The Physiology of Cognition in Autism Spectrum Disorder: Current and Future Challenges

Prenatal ozone exposure and risk of intellectual disability

BACKGROUND

Knowledge of relationships between tropospheric ozone and mental and developmental health outcomes is currently inconclusive, with the largest knowledge gaps for children. This gap is important to address as evidence suggests that climate change will worsen ozone pollution.

OBJECTIVE

We examine the association of average ozone exposure during the preconception period, and first, second and third trimesters of pregnancy on the odds of intellectual disability (ID) in Utah children.

METHODS

For the period of 2002-2020, we assembled daily, tract-level ozone concentration data, data on ID case status, and data on cases' full siblings and population controls. We analyzed the data using generalized estimating equations.

RESULTS

Ozone was positively associated with the odds of ID in cases vs. their siblings (in the preconception, first, second and third trimester exposure windows, all p < 0.05, n = 1042) and vs. population controls (only in the second trimester exposure window, p < 0.05, n = 5179). The strength of the association was largest during the second trimester in both analyses. A second trimester average ozone level increase of 10 ppb was associated with a 55.3% increase in the odds of ID relative to full siblings (95% confidence interval [CI]: 1.171-2.058) and a 22.8% increase in the odds of ID relative to population controls (CI: 1.054-1.431). Findings were robust to different subsets of sibling controls as well as several sensitivity analyses.

SIGNIFICANCE

Results document that ozone has a measurable relationship with children's cognitive development in Utah.

IMPACT STATEMENT

Evidence suggests that climate change will worsen ozone pollution. The potential amplifying effect of climate change on ozone is more certain than it is for fine particulate matter. This means that ozone and health research will remain relevant into the future. Currently, several systematic reviews and meta-analyses have concluded that knowledge about ozone and cognitive health is insufficient, especially for children. Using two different study designs, we find that prenatal ozone exposure is associated with risk of intellectual disability in children.

Molecular physiology unlocks the mystery that relates cognitive impairment with the retina in schizophrenia and autism spectrum disorders: a perspective review

Schizophrenia and Autism spectrum disorders (SSD and ASD) are neurodevelopmental disorders involving cognitive impairment. Timely diagnosis is important for early intervention; currently, no tools are available to help with early diagnosis. Molecular biomarkers of cognitive impairment have been extensively studied, but clinical correlation is crucial in screening for cognitive impairment in SSD and ASD. There has been growing interest in examining the retina to scan for neurological disorders since the retina is the only part of the central nervous system that can be directly imaged non-invasively and in a timely manner. This review discusses biomarkers of cognitive impairment and their correlation to the retina in SSD and ASD. It also discusses the possible involvement of the retina and molecular biomarkers, specifically Disintegrin and metalloproteinase domain-containing protein 10 (ADAM10) and ciliary neurotrophic factor (CNTF) in the pathophysiology of SSD and ASD. A protocol for early diagnosing cognitive impairment and its severity in SSD and ASD is also suggested. This review also mentions insights into the potential use of molecular biomarkers of cognitive impairment to enhance cognitive performance in ASD and SSD and areas where more research is needed to solve the mystery of the relationship between the retina and cognitive impairment in neurodevelopmental psychiatric disorders.

Multimodal Physiotherapy Approach for Autism With Speech Impairment and Attention Deficit: A Case Report

Autism is a disorder distinguished by significant challenges in social interaction and communication coupled with repetitive and stereotypical patterns of behavior and activities. Deficits in social interaction and language development become apparent before age three. In children, this condition is referred to as autism spectrum disorder (ASD). Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. Individuals with ADHD may struggle with sustaining attention, organizing tasks, and completing assignments. They may exhibit hyperactive behaviors such as fidgeting, difficulty staying seated, and impulsive actions like interrupting others. ADHD can significantly impact daily functioning and is often diagnosed in childhood, with symptoms potentially persisting into adulthood. The disorder has three main subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined presentation. Treatment typically involves a combination of behavioral interventions, psychoeducation, and, in some cases, medication, aiming to provide support and strategies for individuals to manage their symptoms effectively in various aspects of life. Cognitive impairment in ASD varies, meaning it could be at the sensory perception level of cognitive processing, learning, and memory. The goal of the training intervention was to control physiological arousal, enhance awareness, keep annoyance from getting worse, and encourage self-regulation abilities. In this case report, we discuss the approach of multimodal physiotherapy for autism with speech impairment and attention deficit. Furthermore, physiotherapy needs to find a position in the new mental health care paradigm in order to contribute to mental health care.