1. Ayaz E, Özcan GH, Şahin M, Özer D. Effects of physical activity program on psychomotor and psycho-social characteristics of autistic children. Sci Rep;2026 (Jan 12)

The aim of this study was to examine the effect of Physical Activity Program (PAP) on psychomotor and psychosocial characteristics of autistic children. In this study, a mixed-methods sequential exploratory design consisting of two stages, quantitative and qualitative, was used. The research group consisted of a total of 40 participants (girls n = 20, boys n = 20), aged between 8 and 12 years, with 20 in the control group (CG) and 20 in the experimental group (EG). EG participated in the PAP for 60 min a day, 3 days a week for 10 weeks. Gilliam Autistic Disorder Rating Scale-2 (GARS-2), Bruininks-Oseretsky motor competence test-2 short form (BOT-2 SF), Eurofit Test Battery, Pediatric Quality of Life Form and Social Skills Rating System Parent Form were used in the study. Mann Whitney U test was used for two-group comparisons of parameters that did not show normal distribution, and Wilcoxon signed-rank test was used to examine the changes between pretest and posttest measurements. Significance was evaluated at p < 0.05 level. The thematic analysis method was used for the focus group interview, one of the qualitative research methods.After PAP, a statistically significant difference was found in favor of EG in all subtests of GARS-2 and in total standard scores (p < 0.05). The increase in all subtests and total scores of the BOT-2 was higher in favor of the EG (p < 0.05), and an increase in performance in all subtests of the Eurofit test battery was detected (p < 0.05). The positive effects of PAP on social skills and quality of life were supported by qualitative findings, but quantitative findings did not reveal a significant change (p > 0.05). Effect size analyses showed that the program produced moderate effects on autistic symptoms (r = 0.3-0.5), very large effects on motor skills (r = 0.8-1.5), and large effects on physical fitness variables (r = 0.6-0.9). 10 weeks of PAP applied to autistic children seems to be sufficient to provide positive effects on motor skills, physical fitness and autistic disorder index, but longer programs are needed for more striking effects on quality of life and social skills.

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2. Cuitavi J, Martínez-Rodríguez E, Abellán-Álvaro M, Rodríguez-Agut M, García-Arencibia M, Santos M, Hipólito L, Forte A, Agustín-Pavón C, Torres-Pérez JV. Longitudinal analysis in Mecp2-het female mice reveals atypical nociceptive behaviours. J Mol Med (Berl);2026 (Jan 13);104(1):28.

Rett Syndrome (RTT), a neurodevelopmental disorder predominantly affecting females, is characterised by evolving symptoms impacting motor and sensory domains. Herein, we present a study of longitudinal analyses, from 2- to 6-month of age, of Mecp2 heterozygous (Mecp2-het) female mice to comprehensively explore pain perception in RTT. Interestingly, we found a significant variability in the timing and progression of symptom onset among Mecp2-het females, with individuals classified as either early- or late-symptomatic based on the emergence of hallmark neurological features such as clasping and gait abnormalities. This variability pinpoints the heterogeneity of the disease model and highlights the need to stratify Mecp2-het females by symptom onset in future studies to account for the diverse trajectories of disease progression. Additionally, our results reveal a shift from presymptomatic hypersensitivity in the von Frey test to apparent hyposensitivity, intricately linked with the onset of motor symptoms. Further, we found decreased neuronal activation in 6-month-old Mecp2-het females after the hot plate test in the periaqueductal grey, as measured by cFos expression, which does not happen with younger presymptomatic Mecp2-het females. Similarly, there is a lower expression of cannabinoid receptor 1 (CB1) in this area when compared to wild-type siblings. Taken together, our results suggest that both motor impairment and a possible dysregulation of endogenous analgesia might contribute to aberrant sensitivity in Mecp2-het mice. Our study emphasises the presymptomatic phase as crucial for understanding sensory abnormalities in Mecp2-het mice and highlights the challenges in identifying pain in RTT patients. KEY MESSAGES: Mecp2-het mice show early hypersensitivity to stimuli that shifts with age. Classification of Mecp2-het mice by symptom onset shows phenotypic variety. Mecp2-het mice show lower PAG activity when facing a thermal stimulus. Mecp2-het mice show decreased activity and CB1 receptor levels in the PAG.

