1. Aarthi D, Kannimuthu S. MACAFNet transformer-based multi-atlas fusion framework for autism spectrum disorder classification using functional connectivity. Sci Rep. 2026.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in communication, social interaction and behavior. ASD individuals develop symptoms such as recurrent actions, atypical facial expressions and challenges in social engagement. This study proposes a Multi-Atlas Context-Aware Fusion Network (MACAFNet) for ASD classification using functional connectivity (FC) features derived from resting-state functional MRI (rs-fMRI) to enable reliable ASD classification. This framework integrates information from multiple brain atlases such as AAL, CC200, Dosenbach160, EZ, HO and TT to capture complementary neurofunctional features across diverse brain parcellations. Each atlas-specific connectivity representation is projected into a shared embedding space and fused using a Transformer-based attention mechanism that explicitly models inter-atlas contextual dependencies. Unlike traditional static fusion systems, this allows for dynamic and adaptive feature integration. The fused representation is then processed by a neural classifier for ASD classification. Experiments conducted on the ABIDE-I dataset demonstrate that the proposed approach achieves an accuracy of 88.46% and an AUC of 0.9546, indicating strong discriminative capability. The results highlight the effectiveness of context-aware multi-atlas fusion in capturing complex brain connectivity patterns for research-oriented ASD classification.

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2. Acevedo-Triana C, Medeiros D, Lopes Gonçalez J, Li W, Pozzo-Miller L. Atypical social behaviors in mouse models for Rett syndrome. Front Neurol. 2026; 17: 1744450.

Social behavior depends on neural circuits that encode social identity, memory, and motivational value. These processes engage coordinated activity across hippocampal subregions, medial prefrontal cortex, thalamic and hypothalamic nuclei, as well as the mesocorticolimbic dopaminergic systems that regulate internal state, hierarchy, and social reward. In Rett syndrome and MeCP2-deficient rodent models, basic sociability is often preserved, alongside impairments in social memory, dominance behavior, aggression control, and flexible social responding, frequently accompanied by anxiety-like and sensorimotor disturbances. These behavioral phenotypes are associated with MeCP2-dependent molecular dysfunctions, including altered activity-dependent transcription, reduced BDNF-TrkB signaling, disrupted synaptic maturation, and altered network activity within prefrontal and hippocampal circuits. Together, these findings indicate that Rett-related social deficits reflect impaired integration and valuation of social information rather than a primary loss of social interest. Understanding how MeCP2 regulates the development and function of distributed social circuits may inform strategies to restore adaptive social behavior in Rett syndrome and related neurodevelopmental disorders.

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3. Aishworiya R, Gangi D, Ma VK, Parikh C, Yusoff NA, Likhitweerawong N, Ozonoff S. Psychological Impact of Autism Screening on Caregivers. Autism Res. 2026: e70267.

Autism screening in childhood is common, yet little is known about its potential psychological impact on caregivers. The U.S. Preventive Services Task Force, an independent national panel of disease prevention experts, stated that this gap in knowledge limited their ability to endorse universal autism screening. This study examined the psychological impact of autism screening, using data from a large community-based sample (n = 1272) involving online caregiver-completed autism screeners at child age 6, 9, 12, 18, and 24 months. Caregivers completed the Participation Impact Questionnaire retrospectively (mean child age at completion 37.2 ± 4.8 months) to measure feelings about screening. A minority (34.7%) of the sample reported presence of ≥ 1 negative feeling; the most commonly endorsed was « worried ». Among this subset, negative feelings were of short duration (lasted for < 1 day in 56.9%), were mild in severity (86.4%), and did not affect functioning (85.3%). A majority (86.2%) also reported ≥ 1 positive feeling. Our findings address a critical evidence gap regarding potential harms of autism screening and support universal screening, given that psychological harms are not common and have low functional impact, as well as possible psychological benefits. Although screening for presence of autism among young children is commonly done, little is known about its potential psychological impact on caregivers. There is very limited information related to this topic currently, with the U.S. Preventive Services Task Force, an independent national panel of experts, stating that this gap in knowledge limited their ability to make recommendations related to guidelines on routine autism screening for all children. This study addresses this knowledge gap and aimed to study the potential psychological impact (harms, as well as benefits) of autism screening in caregivers. Data was obtained from a longitudinal study involving online caregiver‐completed autism screeners at child age 6, 9, 12, 18, and 24 months. Caregivers were notified at child age 18–24 months if their children had screened positive at any time‐point and offered diagnostic evaluation to determine a final outcome by 36 months. Subsequently caregivers were invited to complete the Participation Impact Questionnaire (PIQ) which was designed to measure negative and positive feelings about screening, their duration, and functional impact. In our study, a total of 1272 caregivers completed the PIQ. Only a minority (34.7%) reported presence of ≥ 1 negative feeling; the most commonly endorsed feeling was “worried”. Among those who reported these feeling(s), they were of short duration, were mild in severity and did not affect day‐to‐day activities in the majority. A majority (86.2%) also reported ≥ 1 positive feelings; the most common ones were “interested” and “curious.” Study findings suggest that psychological harms reported by caregivers following autism screening are less common than positive feelings and even if present, have short duration, low functional impact, and low severity. Our findings are in support of recommendations toward universal autism screening recommendations, given low harm potential and possible psychological benefits of screening on caregivers. eng.

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4. Akan Z, Subaşı Turgut F, Öztürk M, Kolbaşı B, Unal E, Mete N. Microglia Regulatory and T-Helper Cytokine Profiles in Autism Spectrum Disorder. Int J Dev Neurosci. 2026; 86(3): e70135.

