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Griffin JW, Azu MA, Cramer-Benjamin S, Franke CJ, Herman N, Iqbal R, Keifer CM, Rosenthal LH, McPartland JC. Investigating the Face Inversion Effect in Autism Across Behavioral and Neural Measures of Face Processing: A Systematic Review and Bayesian Meta-Analysis. JAMA Psychiatry 2023; 80:1026-1036. [PMID: 37405787 PMCID: PMC10323765 DOI: 10.1001/jamapsychiatry.2023.2105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/03/2023] [Indexed: 07/06/2023]
Abstract
Importance Face processing is foundational to human social cognition, is central to the hallmark features of autism spectrum disorder (ASD), and shapes neural systems and social behavior. Highly efficient and specialized, the face processing system is sensitive to inversion, demonstrated by reduced accuracy in recognition and altered neural response to inverted faces. Understanding at which mechanistic level the autistic face processing system may be particularly different, as measured by the face inversion effect, will improve overall understanding of brain functioning in autism. Objective To synthesize data from the extant literature to determine differences of the face processing system in ASD, as measured by the face inversion effect, across multiple mechanistic levels. Data Sources Systematic searches were conducted in the MEDLINE, Embase, Web of Science, and PubMed databases from inception to August 11, 2022. Study Selection Original research that reported performance-based measures of face recognition to upright and inverted faces in ASD and neurotypical samples were included for quantitative synthesis. All studies were screened by at least 2 reviewers. Data Extraction and Synthesis This systematic review and meta-analysis was conducted according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Multiple effect sizes were extracted from studies to maximize information gain and statistical precision and used a random-effects, multilevel modeling framework to account for statistical dependencies within study samples. Main Outcomes and Measures Effect sizes were calculated as a standardized mean change score between ASD and neurotypical samples (ie, Hedges g). The primary outcome measure was performance difference between upright and inverted faces during face recognition tasks. Measurement modality, psychological construct, recognition demand, sample age, sample sex distribution, and study quality assessment scores were assessed as moderators. Results Of 1768 screened articles, 122 effect sizes from 38 empirical articles representing data from 1764 individual participants (899 ASD individuals and 865 neurotypical individuals) were included in the meta-analysis. Overall, face recognition performance differences between upright and inverted faces were reduced in autistic individuals compared with neurotypical individuals (g = -0.41; SE = 0.11; 95% credible interval [CrI], -0.63 to -0.18). However, there was considerable heterogeneity among effect sizes, which were explored with moderator analysis. The attenuated face inversion effect in autistic individuals was more prominent in emotion compared with identity recognition (b = 0.46; SE = 0.26; 95% CrI, -0.08 to 0.95) and in behavioral compared with electrophysiological measures (b = 0.23; SE = 0.24; 95% CrI, -0.25 to 0.70). Conclusions and Relevance This study found that on average, face recognition in autism is less impacted by inversion. These findings suggest less specialization or expertise of the face processing system in autism, particularly in recognizing emotion from faces as measured in behavioral paradigms.
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Affiliation(s)
- Jason W. Griffin
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Margaret A. Azu
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | | | - Cassandra J. Franke
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Nicole Herman
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Reeda Iqbal
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Cara M. Keifer
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Lindsey H. Rosenthal
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - James C. McPartland
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
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Shan J, Gu Y, Zhang J, Hu X, Wu H, Yuan T, Zhao D. A scoping review of physiological biomarkers in autism. Front Neurosci 2023; 17:1269880. [PMID: 37746140 PMCID: PMC10512710 DOI: 10.3389/fnins.2023.1269880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by pervasive deficits in social interaction, communication impairments, and the presence of restricted and repetitive behaviors. This complex disorder is a significant public health concern due to its escalating incidence and detrimental impact on quality of life. Currently, extensive investigations are underway to identify prospective susceptibility or predictive biomarkers, employing a physiological biomarker-based framework. However, knowledge regarding physiological biomarkers in relation to Autism is sparse. We performed a scoping review to explore putative changes in physiological activities associated with behaviors in individuals with Autism. We identified studies published between January 2000 and June 2023 from online databases, and searched keywords included electroencephalography (EEG), magnetoencephalography (MEG), electrodermal activity markers (EDA), eye-tracking markers. We specifically detected social-related symptoms such as impaired social communication in ASD patients. Our results indicated that the EEG/ERP N170 signal has undergone the most rigorous testing as a potential biomarker, showing promise in identifying subgroups within ASD and displaying potential as an indicator of treatment response. By gathering current data from various physiological biomarkers, we can obtain a comprehensive understanding of the physiological profiles of individuals with ASD, offering potential for subgrouping and targeted intervention strategies.