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3. Cukier SH, Maglio A, Berman J, Arduini M, Barrios N, Ngue M, Montiel C, Ferrea ME, Gutson K, Zieba E, Menassé M, Grodberg D. [Not Available]. Vertex;2026 (Jan 10);36(170, oct.-dic.):14-30.

Introducción: El examen del estado mental en autismo (AMSE, por sus siglas en inglés) es un instrumento breve completado por el clínico que estructura la observación y documentación de los signos y características socio-comunicativas y conductuales del autismo. En su versión original en inglés demostró alta precisión en la identificación del trastorno del espectro autista (TEA). El presente estudio explora la sensibilidad y especificidad de una versión de AMSE en lengua española en una muestra argentina de 313 sujetos, frente al diagnóstico de consenso clínico utilizando los criterios del DSM-5. Materiales y métodos: Se calcularon los valores de corte mediante el análisis de la curva ROC (Característica Operativa del Receptor por sus siglas en inglés: Receiver Operating Characteristic), identificando la sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN) correspondientes. La homogeneidad interna de los ítems fue evaluada a través del coeficiente alfa de Cronbach. Asimismo, se calculó el coeficiente Kappa de Cohen para estimar la confiabilidad interevaluador. Resultados: Los hallazgos indican una sensibilidad optimizada del 90,71 % y una especificidad del 92,17 % para esta muestra de 313 pacientes. AMSE mostró una consistencia interna aceptable de .75 y una alta confiabilidad entre evaluadores (K = .97). Discusión y conclusiones: AMSE se perfila como una herramienta prometedora para la evaluación diagnóstica de TEA en niños, adolescentes y adultos en riesgo, destacándose por su alta utilidad clínica. Su aplicación es especialmente relevante en regiones como América Latina, donde el acceso a la capacitación y uso de las escalas que son estándar de oro es limitado. Estos resultados respaldan el uso de AMSE como una herramienta diagnóstica breve, confiable y culturalmente adaptada para apoyar el diagnóstico clínico de autismo en contextos de habla hispana con recursos limitados.

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4. Gutowski C, Lombard M, Kurtz-Nelson E, Christensen C. Whole exome sequencing facilitates early neurodevelopmental diagnosis in an outpatient clinic. BMJ Case Rep;2026 (Jan 12);19(1)

The American College of Medical Genetics and Genomics (ACMG) and other professional organisations recommend whole exome sequencing (WES) as a first-tier genetic test for paediatric patients with congenital anomalies, developmental delay and/or intellectual disability, which has contributed to rapidly increasing rates of genetic testing and diagnosis in this population. We present a case of Rett syndrome diagnosed in early childhood following an atypical presentation of the condition with no regression using WES. This diagnosis was facilitated by a multidisciplinary outpatient neurodevelopmental genetics programme. Non-genetics providers trained in consent for genetic testing allowed for ample access to a comprehensive genetics work-up. The subsequent diagnosis of Rett syndrome qualified this patient for additional resources, novel interventions and family support.

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5. Kennedy BS, Weir E, Fysh MC, Tsompanidis A, Payne RA, Allison C, Matthews FE, Baron-Cohen S. Risk of hospitalization and death among autistic young people in England during the Covid-19 pandemic. Mol Autism;2026 (Jan 12)

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6. Kolisnyk M, Lyons K, Choi EJ, Vandewouw MM, Stojanoski B, Anagnostou E, Kushki A, Nicolson R, Kelley E, Georgiades S, Lerch J, Crosbie J, Schachar R, Ayub M, Jones J, Arnold P, Liu X, Stevenson R. Decoding the neural basis of sensory phenotypes in autism. Biol Psychiatry Cogn Neurosci Neuroimaging;2026 (Jan 10)

