1. Akkeçili Y, Pırıldar Ş. Autistic traits and obsessive-compulsive symptom severity: a retrospective six-month follow-up study. Front Psychiatry. 2026; 17: 1940901.

Autistic traits have been increasingly associated with obsessive-compulsive disorder (OCD), yet their influence on longitudinal symptom severity and treatment-related change remains poorly understood. This retrospective longitudinal study included 38 adults with DSM-5 OCD who completed six months of guideline-based pharmacological treatment. Obsessive-compulsive symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at baseline, one month, and six months. Autistic traits were evaluated at the six-month follow-up using the Autism Spectrum Quotient (AQ). Linear mixed-effects models served as the primary analyses, while repeated-measures analyses of covariance were performed as sensitivity analyses. Exploratory analyses examined the contribution of individual AQ subscales. Higher autistic trait levels were independently associated with persistently greater OCD symptom severity across the six-month follow-up, whereas the rate of treatment-related improvement did not differ according to autistic trait levels. This association was primarily driven by compulsive rather than obsessive symptoms. Exploratory analyses further identified social skills and attention switching as the AQ dimensions most strongly associated with overall OCD severity and compulsive symptom burden, whereas attention to detail was not significantly associated with symptom severity. These findings suggest that autistic traits represent stable markers of greater clinical burden in OCD without necessarily conferring poorer pharmacological treatment responsiveness. The results further support a dimensional conceptualization of autistic traits and highlight social functioning as a potentially important contributor to OCD symptom burden.

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2. Arutiunian V, Sugar CA, Naples A, Santhosh M, Levin AR, Borland H, Benton J, Bernier RA, Chawarska K, Dawson G, Dziura J, Hellemann G, Faja S, Jeste S, Kleinhans N, Sabatos-DeVito M, Şentürk D, Shic F, McPartland JC, Webb SJ. EEG resting-state gamma power as a potential biomarker of excitation / inhibition imbalance in autism: Evidence from the Autism Biomarkers Consortium for Clinical Trials. Eur Neuropsychopharmacol. 2026; 113: 113864.

Identification of neural biomarkers is one of the central challenges in autism research as they could significantly advance our understanding of the brain mechanisms of symptom trajectories, serve as objective markers in clinical trials (e.g., for subgrouping children, or use for prognostic relationship), and lead to targeted treatment development. The Autism Biomarkers Consortium for Clinical Trials (ABCCT) is a naturalistic longitudinal study assessing a set of candidate electroencephalographic (EEG) biomarkers, their change over time, utility for group discrimination, and relation to clinical phenotype. Here, we focused on one of the ABCCT biomarkers – resting-state gamma-band neural activity – as a measure of excitation-inhibition balance, which is considered a key neurophysiological mechanism in autism. A total of 1597 EEGs were analyzed resulting in 399 autistic children and typically developing (TD) peers with resting-state EEG and behavioral measures at four timepoints: baseline, +6 weeks, +6 months, and +4 years. The results revealed a significantly increased gamma power in autistic children, suggesting an excitation-inhibition imbalance. This elevation was longitudinally associated with lower non-verbal IQ and memory for faces. Finally, males had higher gamma power in comparison to females and gamma power decreased with age in both groups. The study demonstrates that resting-state gamma power is related to cognitive ability across ages and timepoints of our study in autistic youth.

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3. Bala A, Deban C, Hoskinson H, Mukhtar M, Shah A, Syeda A, Hashmi A. Understanding disparities in autism diagnosis and care: A socioecological perspective. PLOS Ment Health. 2026; 3(9): e0000703.

Disparities in autism spectrum disorder (ASD) identification and care are well documented across racial and ethnic, socioeconomic, and geographic lines, yet their underlying mechanisms are incompletely understood. This paper applies the Socioecological Model (SEM) as an organizing framework to examine how individual, interpersonal, community, organizational, and policy-level factors interact to produce inequitable trajectories in ASD diagnosis and service access. At the individual level, heterogeneity in symptom presentation, co-occurring psychiatric conditions, and diagnostic tools normed on Western, predominantly White samples contribute to variation in recognition. Girls from minoritized racial and ethnic backgrounds face compounded delays related to both sex-related camouflaging and cultural assessment bias. At the interpersonal level, provider-family communication, trust, and stigma shape whether developmental concerns are raised, referrals are completed, and services are engaged. Systematic reviews document that caregivers from minoritized groups report lower perceived quality of care and greater barriers to diagnostic follow-through. At the community level, neighborhood disadvantage, school resource variability, and culturally embedded interpretations of child development influence help-seeking and access to early intervention. At the organizational level, inconsistent screening adherence, limited diagnostic capacity, lengthy waitlists, and inequitable reimbursement structures create structural bottlenecks that disproportionately affect publicly insured and minoritized families. At the policy level, variation in state insurance mandates, Medicaid reimbursement rates, workforce distribution, and telehealth regulatory frameworks establish the conditions under which all lower-level factors operate. Recent surveillance data indicate that ASD prevalence among Hispanic, Black, and Asian or Pacific Islander children now exceeds that of White children in some cohorts, reflecting expanded screening and policy reform. However, convergence in prevalence does not constitute equity. Disparities in age at diagnosis, co-occurring intellectual disability, service intensity, and long-term outcomes persist. This paper also addresses training and workforce implications, arguing that sustainable equity requires structural competency education, workforce diversification, and community-partnered approaches integrated across career stages. The SEM framework highlights that disparities in ASD care are not attributable to individual clinical factors alone but emerge from the interaction of relational, institutional, and structural forces. Coordinated, multilevel strategies that extend beyond improved symptom recognition to systemic transformation are necessary to ensure timely, culturally responsive, and universally accessible care for all children.

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4. Cardenas-Hernandez NA, Perez-Diaz M, García-Ramó KB, Valdés Hernández MDC. Diffusion tensor imaging measurements for computer-aided diagnosis of autism: derived data from ABIDE II. Front Psychiatry. 2026; 17: 1819266.

Advancing the understanding of neuroimaging biomarkers in neurodevelopmental research requires structured, well-documented datasets to support reproducibility and comparative analyses. This dataset comprises diffusion MRI-derived measurements from the Autism Brain Imaging Data Exchange (ABIDE II) database-fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD)-across multiple brain regions for both ASD and control groups, associated with unique image identifiers. Data were generated using standardized image acquisition and computational processing pipelines, resulting in uniformly processed and reproducible quantitative region-specific metrics to facilitate cross-sectional comparative studies. The dataset is structured with explicit metadata, detailed variable descriptions, and complete case records to support programmatic access and automated workflows. Data visualization and harmonization codes accompany the dataset. This resource enables the investigation of white matter microstructural properties in relation to autism through different analytical approaches, including hypothesis testing, machine learning, and meta-analyses. The structured format and transparent documentation promote its reuse in other neuroimaging studies. FAIR(2)Data Portal: https://www.doi.org/10.71728/senscience.dbrh-5zc8.

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5. Çelikkol Sadiç Ç, Çetin BK. Autistic Traits and Probability of Suicide in Adolescents with Major Depressive Disorder: A Comparison with Psychiatrically Healthy Controls. Behav Med. 2026: 1-11.