OBJECTIVE: This study aimed to evaluate serum levels of the microglia-regulating cytokines IL-34 and CSF-1, as well as T-helper cytokines IL-12, IFN-γ, IL-4, IL-10, TGF-β, IL-17 and IL-23, in individuals with autism and healthy controls, and to investigate the relationships between these parameters and the severity of autism symptoms. METHODS: The study sample consisted of 42 children diagnosed with autism spectrum disorder (ASD) and 40 healthy participants. The severity of autism in the patient group was assessed using the Childhood Autism Rating Scale (CARS). Serum levels of IL-34, CSF-1, IL-12, IFN-γ, IL-4, IL-10, TGF-β, IL-17 and IL-23 were measured using the ELISA method. RESULTS: Serum levels of IL-34, CSF-1, IFN-γ, IL-4, IL-10 and IL-17 were significantly higher in the ASD group compared to the control group. IL-34, CSF-1, IFN-γ, IL-4, IL-10 and IL-17 showed significant discriminative power in distinguishing ASD (p < 0.05). ROC analysis indicated that IL-10 had the highest area under the curve (AUC = 0.743; p < 0.001), and Delong test results demonstrated that its discriminative ability was statistically stronger than that of the other parameters. No significant correlations were observed between the examined cytokine levels and autism severity. CONCLUSION: Our findings indicate that IL-34 and CSF-1, along with T-helper-related cytokines (IFN-γ, IL-4, IL-10 and IL-17), were elevated in the ASD group. These alterations may reflect underlying pathophysiological processes. However, due to the cross-sectional design and limited sample size, the findings should be interpreted with caution, and their clinical utility requires further investigation in larger, longitudinal studies.

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5. Arildskov ES, Ahlqvist VH, Khachadourian V, Asgel Z, Schendel D, Hansen SN, Grove J, Janecka M. Genetic confounding in the associations between maternal health and autism. medRxiv. 2026.

The etiology of autism is influenced by genetic and non-genetic factors, with observational studies suggesting associations between early maternal health diagnoses and offspring autism. However, these associations may partly reflect shared familial genetic liability rather than direct causal effects. Using comprehensive national health registers and individual-level genetic data from the iPSYCH cohort (N=117,542), we examined whether maternal health diagnoses are associated with offspring polygenic scores (PGS) for autism. Such associations between maternal health and offspring autism would indicate shared genetic factors and the possibility of genetic confounding in the observational associations. We also tested such associations with PGSs for other neuropsychiatric and neurodevelopmental conditions that are genetically correlated with autism, but with better-powered PGS (due to larger GWAS sample sizes and likely more polygenic genetic architecture), as well as height, a negative control. Several maternal diagnoses were nominally associated with autism PGS in the child, including, e.g., certain obstetric complications, asthma, and obesity. After adjustment for multiple testing, the only statistically significant results included those between maternal diagnoses, predominantly psychiatric, and other neuropsychiatric and neurodevelopmental PGSs in the child. Sensitivity analyses confirmed the robustness of our results across exposure windows, diagnostic settings, and socioeconomic adjustments. These findings indicate that maternal diagnoses associated with autism partially reflect shared genetic liabilities between mothers and their children. However, such genetic effects, as captured by child PGS do not fully explain the observed associations, suggesting additional factors, including e.g., non-genetic familial factors, rare variants, and indirect effects.

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6. Arildskov ES, Khachadourian V, Grove J, Schendel D, Hansen SN, Janecka M. Maternal health and autism risk: parsing direct and indirect genetic effects using 3-generation family linkage. medRxiv. 2026.

Despite autism’s prominent genetic etiology and early-life origins, parsing genetic effects contributing to the condition into those that operate directly (via allelic transmission to offspring) vs. indirectly (via influencing prenatal environment) remains challenging. We examined this using a novel design leveraging 3-generation family linkage in Danish national registers. The cohort included all children born in Denmark from 1998-2015 and their relatives identified through 3-generation family linkage. The analytic sample comprised full maternal cousin pairs, including parallel (children of mother’s sister) and cross cousins (children of mother’s brother). Exposures were diagnoses in the index mother previously associated with offspring autism; the outcome was autism diagnosis in cousins of the index child. We used Cox proportional hazards models to estimate associations separately in parallel and cross cousins, followed by comparisons of these hazard ratios to infer mechanisms. Several maternal diagnoses (e.g., postpartum hemorrhage, personality disorders, epilepsy) were associated with autism in both parallel and cross cousins, consistent with shared direct genetic effects. Other conditions (e.g., false labor, recurrent major depressive disorder, other anxiety disorders, systemic connective tissue involvement) showed stronger associations in parallel than cross cousins, supporting additional indirect genetic effects operating through the prenatal environment. Adjustment for the same diagnosis in the cousin’s own mother did not substantially change estimates, providing no evidence for an additional role of non-genetic mechanisms associated with the diagnosis. These findings suggest that both direct and indirect genetic effects contribute to observed links between maternal health and offspring autism, highlighting etiologic heterogeneity and highlighting a registry-based family design to separate these pathways without genetic data.

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7. Bostwick JM, McKean AJS. On the Spectrum: High-Functioning Autism and Its Contemporary Relevance. Mayo Clin Proc. 2026.

With publication of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) in 2013, autism’s prevalence in the United States nearly doubled to more than 2% of the population. In reconceptualizing the condition, DSM-5 collapsed 4 diagnoses into 1 diagnosis: autism spectrum disorder. What the 4 had in common were deficits in 2 broad areas: restricted, repetitive behaviors or interests; and deficits in social communication. Three of the 4 were severe forms easily recognized in childhood. The fourth, constituting most of the increase in prevalence, was Asperger disorder, or high-functioning autism, frequently going undiagnosed until adulthood. These patients typically have fluent language, intact intellect, and highly developed compensatory strategies including social « masking. » The adult diagnosis is manifested in struggles to maintain employment or friendships both platonic and intimate. Nonpsychiatric providers are likely to encounter patients with autism spectrum disorder seeking care for myriad comorbid psychiatric and physical problems. Complicating matters is that many adult psychiatrists are unfamiliar with what was until recently the purview of child psychiatrists. Autism has neither cure nor specific pharmacologic treatments, but addressing comorbidities, with psychiatric and medical referrals where indicated, mitigates suffering. Services targeting employment and educational support, occupational therapy focused on activities of daily living, and skill-based psychotherapies that aim to improve social interactions can reduce stress and anxiety while enhancing function, reducing isolation, and encouraging satisfying relationships.

