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Radhoe TA, van Rentergem JAA, Torenvliet C, Groenman AP, van der Putten WJ, Geurts HM. Comparison of network structures between autistic and non-autistic adults, and autism subgroups: A focus on demographic, psychological, and lifestyle factors. Autism 2024; 28:1175-1189. [PMID: 37776020 PMCID: PMC11067416 DOI: 10.1177/13623613231198544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
LAY ABSTRACT There are large differences in the level of demographic, psychological, and lifestyle characteristics between autistic and non-autistic adults but also among autistic people. Our goal was to test whether these differences correspond to differences in underlying relationships between these characteristics-also referred to as network structure-to determine which characteristics (and relationships between them) are important. We tested differences in network structure in (1) autistic and non-autistic adults and (2) two previously identified subgroups of autistic adults. We showed that comparing networks of autistic and non-autistic adults provides subtle differences, whereas networks of the autism subgroups were similar. There were also no sex differences in the networks of the autism subgroups. Thus, the previously observed differences in the level of characteristics did not correspond to differences across subgroups in how these characteristics relate to one another (i.e. network structure). Consequently, a focus on differences in characteristics is not sufficient to determine which characteristics (and relationships between them) are of importance. Hence, network analysis provides a valuable tool beyond looking at (sub)group level differences. These results could provide hints for clinical practice, to eventually determine whether psychological distress, cognitive failures, and reduced quality of life in autistic adults can be addressed by tailored support. However, it is important that these results are first replicated before we move toward intervention or support.
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Affiliation(s)
| | | | | | | | - Wikke J van der Putten
- University of Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassia Groep), The Netherlands
| | - Hilde M Geurts
- University of Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassia Groep), The Netherlands
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Pugliese CE, Handsman R, You X, Anthony LG, Vaidya C, Kenworthy L. Probing heterogeneity to identify individualized treatment approaches in autism: Specific clusters of executive function challenges link to distinct co-occurring mental health problems. Autism 2024:13623613241246091. [PMID: 38642028 DOI: 10.1177/13623613241246091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
LAY ABSTRACT Many autistic people struggle with mental health problems like anxiety, depression, inattention, and aggression, which can be challenging to treat. Executive function challenges, which impact many autistic individuals, may serve as a risk factor for mental health problems or make treating mental health conditions more difficult. While some people respond well to medication or therapy, others do not. This study tried to understand if there are different subgroups of autistic young people who may have similar patterns of executive function strengths and challenges-like flexibility, planning, self-monitoring, and emotion regulation. Then, we investigated whether executive function subgroups were related to mental health problems in autistic youth. We found three different types of executive function subgroups in autistic youth, each with different patterns of mental health problems. This helps us identify specific profiles of executive function strengths and challenges that may be helpful with identifying personalized supports, services, and treatment strategies for mental health conditions.
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Gomozova M, Lezzhova V, Dragoy O, Lopukhina A. Testing the Continuum/Spectrum Model in Russian-Speaking Children With and Without Developmental Language Disorder. J Speech Lang Hear Res 2024:1-17. [PMID: 38573830 DOI: 10.1044/2024_jslhr-23-00596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
PURPOSE Previously, Lancaster and Camarata (2019) showed that the continuum/spectrum model of the developmental language disorder (DLD) best explained the high heterogeneity of symptoms in children with DLD. We hypothesize that the continuum/spectrum approach can include not only children with DLD but also typically developing (TD) children with different timelines and patterns of language acquisition. This model can explain individual language profiles and deficits in children. METHOD We assessed language abilities in a group of Russian-speaking children with DLD aged 4-7 years (n = 53) and their age- and gender-matched peers without speech and language diagnoses (n = 53, TD). We evaluated the children's performance at four language levels in production and comprehension domains, using 11 subtests of the standardized language assessment for Russian: Russian Child Language Assessment Battery (RuCLAB). Using the k-means cluster method and RuCLAB scores, we obtained two clusters of children and analyzed their language performance in individual subtests. RESULTS The analysis revealed that the two clusters of children both included DLD and TD participants: Group 1, with higher test scores (TD = 45, DLD = 24 children), and Group 2, with lower scores (TD = 8, DLD = 29). Children from Group 1 mostly had lower scores at one of the language levels, whereas those from Group 2 struggled at several language levels. Furthermore, children with DLD from both groups tended to be more sensitive to linguistic features such as word length, noun case, and sentence reversibility compared to TD children. CONCLUSIONS The presence of two mixed groups shows that children with diagnosed DLD could perform on par with TD children, whereas some younger TD children could perform similarly to children with DLD. Our findings support the continuum/spectrum model: Linguistic skills in preschool children are a continuum, varying from high to poor skills at all language levels in comprehension and production. To describe a child's language profile, the tasks assessing all language levels should be used. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25521400.