This study aimed to compare the autistic traits and probability of suicide in adolescents diagnosed with major depressive disorder (MDD) aged 12-17 years with psychiatrically healthy controls. The study was conducted with a total of 128 adolescents, including 64 patients with MDD and 64 psychiatrically healthy controls, recruited from an outpatient child and adolescent psychiatry clinic in Turkey. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was administered to all subjects. Additionally, sociodemographic data were collected from each participant. The Suicide Probability Scale (SPS) and the Children’s Depression Inventory (CDI) were completed by the participants, while parents filled out the Autism Spectrum Quotient-Adolescent (AQ-Adolescent) for their children. In the MDD group, the total scores of CDI, SPS, and AQ-Adolescent were found to be statistically significantly higher compared to the psychiatrically healthy controls. Additionally, a significant positive correlation was observed between the total CDI score and both the total SPS and the AQ-Adolescent scores in the MDD group. The log-transformed CDI total score, after controlling for age and gender, was found to be significantly higher in adolescents with MDD who had elevated autistic traits than in those who did not have elevated autistic traits. Our study’s findings indicate that in comparison to controls, adolescents with MDD have a higher probability of suicide and autistic traits. Furthermore, adolescents with MDD and elevated autistic traits had significantly greater depressive symptom severity than those without elevated autistic traits. Adolescents with major depressive disorder may exhibit increased autistic traits, particularly when depressive symptoms are severe. Recognizing the relationship between depression severity, autistic traits, and probability of suicide may help clinicians identify high-risk adolescents earlier and support timely prevention and intervention strategies. eng.

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6. Chen F, Dong L. Fundamental Frequency and Noise Effects on Sentence Recognition in Mandarin-Speaking Autistic Children: The Role of Cognitive Abilities. J Speech Lang Hear Res. 2026; 69(9): 4132-47.

PURPOSE: Previous studies have shown that Mandarin-speaking autistic children exhibit atypical pitch processing and their speech perception is easily affected by noise. This study examined how fundamental frequency (F0) contour and background noise affect Mandarin sentence recognition in autistic children, and evaluated the roles of verbal intelligence (VIQ), nonverbal intelligence (NVIQ), and working memory (WM) as cognitive predictors. METHOD: Thirty Mandarin-speaking autistic children and 31 age-matched typically developing (TD) controls completed an open-set sentence recognition task under four conditions: natural F0 (NF0) versus flat F0 (FF0) in quiet and in speech-shaped noise at 10 dB SNR. Performance was scored as percent correct monosyllables. VIQ and NVIQ were assessed using the Wechsler Intelligence Scale, and WM was assessed via forward digit span. RESULTS: Both the ASD and TD groups showed reduced accuracy when F0 contours were flattened and in the presence of noise. The performance of autistic children declined disproportionately under FF0 conditions, whereas they matched TD peers when the F0 was natural. Noise imposed a similar energetic-masking effect across both groups. Within the ASD group, correlational analyses revealed that under NF0, WM was significantly associated with sentence recognition in quiet, and both VIQ and WM were significantly associated with performance in noise. NVIQ showed no significant association under any listening condition. When F0 contours were flattened, none of the cognitive measures correlated with recognition accuracy. CONCLUSIONS: Autistic children rely on intact prosodic cues for sentence intelligibility, and higher order verbal abilities and working memory can only compensate when these cues are preserved. Therefore, interventions should integrate prosody-focused listening training with support for cognitive-linguistic skills to enhance speech comprehension in autistic individuals.

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7. Dando CJ, Buchanan T, Maras K. Autism and detecting verbal truth and lies: veracity decisions, cue selection, judgment confidence, and self-report reasoning. Front Psychol. 2026; 17: 1871792.

INTRODUCTION: Assessing veracity is a consequential task across many real-world settings, since judgments about truthfulness can shape important decisions. The way in which autistic individuals experience the social world potentially shapes how they make veracity decisions. Empirical research examining veracity judgments in autistic samples is sparse highlighting a clear gap in understanding how autistic observers make real-time veracity judgments following single exposure to an unfamiliar individual. METHODS: We investigated the veracity decisions of 201 autistic and 193 not autistic adults from the general population, the cues they reported attending to, and using content analysis we explored reported reasoning. To approximate one feature of some real-world judgments, participants made a real-time veracity judgment following exposure to only one video clip of an interview with a mock suspect who was being either deceptive or truthful without feedback or opportunities for comparison. ANALYSIS: Autistic observers were 1.47 times more likely to make a truth decision than non-autistic observers and overall were 1.51 times more likely to make an erroneous veracity decision. Both groups were comparably accurate when evaluating truth-tellers. Autistic participants noted reduced detail in deceptive accounts, and despite indicating the importance of verbal behaviours, most self-reported relying more on physical behaviours to guide their decisions. Autistic participants reported greater confidence overall in their veracity judgments. DISCUSSION: Perceived discrepancies between the interviewee’s verbal and non-verbal communication were reported by many autistic participants. This may help explain an increased tendency toward truth judgments in this case, possibly resolving uncertainty by defaulting to honesty unless sufficient cues prompted a shift. Explicit, content-focused guidance regarding the diagnostic value of verbal behaviours for guiding veracity judgments may be beneficial.

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8. Fazioli L, Hadad BS, Denison RN, Yashar A. Suboptimal but intact integration of reward information during perceptual decision-making in autism. Cognition. 2026; 278: 106716.

Alterations in reward processing have been proposed as a contributing factor to social and communication symptoms in autism. However, the nature of these alterations remains unclear, and it is debated whether autism is characterized by reduced sensitivity to reward. Evidence for general reduced reward processing in autism primarily comes from neurobiological studies, yet it remains uncertain how these findings translate to autistic behavior. A key challenge in addressing this question lies in the quantitative assessment of behavioral responses to reward. Here, we addressed this issue by investigating the integration of monetary reward information into behavior through the framework of Bayesian perceptual decision-making, enabling a quantitative evaluation of the direct contribution of reward to decision-making. Autistic (n = 32) and non-autistic (n = 48) participants performed an orientation categorization task, while the monetary reward given per correct answer varied across categories. Using signal-detection theory, we estimated decision boundaries while accounting for sensory uncertainty and prior expectation. Both groups comprehended the reward contingencies similarly and showed comparable perceptual sensitivity. Importantly, autistic individuals adjusted their decision boundaries in response to monetary reward in a suboptimal yet similar manner to that of non-autistic individuals. Integration of monetary reward during perceptual decision-making is intact in autism. These findings challenge the view of general reduced reward processing in autism and are inconsistent with accounts proposing enhanced rationality in autism.

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9. Frisoni M, Tarasi L, Borgomaneri S, Romei V. Autistic traits are associated with suboptimal decision Bias strategies in subsecond timing. Conscious Cogn. 2026; 145: 104123.

Time perception difficulties are frequently reported in Autism Spectrum Disorder(ASD), yet empirical findings remain inconsistent: some studies document impaired timing, while others find no such deficit. This lack of consensus may reflect a key methodological limitation, failing to separate perceptual sensitivity from decision-making strategies. We applied Signal Detection Theory (SDT) to a sub-second duration discrimination task (100 and 500 ms) in 65 non-clinical adults varying in autistic traits, assessed via the Autism-Spectrum Quotient (AQ) and its five subscales. Autistic traits showed no reliable association with reduced perceptual sensitivity (d’): temporal discrimination remained intact across the subclinical range, with Bayesian analyses providing converging evidence against a perceptual deficit. Instead, trial-level generalized linear mixed modeling including all five AQ subscales revealed that higher scores on the Imagination subscale were uniquely associated with a systematic shift in decision bias (c). While observers generally exploited the statistical regularity of the repeated standard stimulus to build a stabilized internal reference consistent with the Internal Reference Model (IRM), individuals with higher Imagination scores (reflecting reduced imaginative flexibility) showed a shift toward positional anchoring, favoring whichever stimulus appeared first. These findings suggest that temporal differences along the autistic-trait dimension do not reflect a core perceptual deficit, but rather a suboptimal decision-making strategy favoring immediately available within-trial information over accumulated representational knowledge.

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10. Giorlandino C, Mesoraca A, Margiotti K, Fabiani M, Cupellaro M, Giorlandino F, Mastrandrea ML, Raffio R, Pignataro F, Mangiafico L, D’Emidio L, Coco C, Milite V. Prenatal Folinic Acid in FRAA-Positive Pregnancies: Preschool Neurodevelopmental Outcomes from a Pilot RCT Follow-Up. Nutrients. 2026; 18(18).