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8. Boutelle KN, Eichen DM, Martinez K, Pinson CK, Strong DM, Reed KL, Akshoomoff N, Rhee KE, Brookman-Frazee L. Design of the FRESH-A study: A randomized controlled trial evaluating telehealth parent-only treatment for autistic youth with overweight/obesity. Contemp Clin Trials. 2026: 108330.

Autistic children have higher rates of overweight and obesity (OW/OB) compared to nonautistic children. Family-based behavioral treatment (FBT) is the standard of care for children with obesity and is delivered to both the parent and the child. Common autism characteristics, such as sensory sensitivities, social communication challenges, and behavioral rigidity, can limit the feasibility of providing FBT to both parent and child. Our team developed a parent-based treatment (PBT) model that is delivered only to the parent of an autistic child with OW/OB. Our published pilot data established the initial feasibility, acceptability and initial weight-loss efficacy of this program. This paper presents a protocol for an ongoing two-arm randomized controlled trial comparing the effect of a telehealth PBT program tailored for families with an autistic child (PBT-A) with a health education (HE) comparator on the child’s weight over 18 months. We aim to recruit 150 families with an autistic child with OW/OB and randomize them to either six-months of telehealth PBT-A or HE treatment delivered to the parent only. The primary outcome is change in child body size, assessed by BMIz and percent of the 95th percentile, over the 18 months of the study. Secondary outcomes include parent BMI, dietary intake for both parent and child, child mealtime behavior, physical activity levels, parenting style, and parental self-efficacy. This ongoing study may provide a scalable, cost-effective intervention for families with an autistic child with OW/OB. Clinical trials # NCT05741840.

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9. de Oliveira JRM, Soares LRF, Padilla M. National Census Data on Autism in Brazil: Historic Advances and Persistent Inequities. Am J Psychiatry. 2026; 183(5): 364.

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10. de Souza VG, Santos MS, Panno L, Dos Santos Soares F, Bertolini GRF, de Fátima Chasko Ribeiro L. Prevalence of motor development delay in children with craniosynostosis: a systematic review and meta-analysis. Eur J Pediatr. 2026; 185(5).

Craniosynostosis (CS) may influence motor development in childhood through anatomical and functional alterations resulting from premature fusion of cranial sutures. Although several studies have addressed neuropsychomotor outcomes in CS, the lack of consolidated estimates of motor delay prevalence represents a relevant scientific gap, which motivated the present study. This systematic review and meta-analysis aimed to estimate the prevalence of motor development delay in children with CS. Seven electronic databases, gray literature sources, and reference lists of included studies were systematically searched. Observational studies reporting quantitative data on motor performance in children with CS, assessed using standardized instruments, were included. Risk of bias was evaluated using the Joanna Briggs Institute (JBI) Checklist for Prevalence Studies. A total of 8 studies published between 2001 and 2024, involving 510 children with CS, were included. The samples were predominantly non-syndromic, although one study included a small syndromic subgroup (n = 8). The meta-analysis demonstrated a pooled preoperative prevalence of motor delay of 31% (95% CI: 20-44%) with substantial heterogeneity across studies (I(2) = 85.8%). CONCLUSION: Overall, the findings indicate that approximately one in three children with CS presents some degree of motor delay, reinforcing the need for standardized motor assessments, particularly during the preoperative period. WHAT IS KNOWN: • Craniosynostosis (CS) is a congenital condition that may impair neuropsychomotor development due to anatomical and functional brain alterations. • Previous studies have reported heterogeneous findings on motor outcomes in children with CS, but no systematic review or meta-analysis had consolidated the prevalence of motor delay, particularly in the preoperative period. WHAT IS NEW: • This meta-analysis provides the first pooled estimate of motor delay prevalence in children with non‑syndromic CS, showing that approximately one in three children (36%; 95% CI: 28-44%) presents with motor delay before surgery. • The findings highlight the high frequency of motor impairment across all suture subtypes and underscore the urgent need for standardized preoperative motor screening and early multidisciplinary intervention.

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11. Guerrero-Gonzalez JM, Lowe AK, Kecskemeti SR, Travers BG, Alexander AL, Sterling AM. Cerebral Cortex Morphometry and Relaxometry in Male Children With Fragile X Syndrome and Autism. Brain Behav. 2026; 16(5): e71375.

PURPOSE: An estimated 30%-50% of male individuals with fragile X syndrome (FXS) meet criteria for autism spectrum disorder (ASD), indicating phenotypic overlap but potentially distinct neurobiology. Here, we aimed to characterize shared and divergent cortical features between FXS and ASD. METHOD: High-resolution, motion-corrected quantitative MRI was used to compare cortical morphometry and relaxometry in 61 male participants (9-18 years) with FXS or ASD. To increase power, ASD participants were pooled from multiple MPnRAGE studies and harmonized across protocols using ComBat. Cortical thickness and R1 (longitudinal relaxation rate; proxy for myelination) were computed across the cerebral cortex. FINDING: Relative to ASD, FXS exhibited greater cortical thickness predominantly in early sensory cortices implicated in low-level visual and auditory processing spanning occipital, parietal, and temporal regions. No significant group differences in R1 were found. CONCLUSION: Thicker cortex in FXS within primary and early associative sensory areas suggests divergent early sensory processing mechanisms between FXS and ASD. Characterizing different neuroanatomical features between the two disorders provides a grounding to develop more disorder-specific interventions despite similar behavioral difficulties. Future work should test developmental trajectories, include females and comorbidities, and link imaging markers to individual sensory/clinical profiles to inform and improve personalized therapies and interventions.

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12. Haghighat H. Diagnostic Classification of Autism Spectrum Disorder in the Frequency Domain Using Resting-State fMRI. Neuroinformatics. 2026; 24(2).

