
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19. Yerys BE, Bertollo JR, Pandey J, Guy L, Schultz RT. {{Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated With Lower Adaptive Behavior Skills in Children With Autism}}. {J Am Acad Child Adolesc Psychiatry}. 2019; 58(5): 525-33.e3.
OBJECTIVE: To investigate the predictive power of comorbid attention-deficit/hyperactivity disorder (ADHD) symptoms on adaptive behavior skills in children who have an autism specrum disorder (ASD) diagnosis. METHOD: This case-control study recruited 347 children from specialty clinics, primary care, and the community. Linear regression was used to test whether ADHD Rating Scale, Fourth Edition, scores of autistic children associated with poorer adaptive behavior scores, after controlling for the effects of age, intelligence, sex, and ASD symptom severity. Adaptive behaviors were measured with the Vineland Adaptive Behavior Scales, Second Edition. Subsequent analyses tested this relation in a subset of the ASD sample with subclinical ADHD symptoms (n = 179) and another with teacher ratings (n = 153). Prior relations between age with adaptive behaviors and ADHD symptoms were replicated and age was explored as a moderator. RESULTS: ADHD symptoms predicted poor adaptive behavior scores in the full ASD sample (caregiver ratings, DeltaR(2) = 0.033-0.119; teacher ratings, DeltaR(2) = 0.113-0.163) and in the subset with subclinical ADHD symptoms (caregiver ratings, DeltaR(2)= 0.023-0.030; teacher ratings, DeltaR(2) = 0.097-0.159) after controlling for confounds. Age correlated negatively with ADHD symptoms (r = -0.21) and adaptive behaviors (-0.17 < r < -0.39) in the full ASD sample. Age did not moderate the effect of ADHD symptoms on adaptive behaviors. CONCLUSION: ADHD symptoms predict poorer adaptive behavior for autistic children across settings, even for children with subclinical co-occurring ADHD symptoms. Findings support a Research Domain Criteria framework that behavioral impairments and functional outcome measures exist along a continuum. Lien vers le texte intégral (Open Access ou abonnement)