BACKGROUND: Differences in sensory processing are a defining characteristic of autism, affecting up to 87% of autistic individuals. These differences cause widespread perceptual changes that can negatively impact cognition, development, and daily functioning. Our research identified five sensory processing ‘phenotypes’ with varied behavioural presentations; however, their neural basis remains unclear. This study aims to ground these sensory phenotypes in unique patterns of functional connectivity. METHODS: We analyzed data from 146 autistic participants from the Province of Ontario Neurodevelopmental Network. We classified participants into five sensory phenotypes using k-means clustering of scores from the Short Sensory Profile. We then computed a connectivity matrix from 200 cortical and 32 subcortical regions and calculated graph-theoretic measures (betweenness centrality, strength, local efficiency, and clustering coefficient) to assess information exchange between these regions. We then trained machine learning models to use these measures to classify between all pairs of sensory phenotypes. RESULTS: Our sample was clustered into five sensory phenotypes. The machine learning models distinguished seven of the ten total pairs of sensory phenotypes using graph-theoretic measures (p < 0.005). Information exchange within and between the somatomotor network, orbitofrontal cortex, posterior parietal cortex, prefrontal cortex and subcortical areas was predictive of sensory phenotype. CONCLUSIONS: Sensory phenotypes in autism correspond to differences in functional connectivity across cortical, subcortical, and network levels. These findings support the view that variability in sensory processing is reflected in measurable neural patterns and motivate continued work to refine models of sensory processing, with the goal of better understanding and capturing the heterogeneity implicit in autism.

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7. Lamônica D, Rosa KG, da Rocha E, Lemos D, Giacheti CM. Diagnostic challenges in Landau-Kleffner syndrome. BMJ Case Rep;2026 (Jan 12);19(1)

A boy in his early childhood was brought by his parents to the Laboratory of Investigation of Neurological and Genetic Disorders of the School Clinic of the University with a suspicion of Autism Spectrum Disorder (ASD) and hearing loss. The parents’ complaint was that their child had language regression, did not respond to auditory stimuli and was presenting ASD behaviours. The parents were searching for information and a possible diagnosis and treatment for their child. Considering the child’s history, an electroencephalogram (EEG) and a CT exam, as well as audiological and language assessments, were requested. The audiological assessment indicated normality. As for the language assessment, auditory agnosia and expressive deficits, language fluctuation, restricted sound production and sporadic word use, many of which were unintelligible, were verified. Regarding neurodevelopment, all areas were compromised and symptoms included irritability, motor excitation and impulsivity. There was no score for signs of ASD, although some behaviours could be observed. The child was diagnosed with Landau-Kleffner syndrome (LKS), a rare paediatric neurological disorder characterised by language regression and abnormal EEG activity. Although LKS is a rare condition, there is a need for greater awareness of this syndrome, particularly in light of language regression and suspicion of Acquired Hearing Loss.

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8. Mathée-Scott J, Venker CE. Beyond Mean Length of Utterance: Novel Measures for Characterizing the Spoken Language of Autistic Children. Am J Speech Lang Pathol;2026 (Jan 13);35(1):361-370.