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with problems in social interactions, verbal and non-verbal communication, repetitive behaviors, and limited interests in a person. Considering the challenges in diagnosing ASD based on behavioral symptoms-such as subjectivity, variability among individuals, and overlap with other developmental conditions-it seems necessary to propose computer-aided diagnosis systems (CADS) for ASD. We proposed an age-dependent CADS based on functional connectivity (FC) in the frequency domain for ASD using resting-state functional magnetic resonance imaging (rs-fMRI). Also, the features and classification accuracy obtained in the frequency and time domains were compared. First, preprocessing was performed on the rs-fMRI data. Then, group-independent component analysis (GICA) was used to obtain resting state networks (RSNs). This was followed by obtaining separate components of RSNs for each individual using dual regression. Then, coherence analysis was used to extract the features of FC in the frequency domain between RSNs. To consider the role of age in the classification process, three age groups of children, adolescents, and adults were considered, and feature selection for each age group was applied separately using an embedded approach, in which all classifiers in the Waikato Environment for Knowledge Analysis (WEKA) machine learning platform were used simultaneously. Finally, classification accuracy was obtained for each age group. The proposed CADS was able to classify 95.23% in the children group, 88.1% in the adolescent group, and 92.8% in the adult group. In addition, the frequency bands whose features obtained the most distinction in each age group were identified, highlighting their potential relevance for supporting ASD diagnosis and monitoring rehabilitation.

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13. Harikumar A, Baker B, Amen D, Keator D, Calhoun VD. Examining comorbid and transdiagnostic depression clinical outcomes across anxiety, autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, depression, and schizotypal personality groups: a novel NeuroMark SPECT approach. medRxiv. 2026.

Major depressive disorder (MDD) is a highly prevalent neuropsychiatric disorder characterized by depressed mood, feelings of sadness, loss of interest, and reduced pleasure related to daily activities. The clinical etiology of depression has been extensively studied, with research indicating biological, social, and psychological factors related to onset of depressive symptoms. Despite increased knowledge related to MDD, there is no tangible biomarker developed for MDD. Neuroimaging modalities such as single photon emission computed tomography (SPECT) have been utilized to characterize regional cerebral perfusion (rCBF). Functional dysconnectivity in depressed patients have been examined, with depressed individuals showing elevated depression scores and decreased rCBF in cognition and executive functioning networks. While SPECT can be utilized to monitor rCBF changes with respect to symptom severity, it alone cannot be utilized to develop a potent biomarker. Advanced multivariate methods such as independent component analysis (ICA) have been used to visualize disconnected functional patterns across disorders including depression and schizophrenia. Given no current SPECT studies examine transdiagnostic clinical profiles, the current study aims to bridge this gap. We utilized the 68 NeuroMark SPECT template across six patient groups. Factor scores investigating three key symptoms of depression: worry/rumination, moodiness, and social disinterest, and measured the loading parameter strength (i.e. component expression for each NeuroMark domain/subdomain) across the 68 components were examined. We identified significant relationships between symptoms and frontal, triple network, sensorimotor, and visual components across the three symptom profiles. Future studies should examine these trends across larger sample sizes, and increased clinical samples.

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14. Hellmann Whitaker RA, Storey JJ, Vannavong I, Mangiamele RS, Trihus MA, Floyd DD, Rohder T, Cleveland DL, Rizea A. A Biochemical Analysis of LINC00896 RNA in Cortex Neuronal Cells and Its Possible Connection to the Development of Autism. J Nucleic Acids. 2026; 2026: 5292315.

Autism spectrum disorder is a complex neurological and developmental disorder that is characterized by altered brain structures and interconnectivity, which results in a vast array of psychosocial and physiological irregularities. This is due to the complex genetic topography of autism and to the intersectionality of genetic and environmental factors that contribute to the development of this disorder. To better understand the genetic factors that cause autism, the gene linc00896, which encodes a long noncoding intergenic RNA, was biochemically and biologically analyzed primarily through circular dichroism, liquid chromatography, and mass spectrometry. From this analysis, it was determined that LINC00896 RNA has a vast interactome and that through this interactome, LINC00896 RNA influences numerous cellular processes that contribute to the symptoms of autistic patients. Additionally, the structural analysis of LINC00896 RNA indicated stable but flexible secondary and tertiary structures that support the numerous binding interactions identified in the interactome. Through these empirical findings, the linc00896 gene was identified as being an important genetic factor that contributes to the development of autism.

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15. Ip IN, Chiu HT, Ching FNY, Law CK, Tang EHL, Ng CSF, Wong SWH. Autistic traits and proneness to shame and guilt: The mediating role of functional connectivity of cortical midline structures. Personal Neurosci. 2026; 9: e2.

Shame and guilt are similar yet distinct self-conscious emotions that often facilitate the attainment of social goals and motivate behaviors that promote social acceptance. Recent studies have shown that individuals with autism or high autistic traits may tend to exhibit higher shame-proneness and lower guilt-proneness. This study examined whether this profile of self-conscious emotions can be explained by the functional organization of the brain using resting-state fMRI. Autistic traits, shame- and guilt-proneness and whole-brain resting-state fMRI data were measured in 45 neurotypical individuals. Our results revealed that the positive association between autistic traits and shame-proneness was mediated by resting-state functional connectivity between the right frontal pole and several regions among the cortical midline structures, including the precuneus, anterior cingulate and posterior cingulate. Additionally, functional connectivity between the right frontal pole and precuneus was found to mediate the negative association between autistic traits and guilt-proneness. These findings highlight the role of the cortical midline structures as a key neural substrate underlying differential experiences of negative self-conscious emotions among individuals with high autistic traits.

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16. Joon P, Bansal S, Aranjani JM, Kumar A, Deepak D. Rosmarinic acid as a potential GSK3β inhibitor for autism spectrum disorder: insights from an integrative in silico study. In Silico Pharmacol. 2026; 14(2): 124.

