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Duan X, Shan X, Uddin LQ, Chen H. The Future of Disentangling the Heterogeneity of Autism With Neuroimaging Studies. Biol Psychiatry 2025; 97:428-438. [PMID: 39181387 DOI: 10.1016/j.biopsych.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/01/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024]
Abstract
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition. Over the past decade, a considerable number of approaches have been developed to identify potential neuroimaging-based biomarkers of ASD that have uncovered specific neural mechanisms that underlie behaviors associated with ASD. However, the substantial heterogeneity among individuals who are diagnosed with ASD hinders the development of biomarkers. Disentangling the heterogeneity of ASD is pivotal to improving the quality of life for individuals with ASD by facilitating early diagnosis and individualized interventions for those who need support. In this review, we discuss recent advances in neuroimaging that have facilitated the characterization of the heterogeneity of this condition using 3 frameworks: neurosubtyping, dimensional models, and normative models. We also discuss the challenges, possible solutions, and clinical utility of these 3 frameworks. We argue that several factors need to be considered when parsing heterogeneity using neuroimaging, including co-occurring conditions, neurodevelopment, heredity and environment, and multisite and multimodal data. We close with a discussion of future directions for achieving a better understanding of the neural mechanisms that underlie neurodevelopmental heterogeneity and the future of precision medicine in ASD.
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Affiliation(s)
- Xujun Duan
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xiaolong Shan
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Lucina Q Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California; Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Huafu Chen
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China.
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Arija V, Esteban-Figuerola P, Morales-Hidalgo P, Jardí C, Canals-Sans J. Nutrient intake and adequacy in children with autism spectrum disorder: EPINED epidemiological study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:371-388. [PMID: 35722960 DOI: 10.1177/13623613221098237] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Children with autism spectrum disorder (ASD) have a fivefold elevated risk of developing eating problems, which predisposes them to nutritional deficiencies. This study assesses nutritional intake and adequacy in children with ASD, subdiagnostic autistic symptoms and typically developing (TD) children. Preschool children with ASD and subdiagnostic symptoms had slightly lower intake of monounsaturated fatty acids (MUFA), vitamin D and vitamin B12. Primary school children with ASD and subdiagnostic symptoms had slightly higher intake of protein, cholesterol, thiamine and niacin, and a higher percentage of obesity than children with TD. All children had a high intake in sugars, fats and saturated fatty acids; a very highly inadequate intake of vitamins (vitamins D and E), fibre, b-carotene, calcium and magnesium; and a moderately inadequate intake of vitamin C, folate and iron. However, although all children need nutrition advice, children with ASD and subdiagnostic autistic symptoms had a poorer quality diet than those with TD.
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Affiliation(s)
- Victoria Arija
- Rovira i Virgili University (URV), Spain.,Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Spain
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Whelan M, McGillivray J, Rinehart NJ. The Association Between Autism Spectrum Traits and the Successful Transition to Mainstream Secondary School in an Australian School-Based Sample. J Autism Dev Disord 2020; 51:1759-1771. [PMID: 32809171 DOI: 10.1007/s10803-020-04655-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The transition to secondary school is an important educational milestone impacting wellbeing and academic achievement. Students with Autism Spectrum Disorder may be vulnerable during transition however little is known about how Autism Spectrum (AS) traits influence transition outcomes. Generalised estimating equations were used to examine how AS traits were associated with four indicators of successful transition in a school-based sample of 51 students. Higher AS traits were associated with lower quality of life, school belonging and mental health, however the hypothesised decline after school transition was not supported. Characteristics of both the primary and secondary school appeared to be contributing to the wellbeing of students with high AS traits which could be clarified by further investigation with a larger sample.
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Affiliation(s)
- Moira Whelan
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Waterfront Campus, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Jane McGillivray
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Waterfront Campus, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Nicole J Rinehart
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Waterfront Campus, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
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Kamp-Becker I, Stroth S, Stehr T. [Autism spectrum disorder in childhood and adults: diagnosis and differential diagnoses]. DER NERVENARZT 2020; 91:457-470. [PMID: 32303788 DOI: 10.1007/s00115-020-00901-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Autistic disorders are summarized in DSM‑5 under the term autism spectrum disorder (ASD) and are severe, lifelong, pervasive neurodevelopmental disorders. Core features manifested even in childhood are impairments in social interaction and communication as well as restricted and repetitive behavior. The intensity of symptoms, language and cognitive impairments vary but the majority of affected individuals have below average intelligence and 80% have at least one comorbid disorder. The diverse pathology and heterogeneity in phenotypes are caused by a complex genetic etiology, which is associated with a reduced synaptic plasticity of neural networks. The disorder is associated with a clearly reduced quality of life as well as a high familial burden. The differential diagnostics have a high relevance and the diagnosis should be carried out by specialized institutions. Behavioral therapeutic interventions are indicated.
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Affiliation(s)
- Inge Kamp-Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Fachbereich Medizin, Philipps-Universität Marburg, Hans-Sachs-Str. 4, 35039, Marburg, Deutschland.
| | - Sanna Stroth
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Fachbereich Medizin, Philipps-Universität Marburg, Hans-Sachs-Str. 4, 35039, Marburg, Deutschland
| | - Thomas Stehr
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Fachbereich Medizin, Philipps-Universität Marburg, Hans-Sachs-Str. 4, 35039, Marburg, Deutschland
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Chiarotti F, Venerosi A. Epidemiology of Autism Spectrum Disorders: A Review of Worldwide Prevalence Estimates Since 2014. Brain Sci 2020; 10:brainsci10050274. [PMID: 32370097 PMCID: PMC7288022 DOI: 10.3390/brainsci10050274] [Citation(s) in RCA: 273] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Abstract
The prevalence of Autism Spectrum Disorder (ASD) has increased dramatically in recent decades, supporting the claim of an autism epidemic. Systematic monitoring of ASD allows estimating prevalence and identifying potential sources of variation over time and geographical areas. At present, ASD prevalence estimates are available worldwide, coming either from surveillance systems using existing health and educational databases or from population studies specifically performed. In the present article, we present a review of the ASD prevalence estimates published since 2014. Data confirm a high variability in prevalence across the world, likely due to methodological differences in case detection, and the consistent increase of prevalence estimates within each geographical area.
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Luisier AC, Petitpierre G, Clerc Bérod A, Garcia-Burgos D, Bensafi M. Effects of familiarization on odor hedonic responses and food choices in children with autism spectrum disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1460-1471. [PMID: 30523698 DOI: 10.1177/1362361318815252] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study assessed whether olfactory familiarization can render food odors more pleasant, and consequently food more attractive, to children with autism spectrum disorder. Participants were first presented with a series of food odors (session 1). Then, they were familiarized on four occasions (time window: 5 weeks) with one of the two most neutral odors (the other neutral odor was used as control) (session 2). In session 3, participants smelled the entire series of odors again. Both verbal and facial responses were compared from session 1 to session 3. After session 3, the children were presented with two identical foods (one containing the familiarized odor and one the control odor) and were asked to choose between these foods. Results revealed (1) a specific increase in positive emotions for the familiarized odor and (2) that 68% of the children chose the food associated with the "familiarized odor" (children who chose the "familiarized odor" food exhibited significantly more sensory particularities). These findings suggest that it is possible to modulate olfactory emotions and expand the dietary repertoire of children with autism spectrum disorder. Application of this paradigm may enable innovative prospects for food education in autism.
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Affiliation(s)
- Anne-Claude Luisier
- 1 Claude Bernard University Lyon 1, France.,2 University of Fribourg, Switzerland.,3 Brocoli Factory, Switzerland
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