PURPOSE: Mean length of utterance (MLU) is a common measure of expressive language complexity in young children, including autistic children. However, means, by nature, obscure some information about spread and variability in data. Thus, we aimed to examine a new approach to characterizing linguistic complexity in autistic children by investigating the validity of two novel measures-range of length of utterance (RLU), standard deviation of length of utterance (SDLU)-alongside established measures: MLU and total utterances (TU). METHOD: Participants were 40 autistic children (12 girls, 28 boys; M(age) = 41.78 months). Children participated in 10-min, play-based language samples with their caregivers. Language samples were transcribed and measures (MLU, TU, SDLU, and RLU) were derived. To examine the criterion validity of these measures, we used regression analyses to examine how well each measure explained variance in children’s expressive language, as measured by the Preschool Language Scales-Fifth Edition (PLS-5). RESULTS: All measures (MLU, SDLU, RLU, and TU) significantly predicted PLS expressive language (ps < .001). Effect size comparisons revealed that all four predictors had large effect sizes (R(2) > .6). In absolute terms, MLU had the smallest effect size (R(2) = .682), followed by TU (R(2) = .72) and RLU (R(2) = .781), and SDLU had the largest effect size (R(2) = .822). CONCLUSIONS: Findings suggest that these novel measures (SDLU and RLU) explained significant variance in children’s expressive language, as measured by the PLS-5, as did MLU and TU. SDLU had the largest explanatory power, in absolute terms, followed by RLU and TU. MLU had the smallest effect size, indicating that it had the lowest explanatory power for explaining variance in children’s expressive language as compared to the other three measures. Thus, examining spread and variability in utterance length data might provide important, previously overlooked, information about the complexity of autistic children’s spoken language. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30559880.

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9. Mihalcea D, Iordache MP, Angelescu C. Neurodegeneration Within the Spectrum of Pervasive Developmental Disorders. Cureus;2025 (Dec);17(12):e99010.

The historical framework of pervasive developmental disorders (PDD) continues to hold relevance despite its replacement by the Neurodevelopmental Disorders category in DSM-5. Emerging evidence indicates that neurodevelopmental and neurodegenerative mechanisms, traditionally considered distinct, may intersect in individuals formerly classified under PDD. Shared biological pathways, including aberrant synaptic pruning, mitochondrial dysfunction, immune dysregulation, and impaired proteostasis, suggest potential long-term neurological vulnerability, particularly in autism spectrum disorder (ASD), the principal diagnosis within the former PDD group. Clinical overlap is most evident in « bridging conditions » such as Rett syndrome, MECP2-related disorders, and Fragile X-associated tremor/ataxia syndrome, which illustrate the continuum between developmental and degenerative processes. As individuals with ASD increasingly reach older adulthood, gaps in longitudinal data hinder understanding of risks related to cognitive decline, dementia, and atypical aging. Additionally, chronic stress, psychiatric comorbidities, and sensory dysregulation may further influence neuroinflammatory and neurodegenerative pathways. Recognizing these intersections provides opportunities for early neuroprotective interventions and biomarker-driven risk stratification. This editorial argues for a lifespan-oriented, integrative model that bridges developmental and degenerative neuroscience, aiming to better characterize and support the long-term neurological health of individuals previously encompassed by the PDD construct.

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10. Peres G, Wiprich MT, Gusso D, Bonan CD. Oxytocinergic Signaling in Zebrafish: Translational Perspectives for Autism Spectrum Disorder. J Neurochem;2026 (Jan);170(1):e70346.

Alterations in the oxytocin system, accompanied by cognitive and behavioral deficits, are common in several neurodevelopmental conditions, including Autism Spectrum Disorder. Oxytocin, a neuropeptide produced in the hypothalamus, plays a pivotal role in modulating social cognition and complex social behaviors. Recently, increasing attention has been given to the therapeutic potential of oxytocin in the treatment of neurodevelopmental disorders. However, many aspects of oxytocin signaling and its effects remain to be fully elucidated. Given its pronounced social behaviors and conserved neurochemical pathways, the zebrafish (Danio rerio) has emerged as a model for investigating the neural and behavioral effects of oxytocin. This species exhibits a wide behavioral repertoire, making it suitable for modeling oxytocin-related neurodevelopmental alterations. Here we provide an overview of the key mechanisms underlying oxytocin signaling and discuss current findings supporting the use of zebrafish as an Autism Spectrum Disorder model.