Autism Spectrum Disorder (ASD) is characterized by dysregulated signaling pathways, notably involving Glycogen Synthase Kinase 3 Beta (GSK3β). The present study investigates Rosmarinic acid (RA), a natural polyphenol, as a potential GSK3β inhibitor for ASD using an integrative in silico framework. Multiple sequence alignment across six species revealed high conservation of GSK3β’s ATP-binding pocket, underscoring its therapeutic relevance and translatability across model organisms. Molecular docking showed RA binds robustly to GSK3β’s ATP-binding pocket (estimated affinity: 58.11 nM in SeeSAR scoring), compared to previously validated inhibitors such as Tideglusib (4077.20 nM in SeeSAR scoring) and Laduviglusib (93.26 nM in SeeSAR scoring). Independent Glide docking reproduced the binding orientation (GlideScore: - 7.548 kcal/mol), and MM-GBSA refinement indicated favorable binding free energy (ΔG(bind) = - 42.37 kcal/mol). A 100 ns molecular dynamics simulation demonstrated stable ligand retention and sustained catalytic pocket interactions with the engagement of catalytic amino acid residues including Lys85 and Asp200. Off-target docking against CDK2, CDK5, and GSK3α suggested preferential binding toward GSK3β. Structure-activity exploration of RA analogs identified aromatic balance and moderated polarity as determinants of predicted affinity. Together, these findings provide convergent computational evidence that RA may directly interact with GSK3β, supporting further biochemical and cellular validation studies to assess its potential as a modulator of GSK3β-associated pathways relevant to ASD pathophysiology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40203-026-00627-2.

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17. Kim S, Cantin-Garside KD, Nussbaum MA. Feasibility of forecasting self-injurious behavior among autistic youth using wearable sensors and machine learning models. Sci Rep. 2026.

Self-injurious behavior (SIB) is a substantial clinical challenge for many individuals on the autism spectrum, and support strategies are often only reactive. Forecasting of SIB could enable timely support, especially using wearable sensors, but its feasibility is not well understood. We evaluated SIB forecasting using a previously collected dataset (n = 9) comprising motion and physiological data. We compared the performance of four machine learning models-Random Forest, AdaBoost.M2, Long Short-Term Memory (LSTM), and a Double-Stacked LSTM-across five forecast horizons (3s to 120s) and three feature sets: Motion-Only (from accelerometers), Physiological-Only (e.g., heart rate, skin conductance), and Combined. Performance was measured with a range of metrics, using Leave-One-Subject-Out cross-validation. We found a significant main effect of forecast horizon on the Area Under the Precision-Recall Curve; performance rose from near-chance at short horizons to having median scores above chance at one minute or longer. While aggregated results showed no significant differences between models or feature sets, subject-level analysis suggested predictive feasibility and that the optimal model configuration were highly person-specific. Our findings demonstrate that forecasting using wearable sensor data is feasible, but the substantial performance variability highlights a critical need for person-specific approaches to enable the development of clinically useful, proactive support systems.

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18. Limburg R, Kopp MB, Zhou X, Ghorbani F, Roessner V, Hommel B, Beste C, Prochnow A. Altered neural oscillatory dynamics underlie reduced anticipatory schema use during event segmentation in adolescents with High-Functioning Autism Spectrum disorder. Neuroimage Clin. 2026; 50: 103998.

Autism Spectrum Disorder (ASD) is characterized by diverse symptoms that may stem from atypical integration of sensory information and prediction processes. Event Segmentation Theory (EST) offers a framework to examine how individuals parse continuous experience into meaningful units. This study investigated whether altered event segmentation in adolescents with ASD arises from atypical neural oscillatory dynamics underlying prediction and updating processes. Behaviorally, adolescents with ASD showed a weaker adaption of segmentation behavior to the occurrence of situational changes than neurotypical participants, particularly in response to small spatial changes. Neurophysiologically, both groups exhibited alpha and beta power reductions at event boundaries, but these modulations were less extensive and more localized in ASD. Source-level theta modulations before boundaries were only present in ASD, suggesting increased reliance on error monitoring rather than event schema access. Adolescents with ASD show reduced event segmentation in response to contextual changes accompanied by altered alpha, beta and theta oscillatory dynamics, indicative of reduced schema-based integration, inflexible updating of event representations and heightened conflict monitoring. These findings highlight event segmentation as a potential cognitive mechanism contributing to broader ASD symptomatology.

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19. Myers IK, Bian F, Solano MP, Zoghby YE, Tavares-Ferreira D, Danaphongse T, Engineer CT. Vagus Nerve Stimulation Paired With Tones Alters the Auditory Cortex Proteome in a Rat Model of Rett Syndrome. Dev Neurobiol. 2026; 86(3): e70032.

Rett syndrome is a neurodevelopmental disorder caused by an X-linked mutation of the MeCP2 gene. Individuals with Rett syndrome, as well as rodent models of this disorder, demonstrate abnormal cortical responses to sound, which impair auditory discrimination ability. Vagus nerve stimulation (VNS) paired with tones has been shown to drive robust changes in the auditory cortex physiology of Mecp2(+/-) rats and has the potential to improve the communication abilities of individuals with Rett syndrome. The aim of this study was to describe the proteomic differences present in the auditory cortex of the Mecp2(+/-) rat model of Rett syndrome, as well as the molecular effect of VNS paired with tones. This study used global proteomic analysis of auditory cortex tissue taken from Mecp2(+/-) rats exposed to VNS paired with tones compared to untreated Mecp2(+/-) rats and wild-type (WT) littermate controls with no VNS exposure. Our results demonstrate dysregulation of mitochondrial and synaptic proteins in the Mecp2(+/-) rat auditory cortex. In addition, we show that VNS-tone pairing induces significant alterations to the auditory cortex proteome of Mecp2(+/-) rats by changing the expression of proteins involved in regulating synaptic vesicles and synaptic transmission. This work provides evidence of key mechanisms that may drive auditory processing dysfunction in Rett syndrome and demonstrates that VNS-tone pairing is sufficient to alter protein expression in the auditory cortex.

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20. Naguy A, Pridmore S, Abul HH, Alamiri B. Compulsive Polydipsia-Related Symptomatic Hyponatremia in a Low-Functioning Autistic Boy. Prim Care Companion CNS Disord. 2026; 28(2).

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21. Noriyama Y, Ishida R, Yamamuro K, Kashida N, Okumura K, Okuda M, Ikehara M, Toritsuka M, Saito Y, Okada T, Iwata N, Makinodan M. Sex differences in autism spectrum disorder: behavioral and sensory phenotypes in humans and mouse models. Transl Psychiatry. 2026.