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Affiliation(s)
| | | | - Olga Dragoy
- Center for Language and Brain, HSE University, Moscow, Russia
- Institute of Linguistics, Russian Academy of Sciences, Moscow, Russia
| | - Anastasiya Lopukhina
- Center for Language and Brain, HSE University, Moscow, Russia
- Royal Holloway, University of London, Egham, United Kingdom
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van der Putten WJ, Mol AJJ, Radhoe TA, Torenvliet C, Agelink van Rentergem JA, Groenman AP, Geurts HM. The relationship between camouflaging and mental health: Are there differences among subgroups in autistic adults? Autism 2024; 28:908-919. [PMID: 37497845 PMCID: PMC10981194 DOI: 10.1177/13623613231185402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
LAY ABSTRACT When autistic people use strategies to hide their autistic characteristics, we call this camouflaging. Autistic adults suggested that camouflaging can result in mental health difficulties. That is, people who report to camouflage also report mental health difficulties. However, since there are many differences between autistic people, this relationship may also differ between subgroups. Therefore, in this study we investigated whether camouflaging and mental health difficulties are related and whether this relationship is equal for all autistic adults. For this study, 352 autistic adults aged 30-84 years filled in the Dutch Camouflaging Autistic Traits Questionnaire to measure camouflaging and the Symptom Checklist-90 Revised to measure mental health difficulties. We found that camouflaging was moderately related to mental health difficulties. This means that people who report more camouflaging also report more mental health difficulties. When we looked closer, we found that this relationship was strong for only a small subgroup of autistic adults. In most other autistic adults, there was a small or no relationship between camouflaging and mental health difficulties. Therefore, it is important that clinicians are aware of camouflaging and its possible relationship with mental health difficulties, but that they do not generalize the negative consequences to everyone.
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Affiliation(s)
- Wikke J van der Putten
- Leo Kannerhuis (Youz/Parnassia Group), The Netherlands
- University of Amsterdam, The Netherlands
| | - Audrey JJ Mol
- Leo Kannerhuis (Youz/Parnassia Group), The Netherlands
| | | | | | | | | | - Hilde M Geurts
- Leo Kannerhuis (Youz/Parnassia Group), The Netherlands
- University of Amsterdam, The Netherlands
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Lamanna J, Meldolesi J. Autism Spectrum Disorder: Brain Areas Involved, Neurobiological Mechanisms, Diagnoses and Therapies. Int J Mol Sci 2024; 25:2423. [PMID: 38397100 PMCID: PMC10889781 DOI: 10.3390/ijms25042423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Autism spectrum disorder (ASD), affecting over 2% of the pre-school children population, includes an important fraction of the conditions accounting for the heterogeneity of autism. The disease was discovered 75 years ago, and the present review, based on critical evaluations of the recognized ASD studies from the beginning of 1990, has been further developed by the comparative analyses of the research and clinical reports, which have grown progressively in recent years up to late 2023. The tools necessary for the identification of the ASD disease and its related clinical pathologies are genetic and epigenetic mutations affected by the specific interaction with transcription factors and chromatin remodeling processes occurring within specific complexes of brain neurons. Most often, the ensuing effects induce the inhibition/excitation of synaptic structures sustained primarily, at dendritic fibers, by alterations of flat and spine response sites. These effects are relevant because synapses, established by specific interactions of neurons with glial cells, operate as early and key targets of ASD. The pathology of children is often suspected by parents and communities and then confirmed by ensuing experiences. The final diagnoses of children and mature patients are then completed by the combination of neuropsychological (cognitive) tests and electro-/magneto-encephalography studies developed in specialized centers. ASD comorbidities, induced by processes such as anxieties, depressions, hyperactivities, and sleep defects, interact with and reinforce other brain diseases, especially schizophrenia. Advanced therapies, prescribed to children and adult patients for the control of ASD symptoms and disease, are based on the combination of well-known brain drugs with classical tools of neurologic and psychiatric practice. Overall, this review reports and discusses the advanced knowledge about the biological and medical properties of ASD.