Background: Folate receptor alpha autoantibodies (FRAAs) during pregnancy impair placental and cerebral folate transport, predisposing the developing brain to autism spectrum disorder (ASD) through cerebral folate deficiency (CFD). A previously published pilot randomised controlled trial (RCT) showed that prenatal calcium folinate (folinic acid), compared with standard folic acid, lowered ASD incidence in the offspring of FRAA-positive mothers at 24-30 months. Mechanistically, whereas folic acid depends largely on the antibody-blocked folate receptor alpha, folinic acid (a reduced folate) enters cells through the reduced folate carrier and proton-coupled folate transporter, restoring cerebral folate delivery despite receptor blockade. We investigated whether this benefit persists at preschool age (36-50 months); the primary endpoint was verification that children born without ASD remain ASD-free. Methods: Pre-planned longitudinal follow-up of the 18 mother-child pairs who completed the original pilot RCT. Sixteen families (88.9%) were re-evaluated at a mean age of 45.4 ± 3.8 months (folinic acid, n = 9; folic acid, n = 7) using DSM-5-TR diagnosis, ADOS-2, ADI-R, WPPSI-IV, and Vineland-3, alongside standardised language and learning-prerequisite batteries. Results: The pre-specified primary endpoint was met: none of the eight folinic acid-group children who were ASD-free at 24-30 months developed ASD (0/8; 95% CI 0-36.9%). With only eight children in this subgroup, the estimate is inevitably imprecise, and we read it as pilot evidence of stability rather than proof of complete protection. Confirmed ASD at preschool age was 1/9 (11.1%) versus 5/7 (71.4%; p = 0.024). Folinic acid-exposed children showed lower ADOS-2 scores (p = 0.008), higher WPPSI-IV Full Scale IQ (p < 0.001), and superior Vineland-3 Adaptive Behaviour Composite scores (p = 0.002). Trajectory analysis showed neurodevelopmental stability in the folinic acid group versus progressive worsening in the folic acid group (p = 0.043). Conclusions: Children born without ASD to FRAA-positive mothers prenatally supplemented with folinic acid remained ASD-free at preschool age; the single folinic acid-group ASD case was attributable to a pathogenic SHANK2 variant. These findings support prenatal folinic acid as a targeted neuroprotective strategy in FRAA-positive pregnancies and warrant confirmation in larger, multicentre randomised trials.

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11. Gopukumar ST, Saha M, Bhardwaj S, Gopalakrishnan K, Alatwi ES, Alonaizan R, Alqahtani HA, Soni TK, Shamshad S, Das U. Rett syndrome: MECP2 biology, multisystem pathophysiology, and the evolving therapeutic landscape. Eur J Pediatr. 2026; 185(10).

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder arising predominantly from de novo loss-of-function mutations in MECP2, affecting approximately 1 in 10,000 live female births. MECP2 is a dosage-sensitive epigenetic regulator acting through its methyl-CpG-binding (MBD) and transcriptional-repression (TRD) domains; isoform-specific expression and X-chromosome-inactivation mosaicism drive the wide phenotypic variability, with mutation type broadly correlating with severity. Although historically viewed as neuron-centric, RTT is a multisystem disorder: beyond psychomotor regression, stereotypic hand movements, gait apraxia, and loss of spoken language, MECP2 deficiency contributes to brainstem-mediated breathing dysrhythmia, QTc prolongation, enteric dysmotility, low bone density, and mitochondrial/metabolic deficits, amplified by glial-neuronal crosstalk. Preclinical models, MECP2 rodents, patient iPSC-derived neurons, and cerebral organoids, reveal synaptic and dendritic deficits that improve substantially when MECP2 is reactivated in these systems, indicating that MECP2-deficient neurons remain viable rather than degenerating; whether comparable improvement can be achieved in affected individuals is not yet established. The therapeutic landscape now spans multidisciplinary supportive care, the first approved pharmacotherapy trofinetide, AAV-mediated MECP2 gene replacement (now in pivotal trials, with an important gene-therapy safety signal), antisense oligonucleotides for dosage normalisation, and emerging metabolic agents; validated biomarkers and objective outcome measures remain a major unmet need. CONCLUSION: RTT is a multisystem monogenic disorder whose management is shifting from symptom control toward disease modification. Phenotypic rescue after MECP2 restoration in rodent models provides the rationale for this shift but does not establish that RTT is reversible in patients; progress now depends on validated biomarkers, dose-controlled disease-modifying therapies, long-term outcome data, and equitable global access. WHAT IS KNOWN: • More than 90-95% of classic Rett syndrome is caused by de novo loss-of-function mutations in MECP2, a dosage-sensitive epigenetic reader whose isoform distribution, residual function and X-chromosome-inactivation mosaicism together account for much of the phenotypic variability. • Reactivating MECP2 in symptomatic adult rodents substantially improves many disease features, establishing that MECP2-deficient neurons are functionally impaired rather than lost and providing the rationale for disease-modifying therapy. WHAT IS NEW: • This review integrates isoform-specific and non-neuronal (glial, respiratory, cardiac, gastrointestinal, skeletal and metabolic) mechanisms with a literature base updated to 15 August 2026, and identifies the continuing absence of any validated biomarker or surrogate endpoint, rather than target identification, as the principal obstacle to efficient trials. • It critically appraises the post-trofinetide landscape – divergent FDA and EMA assessments of the same trial data, a fatal high-dose AAV hyperinflammatory event, and single-arm registrational gene-therapy programmes reported largely outside peer review – and concludes that the demonstrated outcome to date is gain or re-acquisition of developmental milestones, not reversal of established disease.

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12. Hira F, Hira S. Does the Physical Restraint Disparity Increase With Age in Autistic Youth?. J Autism Dev Disord. 2026.

McGaughey et al. reported age-stratified differences in physical restraint among autistic youth presenting to a pediatric emergency department and interpreted the findings as evidence of a progressively increasing disparity across development. We note that separate statistical significance tests within age groups do not establish that the magnitude of the association differs between age groups. In particular, the wide confidence interval in the youngest group indicates imprecision rather than evidence that no disparity is present. A direct autism spectrum disorder-by-age interaction is required to evaluate whether age modifies the association between autism spectrum disorder and physical restraint. Because the analysis does not follow the same individuals over time, the findings also represent population-level age heterogeneity rather than a within-person developmental trajectory. The study provides important evidence of overall restraint inequity, while the proposed age-dependent progression should remain hypothesis-generating until formally tested.

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13. Huang T, Wang J, Li Y, Chen O. Mindful Parenting and Emotional and Behavioural Problems in Children with Autism Spectrum Disorder: The Chain Mediating Role of Parenting Stress and Family Management. Behav Sci (Basel). 2026; 16(9).

Autism spectrum disorder (ASD) has a continuously rising global prevalence, imposing a heavy burden on affected families and society. Emotional and behavioural problems are the most common comorbidities of ASD and severely impair the long-term prognosis of affected children. While mindful parenting represents a validated positive parenting model, the internal mechanisms underlying its association with emotional and behavioural developmental outcomes in children with ASD remain unclear. This study adopted a cross-sectional design. Between April and August 2023, 268 parent-child dyads were recruited via convenience sampling from hospitals and special education settings in Jinan, China. Validated instruments were used to assess mindful parenting, parenting stress, family management, and child emotional and behavioural problems, and data were analysed using path analysis with observed variables. The results showed that the sequential chain mediation pathway was fully consistent with the data for total difficulties, with the total indirect effect accounting for 66.71% of the total association. For prosocial behaviour, the model received only partial support, with a 61.54% total indirect association, as the unique indirect path via parenting stress did not reach statistical significance. These findings indicate that mindful parenting is associated with fewer child difficulties through a sequence involving reduced parenting stress and better family management. For prosocial behaviour, this association appears primarily linked to family management, with no significant unique contribution of parenting stress. The study reveals potential family process mechanisms and can inform the development of family-centred interventions.