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11. Rancaño KM, Kranz AM. Pediatric dental surgeries in children with intellectual disabilities and autism paid by means of Medicaid. J Am Dent Assoc;2026 (Jan 12)

BACKGROUND: Use of ambulatory surgery centers (ASCs) relative to hospital outpatient departments (HOPDs) for outpatient surgeries for caries in children with intellectual disabilities and related conditions (IDRC) and autism has not been characterized. METHODS: In this cross-sectional analysis of Medicaid data (2016-2020) from 40 states, the authors examined 601,286 outpatient dental surgeries performed in ASCs and HOPDs in children (1-18 years) with IDRC, with autism, and without IDRC or autism (IDRC/A), overall and according to race and ethnicity. Multivariable regression models estimated regression-adjusted probabilities of receiving care in ASCs. Models included year and state fixed effects and child-level clustered SEs. RESULTS: Among surgeries in ASCs and HOPDs, the regression-adjusted predicted probability of ASC use was 14.0 percentage points lower for children with IDRC (15.9%; P < .001) and 3.8 percentage points lower for children with autism (26.1%: P < .001) than for children without IDRC/A (29.9%). Racial and ethnic differences within disability groups were small. Among surgeries in ASCs and HOPDs, the probability of ASC use was 1.8 percentage points lower for Hispanic autistic children (P = .009) than White autistic children. Among children without IDRC/A who were treated in an ASC or HOPD, ASC use was 0.6 percentage points higher for Black children (P < .001) and 1.1 percentage points higher for Hispanic children (P = .001) than for White children. CONCLUSIONS: Children with IDRC and autism were less likely to receive care in ASCs than HOPDs than children without IDRC/A. PRACTICAL IMPLICATIONS: Because ASCs are less costly than HOPDs, providing more care at ASCs for children with IDRC and autism may help reduce costs for this population.

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12. Ranjabaran G, Moreau Q, Dubois A, Dumas G. Towards Multi-Brain Decoding in Autism: A Self-Supervised Learning Approach. Neuroinformatics;2026 (Jan 13);24(1):6.

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13. Saad K, Abdel-Sadek ZM, Al-Atram AA, Elhoufey A, Alanazi ATB, Temsah MH, Embaby MM, Gad EF. Analysis of the global burden, biological risk factors, and implications of autism spectrum disorder. Pediatr Res;2026 (Jan 13)

Widening ASD burden disparities between high and low socioeconomic regions require targeted workforce development and resource allocation in underserved areas. With ASD disability projected to rise 58.83% by 2030, healthcare systems must expand developmental screening and early intervention services in primary care. Integration of GBD epidemiological data with causal inference techniques enables evidence-based policy development for children’s neurodevelopmental health services.

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14. Sousa D, Queirós JC, Tavares T, Soares S, Vaz Matos I, Prior C, Gonzaga D. Early Neurodevelopmental Milestones in Children With Autism Spectrum Disorder: A Retrospective Observational Study. Cureus;2025 (Dec);17(12):e99042.