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Affiliation(s)
- Jiatong Shan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Arts and Sciences, New York University Shanghai, Shanghai, China
| | - Yunhao Gu
- Graduate School of Education, University of Pennsylvania, Philadelphia, PA, United States
| | - Jie Zhang
- Department of Neurology, Institute of Neurology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoqing Hu
- Department of Psychology, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- HKU, Shenzhen Institute of Research and Innovation, Shenzhen, China
| | - Haiyan Wu
- Center for Cognitive and Brain Sciences and Department of Psychology, Macau, China
| | - Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhao
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Effect of perceived eye gaze on the N170 component – A systematic review. Neurosci Biobehav Rev 2022; 143:104913. [DOI: 10.1016/j.neubiorev.2022.104913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
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Electrophysiological and Behavioral Evidence for Hyper- and Hyposensitivity in Rare Genetic Syndromes Associated with Autism. Genes (Basel) 2022; 13:genes13040671. [PMID: 35456477 PMCID: PMC9027402 DOI: 10.3390/genes13040671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 01/27/2023] Open
Abstract
Our study reviewed abnormalities in spontaneous, as well as event-related, brain activity in syndromes with a known genetic underpinning that are associated with autistic symptomatology. Based on behavioral and neurophysiological evidence, we tentatively subdivided the syndromes on primarily hyper-sensitive (Fragile X, Angelman) and hypo-sensitive (Phelan–McDermid, Rett, Tuberous Sclerosis, Neurofibromatosis 1), pointing to the way of segregation of heterogeneous idiopathic ASD, that includes both hyper-sensitive and hypo-sensitive individuals. This segmentation links abnormalities in different genes, such as FMR1, UBE3A, GABRB3, GABRA5, GABRG3, SHANK3, MECP2, TSC1, TSC2, and NF1, that are causative to the above-mentioned syndromes and associated with synaptic transmission and cell growth, as well as with translational and transcriptional regulation and with sensory sensitivity. Excitation/inhibition imbalance related to GABAergic signaling, and the interplay of tonic and phasic inhibition in different brain regions might underlie this relationship. However, more research is needed. As most genetic syndromes are very rare, future investigations in this field will benefit from multi-site collaboration with a common protocol for electrophysiological and event-related potential (EEG/ERP) research that should include an investigation into all modalities and stages of sensory processing, as well as potential biomarkers of GABAergic signaling (such as 40-Hz ASSR).
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Sato A, Tominaga K, Iwatani Y, Kato Y, Wataya-Kaneda M, Makita K, Nemoto K, Taniike M, Kagitani-Shimono K. Abnormal White Matter Microstructure in the Limbic System Is Associated With Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders. Front Neurol 2022; 13:782479. [PMID: 35359647 PMCID: PMC8963953 DOI: 10.3389/fneur.2022.782479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTuberous sclerosis complex (TSC) is a genetic disease that arises from TSC1 or TSC2 abnormalities and induces the overactivation of the mammalian/mechanistic target of rapamycin pathways. The neurological symptoms of TSC include epilepsy and tuberous sclerosis complex-associated neuropsychiatric disorders (TAND). Although TAND affects TSC patients' quality of life, the specific region in the brain associated with TAND remains unknown. We examined the association between white matter microstructural abnormalities and TAND, using diffusion tensor imaging (DTI).MethodsA total of 19 subjects with TSC and 24 age-matched control subjects were enrolled. Tract-based spatial statistics (TBSS) were performed to assess group differences in fractional anisotropy (FA) between the TSC and control groups. Atlas-based association analysis was performed to reveal TAND-related white matter in subjects with TSC. Multiple linear regression was performed to evaluate the association between TAND and the DTI parameters; FA and mean diffusivity in seven target regions and projection fibers.ResultsThe TBSS showed significantly reduced FA in the right hemisphere and particularly in the inferior frontal occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF), uncinate fasciculus (UF), and genu of corpus callosum (CC) in the TSC group relative to the control group. In the association analysis, intellectual disability was widely associated with all target regions. In contrast, behavioral problems and autistic features were associated with the limbic system white matter and anterior limb of the internal capsule (ALIC) and CC.ConclusionThe disruption of white matter integrity may induce underconnectivity between cortical and subcortical regions. These findings suggest that TANDs are not the result of an abnormality in a specific brain region, but rather caused by connectivity dysfunction as a network disorder. This study indicates that abnormal white matter connectivity including the limbic system is relevant to TAND. The analysis of brain and behavior relationship is a feasible approach to reveal TAND related white matter and neural networks. TAND should be carefully assessed and treated at an early stage.