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14. Li J, Zhao X, Wei J, Yang W, Li R, Zhou X, Tian M, Li D, Yan X, Liu C, Zhang Y. Tmlhe deficiency induces neurodevelopmental dysfunction and synaptic excitatory/inhibitory imbalance linked to autism-like phenotypes in zebrafish. Prog Neuropsychopharmacol Biol Psychiatry. 2026; 150: 111927.

Mutations in TMLHE, the initial enzyme for carnitine biosynthesis, are linked to autism spectrum disorder (ASD). However, the molecular mechanisms by which TMLHE defects contribute to neurodevelopmental abnormalities remain elusive. This study aimed to elucidate the role of tmlhe deficiency in vertebrate neural development and its link to ASD-like behaviors using a zebrafish model. We established a tmlhe knockdown zebrafish model using morpholino microinjection. The tmlhe gene is specifically expressed in the developing nervous system, as characterized by whole-mount in situ hybridization (WISH). Its knockdown induces severe morphological defects and significant ASD-like behaviors, including impaired social interaction and delayed environmental response. Metabolomic analysis confirmed a blockage in carnitine biosynthesis, leading to deficient long-chain acylcarnitine levels and impaired fatty acid transport. Transcriptomic profiling revealed downregulation of fatty acid transport and β-oxidation pathways and negative enrichment of peroxisome proliferator-activated receptor (PPAR) signaling. Consequently, tmlhe morphants exhibited severe neurodevelopmental defects, including blocked neuronal progenitor cell differentiation, increased apoptosis in the brain, and profound disruption of synaptic function. Transcriptional alterations in glutamatergic and GABAergic receptor-related genes suggest a potential excitatory/inhibitory (E/I) imbalance. Exogenous l-carnitine supplementation successfully rescued the morphological and behavioral deficits. Our findings demonstrate that tmlhe deficiency disrupts carnitine biosynthesis, impairing energy and glycerophospholipid metabolism, which is critical for early neurogenesis. This may lead to impaired neural development and a synaptic E/I imbalance, ultimately causing ASD-like phenotypes. This study establishes a crucial link between carnitine metabolism and ASD etiology, proposing a potential therapeutic target.

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15. Menu I, Ji L, Chen B, Bhatia T, Duffy M, Trapaga S, Jacques SM, Qureshi F, Eggebrecht A, Wheelock MD, Trentacosta CJ, Thomason ME. Associations between chronic placental inflammation, fetal brain development and later autism traits. Brain Behav Immun Health. 2026; 57: 101351.

Prenatal inflammation is a recognized risk factor for autism spectrum disorder (ASD), but the neural pathways linking in utero immune exposure to later outcomes remain unclear. We examined whether chronic placental inflammation (CPI), a sustained immune response within the placenta, is associated with fetal brain functional connectivity differences and later ASD traits. A cohort of 105 pregnant individuals (85.7% African American/Black, 1.0% Asian American, 4.8% Bi-racial, 4.8% White, 1.0% Other, 2.9% Missing) underwent fetal resting-state fMRI between 24 and 38 weeks’ gestation. After delivery, placental tissues were evaluated by expert pathologists for CPI lesions. Fetuses exposed to CPI (n = 44) showed significant differences in resting-state functional connectivity (RSFC) compared to non-exposed fetuses (n = 61) across ten network pairs, with the greatest effects in prefrontal, cerebellar, visual, and motor regions. These connectivity differences were associated with behavioral outcomes: cerebellar-medial visual RSFC was the strongest prenatal predictor of ASD traits at age 3. An exploratory structural equation modeling indicated that CPI was associated with reduced cerebellum-medial visual RSFC, which was associated with higher ASD trait scores, though the indirect pathway did not reach statistical significance. This study provides the first human evidence that chronic placental inflammation is associated with large-scale fetal brain network differences that are also associated with autism traits, suggesting that prenatal immune activity may be relevant to neurodevelopmental trajectories.

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16. Merahn S. The inner life of autism: a call to action. Front Pediatr. 2026; 14: 1908533.

Autism intervention systems remain organized around observable behavior, reflecting frameworks established before network neuroscience reshaped how the condition is understood. Meanwhile, adult outcomes in employment, independent living, and social participation remain poor, and intervention trials have rarely followed children far enough to know whether they change. Differences in large-scale brain network organization appear to have reproducible implications for how autistic individuals experience participation, regulate arousal, process internal states, and sustain adaptive performance. This suggests that observable behavior is the downstream expression of network-level organization rather than its primary explanatory locus, with sustained compensatory efforts such as masking and camouflaging carrying measurable costs, including elevated risk for anxiety, burnout, and suicidality. Using joint attention as a case study, this article argues that behavioral description and neural mechanism are not interchangeable, and that training behavioral surface forms without supporting the underlying neural integration may produce assessment-satisfying performance while leaving core developmental functions unaddressed. Rather than asserting a new model of care, the article poses a translational challenge to the pediatric community: to examine whether these network differences should inform the next evolution of autism care, incorporating regulatory capacity, interoceptive awareness, and executive burden as clinical considerations alongside-not merely in service of-observable behavior.

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17. Merwana JU, Kalrao VR, Chaudhry R, Srivastava L. Association of iron deficiency and iron-deficiency anemia with behavioral problems in children with autism: a cross-sectional study. Front Psychiatry. 2026; 17: 1900958.

PURPOSE: Iron deficiency (ID) and iron deficiency anemia (IDA) are common in children with autism spectrum disorder (ASD) and may contribute to behavioral problems. We examined their association with internalizing and externalizing behavioral problems. METHODS: This cross-sectional study (October 2023 to March 2025) was conducted at a tertiary hospital in India. Of 179 children aged 2 to 18 years with newly diagnosed ASD (DSM-5 criteria), 173 were analyzed after six exclusions for missing data. ID and IDA were defined using age-specific World Health Organization thresholds and modeled as a three-category variable with normal iron status as the reference. The Child Behavior Checklist was used to assess internalizing and externalizing problems (T-score > 63). Multivariable logistic regression was used to estimate adjusted odds ratios (aORs), controlling for age, sex, maternal education and family type; ferritin and hemoglobin were modeled using restricted cubic splines. Bonferroni correction was applied across the six adjusted comparisons. RESULTS: Among 173 children (median age 4.0 years [IQR 3.0-5.0]; 79.8% male), 19.7% had ID, 22.5% had IDA and 42.2% had either; internalizing and externalizing problems occurred in 39.9% and 35.8% of the children, respectively. Compared with normal iron status, both ID and IDA were associated with higher odds of internalizing problems (ID aOR 3.03, 95% confidence interval [CI] 1.34-6.86; IDA aOR 2.73, 95% CI 1.23-6.05) and externalizing problems (ID aOR 3.71, 95% CI 1.63-8.46; IDA aOR 3.24, 95% CI 1.45-7.24), corresponding to prevalence differences of 25 to 29 percentage points. An interquartile increase in ferritin (9.2 to 21.4 µg/L) was associated with lower odds of both outcomes (internalizing aOR 0.23, 95% CI 0.11-0.46; externalizing aOR 0.30, 95% CI 0.15-0.60). Five of six associations survived Bonferroni correction; IDA with internalizing problems did not. Hemoglobin was not consistently associated with either outcome. CONCLUSIONS: ID and IDA are prevalent in Indian children with ASD and are associated with clinically significant behavioral problems, with higher serum ferritin inversely associated with both outcomes. Routine iron screening may be considered during initial ASD evaluation, particularly in high-burden settings, although randomized trials are needed to determine whether correcting deficiency improves behavioral outcomes.