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Affiliation(s)
- Jacopo Lamanna
- Center for Behavioral Neuroscience and Communication (BNC), 20132 Milan, Italy;
- Faculty of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Jacopo Meldolesi
- IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
- CNR Institute of Neuroscience, Milano-Bicocca University, 20854 Vedano al Lambro, Italy
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Chen P, Zhang S, Zhao K, Kang X, Rittman T, Liu Y. Robustly uncovering the heterogeneity of neurodegenerative disease by using data-driven subtyping in neuroimaging: A review. Brain Res 2024; 1823:148675. [PMID: 37979603 DOI: 10.1016/j.brainres.2023.148675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
Neurodegenerative diseases are associated with heterogeneity in genetics, pathology, and clinical manifestation. Understanding this heterogeneity is particularly relevant for clinical prognosis and stratifying patients for disease modifying treatments. Recently, data-driven methods based on neuroimaging have been applied to investigate the subtyping of neurodegenerative disease, helping to disentangle this heterogeneity. We reviewed brain-based subtyping studies in aging and representative neurodegenerative diseases, including Alzheimer's disease, mild cognitive impairment, frontotemporal dementia, and Lewy body dementia, from January 2000 to November 2022. We summarized clustering methods, validation, robustness, reproducibility, and clinical relevance of 71 eligible studies in the present study. We found vast variations in approaches between studies, including ten neuroimaging modalities, 24 cluster algorithms, and 41 methods of cluster number determination. The clinical relevance of subtyping studies was evaluated by summarizing the analysis method of clinical measurements, showing a relatively low clinical utility in the current studies. Finally, we conclude that future studies of heterogeneity in neurodegenerative disease should focus on validation, comparison between subtyping approaches, and prioritise clinical utility.
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Affiliation(s)
- Pindong Chen
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Shirui Zhang
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China
| | - Kun Zhao
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China
| | - Xiaopeng Kang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Yong Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
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Napolitano A, Guerrera S, Lucignani M, Parrillo C, Baldassari G, Bottino F, Moltoni G, Espagnet MCR, Talamanca LF, Valeri G, Vicari S. Assessing cortical features in early stage ASD children. Front Psychiatry 2024; 14:1098265. [PMID: 38268563 PMCID: PMC10806120 DOI: 10.3389/fpsyt.2023.1098265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/15/2023] [Indexed: 01/26/2024] Open
Abstract
Autism Spectrum Disorder (ASD) is defined as a neurodevelopmental disorder largely investigated in the neurologic field. Recently, neuroimaging studies have been conducted in order to investigate cerebral morphologic alterations in ASD patients, demonstrating an atypical brain development before the clinical manifestations of the disorder. Cortical Thickness (CT) and Local Gyrification Index (LGI) distribution for ASD children were investigated in this study, with the aim to evaluate possible relationship between brain measures and individual characteristics (i.e., IQ and verbal ability). 3D T1-w sequences from 129 ASD and 58 age-matched Healthy Controls (HC) were acquired and processed in order to assess CT and LGI for each subject. Intergroup differences between ASD and HC were investigated, including analyses of 2 ASD subgroups, split according to patient verbal ability and IQ. When compared to HC, ASD showed increased CT and LGI within several brain areas, both as an overall group and as verbal ability an IQ subgroups. Moreover, when comparing language characteristics of the ASD subjects, those patients with verbal ability exhibit significant CT and LGI increase was found within the occipital lobe of right hemisphere. No significant results occurred when comparing ASD patients according to their IQ value. These results support the hypothesis of abnormal brain maturation in ASD since early childhood with differences among clinical subgroups suggesting different anatomical substrates underlying an aberrant connectivity.