Sex differences in autism spectrum disorder (ASD) are increasingly recognized, not only in symptom presentation but also in underlying neurobiology and response to environmental factors. However, current diagnostic practices and animal models are male-centric, overlooking female-specific phenotypes and mechanisms. We conducted a multimodal, cross-species study to assess sex-dependent ASD phenotypes. In high-functioning adults with ASD and typically developing (TD) controls, we evaluated self-reported autistic traits, self-reported sensory sensitivity, and clinician-observed behaviors using standardized tools: Autism-Spectrum Quotient, Adolescent/Adult Sensory Profile, and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). In parallel, we assessed behavioral phenotypes in a paternal 15q11-q13 duplication mouse model (15q dup/+) using open-field, light-dark transition, and augmented reality-based behavioral assays. Among humans, individuals with ASD showed greater self-reported sensory sensitivity and autistic traits than TD individuals. Within the ASD group, female participants reported greater self-reported sensory sensitivity and exhibited lower clinician-rated impairments (ADOS-2) than male participants, despite comparable self-reported autistic traits. No sex differences were found among TD individuals. In contrast, female 15q dup/+ mice exhibited heightened light-related sensory reactivity and reduced exploratory behavior under bright light. These findings suggest that sex differences in light-related sensory reactivity may be more readily detected through behavioral measures in animal models. Our findings underscore the importance of considering sex as a biological and behavioral variable in ASD research. Cross-species, phenotype-oriented approaches that integrate human and animal data may uncover subtle phenotypic variations and enhance sex-informed diagnostics and interventions.

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22. Osredkar J, Finderle P, Godnov U, Jekovec-Vrhovšek M, Vidova V, Elliott JP, Fabjan T, Avguštin G, Osredkar D, Kumer K. Faecal inflammatory protein markers in children with autism spectrum disorder are comparable to their healthy siblings. Front Psychiatry. 2026; 17: 1792801.

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition often accompanied by gastrointestinal (GI) symptoms. Inflammatory proteins in stool have been proposed as potential biomarkers, but evidence remains inconsistent. We compared fecal levels of α1-antitrypsin (A1AT), immunoglobulin A (IgA), and calprotectin (Cal) in 57 children with ASD and 57 biological siblings without ASD. Sibling designs are now preferred to disentangle ASD-specific biology from shared environmental and microbiome factors. Participants were carefully screened to exclude recent antibiotic use, digestive problems, gastrointestinal infections, and abnormal dietary patterns, thereby controlling for major factors known to influence gut inflammatory markers. METHODS: Stool samples were thawed, freeze-dried, and proteins extracted using ammonium bicarbonate buffer with sodium deoxycholate. After BCA quantification, samples were reduced, alkylated, spiked with stable isotope-labelled peptides, and digested with trypsin. Peptides were purified and analyzed by UHPLC-MS/MS (Agilent 6495A) in dynamic SRM mode. Quantification used internal standards and normalization to total protein. Ratios of IgA1/IgA2 and S100A8/S100A9 were calculated. ASD severity was evaluated using the Childhood Autism Rating Scale (CARS). RESULTS: Children with ASD showed trends toward higher IgA and calprotectin and lower α1-antitrypsin compared with siblings, but differences were not statistically significant. Subgroup analysis suggested different distribution patterns in moderate versus severe ASD, including higher IgA in the moderate group and altered S100A8/S100A9 ratio in the severe group. These subgroup findings were exploratory, derived from critically underpowered post-hoc analyses (severe subgroup: n = 11 pairs, ~18% power for medium effects), and should be considered hypothesis-generating only, pending validation in adequately powered pre-registered studies. CONCLUSIONS: The results are consistent with recent meta-analyses reporting no consistent evidence of gut inflammation in ASD. Larger, sex-matched studies with full assay validation are needed to clarify the role of stool proteins in ASD.

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23. Porsnok D, Yardımcı-Lokmanoğlu BN, Mutlu A. Trajectories of detailed general movements and their association with one-year developmental outcomes in very preterm, moderate-to-late preterm, and term infants. Eur J Pediatr. 2026; 185(5).

Trajectories of early spontaneous movements provide valuable insights into developmental outcomes in preterm infants. We aimed to compare the longitudinal trajectory of early spontaneous movements in very preterm (VPT), moderate-to-late preterm (MLP) and term infants, and determine the relationship between early spontaneous movements and one-year developmental outcomes in preterm infants. This prospective longitudinal study included 133 infants, comprising 91 preterm and 42 term infants. Early spontaneous movements were assessed longitudinally according to the infants’ ages, using the revised General Movements Assessment (GMA) score sheet, the General Movements Optimality Score-Revised (GMOS-R), and the Motor Optimality Score for 3-to 5-Month-Old Infants-Revised (MOS-R). Developmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Two hundred and twenty-four video recordings for GMOS-R and 133 video recordings for MOS-R were evaluated. There was no difference in GMOS-R between VPT and MLP infants in the preterm or term periods (p = 0.343). However, VPT infants exhibited lower GMOS-R (p = 0.001) in the postterm period and lower MOS-R (p = 0.018) in the fidgety period compared to term infants. VPT infants had lower Bayley-III outcomes than MLP infants in the cognitive (p = 0.006), language (p = 0.003), and motor domains (p = 0.004), and lower motor outcome than term infants (p < 0.001). GMOS-R in the preterm or term periods was correlated only with motor outcomes (p = 0.002; r = 0.329), while in the postterm period GMOS-R was correlated with cognitive (p = 0.039; r = 0.222), language (p = 0.045; r = 0.215), and motor (p = 0.001; r = 0.340) outcomes in all preterm infants. MOS-R was also related with cognitive (p < 0.001; r = 0.396), language (p = 0.005; r = 0.301), and motor (p < 0.001; r = 0.457) outcomes. CONCLUSION: This study supports the concept that VPT infants are at high-risk of developmental problems. Additionally, while the relationship of GMOS-R to developmental outcomes is highlighted, MOS-R is more strongly associated with later developmental outcomes. WHAT IS KNOWN: • Time-based General Movements Assessment through trajectories provide important information to identify infants at high neurodevelopmental risk. WHAT IS NEW: • The General Movements Optimality Score-Revised (GMOS-R) may support early risk stratification in the earliest months of life and is potentially informative for early intervention referrals. However, MOS-R demonstrates stronger overall associations, highlighting its important role in early developmental assessments.