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18. Muris P, Voermans L, Paes L, Langen I, Sollman E. Correlates of Selective Mutism in Young Children: A Preliminary Investigation of Social Anxiety, Autistic Traits, Extreme Demand Avoidance, and Sensory Processing Sensitivity. Clin Child Psychol Psychiatry. 2026: 13591045261487890.

Selective mutism (SM) is an infrequent pediatric condition defined by a sustained inability to speak in specific social contexts, despite demonstrating age-appropriate verbal communication in settings perceived as safe or familiar, such as the home environment. This parent-report survey study examined the roles of social anxiety, autistic traits, extreme demand avoidance, and sensory processing sensitivity in 3- to 6-year-old children with a diagnosis of SM (n = 11) and non-clinical peers (n = 55), of whom a considerable proportion also exhibited elevated levels of SM symptoms (n = 22). Results indicated that children with SM displayed significantly higher levels of social anxiety, autistic traits, extreme demand avoidance, and sensory processing sensitivity than their non-clinical counterparts. Additional analyses showed a gradient across clinical, subclinical, and non-clinical groups, with children with diagnosed SM scoring highest across all measures, children with elevated SM symptoms showing intermediate scores, and non-clinical controls scoring lowest. Correlational analyses revealed that greater SM severity was associated with elevated levels across all measured traits. These findings highlight that, in addition to the established contributions of social anxiety and autistic traits, extreme demand avoidance and sensory processing sensitivity may also contribute to the clinical profile of children with SM. Selective mutism (SM) is a rare condition in young children where they are unable to speak in certain social situations, such as at school or with unfamiliar people, even though they can speak normally in places where they feel safe, like at home. This study looked at whether several characteristics – social anxiety, autistic traits, extreme demand avoidance (a strong resistance to everyday demands), and sensory processing sensitivity (being very sensitive to sounds, textures, or other sensory experiences) – are related to selective mutism. Parents of 66 children aged 3 to 6 completed surveys: 11 children had selective mutism and 55 did not. The results showed that children with selective mutism had higher levels of social anxiety, autistic traits, extreme demand avoidance, and sensory sensitivity compared with children without the condition. The study also found that children with more severe selective mutism tended to show higher levels of all these characteristics. These findings suggest that, besides social anxiety and autistic traits – which are already known to be related to selective mutism – extreme demand avoidance and sensory sensitivity may also be important parts of the condition in young children. Understanding these factors may help researchers and clinicians better understand and support children with selective mutism. eng.

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19. Mutlu A, Cemali M, Köklü Şimşek FN, Uygun MN. Association Between Autism Severity and Feeding Behaviors in Children: A Cross-Sectional Study. Am J Occup Ther. 2026: 19437676261478045.

ImportanceFeeding difficulties are common in autistic children, but their relationship with autism severity remains unclear.ObjectiveTo examine differences in feeding behaviors according to autism severity and investigate associations between selected autism symptom domains and feeding behaviors in autistic children.DesignCross-sectional study.SettingSpecial education and rehabilitation center.ParticipantsEighty-two autistic children aged 4-8 years participated. Based on Childhood Autism Rating Scale (CARS) scores, 42 children were classified into the mild-to-moderate group and 40 into the severe group.Outcomes and MeasuresAutism severity was assessed using CARS. Feeding behaviors were evaluated using the Behavioral Pediatric Feeding Assessment Scale (BPFAS).ResultsChildren in the severe group showed significantly higher total and subdomain BPFAS scores than children in the mild-to-moderate group (p < .05). Significant positive associations were observed between selected CARS domains and feeding behavior problems. The strongest associations were observed for sensory-related characteristics (taste, smell, and touch response and use), relating to people, and fear or nervousness. In contrast, emotional response showed weaker but significant associations (p < .05). Regression analysis showed that autism severity significantly predicted feeding difficulties and explained 65.1% of the variance in BPFAS scores (adjusted R(2) = .651, p < .001).Conclusions and RelevanceFeeding behavior problems were more pronounced in children in the severe group, and autism severity emerged as a clinically relevant predictor of feeding difficulties. Sensory-related and socioemotional characteristics demonstrated meaningful associations with feeding behaviors, supporting the importance of individualized and multidisciplinary assessment and intervention in autistic children. Children in the severe group showed greater feeding problems, especially food refusal and food selectivity. Feeding difficulties were associated with sensory-related, social, and emotional-behavioral characteristics, highlighting the importance of early multidisciplinary support for autistic children and their families. eng.

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20. Natu VS, Tyagi C, Yan X, Tung S, Kubota E, Karakose-Akbiyik S, Wu H, Mezer A, Drori E, Wang N, Liao C, Cao X, Setsompop K, Grill-Spector K. Postnatal maturation of putamen microstructure accompanies topographic white matter connectivity and altered circuits in autism. bioRxiv. 2026.

The putamen is a major hub of the basal ganglia that emerges early in gestation. However, whether its mature organization is established before birth or emerges postnatally remains unknown. Using cross-sectional and longitudinal quantitative MRI (R (1) and R (2) *, related to tissue density and iron, respectively), and diffusion MRI, we characterized the development of putamen’s microstructure and its white matter connectivity with cortex from birth to 12 months and compared their trajectories with those in adults. Despite its prenatal emergence, the putamen undergoes substantial postnatal development. R (1) increases from birth to 12 months, producing a prominent anterior-posterior gradient, whereas R (2) * increases primarily between age one and adulthood, producing a medial- lateral gradient. Cortico-putamen white matter connectivity is diffuse in infants but becomes topographic in adults, with anterior putamen linked to frontal cortex and posterior putamen to sensorimotor cortex. In autism spectrum disorder, this organization is largely preserved and accompanied by increased anterior putamen-prefrontal connectivity. Our findings reveal distinct spatial developmental trajectories of putamen microstructure and cortical connectivity providing a developmental framework for understanding the organization of the putamen in infancy, which has implications for assessing neurodevelopmental disorders of the basal ganglia. TEASER: From birth to one year, the putamen develops distinct microstructural gradients and increasingly topographic cortical connections.

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21. Oh A, Kwon D. Flow in screen-based gamified virtual reality sports: development and validation of a behaviorally anchored proxy rating scale for adolescents with autism spectrum disorder. Front Public Health. 2026; 14: 1947117.