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Affiliation(s)
- Antonio Napolitano
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Silvia Guerrera
- Neuroscience Department, Child Neuropsychiatric Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Martina Lucignani
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Chiara Parrillo
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giulia Baldassari
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Francesca Bottino
- Medical Physics Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giulia Moltoni
- Imaging Department, Neuroradiology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Neuroradiology, NEMOS S. Andrea Hospital, University Sapienza, Rome, Italy
| | | | - Lorenzo Figà Talamanca
- Imaging Department, Neuroradiology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giovanni Valeri
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Guo X, Zhai G, Liu J, Zhang X, Zhang T, Cui D, Zhou R, Gao L. Heterogeneity of dynamic synergetic configurations of salience network in children with autism spectrum disorder. Autism Res 2023; 16:2275-2290. [PMID: 37815146 DOI: 10.1002/aur.3037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
Atypical functional connectivity (FC) patterns have been identified in autism spectrum disorders (ASD), especially within salience network (SN) and between SN and default mode network (DMN) and central executive network (CEN). But whether the dynamic configuration of intra-SN and inter-SN (SN with DMN and CEN) FC in ASD is also heterogeneous remains unknown. Based on the resting-state functional magnetic resonance imaging data from 105 ASD and 102 typically-developing controls (TC), we calculated the time-varying FC of intra-SN and inter-SN (SN with DMN and CEN). Then, the joint recurrence features for the time-varying FC were calculated to assess how the SN dynamically recruits different configurations of network segregation and integration in ASD, that is, synergies, from the dynamical systems perspective. We analyzed the differences in synergetic patterns between ASD subtypes obtained by k-means clustering algorithm based on the synergy of SN and TC, and investigated the relationships between synergy of SN and severity of clinical symptoms of ASD for ASD subtypes. Two ASD subtypes were revealed, where the synergy of SN in ASD subtype 1 has lower stability and periodicity compared to the TC, and ASD subtype 2 exhibits the opposite alteration. Synergy of SN for ASD subtype 1 and 2 was found to predict the severity of communication impairments and restricted and repetitive behaviors in ASD, respectively. These results suggest the existence of subtypes with distinct patterns of the synergy of SN in ASD, and provide insight into the complex pathophysiological mechanism of clinical manifestations of ASD.
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Affiliation(s)
- Xiaonan Guo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
| | - Guangjin Zhai
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
| | - Junfeng Liu
- Department of Neurology, West China Hospital Sichuan University, Chengdu, China
| | - Xia Zhang
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
| | - Tao Zhang
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
| | - Dong Cui
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
| | - Rongjuan Zhou
- Finance Department, Maternity and Child Health Hospital of Qinhuangdao, Qinhuangdao, China
| | - Le Gao
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
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Uljarević M, Frazier TW, Chetcuti L. Asperger syndrome and clinical heterogeneity: Reflections on the past, present, and future. Dev Med Child Neurol 2023; 65:1414-1415. [PMID: 37641436 DOI: 10.1111/dmcn.15741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, CA, Stanford, USA
| | - Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights, OH, USA
| | - Lacey Chetcuti
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, CA, Stanford, USA
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
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Wittkopf S, Langmann A, Roessner V, Roepke S, Poustka L, Nenadić I, Stroth S, Kamp-Becker I. Conceptualization of the latent structure of autism: further evidence and discussion of dimensional and hybrid models. Eur Child Adolesc Psychiatry 2023; 32:2247-2258. [PMID: 36006478 PMCID: PMC10576682 DOI: 10.1007/s00787-022-02062-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
Autism spectrum disorder (ASD) might be conceptualized as an essentially dimensional, categorical, or hybrid model. Yet, current empirical studies are inconclusive and the latent structure of ASD has explicitly been examined only in a few studies. The aim of our study was to identify and discuss the latent model structure of behavioral symptoms related to ASD and to address the question of whether categories and/or dimensions best represent ASD symptoms. We included data of 2920 participants (1-72 years of age), evaluated with the Autism Diagnostic Observation Schedule (Modules 1-4). We applied latent class analysis, confirmatory factor analysis, and factor mixture modeling and evaluated the model fit by a combination of criteria. Based on the model selection criteria, the model fits, the interpretability as well as the clinical utility we conclude that the hybrid model serves best for conceptualization and assessment of ASD symptoms. It is both grounded in empirical evidence and in clinical usefulness, is in line with the current classification system (DSM-5) and has the potential of being more specific than the dimensional approach (decreasing false positive diagnoses).