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24. Saniee S, Pouretemad HR, Mokhtari S. The relationship between cognitive flexibility and restricted, repetitive behaviors in children with autism: parents’ reports vs. cognitive task performance. Sci Rep. 2026.

Cognitive flexibility (CF), a core component of executive functioning, is often impaired in children with autism and closely linked to restricted and repetitive behaviors and interests (RRBIs). This study examined CF in 43 young children with autism (ages 3-7) using both performance-based measures (DCCS) and parent-reported CF (BFRS-R). We investigated the associations between CF and higher-order versus lower-order RRBIs, assessed convergence between performance-based and parent-report CF measures, and evaluated the contribution of other executive function (EF) domains and autism-related symptoms. Results revealed that higher-order RRBIs (e.g., ritualistic routines, insistence on sameness) were consistently associated with CF deficits, whereas lower-order RRBIs (sensorimotor behaviors) showed nonsignificant associations. Additionally, strong convergence between performance-based and parent-reported assessment of CF, with accuracy-based switch cost emerging as the most sensitive and robust indicator of CF in early childhood. Regression analyses confirmed that higher-order RRBIs, working memory, and communication difficulties significantly accounted for variance in cognitive flexibility. Taken together, these findings provide a comprehensive understanding of the relationships among cognitive flexibility, RRBIs as well as executive functions, and communication in early childhood autism. The integration of performance-based and parent-report assessments highlights the complementary value of multi-method approaches and offers a foundation for refining future assessment strategies and developmental research.

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25. Scenna MS, Bej E, Cesare P, Persichitti I, Cimini A, D’Angelo M, Castelli V. Mitochondrial dysfunction and oxidative stress in autism spectrum disorder: pharmacological insights into natural antioxidants. Front Pharmacol. 2026; 17: 1783888.

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by social communication deficits, restricted and fixated interests and abnormal motor behaviors. Increasing evidence implicates oxidative stress, mitochondrial dysfunction, and neuroinflammation as key biological features of ASD. Aberrant redox homeostasis, reduced glutathione reserves, increased lipid peroxidation, and dysregulated NRF2 signaling have been documented in both peripheral tissues and brain samples. Post-mortem and imaging studies further reveal deficits in electron transport chain complexes and pyruvate dehydrogenase activity, suggesting a mechanistic link between mitochondrial bioenergetics and ASD-related phenotypes. These pathomechanisms have motivated interest in antioxidant metabolites from botanical drugs and nutrients as complementary strategies. To critically appraise mechanisms and levels of evidence (in vitro, in vivo, clinical) for vitamin E and C, glutathione and its precursors, polyphenols (quercetin, resveratrol, curcumin), Crocus sativus carotenoids (crocin/safranal), and « indirect » modulators (e.g., omega-3, folinic acid), emphasizing study quality, translational relevance, and limitations. The aim of this review is to synthesize current findings on the potential benefits of antioxidants in addressing both molecular and behavioral aspects of ASD, while also examining the link between oxidative stress and ASD. Furthermore, we discuss the role of antioxidant-based interventions in managing ASD symptoms. The review highlights the complex challenges associated with antioxidant therapies and deficiencies, emphasizing the need for a multifaceted nutritional approach particularly in children with ASD.

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26. Seng GJ, Lin JY, Chiu YN, Tsai WC, Li SC, Hsiao MN, Soong WT, Gau SS, Shang CY. Group-based early intervention in a public health daycare setting improves group adaptive functioning in autistic children. J Formos Med Assoc. 2026.

BACKGROUND: Group-based early intervention was widely implemented for autistic children, yet the impact on group adaptive functioning remained under-investigated. These abilities were critical for successful transition into preschool environments. This study examined the effectiveness of a group-based early intervention program in a public health daycare setting on both developmental outcomes and group adaptive functioning, and explored potential predictors of treatment response. METHOD: We conducted a retrospective chart review of autistic children aged 2-6 years who attended a group-based early intervention program in a daycare setting. Developmental outcomes were assessed using the Chinese Child Development Inventory (CCDI), group adaptive functioning using a newly developed Group Adaptive Function Index (GAFI), and overall symptom severity using the Clinical Global Impression-Severity (CGI-S). Psychometric and convergent validity of the GAFI were examined. Pre- and post-intervention changes were analyzed, and their associations with age at admission, treatment duration, and baseline developmental profiles were explored. We also compared good and poor responders to identify potential predictors of treatment response. RESULTS: Results showed significant improvements in expressive language, concept comprehension, general developmental quotients, and all GAFI subscales. CGI-S scores also showed a significant decrease, indicating overall symptom improvement. The GAFI demonstrated acceptable validity. Baseline developmental levels, particularly expressive language, concept comprehension, and general development, predicted better treatment response. CONCLUSION: Group-based early intervention in a daycare setting effectively improved both developmental and group adaptive functioning in autistic children. The GAFI might serve as a clinically relevant outcome measure, and baseline developmental profiles might inform clinical decision-making.

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27. Setiawan A, Saputra AA, Ayu IR, Setiyowati AJ, Eva N. Enhancing diagnostic precision in autism spectrum disorder: Integrating POV technology with expanded behavioral markers. Asian J Psychiatr. 2026; 120: 104989.

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28. Vercontaire S, Deville C, Missell K, Early D, Huang R. Effects of Music-Based Auditory Stimulation on Children with Autism Spectrum Disorder and Auditory Sensory Over-Responsivity: A Pilot Study. Occup Ther Health Care. 2026: 1-15.