Introduction Early diagnosis and intervention in autism spectrum disorder (ASD) are crucial for improving cognitive, social, and adaptive outcomes. ASD is characterized by deficits in social communication and interaction, alongside restricted and repetitive behaviors. Although diagnosis typically occurs around age three, developmental concerns often emerge within the first year, particularly in language, social engagement, and adaptive functioning. Early identification of these markers allows timely referral, assessment, and intervention. This study aimed to characterize early neurodevelopmental milestones in preschool children with ASD, compare milestone acquisition with normative expectations using Haizea-Llevant charts, and evaluate associations with cognitive and adaptive functioning using the Griffiths Mental Development Scales-Extended Revised (GMDS-ER). Materials and methods A retrospective observational study included 127 children with ASD followed at a tertiary hospital Neurodevelopment Unit. Data from medical records included demographics, prenatal and family history, comorbidities, age at referral and diagnosis, and early clinical signs. Six developmental milestones were analyzed: social smile, sitting without support, walking, first words, first phrases, and urinary daytime sphincter control. Delays were defined as acquisition at or above the 95th percentile of the Haizea-Llevant chart or absence of the milestone. Language regression, defined as loss of at least five previously acquired words for ≥3 months, was recorded. Cognitive and adaptive functioning were assessed using GMDS-ER, including global development quotient (GDQ) and subscales for personal/social, hearing/language, locomotor, hand-eye coordination, and performance. Statistical comparisons between normative and delayed milestone acquisition were performed. Results Of the 127 children, 85.8% were male, with a mean age at diagnosis of 34±10 months. Language delay was the most frequent reason for referral; 11% had experienced regression. Social smile was delayed in 20.5%, sitting in 2.5%, walking in 38.6%, first words in 62.6%, first phrases in 96.8%, and daytime sphincter control in 85.2%. GMDS-ER assessments in 62.2% of children showed a mean GDQ of 61.8±12.7. Delayed sphincter control was associated with lower GDQ (60.2 vs. 76.2, p=0.002), personal/social (56.7 vs. 70, p<0.01), hearing/language (42 vs. 51.7, p=0.048), and performance scores (69.3 vs. 78, p=0.011). Delayed social smile correlated with lower personal/social scores (51.1 vs. 60, p=0.03). Delays in first words (56.7 vs. 64, p=0.014) and phrases (58 vs. 80.5, p=0.023) were linked to reduced personal/social outcomes. Delayed walking was associated with lower performance scores (62.8 vs. 72.8, p=0.025). Discussion and conclusion Motor milestones in the first year, except walking, were generally achieved on time. Delayed walking, language acquisition, and daytime sphincter control were strongly associated with lower cognitive, social, and adaptive outcomes. Delayed social smile was associated with poorer personal/social functioning. Careful monitoring of early milestones, particularly social, language, and adaptive skills, can facilitate early ASD identification and guide timely, individualized interventions that may improve long-term outcomes.

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15. Tan Y, Chan KKS. Emotion regulation in families of autistic children and adolescents: A longitudinal study. Autism;2026 (Jan 13):13623613251401049.

This study investigated whether parental emotion-regulation difficulties are prospectively associated with increased emotion-regulation challenges in autistic children and adolescents and explored the underlying mechanisms and behavioral implications of these potential intergenerational associations. Over three time points (T1, T2, T3) spanning 2 years, 363 parents of autistic children and adolescents from Hong Kong provided questionnaire data. Path analyses revealed that parental emotion-regulation difficulties at T1 were associated with greater negative emotional expressiveness at T2, which in turn was linked to increased emotion-regulation difficulties and more internalizing and externalizing problems in autistic children and adolescents at T3. Importantly, these findings indicate that when parents have difficulty regulating their emotions and express negativity, their autistic children and adolescents are more likely to face emotion-regulation challenges and exhibit behavior problems. This underscores the need to support parents in regulating their emotions and optimizing their emotional expressiveness. Clinicians and policymakers should help parents strengthen their emotion regulation and enhance their emotional well-being by building coping strategies and fostering supportive environments. By promoting parents’ emotional wellness, we may also improve psychological adjustment and behavioral outcomes for their autistic children and adolescents.Lay abstractParents of autistic children and adolescents often experience high levels of parenting stress and face challenges in managing their own negative emotions. These emotional struggles can impact their autistic children and adolescents during everyday interactions, potentially intensifying the emotional and behavioral difficulties they experience. This study examined whether parents’ emotion-regulation patterns are longitudinally linked to the development of emotion regulation in their autistic children and adolescents. The findings revealed that when parents had difficulty regulating their emotions and frequently expressed negative emotions, their autistic children and adolescents were more likely to face emotion-regulation challenges and experience personal distress and interpersonal difficulties. This underscores the importance of supporting parents in regulating their emotions and optimizing their emotional expressiveness. Clinicians and policymakers should assist parents in strengthening their emotion regulation and enhancing their emotional well-being by building coping strategies and fostering supportive environments. By promoting parents’ emotional wellness, we may also improve psychological adjustment and behavioral functioning for their autistic children and adolescents.