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Affiliation(s)
- Sarah Wittkopf
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
| | - Anika Langmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Technical University Dresden, Dresden, Germany
| | - Stefan Roepke
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany.
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
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Fung HW, Chau AKC, Hung SL, Lam SKK, Chien WT, Lee VWP. Persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms: a one-year follow-up study. Eur J Psychotraumatol 2023; 14:2263314. [PMID: 37818716 PMCID: PMC10569344 DOI: 10.1080/20008066.2023.2263314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has been proposed, little is known about the persistence and clinical consequences of these symptoms. OBJECTIVE This one-year follow-up study investigated the persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms. METHODS We analyzed longitudinal data from an international sample of people self-reporting depressive emotions (N = 152) (mean Patient Health Questionnaire-9 score = 17.27; SD = 6.31). RESULTS More than half (58.4%) of participants with baseline post-traumatic stress disorder (PTSD) still met the criteria for PTSD after one year. Participants with dissociative symptoms at baseline were significantly more likely to report lifetime psychiatric hospitalization (31.2% vs 14.7%), past-year use of psychiatric hospitalization (10.4% vs 0%) and emergency services (16.9% vs 4%) than those without dissociative symptoms. All post-traumatic and dissociative symptom clusters were cross-sectionally (r = .286 to .528, p < .001) and longitudinally (r = .181 to .462, p < .001) correlated with depressive symptoms. A sense of current threat (β = .146, p < .05) and negative self-concept (β = .173, p < .05) at baseline significantly predicted depressive symptoms after one year. CONCLUSIONS These findings contribute to the increasing body of knowledge regarding the PTSD/dissociation-depression comorbidity. Given their persistence and clinical consequences, we recommend that post-traumatic and dissociative symptoms be regularly screened for in clinical settings. The existence of a possible trauma-related subtype of depression should receive more attention in both research and clinical practice.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Anson Kai Chun Chau
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wai Tong Chien
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Zhang X, Song XK, So WC. Examining Phenotypical Heterogeneity and its Underlying Factors in Gesture Skills of Chinese Autistic Children: Clustering Analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06049-9. [PMID: 37642873 DOI: 10.1007/s10803-023-06049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE The heterogeneity of autism is well documented, but few studies have studied the heterogeneity of gesture production ability in autistic children. The present study aimed to identify subgroups of autistic children who displayed heterogeneous gesture production abilities and explore the underlying factors, including autism characteristics, intellectual ability, and language ability, that were associated with the heterogeneity. METHODS A total of 65 Chinese autistic children (mean age = 5;3) participated. Their autism characteristics and intellectual ability were assessed by standardized measurements. Language output and gesture production were captured from a parent-child interaction task. RESULTS We conducted a hierarchical cluster analysis and identified four distinct clusters. Cluster 1 and Cluster 2 both had low gesture production whereas Cluster 3 and Cluster 4 had high gesture production. Both Clusters 1 and 2 had relatively strong autism characteristics, in comparison to Clusters 3 and 4. CONCLUSIONS Our findings revealed that children with stronger autism characteristics may gesture less often than those with weaker characteristics. However, the relationship between language ability and intellectual ability and gesture production was not clear. These findings shed light on the directions of intervention on gesture production for autistic children, especially those with stronger autism characteristics.
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Affiliation(s)
- Xin Zhang
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, The People's Republic of China.
| | - Xue-Ke Song
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, The People's Republic of China
| | - Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, The People's Republic of China
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Vicedo M. Autism's heterogeneity in historical perspective: from challenge to opportunity. Front Psychol 2023; 14:1188053. [PMID: 37599736 PMCID: PMC10435077 DOI: 10.3389/fpsyg.2023.1188053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Marga Vicedo
- Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, ON, Canada
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14
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Radhoe TA, Agelink van Rentergem JA, Torenvliet C, Groenman AP, van der Putten WJ, Geurts HM. Finding Similarities in Differences Between Autistic Adults: Two Replicated Subgroups. J Autism Dev Disord 2023:10.1007/s10803-023-06042-2. [PMID: 37438586 DOI: 10.1007/s10803-023-06042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/14/2023]
Abstract
Autism is heterogeneous, which complicates providing tailored support and future prospects. We aim to identify subgroups in autistic adults with average to high intelligence, to clarify if certain subgroups might need support. We included 14 questionnaire variables related to aging and/or autism (e.g., demographic, psychological, and lifestyle). Community detection analysis was used for subgroup identification in an original sample of 114 autistic adults with an adulthood diagnosis (autism) and 58 non-autistic adults as comparison group (COMP), and a replication sample (NAutism = 261; NCOMP = 287), both aged 30-89 years. Next, we identified subgroups and assessed external validity (for cognitive and psychological difficulties, and quality of life [QoL]) in the autism samples. To test specificity, we repeated the analysis after adding 123 adults with ADHD, aged 30-80 years. As expected, the autism and COMP groups formed distinct subgroups. Among autistic adults, we identified three subgroups of which two were replicated. One of these subgroups seemed most vulnerable on the cluster variables; this subgroup also reported the most cognitive and psychological difficulties, and lowest QoL. Adding the ADHD group did not alter results. Within autistic adults, one subgroup could especially benefit from support and specialized care, although this must be tested in future studies.
