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Constable PA, Lim JKH, Thompson DA. Retinal electrophysiology in central nervous system disorders. A review of human and mouse studies. Front Neurosci 2023; 17:1215097. [PMID: 37600004 PMCID: PMC10433210 DOI: 10.3389/fnins.2023.1215097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
The retina and brain share similar neurochemistry and neurodevelopmental origins, with the retina, often viewed as a "window to the brain." With retinal measures of structure and function becoming easier to obtain in clinical populations there is a growing interest in using retinal findings as potential biomarkers for disorders affecting the central nervous system. Functional retinal biomarkers, such as the electroretinogram, show promise in neurological disorders, despite having limitations imposed by the existence of overlapping genetic markers, clinical traits or the effects of medications that may reduce their specificity in some conditions. This narrative review summarizes the principal functional retinal findings in central nervous system disorders and related mouse models and provides a background to the main excitatory and inhibitory retinal neurotransmitters that have been implicated to explain the visual electrophysiological findings. These changes in retinal neurochemistry may contribute to our understanding of these conditions based on the findings of retinal electrophysiological tests such as the flash, pattern, multifocal electroretinograms, and electro-oculogram. It is likely that future applications of signal analysis and machine learning algorithms will offer new insights into the pathophysiology, classification, and progression of these clinical disorders including autism, attention deficit/hyperactivity disorder, bipolar disorder, schizophrenia, depression, Parkinson's, and Alzheimer's disease. New clinical applications of visual electrophysiology to this field may lead to earlier, more accurate diagnoses and better targeted therapeutic interventions benefiting individual patients and clinicians managing these individuals and their families.
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Affiliation(s)
- Paul A. Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Jeremiah K. H. Lim
- Discipline of Optometry, School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Dorothy A. Thompson
- The Tony Kriss Visual Electrophysiology Unit, Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Weitlauf AS, Broderick N, Alacia Stainbrook J, Slaughter JC, Taylor JL, Herrington CG, Nicholson AG, Santulli M, Dorris K, Garrett LJ, Hopton M, Kinsman A, Morton M, Vogel A, Dykens EM, Pablo Juárez A, Warren ZE. A Longitudinal RCT of P-ESDM With and Without Parental Mindfulness Based Stress Reduction: Impact on Child Outcomes. J Autism Dev Disord 2022; 52:5403-5413. [PMID: 35040001 PMCID: PMC9289080 DOI: 10.1007/s10803-021-05399-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
This randomized controlled trial (NCT03889821) examined Mindfulness Based Stress Reduction (MBSR) in conjunction with the Parent-implemented Early Start Denver Model (P-ESDM). A previous report described improved metrics of parental distress (Weitlauf et al. in Pediatrics 145(Supplement 1):S81-S92, 2020). This manuscript examines child outcomes. 63 children with ASD (< 36 months) and their parents received 12 P-ESDM sessions. Half of parents also received MBSR. Longitudinal examination of whole sample means revealed modest improvements in autism severity, cognitive, and adaptive skills. There was not a significant time × group interaction for children whose parents received MBSR. Future work should examine more proximal markers of child or dyadic change to enhance understanding of the impact of providing direct treatment for parents as part of early intervention initiatives.
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Affiliation(s)
- Amy S Weitlauf
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Neill Broderick
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J Alacia Stainbrook
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - Julie Lounds Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Amy G Nicholson
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Madeline Santulli
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristin Dorris
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Michelle Hopton
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy Kinsman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mary Morton
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ashley Vogel
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elisabeth M Dykens
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - A Pablo Juárez
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Zachary E Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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Masi A, Azim SI, Khan F, Karlov L, Eapen V. Dissemination of Early Intervention Program for Preschool Children on the Autism Spectrum into Community Settings: An Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052555. [PMID: 35270253 PMCID: PMC8909550 DOI: 10.3390/ijerph19052555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 11/17/2022]
Abstract
We aimed to address a policy-relevant research area with high priority, namely disseminating early intervention for children on the autism spectrum into mainstream community settings. The study cohort comprised 47 children with a diagnosis of Autism Spectrum Disorder (ASD) receiving the Early Start Denver Model (ESDM) intervention: 23 children attending an Autism Specific Early Learning and Care Centre (ASELCC) and 24 children attending a mainstream preschool setting. Group comparisons revealed that the overall response to intervention was in the majority of cases not significantly different between settings. One difference was found in that children in the mainstream preschool setting showed a significant reduction in externalising behaviours compared to the children attending the autism-specific preschool. Intervention duration was found to influence outcomes with a one-month increase in duration found to improve expressive language skills. While the results need to be interpreted with caution due to the small sample size, these findings suggest that early intervention can be successfully delivered in both autism-specific and mainstream settings. However, those families needing additional parent support may be better served by a specialised service.
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Affiliation(s)
- Anne Masi
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia; (A.M.); (S.I.A.); (F.K.); (L.K.)
| | - Syeda Ishra Azim
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia; (A.M.); (S.I.A.); (F.K.); (L.K.)
| | - Feroza Khan
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia; (A.M.); (S.I.A.); (F.K.); (L.K.)
| | - Lisa Karlov
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia; (A.M.); (S.I.A.); (F.K.); (L.K.)
- South Western Sydney Local Health District, Liverpool 2170, Australia
- Academic Unit of Child Psychiatry, Level 1, Mental Health Centre, Liverpool Hospital, 1 Elizabeth Street, Liverpool 2170, Australia
| | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia; (A.M.); (S.I.A.); (F.K.); (L.K.)
- South Western Sydney Local Health District, Liverpool 2170, Australia
- Academic Unit of Child Psychiatry, Level 1, Mental Health Centre, Liverpool Hospital, 1 Elizabeth Street, Liverpool 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool 2170, Australia
- Correspondence: ; Tel.: +612-9616-4205
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Co-Design of a Neurodevelopment Assessment Scale: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312837. [PMID: 34886563 PMCID: PMC8657806 DOI: 10.3390/ijerph182312837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/17/2022]
Abstract
Neurodevelopmental disorders are a heterogeneous group of conditions with overlapping symptomatology and fluctuating developmental trajectories that transcend current diagnostic categorisation. There is a need for validated screening instruments which dimensionally assess symptomatology from a holistic, transdiagnostic perspective. The primary aim is to co-design a Neurodevelopment Assessment Scale (NAS), a user-friendly transdiagnostic assessment inventory that systematically screens for all signs and symptoms commonly encountered in neurodevelopmental disorders. Our first objective is to undertake development of this tool, utilising co-design principles in partnership with stakeholders, including both those with lived experience of neurodevelopmental disorders and service providers. Our second objective is to evaluate the face validity, as well as the perceived utility, user-friendliness, suitability, and acceptability (i.e., 'social validity'), of the NAS from the perspective of parents/caregivers and adults with neurodevelopmental disorders, clinicians, and service providers. Our third objective is to ascertain the psychometric properties of the NAS, including content validity and convergent validity. The NAS will provide an efficient transdiagnostic tool for evaluating all relevant signs, symptoms, and the dimensional constructs that underpin neurodevelopmental presentations. It is anticipated that this will maximise outcomes by enabling the delivery of personalised care tailored to an individual's unique profile in a holistic and efficient manner.
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