1. Ayaslan Z, Ermiş Ç, Cevher Binici N, Baykara HB. Clinical Features in Children With Loss of Autism Diagnosis and Persistent Autism: A Comparative Study. J Autism Dev Disord. 2026.

PURPOSE: The aim of this study was to evaluate the loss of autism diagnosis (LAD) in individuals with Autism Spectrum Disorder (ASD) and to compare the clinical features of LAD cases with those who continued to meet criteria for ASD without Intellectual Disability (ID). METHOD: This study included 60 children aged 5-18 years who were previously diagnosed with ASD and were classified either as having lost the diagnosis (LAD) or as continuing to meet criteria for ASD without ID. Data were obtained through clinical interviews and retrospective review of medical records. Comorbidities were evaluated using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Symptom severity and clinical characteristics were assessed using the Childhood Autism Rating Scale (CARS), Strengths and Difficulties Questionnaire (SDQ), Aberrant Behavior Checklist (ABC), and Social Communication Questionnaire (SCQ). RESULTS: The LAD group had an earlier age at ASD diagnosis, earlier initiation of special education, and a longer duration of preschool education. Symptom severity measured by CARS and SCQ was lower in the LAD group. At least one comorbid psychiatric diagnosis was present in 80% of the LAD group, with Attention-Deficit/Hyperactivity Disorder, Anxiety Disorders/Specific Phobia, and Specific Learning Disorder being the most common. A moderate positive association was observed between SCQ-Lifetime scores and the time required to achieve LAD. CONCLUSION: Early diagnosis, earlier initiation of special education, and lower ASD symptom severity at diagnosis were associated with LAD. Despite loss of the ASD diagnosis, subthreshold psychiatric symptoms and non-ASD psychiatric diagnoses remained highly prevalent.

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2. Erdoğan A, Erdoğan MA, Uyanıkgil Y, Erbaş O. Therapeutic Potential of Pioglitazone in a Propionic Acid-Induced Rat Model of Autism Spectrum Disorder: The Role of the SIRT1/PPAR-γ Axis. Int J Dev Neurosci. 2026; 86(6): e70180.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication deficits and repetitive behaviours. Emerging evidence highlights neuroinflammation, oxidative stress and mitochondrial dysfunction in its pathogenesis. Propionic acid (PPA), an enteric short-chain fatty acid, is frequently utilized to replicate ASD-like phenotypes in rodents. This study investigated the therapeutic efficacy of pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist known for its neuroprotective and anti-inflammatory properties, in a PPA-induced rat model of ASD. Thirty male Wistar rats were randomly assigned to control, PPA + saline or PPA + pioglitazone (15 mg/kg/day, orally) groups. Neurobehavioural profiling utilized the sociability, open-field and passive avoidance learning tests. Furthermore, cerebral tissues were analysed for tumour necrosis factor-alpha (TNF-α), brain-derived neurotrophic factor (BDNF), sirtuin-1 (SIRT1), galectin-3 and malondialdehyde (MDA), alongside comprehensive histopathological evaluations of the hippocampus and cerebellum. Pioglitazone significantly improved social interaction, associative memory retention and spontaneous locomotor activity. Biochemically, the treatment significantly suppressed inflammatory and oxidative stress markers (TNF-α, galectin-3 and MDA) while increasing cerebral BDNF and SIRT1 levels. Histological assessments confirmed these neuroprotective benefits, demonstrating preserved neuronal architecture and decreased glial fibrillary acidic protein (GFAP) immunoreactivity, indicative of reduced reactive astrogliosis. These findings indicate that pioglitazone ameliorates behavioural, biochemical and histopathological alterations in the PPA-induced rat model of ASD. The concurrent restoration of cerebral SIRT1 levels suggests that SIRT1-related signalling may contribute to the observed neuroprotective effects.

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3. Guo R, He C, Xiao X, Li J, Zhang Z, He Y, Wang C, Zhao J, Gong J, Liang J, Yuan T, Sun H, Liu X, Gao C, Liu Z. Targeted Restoration of the Microbial Tryptophan Oxidative Pathway Ameliorates Autism-Like Behavioral and Synaptic Deficits. Adv Sci (Weinh). 2026: e22265.

Autism Spectrum Disorder (ASD) is associated with gut microbiota dysbiosis, yet the contribution of specific microbial metabolic pathways remains unclear. Reanalysis of a public ASD cohort revealed reduced functional potential in microbial tryptophan oxidative metabolism. We therefore designed targeted microbial tryptophan oxidative pathway (MTOP) interventions comprising Lacticaseibacillus rhamnosus C502, highland barley β-glucan, or their synbiotic combination. These interventions enhanced oxidative tryptophan metabolic output and restored associated indole derivatives in ASD fecal cultures. In a VPA-induced autism-like mouse model, MTOP-targeted interventions alleviated behavioral deficits, normalized social-stimulus-associated CA3 calcium responses, and improved hippocampal synaptic architecture. These effects were accompanied by gut microbiota remodeling, improved intestinal barrier integrity, increased fecal and brain IAA levels, and restoration of ERK-CREB-BDNF-associated signaling. Microbiota depletion abolished the synbiotic-mediated benefits, whereas oral IAA supplementation partially reproduced behavioral, neuronal, and selected synaptic improvements. Neuronal AhR knockdown in the retrosplenial cortex attenuated the synbiotic-mediated rescue, supporting a required role for neuronal AhR. Independent clinical metabolomic analysis supported an association between lower circulating IAA and ASD symptom severity. Collectively, these findings identify impaired MTOP-related metabolism as a gut-brain metabolic vulnerability and support MTOP restoration as a candidate synbiotic strategy for ASD-related conditions characterized by impaired microbial tryptophan oxidative metabolism.