BACKGROUND: Adolescents with autism spectrum disorder (ASD) face substantial barriers to physical activity participation because of motor coordination difficulties, sensory hypersensitivity, and motivational challenges. Screen-based gamified virtual reality (VR) sports have emerged as a promising alternative, with flow identified as a key psychological mechanism underlying their effects. However, alexithymia and atypical interoceptive processing in adolescents with ASD render conventional self-report flow scales inappropriate for this population. This study aimed to develop and validate a behaviorally anchored rating scale (BARS)-format proxy assessment tool, VR-Flow-BARS, that lets observers evaluate the flow-related behaviors of adolescents with ASD during VR sports participation. METHODS: Eighteen preliminary items were developed from flow theory and the theoretical framework underlying the Flow State Scale-2. An eight-member expert panel of specialists in adapted physical education, ASD education, and VR sports evaluated the items against three criteria: content validity, observability, and appropriateness for ASD. The items were refined through cognitive interviews (n = 8) and pilot testing (n = 30). Exploratory factor analysis (EFA) using principal axis factoring with direct oblimin rotation was conducted on Sample 1 (n = 100), followed by confirmatory factor analysis (CFA) on Sample 2 (n = 200). Reliability was assessed using Cronbach’s α, composite reliability (CR), and the intraclass correlation coefficient (ICC) (2,1). Validity was examined using the average variance extracted (AVE), the Fornell-Larcker criterion, and the heterotrait-monotrait (HTMT) ratio. RESULTS: The expert review yielded an item-level content validity index of 1.00 and a scale-level content validity index of 1.00 across all three criteria for the 15 retained items; the factor « sensorimotor flow expression » (with three items) was deleted for conceptual overlap and limited observability. EFA identified a five-factor structure accounting for 68.394% of the total variance. CFA demonstrated acceptable model fit (χ (2)/df = 2.000, comparative fit index = 0.969, Tucker-Lewis index = 0.959, root mean square error of approximation = 0.071), with standardized factor loadings ranging from 0.763 to 0.940. Internal consistency was high (Cronbach’s α = 0.864-0.946; CR = 0.868-0.946). Inter-rater reliability (ICC) ranged from 0.729 to 0.910 (indicating moderate to excellent reliability). AVE values ranged from 0.687 to 0.854, satisfying the convergent validity criterion of 0.50, and HTMT values for all factor pairs were below 0.90 at the point-estimate level; however, the 95% bootstrap confidence interval for the FR-CEP pair [0.851, 0.939] extended beyond 0.90, indicating borderline discriminant validity for this factor pair. CONCLUSION: To our knowledge, VR-Flow-BARS tool is the first BARS-format proxy assessment instrument developed to evaluate flow-related behaviors in adolescents with ASD during screen-based gamified VR sports. It demonstrates an acceptable factor structure, high internal consistency, adequate inter-rater reliability, and internal structural validity. This scale may serve as a practical tool for the real-time monitoring of immersive behaviors and individualized intervention design in VR-based physical activity programs for adolescents with ASD who have mild-to-moderate educational support needs and are able to engage in VR tasks with routine prompting. Future research should address external criterion-based validation, test-retest reliability, and applicability across a broader range of ASD severity levels.

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22. Riestra JM, Alabed ST, Riestra DB, Jaffry M, Guo S, Iyer P, Szirth BC, Khouri AS, Hussain NU. Vision Care Pathway Measures and Vision Outcomes in US Children With Mental, Emotional, Developmental, or Behavioral Problems: National Survey of Children’s Health 2019-2023. Prim Care Companion CNS Disord. 2026; 28(5).

Objective: Children with mental, emotional, developmental, or behavioral (MEDB) problems may face higher risk of vision concerns and more complicated care pathways. The objective of this study was to evaluate whether vision care utilization, screening/referral steps, and vision-related outcomes differ by MEDB status in US children. Methods: A cross-sectional analysis was conducted using National Survey of Children’s Health (NSCH) Interactive Data Query outputs for children aged 3-17 years from 2019-2023. MEDB status was defined by the NSCH composite indicator (≥1 qualifying condition and/or meeting emotional/behavioral/developmental criteria). We extracted survey-weighted prevalence estimates (95% CIs) for eye doctor exam/visit, non-eye-doctor screening, postscreening recommendations, diagnosis of a nonrefractive vision disorder, unmet vision care need, and functional vision limitation despite correction. Between-group differences were tested using 2-sided comparisons of weighted proportions. Results: In 2023, children with MEDB issues had higher rates of having seen an eye doctor, non-eye doctor vision screening, and recommendations for eye exams (P<.001). Diagnosis of a nonrefractive vision disorder was also higher in the MEDB group (P=.005). Unmet vision care need did not differ by MEDB status (P=.599). Functional vision limitation despite correction was numerically higher among children with MEDB in most years but not significant in 2023 (P=.274). Conclusion: US children with MEDB problems report more screening, referrals, and eye doctor contact and higher rates of nonrefractive vision disorder diagnosis compared with peers without MEDB. Differences in unmet need were minimal, suggesting that follow-up and care coordination after screening/referral may be targets for improving vision-related outcomes. Prim Care Companion CNS Disord 2026;28(5):26m04278. Author affiliations are listed at the end of this article.

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23. She H, Dai X, Deng T, Liu R, Jiang W, Ma X. A pilot randomized controlled study of a digital art therapy paradigm for children with ASD: integrating pivotal response treatment into video animation and physical model design. Front Psychiatry. 2026; 17: 1894877.

BACKGROUND: The integration of digital technology into art therapy for children with autism spectrum disorder (ASD) represents an emerging trend, yet systematic design frameworks that translate evidence-based interventions into digital media remain underdeveloped. This study developed and evaluated a digital art therapy paradigm that structurally integrates pivotal response treatment (PRT) into video animation design while maintaining cross-media consistency with physical generalization tools. METHODS: Based on the behavioral characteristics of children with ASD, 12 sets of video animations integrating PRT and corresponding physical scene models were custom developed. Thirty-eight children with mild to moderate ASD were randomly assigned to an intervention group (PRT-based video animation with physical models, n=19) and a control group (conventional video animation, n=19) for a 12-week intervention. Pre- and postintervention assessments were conducted using four dimensions of the Autism Treatment Evaluation Checklist (ATEC) and behavioral observation. RESULTS: Compared with the control group, the intervention group demonstrated significantly greater improvements across all ATEC dimensions (language communication: F(1,36) = 67.74, p < 0.001, ηp² = 0.755; social skills, F(1,36) = 80.69, p < 0.001, ηp² = 0.786; sensory/cognitive awareness: F(1,36) = 55.69, p < 0.001, ηp² = 0.717; health/physical behavior, F(1,36) = 36.94, p < 0.001, ηp² = 0.627. The percentage of children who reported " no observable behavioral response" in the intervention group decreased from 35% to 10%. CONCLUSIONS: This pilot randomized controlled study provides preliminary evidence for the feasibility and efficacy of a multi-component, PRT-informed digital and physical intervention package for children with ASD. The intervention is characterized by three design principles: (1) theoretical translation--embedding the structured steps of PRT into digital interaction logic; (2) cross-media consistency--maintaining visual and functional coherence between video animations and physical generalization tools; and (3) progressive scaffolding--sequencing intervention content from foundational cognition to complex social skills. These findings offer a preliminary design framework for the development of digital art therapy interventions for children with ASD. Future large-checklist replication studies are needed to further validate this approach.

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24. Su X, Ge J, Yang X. Social Functioning Profiles in Children with Autism Spectrum Disorder in China: A Preliminary Identification of Subtypes. Behav Sci (Basel). 2026; 16(9).

Children with autism spectrum disorder (ASD) exhibit considerable heterogeneity in social functioning, suggesting the existence of distinct latent subtypes. A total of 479 Chinese children diagnosed with ASD (M(age) = 9.338 years) were assessed using the Mandarin translation of the Stanford Social Dimensions Scale (SSDS). This measure aims to better comprehend individual differences in key social dimensions in ASD. Using the latent profile analysis (LPA) method, four profiles were identified and named based on their characteristics, and differences among the profiles were validated using data from the Full-scale Intelligence Quotient (FSIQ), Social Communication Questionnaire (SCQ), Strengths and Difficulties Questionnaire (SDQ), and Social Responsiveness Scale-Second Edition (SRS-2). The results revealed that (1) the social functioning level of children with ASD can be divided into four profiles: Risky, Apathetic, Active but Awkward, and Advantageous. (2) Children in the Advantageous profile showed fewer ASD-related symptoms and more prosocial behaviors than those in the other profiles. This study offers preliminary evidence for the heterogeneity of social functioning in children with ASD, serving as a step toward precision-based social interventions and inclusive educational support.

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25. Wallace S, Lawes S, Scheck AC, Frye RE. Cunermuspir, a Copper(I)-Niacin Complex, Modulates Mitochondrial Respiration and Cellular Oxidant Handling in Fibroblasts from Children with Autism Spectrum Disorder. Antioxidants (Basel). 2026; 15(9).