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Affiliation(s)
- Akemi Sato
- United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Koji Tominaga
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiko Iwatani
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoko Kato
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mari Wataya-Kaneda
- Division of Health Science, Department of Neurocutaneous Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Kiyotaka Nemoto
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kuriko Kagitani-Shimono
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
- *Correspondence: Kuriko Kagitani-Shimono
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Shephard E, McEwen FS, Earnest T, Friedrich N, Mörtl I, Liang H, Woodhouse E, Tye C, Bolton PF. Oscillatory neural network alterations in young people with tuberous sclerosis complex and associations with co-occurring symptoms of autism spectrum disorder and attention-deficit/hyperactivity disorder. Cortex 2021; 146:50-65. [PMID: 34839218 DOI: 10.1016/j.cortex.2021.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/25/2021] [Accepted: 10/20/2021] [Indexed: 12/20/2022]
Abstract
Tuberous sclerosis complex (TSC) is a genetic disorder caused by mutations on the TSC1/TSC2 genes, which result in alterations in molecular signalling pathways involved in neurogenesis and hamartomas in the brain and other organs. TSC carries a high risk for autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), although the reasons for this are unclear. One proposal is that TSC-related alterations in molecular signalling during neurogenesis lead to atypical development of neural networks, which are involved in the occurrence of ASD and ADHD in TSC. We investigated this proposal in young people with TSC who have been studied longitudinally since their diagnosis in childhood. Electroencephalography (EEG) was used to examine oscillatory connectivity in functional neural networks and local and global network organisation during three tasks (resting-state, attentional and inhibitory control Go/Nogo task, upright and inverted face processing task) in participants with TSC (n = 48) compared to an age- and sex-matched group of typically developing Controls (n = 20). Compared to Controls, the TSC group showed hypoconnected neural networks in the alpha frequency during the resting-state and in the theta and alpha frequencies during the Go/Nogo task (P ≤ .008), as well as reduced local network organisation in the theta and alpha frequencies during the Go/Nogo task (F = 3.95, P = .010). There were no significant group differences in network metrics during the face processing task. Increased connectivity in the hypoconnected alpha-range resting-state network was associated with greater ASD and inattentive ADHD symptoms (rho≥.40, P ≤ .036). Reduced local network organisation in the theta-range during the Go/Nogo task was significantly associated with higher hyperactive/impulsive ADHD symptoms (rho = -.43, P = .041). These findings suggest that TSC is associated with widespread hypoconnectivity in neural networks and support the proposal that altered network function may be involved in the co-occurrence of ASD and ADHD in TSC.