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16. Zhong J, Zhu B, Zou Z, Li Y, Feng Y, Wu K, Hou X. Gut microbiota mediates the beneficial effects of exercise on autism-like behaviors. BMC Microbiol;2026 (Jan 12)

BACKGROUND: The gut-brain axis plays a critical role in autism spectrum disorder (ASD), but the mechanisms through which exercise modulates gut microbiota, short-chain fatty acids (SCFAs), and central neurotransmitters to ameliorate ASD-like behaviors remain unclear. This study aimed to investigate the effects of exercise on ASD-like behaviors, gut microbiota, and metabolism in a valproic acid (VPA)-induced ASD rat model and to validate these findings via fecal microbiota transplantation (FMT). METHODS: ASD rat models were established through prenatal exposure to VPA and divided into four groups: exercise (E_ASD), non-exercise (ASD), FMT, and sham FMT (sFMT). The E_ASD group underwent 6 weeks of voluntary wheel running, while the FMT group received fecal microbiota from the E_ASD group for 4 weeks. Behavioral assessments were conducted to evaluate cognitive and social functions. Fecal microbiota composition was analyzed via 16S rRNA sequencing, while SCFAs and neurotransmitters were measured using gas and liquid chromatography-mass spectrometry. RESULTS: Six weeks of voluntary exercise significantly alleviated ASD-like behaviors, particularly improving social interactions. Exercise also altered gut microbiota composition, increasing Limosilactobacillus and Lactobacillus while decreasing Allobaculum. Additionally, SCFAs and neurotransmitter levels in the prefrontal cortex were modulated. Notably, FMT from the exercise group replicated these behavioral and metabolic improvements in ASD rats. Exercise improves ASD-like behaviors by modulating gut microbiota, SCFAs, and neurotransmitter levels, and FMT offers further validation of these effects. CONCLUSION: These findings highlight exercise and FMT as promising strategies for alleviating ASD-related symptoms through gut-brain axis modulation.

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17. Zhu H, Gan Y, Ye J, Li Y, Yu JZ, Li X. Effectiveness of brain-computer interface interventions in autism spectrum disorder rehabilitation: a systematic review and meta-analysis protocol. BMJ Open;2026 (Jan 13);16(1):e102277.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by impairments in social interaction, communication and the presence of repetitive behaviours. Recent advancements in brain-computer interface (BCI) technologies have demonstrated potential benefits in enhancing cognitive, social and communication skills in individuals with ASD. However, the effectiveness of BCI-based interventions in ASD rehabilitation remains inconsistent across studies. Therefore, this protocol outlines a systematic review and meta-analysis to synthesise the evidence on the effectiveness of BCI-based interventions for ASD rehabilitation. METHODS: We will conduct a comprehensive literature search across multiple databases, including MEDLINE Ovid, Embase Ovid, Cochrane Central Register of Controlled Trials (CENTRAL), Conference Proceedings Citation Index-Science (CPCI-S), Science Citation Index Expanded (SCI-EXPANDED) and so on, to identify relevant studies published from inception to the present. The search will be supplemented by screening the reference lists of included studies and relevant systematic reviews. Two independent reviewers will screen the titles, abstracts and full texts of identified studies for eligibility based on predefined criteria. Data extraction will be performed using a standardised form, and the risk of bias (RoB) will be assessed using the Cochrane RoB tool. Heterogeneity will be evaluated using the I² statistic, and a random-effects or fixed-effects model will be selected for meta-analysis based on the degree of heterogeneity. Subgroup analyses will be conducted to explore potential sources of heterogeneity, including participant age, ASD severity, type of BCI intervention and duration of the intervention. The review will be conducted from January 2026 to April 2026. ETHICS AND DISSEMINATION: Ethical approval is not required for this study, as it does not involve the collection of primary data from individual patients. Findings will be disseminated through peer-reviewed publication and conference presentations. PROSPERO REGISTRATION NUMBER: CRD420251010496.

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