Many children with autism spectrum disorder (ASD) have altered sensory processing – including auditory sensory over-responsivity (SOR). Few treatment options exist for children with ASD and auditory SOR. This study investigated whether music-based auditory stimulation (The Listening Program(®) SPECTRUM with Waves(™) bone conduction headphones), could reduce auditory SOR, sensory dysfunction, and behaviors common to children with ASD and improve adaptive functioning. Six boys between the ages of 5 and 10 with ASD and auditory SOR completed listening sessions at home for 40 wk. Participants had statistically significant improvements in the Hearing construct of the Sensory Processing Measure that were sustained 3 months post-intervention. Participants also had significant improvements across multiple other sensory constructs, social skills, and communication skills. This study provides support for The Listening Program(®) SPECTRUM with Waves(™) bone conduction headphones to improve sensory processing and reduce hypersensitivity to sound, which may lead to better social and communication skills for children with ASD and auditory SOR. Larger, randomized-controlled studies are needed.

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29. Wagner L, Chiem E, Liu J, Hernandez LM. Functional Connectivity of the Neonatal Cerebellum is Impacted by Sex and Polygenic Liability for Autism. medRxiv. 2026.

The cerebellum rapidly integrates with cerebral networks during infancy and shows consistent structural and functional alterations in Autism Spectrum Disorder (ASD), suggesting that early cerebellar development may be consequential for later behavioral and psychiatric outcomes. Yet, little is known about the effect of ASD genetic liability on cerebello-cerebral functional connectivity in infancy or whether effects may differ by biological sex. Here, we leveraged neonatal functional magnetic resonance imaging, genetic, and behavioral follow-up data from the Developing Human Connectome Project (dHCP) to examine the relationship between ASD polygenic scores (PGS) and functional connectivity of cerebellar regions associated with sensorimotor and social-cognitive functions in 198 term-born neonates (mean age: 9.7 days). We report widespread sex differences in neonatal cerebello-cerebral connectivity that are regionally specific across cerebellar subdivisions. Across the full sample, elevated ASD PGS predicted alterations in cerebello-cerebral connectivity, with hemisphere-dependent differences in sensorimotor cerebellar connectivity with temporal cortex, and hyperconnectivity between the right social-cognitive seed and posterior cingulate. Notably, elevated ASD PGS predicted opposing patterns of cerebello-cerebral connectivity in males and females, including male hyperconnectivity between the right sensorimotor cerebellum and default mode areas, and female hyperconnectivity between the right social-cognitive seed and sensorimotor cortex. Connectivity associated with elevated ASD PGS showed nominal, sex-specific associations with 18-month language ability, attention problems, and emotional reactivity. Our findings show that ASD PGS influences the functional configuration of the cerebellum at birth and suggest that underlying cerebellar connectivity profiles associated with ASD may partially underlie distinct behavioral presentations in males and females.

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30. Wang L, Hua M, Xie Q, Yang G, Yu Y, Chen Y. Unpacking the daily dynamics of parenting strain: A 15-day diary study of caregiving role overload, depressive symptoms, and parental burnout among parents of autistic children. Res Dev Disabil. 2026; 173: 105300.

OBJECTIVES: To explore the day-to-day dynamics between daily caregiving role overload and daily depressive symptoms among parents of autistic children, and to examine gender differences in these variables’ average levels and day-to-day dynamics, as well as whether such differences help explain parental burnout. METHODS: We recruited parents of autistic children from autism intervention centers using convenience sampling (N = 210; 81.9% mothers) in mainland China. Parents completed a brief online diary survey each evening across 15 weekdays over three consecutive weeks to assess daily depressive symptoms and daily caregiving role overload. After the diary period, parents completed a post-diary questionnaire assessing parental burnout. Data were analyzed using dynamic structural equation modeling (DSEM). RESULTS: (1) At the within-person level, daily caregiving role overload and daily depressive symptoms showed reciprocal cross-day associations, forming a day-to-day feedback loop. (2) At the between-person level, mothers reported higher person-mean depressive symptoms than fathers, which in turn predicted higher parental burnout. (3) At the between-person level, mothers exhibited stronger day-to-day carryover of depressive symptoms than fathers, which in turn predicted higher parental burnout. CONCLUSIONS: The findings clarify processes through which parenting-related stressors contribute to day-to-day resource depletion and suggest gender-specific pathways and dynamic patterns in the development of parental burnout among mothers and fathers. These results have important implications for promoting parents’ mental health in families with high caregiving demands by informing early, sustained, and parent-tailored daily support to prevent resource depletion and reduce parental burnout.

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31. Wang L, Xu G, Li D, Gao X, Zhao J, He Y, Liu S, Guo H, Bu X. Effectiveness of Different Virtual Reality Technologies for Social and Communication Skills in Children With Autism Spectrum Disorder: Systematic Review and Network Meta-Analysis of Current Evidence and Future Directions. JMIR Pediatr Parent. 2026; 9: e82814.

BACKGROUND: Virtual reality (VR) technology offers a new approach for the intervention of social communication skills in children with autism spectrum disorder (ASD), but the comparative effects of different forms of VR technology remain unclear. OBJECTIVE: This study aims to conduct a systematic review and network meta-analysis (NMA) based on existing randomized controlled trials (RCTs) to initially explore and compare the effects of different VR technologies on improving the social and communication skills of children with ASD. METHODS: We systematically searched relevant RCTs in both Chinese and English databases from January 1990 to February 2025. The quality of the literature was evaluated using the revised Cochrane risk of bias assessment tool (RoB-2), and an NMA was conducted under the frequentist framework using STATA 18.0 software. The quality of evidence was assessed using the Confidence in Network Meta-Analysis framework. A total of 11 RCTs (718 children) were included, evaluating 8 VR technologies. The evidence network was extremely sparse, with most interventions connected by single studies. Pairwise meta-analysis revealed overwhelming heterogeneity (I²=91.9%, P<.001), indicating profound clinical and methodological diversity. Due to this heterogeneity and the sparse network, the NMA model failed to produce stable or clinically interpretable effect estimates. Formal assessment using the Confidence in Network Meta-Analysis framework rated the confidence in all comparisons as very low. CONCLUSIONS: The existing evidence is insufficient to support any comparative efficacy conclusions or rankings among VR technologies for ASD social skills. The key finding is the demonstration that current evidence is too heterogeneous and immature for valid quantitative synthesis. Future research must prioritize methodological standardization before head-to-head trials can be meaningfully conducted.

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