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Affiliation(s)
- Elizabeth Shephard
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK; Department of Psychiatry, University of São Paulo, Brazil.
| | - Fiona S McEwen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK; Department of Psychology, Queen Mary University of London, UK
| | - Thomas Earnest
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Nina Friedrich
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Isabelle Mörtl
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Holan Liang
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Emma Woodhouse
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | | | - Charlotte Tye
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK; Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Patrick F Bolton
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK; The Maudsley NIHR Biomedical Research Centre in Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
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O’Brien AM, Bayet L, Riley K, Nelson CA, Sahin M, Modi ME. Auditory Processing of Speech and Tones in Children With Tuberous Sclerosis Complex. Front Integr Neurosci 2020; 14:14. [PMID: 32327979 PMCID: PMC7161665 DOI: 10.3389/fnint.2020.00014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/05/2020] [Indexed: 11/17/2022] Open
Abstract
Individuals with Tuberous Sclerosis Complex (TSC) have atypical white matter integrity and neural connectivity in the brain, including language pathways. To explore functional activity associated with auditory and language processing in individuals with TSC, we used electroencephalography (EEG) to examine basic auditory correlates of detection (P1, N2, N4) and discrimination (mismatch negativity, MMN) of speech and non-speech stimuli for children with TSC and age- and sex-matched typically developing (TD) children. Children with TSC (TSC group) and without TSC (typically developing, TD group) participated in an auditory MMN paradigm containing two blocks of vowels (/a/and/u/) and two blocks of tones (800 Hz and 400 Hz). Continuous EEG data were collected. Multivariate pattern analysis (MVPA) was used to explore functional specificity of neural auditory processing. Speech-specific P1, N2, and N4 waveform components of the auditory evoked potential (AEP) were compared, and the mismatch response was calculated for both speech and tones. MVPA showed that the TD group, but not the TSC group, demonstrated above-chance pairwise decoding between speech and tones. The AEP component analysis suggested that while the TD group had an increased P1 amplitude in response to vowels compared to tones, the TSC group did not show this enhanced response to vowels. Additionally, the TD group had a greater N2 amplitude in response to vowels, but not tones, compared to the TSC group. The TSC group also demonstrated a longer N4 latency to vowels compared to tones, which was not seen in the TD group. No group differences were observed in the MMN response. In this study we identified features of the auditory response to speech sounds, but not acoustically matched tones, which differentiate children with TSC from TD children.
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Affiliation(s)
- Amanda M. O’Brien
- Program in Speech and Hearing Bioscience and Technology, Division of Medical Sciences, Harvard University, Cambridge, MA, United States
| | - Laurie Bayet
- Department of Psychology, American University, Washington, DC, United States
| | - Katherine Riley
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA, United States
| | - Charles A. Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA, United States
- Harvard Graduate School of Education, Harvard University, Cambridge, MA, United States
| | - Mustafa Sahin
- Translational Neuroscience Center, Boston Children’s Hospital, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Meera E. Modi
- Translational Neuroscience Center, Boston Children’s Hospital, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
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Dwyer P, Xu B, Tanaka JW. Investigating the perception of face identity in adults on the autism spectrum using behavioural and electrophysiological measures. Vision Res 2019; 157:132-141. [DOI: 10.1016/j.visres.2018.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 02/06/2018] [Accepted: 02/11/2018] [Indexed: 11/16/2022]
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Modi ME, Sahin M. Translational use of event-related potentials to assess circuit integrity in ASD. Nat Rev Neurol 2017; 13:160-170. [DOI: 10.1038/nrneurol.2017.15] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Purpose
– The purpose of this paper is to provide a brief, descriptive overview of Tuberous Sclerosis Complex (TSC) research with particular reference to studies on Autism Spectrum Disorder (ASD).
Design/methodology/approach
– A search of electronic databases was carried out to identify English language articles on TSC. The literature was explored in more detail with a focus on neurodevelopmental disorders associated with TSC such as ASD.
Findings
– The review included 3,679 references. The earliest articles identified were published in the early twentieth century. Since then research on TSC has advanced rapidly and is being carried out worldwide. Just 62 studies have focused on ASD in TSC, although the number of publications is increasing over time.
Research limitations/implications
– More research on ASD in TSC is needed to benefit those affected by TSC and the broader ASD scientific community.
Practical implications
– Practitioners working with children and adults with ASD should be aware of the wider health issues experienced by those with genetic conditions such as TSC. Similarly, clinicians working with those who have TSC should be aware of the high prevalence of ASD in the group and implications for the way they work with their patients.
Originality/value
– This is the first paper to map and characterise the scientific literature on TSC. There remains a focus on the biomedical aspects of TSC with fewer studies on psychosocial/educational or family impacts. The review concludes with recommended research questions for the future.
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