Copper is a redox-active transition metal that is essential for the assembly and catalytic function of cytochrome c oxidase (Complex IV), the terminal enzyme of the mitochondrial electron transport chain and a principal site of physiological oxygen reduction. Elevated Complex IV activity and respiratory chain uncoupling are among the most consistently replicated biological findings in autism spectrum disorder (ASD), yet the interaction between mitochondrial copper delivery, respiration, and cellular oxidant handling in ASD has not been systematically defined. We treated dermal fibroblasts from 9 children with ASD and 10 typically developing controls with the copper(I)-niacin complex Cunermuspir (0, 50, or 100 µM for 1 or 24 h exposure) and challenged them with graded concentrations (0-5.0 µM) of the redox-cycling agent 2,3-dimethoxy-1,4-naphthoquinone (DMNQ). Mitochondrial respiration was profiled by Seahorse XF respirometry (2133 observations across 28 experiments), and cellular reactive oxygen species (CellROX™ Green) and mitochondrial mass/polarization (MitoTracker™ Deep Red) were quantified by fluorescence imaging. ASD fibroblasts displayed a hypermetabolic, uncoupled respiratory phenotype (~73% higher baseline respiration; ~109% higher proton leak; reduced coupling efficiency). Linear mixed models with polynomial dose terms revealed significant ASD × Cunermuspir complex interactions (ASD × Cunermuspir and/or their higher-order interactions with DMNQ and treatment) for four respiratory parameters. ASD cells exhibited lower steady-state oxidation-dependent CellROX™ Green fluorescence than controls despite greater respiratory uncoupling, as well as lower steady-state MitoTracker™ Deep Red fluorescence; Cunermuspir reshaped the MitoTracker™ DMNQ dose-response in an ASD-selective manner. These findings identify the Cunermuspir-associated modulation of the ASD mitochondrial and oxidant handling phenotype and motivate further mechanistic and translational evaluation.

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26. Wang X, Huang X. Barriers to oral healthcare for autistic children in China. Front Psychiatry. 2026; 17: 1910959.

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27. Wang X, Tong J, Luo L, Lv P, Huang Q, Zheng Y, Zhou S, Gan H, Geng M, Tao S, Tao X, Gao G, Yan S, Wu X, Huang K, Cao Y, Lu M, Gao H, Tao F. Association of prenatal co-exposure to OPEs and PAEs with ASD symptom trajectories in preschool children: the modifying role of vitamin D. Environ Int. 2026; 216: 110510.

INTRODUCTION: Few studies have examined prenatal co-exposure to organophosphate esters (OPEs) and phthalic acid esters (PAEs) in relation to childhood autism spectrum disorder (ASD) symptoms, and whether vitamin D modifies these associations. METHODS: Included 2400 mother-child dyads from the Ma’anshan Birth Cohort and examined levels of maternal OPEs, PAEs, and vitamin D across the three trimesters. Used the Clancy Autism Behavior Scale to assess preschoolers’ ASD symptoms at ages 3, 5, and 6, then used group-based trajectory modeling to fit ASD symptom trajectories. RESULTS: ASD symptom scores fit 3 trajectories: low, moderate, and high. Average-MEOHP, average-ΣHMWP, first-trimester-ΣHMWP, third-trimester-DPHP, and third-trimester-BCIPP were associated with increased risk in the moderate group (p < 0.05). Average-MMP, average-ΣHMWP, second-trimester-BEHP, and third-trimester-ΣHMWP were associated with increased risk in the high-score group (p < 0.05). By contrast, first-trimester-BCIPP was negatively correlated with the moderate group. DPHP, DBP, and Σdi-OPEs showed sex-specific effects (p(sex-int) < 0.05). Maternal vitamin D levels modified these associations, with women with vitamin D deficiency showing significantly higher risks. OPEs and PAEs showed mixed effects. CONCLUSION: Prenatal exposure to OPEs/PAEs exhibited heterogeneous associations with preschoolers' ASD symptom trajectories, and maternal vitamin D deficiency exacerbates the effects of OPEs/PAEs individual exposure on symptom trajectories.

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28. Xin Y, Liu J, Dai T, Xia T. Age-stratified fat-soluble vitamin profiles and exploratory analyses of potential links to disease risk and core autistic symptoms among children with ASD: a propensity score matching case-control study. Front Psychiatry. 2026; 17: 1892933.

OBJECTIVE: To evaluate serum levels of fat-soluble vitamins (vitamin D3 (VD3), vitamin D2 (VD2), vitamin A (VA), total vitamin D (total VD), and vitamin E (VE)) in children with autism spectrum disorder (ASD), to analyze their correlation with autistic symptoms, and provide a theoretical basis for clinical nutritional intervention in ASD. METHODS: A propensity score matching (PSM) case-control study was designed, enrolling 50 children diagnosed with ASD at Wuhan Children’s Hospital from January 2023 to December 2025 and 50 typically developing (TD) children undergoing routine physical examinations. With age, sex, BMI and season of blood sampling as covariates, Analysis of covariance (ANCOVA) was used to analyze the differences in fat-soluble vitamin levels between the ASD and TD groups. Conditional logistic regression was used to analyze the association between fat-soluble vitamin levels and the risk of ASD. Benjamini-Hochberg (BH) false discovery rate (FDR) correction was applied for multiple testing of all the vitamin indicators. Pearson correlation analysis was employed to examine the relationship between vitamin levels and autistic symptoms. RESULTS: After adjustment, serum levels of VD3 and VE in the ASD group were significantly higher than those in the TD group (p < 0.05). Significant age-by-group interactions were observed for VE, VD3, and total VD. Age-stratified ANCOVA analysis showed that the log-transformed VD3 (log VD3) elevation in ASD versus TD children was significant only in the older subgroup and increased with age, whereas no significant group differences were detected for total VD or VE within either age stratum. Our findings revealed no statistically significant association between VD3 levels and ASD risk or core symptoms. CONCLUSION: Age-dependent subtype-specific differences of fat-soluble vitamins exist in children with ASD, with higher log VD3 only observed in older autistic patients. Unadjusted analyses showed tentative correlations between VD3 and ASD risk as well as repetitive behaviors, which disappeared after FDR correction. Clinically, VD3 and total VD should be assessed separately by age for autistic children. Routine VD screening, with longitudinal monitoring tailored to age, is recommended to guide personalized nutritional management.

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29. Yamada T, Kurita K, Nishimura T, Fujii M, Yoshizaki A, Yamamoto T, Iwatani Y, Hirata I, Honaga E, Kimura R, Tachibana M, Mohri I, Kawasaki R, Endo M, Takahashi N, Katayama T, Tsuchiya KJ, Kagitani-Shimono K. Transdiagnostic child mental health trajectories in Japan: protocol for a nationwide web‑based open cohort study. BMC Psychiatry. 2026; 26(1).

BACKGROUND: Preventive psychiatry requires longitudinal, transdiagnostic data from before adolescence, yet such data are scarce. We propose a nationwide, digital, open cohort in Japan to track mental health trajectories from birth to late adolescence using multi-informant assessments (caregivers and adolescents) within a transdiagnostic, biopsychosocial framework. Diagnosis-open recruitment will combine community-facing dissemination with clinically linked neurodevelopmental enrichment (e.g. autism spectrum disorder and attention-deficit/hyperactivity disorder), addressing underrepresentation of neurodivergent children and adolescents alongside neurotypical peers. An optional saliva sub-cohort will support genetic and epigenetic analyses. This design will characterize risk and protective factors and their developmental timing to inform stage-specific prevention and early intervention. METHODS: From February 2026, approximately 7,000 children and caregivers (up to ~14,000 individuals) will be recruited nationwide from community and clinical settings into a longitudinal online cohort. Eligible participants are caregivers aged ≥ 18 years of children and adolescents aged 0-18 years; adolescents aged 13-18 years will also complete self-reports. Enrollment and annual follow-ups will use a secure web platform integrated with LINE, a widely used communication app in Japan. Validated questionnaires will annually assess mental health and development: caregivers report on all children, and adolescents provide self-reports. The principal repeated transdiagnostic outcome is the caregiver-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score across ages 2-18 years. Adolescent self-reported scores will be analyzed as complementary informant-specific secondary outcomes. Longitudinal mixed-effects models will examine developmental changes and associations with risk and protective factors, with exploratory genetic and epigenetic analyses. DISCUSSION: This large longitudinal cohort will generate insights into child and adolescent mental health trajectories in Japan. Following participants from infancy through adolescence will help identify early risk and resilience indicators across traditional diagnoses. Integrating multi-informant surveys with genetic and epigenetic data will clarify how biological, psychological, and social factors interact over time. Nationwide digital recruitment aims to broaden geographic reach and reduce burden; representativeness will be empirically evaluated and findings interpreted cautiously. Results will inform the timing and targets of stage-specific preventive and early interventions in community and clinical settings. TRIAL REGISTRATION: Japan Registry of Clinical Trials (jRCT), jRCT1050250205. Registered on 26 January 2026.