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4. Kim AS, Collett B, Stobbe G, Stein Duker LI, Ramirez M, Mancl L, Jacobson D, Nemawarkar D, Orack J, Li SR, Chi DL. Protocol for a randomized controlled trial of an app-based intervention to improve toothbrushing skills and habits in autistic children and adolescents. Contemp Clin Trials. 2026: 108480.

BACKGROUND: Autistic children and teens are at increased risk of tooth decay, due in part to difficulties with daily toothbrushing routines. There is a dearth of sociobehavioral interventions that specifically support oral health maintenance in this population. BrushUp is a mobile app aimed at improving toothbrushing skills and habits in children. METHODS: This project is a 2-arm randomized controlled trial (RCT) that will enroll 270 autistic children and teens ages 8 to 17 years and their caregivers as dyads. Children and teens will be randomized to the experimental or control arm consisting of the BrushUp or BrushDown app, respectively, to be used twice a day for 3 months. BrushUp incorporates concepts from Video Self Modeling and includes a health education module, digital screen mirror, cartoon role model, and autism-friendly features. BrushDown includes a health education module, digital screen mirror, and a countdown timer. The study’s goal is to compare toothbrushing outcomes among participants in the two arms. The primary outcome is toothbrushing distribution (defined as the mean proportion of total tooth surfaces brushed per toothbrushing episode) and secondary outcomes are toothbrushing duration and frequency. Analyses will follow an intent-to-treat approach. DISCUSSION: This study will be among the first RCTs to evaluate a mobile app-based intervention tailored for autistic children and teens to improve toothbrushing habits. Findings from our study will also produce novel mechanism data to show how apps can help with habit formation. TRIAL REGISTRATION: ClinicalTrials.govNCT06208722 (first posted on 12/22/2023).

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5. Rothermich K, Rountree M, Ahn S, Caldwell-Harris CL, Dannhauer M. Divergent Patterns of Speaker-Intention Discrimination and Emotional Valence Ratings in Self-Reported Autistic and Non-Autistic Adults. Autism. 2026: 13623613261487284.

Autistic adults often interpret verbal and non-verbal cues underlying non-literal language differently compared to non-autistic people, reflecting differences in communicative style and shared context. Research on non-literal language in autism in controlled settings has typically depended on static stimuli that lack ecological validity and primarily focused on children, leaving non-literal language processing in autistic adults relatively understudied. The present study examined how self-reported autistic and non-autistic adults infer speaker intentions and emotional valence in dynamic, naturalistic videos. Participants (N = 66) viewed 50 brief videos from the Relational Inference in Social Communication database, depicting literal, sarcastic, teasing, or prosocial lie scenarios. After each video, they identified the speaker’s communicative intent and rated the emotional response of the addressee. Participants also completed two measures of autistic characteristics (Autism Spectrum Quotient; Comprehensive Autistic Trait Inventory). Self-reported autistic participants showed lower speaker-intention discrimination than non-autistic participants, whereas valence ratings were similar across intentions. Autistic traits predicted lower speaker-intention discrimination in non-autistic adults but were unrelated (Comprehensive Autistic Trait Inventory) or positively associated (Autism Spectrum Quotient) in self-reported autistic adults. These findings highlight shared and differing aspects of social communication and support combining categorical and trait-based approaches to understand individual differences.Lay AbstractAutistic adults often interpret non-literal language such as sarcasm differently, which can affect everyday communication. However, prior research studies have often used written or static materials that do not reflect real-life conversations. In this study, we examined how self-reported autistic and non-autistic adults understand sarcasm, teasing, and prosocial lies using short, realistic video clips. We used videos showing actors having a short conversation. After each video, we asked participants to identify the intention that was used (literal, sarcastic, teasing, or prosocial lie) and to evaluate how happy the person receiving the statement felt. Participants also reported whether they had an autism diagnosis or self-identified as autistic and completed two questionnaires measuring autistic traits (Autism Spectrum Quotient; Comprehensive Autistic Trait Inventory). We found that autistic adults were less accurate than non-autistic adults in identifying speaker intentions, but both groups judged the emotional impact of the statements in similar ways. Among non-autistic adults, higher levels of autistic traits were linked to more difficulty identifying speaker intentions. In contrast, autistic traits were not linked, or were even linked to better performance, in autistic adults. These findings suggest that autistic and non-autistic people may use both shared and different strategies when interpreting social communication and highlight the importance of considering both diagnosis and individual traits.

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