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30. Yao L, Valderrama-Hincapié C, Song J, Kelly IL, Chuong EB, Kasinath V. Structures of MeCP2 bound to nucleosomes reveal distinct mechanisms of Rett syndrome mutations. bioRxiv. 2026.

Methyl-CpG binding protein 2 (MeCP2) is a chromatin-associated regulator essential for neuronal gene regulation, and pathogenic mutations in MeCP2 cause Rett syndrome (RTT). However, the mechanisms governing MeCP2 engagement on chromatin and the effects of RTT mutations on nucleosome interactions remain poorly understood. We determined cryo-EM structures of MeCP2 bound to mono-nucleosomes with or without linker DNA methylation. In the absence of linker DNA methylation, the methyl-CpG binding domain (MBD) engages nucleosomal DNA near superhelical location ±7, whereas a methylated linker CpG redirects MBD to the linker methylation site. Quantitative EMSA, MNase footprinting, and fluorescence polarization show that both MBD and AT-hook regions cooperate to stabilize nucleosome binding, and that six common RTT variants (R133C, T158M, R306C, R168X, R255X, R270X) fall into four mechanistic classes. Loss-of-function truncations progressively weaken binding, whereas missense variants show near-WT DNA affinity. Among the variants, R133C shows near wild-type affinity for naked DNA but loses methylation-directed nucleosome engagement. Our analysis of human neuronal transcriptomic and chromatin occupancy datasets showed that RTT variants R133C and R168X lose CpG-island specificity and redistribute in the genome through distinct biochemical routes. Together, this work establishes a framework linking variant-specific defects in nucleosome binding to chromatin-targeting failure and transcriptional dysregulation in RTT.

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31. You M, Zhou S, Zhou J, He X, Wu K, Ran J, Mei J, Tao J, Chen Y, Zhang X, Yang G, Zhou H. Glyphosate exposure and epigenetic-environmental interactions in ASD: The role of circTiam1. J Hazard Mater. 2026; 517: 143566.

Glyphosate (Gly), the most widely used agrochemical, is epidemiologically linked to escalating autism spectrum disorder (ASD) prevalence, yet mechanisms remain elusive. A mouse model of gestational and lactational glyphosate-based herbicide (GBH) exposure (0.10-1.00%) was established to assess ASD-like neurodevelopmental effects. Neural and microglial cell lines (mouse BV2, human HMC3) were used to elucidate mechanisms of GBH-induced neurodevelopmental deficits. GBH induced dose-dependent ASD-like behaviours, including stereotyped repetitive actions and social impairments, without anxiety-like alterations. These behavioral changes were accompanied by neuronal injury and synaptic loss in the medial prefrontal cortex (mPFC). Mechanistically, GBH selectively upregulated CACNA2D3 in microglia, but not neurons, elevating microglial Ca²⁺ levels, promoting pro-inflammatory cytokines, and activating NF-κB signaling, while impairing phagocytosis. High-throughput circular RNA (circRNA) sequencing identified upregulated circTiam1, which sponges miR-128-3p to derepress CACNA2D3, confirmed by knockdown/overexpression and binding assays. Serum circTiam1 was elevated in children with ASD and positively correlated with Childhood Autism Rating Scale and Social Responsiveness Scale scores. These findings delineate a novel circTiam1/miR-128-3p/CACNA2D3 axis mediating microglial dysfunction, possibly contributing to ASD-like behaviors following GBH exposure, underscoring critical epigenetic-environmental interactions. Future studies using in vivo, microglia-targeting models and independent clinical cohorts are needed to determine the mechanistic, biomarker, and translational relevance of circTiam1.

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32. Zhang F, Cheng L, Shu L, Zheng X, Huang J, Wang J, Wang Y, Zhang S. Altered intertemporal decision-making in individuals with high autistic traits. Behav Brain Res. 2026; 516: 116466.

BACKGROUND: Intertemporal decision-making integrates reward valuation, executive control, and temporal processing. Although individuals with high autistic traits (HAT) often display altered decision-making, the cognitive characteristics associated with altered intertemporal choice remain unclear. METHODS: Eighty-one participants completed an intertemporal choice task assessing preferences for sooner-smaller versus later-larger rewards. Delay discounting rates and delayed choice proportions were adopted as behavioral indicators of temporal reward preference. Measures of inhibitory control, working memory, and cognitive flexibility were also administered. RESULTS: Compared with the LAT group, individuals with HAT showed a stronger preference for sooner-smaller rewards across multiple reward difference conditions and exhibited higher delay discounting rates. No significant group differences were observed in subjective reward attractiveness ratings, suggesting that altered intertemporal choices were unlikely to be explained by differences in reward valuation. Regarding executive function, the HAT group showed poorer performance on backward digit span and Stroop Word performance, whereas no significant group difference was observed in Stroop interference performance. Although Stroop interference was significantly associated with delay discounting in the HAT group, this association was not significantly different from that observed in the LAT group. Trial-level GLMM analyses further indicated that individuals with HAT showed a reduced probability of selecting LL rewards after accounting for reward magnitude and delay duration, without altered sensitivity to these task-related factors. CONCLUSIONS: Individuals with HAT exhibit altered intertemporal decision-making characterized by a stronger preference for immediate rewards and steeper delay discounting. The association between conflict resolution efficiency as a subdimension of inhibitory control and this type of decision-making pattern refines our understanding of the cognitive factors related to impulsive choices in individuals with subclinical autistic traits. However, the present findings do not establish inhibitory control or working memory as specific mechanisms underlying altered intertemporal decision-making. Further research incorporating multidimensional cognitive assessments and direct measures of underlying mechanisms is needed.

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33. Zhao P, Chen X, Bellafard A, Murugesan A, Quan J, Aharoni D, Golshani P. Cell-type-specific disruption of nucleus accumbens social representations in a mouse model of autism. Neuron. 2026.

How cell-type-specific nucleus accumbens (NAc) circuits encode social interactions, and whether this encoding is disrupted in autism spectrum disorder (ASD), remains unresolved. Using longitudinal miniscope calcium imaging and optogenetics in mice, we show that NAc core population activity selectively encodes social interaction and that NAc inhibition enhances sociability. In Cntnap2(-/-) mice, both acute and cross-day social representations are degraded, and NAc inhibition persistently improves sociability. Cell-type-specific recordings and optogenetics reveal opposing medium spiny neuron (MSN) contributions: D1-MSNs promote sociability, and D2-MSNs suppress it. Cntnap2(-/-) mice exhibit selective depletion of socially excited D1-MSNs and socially inhibited D2-MSNs, along with impaired cross-day population decoding. D2-MSN inhibition improves social behavior in Cntnap2(-/-) mice, and D1-MSN activation does not. Together, these findings link disrupted, cell-type-specific NAc social representations to ASD-related social dysfunction and suggest that targeted modulation of NAc activity may improve social behavior.

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