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Affiliation(s)
- Tulsi A Radhoe
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands.
| | - Joost A Agelink van Rentergem
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Carolien Torenvliet
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Annabeth P Groenman
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Research Institute for Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Wikke J van der Putten
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands
| | - Hilde M Geurts
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands
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15
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Ren P, Bi Q, Pang W, Wang M, Zhou Q, Ye X, Li L, Xiao L. Stratifying ASD and characterizing the functional connectivity of subtypes in resting-state fMRI. Behav Brain Res 2023; 449:114458. [PMID: 37121277 DOI: 10.1016/j.bbr.2023.114458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/12/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Although stratifying autism spectrum disorder (ASD) into different subtypes is a common effort in the research field, few papers have characterized the functional connectivity alterations of ASD subgroups classified by their clinical presentations. METHODS This is a case-control rs-fMRI study, based on large samples of open database (Autism Brain Imaging Data Exchange, ABIDE). The rs-MRI data from n=415 ASD patients (males n=357), and n=574 typical development (TD) controls (males n=410) were included. Clinical features of ASD were extracted and classified using data from each patient's Autism Diagnostic Interview-Revised (ADI-R) evaluation. Each subtype of ASD was characterized by local functional connectivity using regional homogeneity (ReHo) for assessment, remote functional connectivity using voxel-mirrored homotopic connectivity (VMHC) for assessment, the whole-brain functional connectivity, and graph theoretical features. These identified imaging properties from each subtype were integrated to create a machine learning model for classifying ASD patients into the subtypes based on their rs-fMRI data, and an independent dataset was used to validate the model. RESULTS All ASD participants were classified into Cluster-1 (patients with more severe impairment) and Cluster-2 (patients with moderate impairment) according to the dimensional scores of ADI-R. When compared to the TD group, Cluster-1 demonstrated increased local connection and decreased remote connectivity, and widespread hyper- and hypo-connectivity variations in the whole-brain functional connectivity. Cluster-2 was quite similar to the TD group in both local and remote connectivity. But at the level of whole-brain functional connectivity, the MCC-related connections were specifically impaired in Cluster-2. These properties of functional connectivity were fused to build a machine learning model, which achieved ~75% for identifying ASD subtypes (Cluster-1 accuracy = 81.75%; Cluster-2 accuracy = 76.48%). CONCLUSIONS The stratification of ASD by clinical presentations can help to minimize disease heterogeneity and highlight the distinguished properties of brain connectivity in ASD subtypes.
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Affiliation(s)
- Pengchen Ren
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China; NHC Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China
| | - Qingshang Bi
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China
| | - Wenbin Pang
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China
| | - Meijuan Wang
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China
| | - Qionglin Zhou
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China
| | - Xiaoshan Ye
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China
| | - Ling Li
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China; School of Pediatrics, Hainan Medical University, Haikou, China.
| | - Le Xiao
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, China; School of Pediatrics, Hainan Medical University, Haikou, China.
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16
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Rabot J, Rødgaard EM, Joober R, Dumas G, Bzdok D, Bernhardt B, Jacquemont S, Mottron L. Genesis, modelling and methodological remedies to autism heterogeneity. Neurosci Biobehav Rev 2023; 150:105201. [PMID: 37116771 DOI: 10.1016/j.neubiorev.2023.105201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
Diagnostic criteria used in autism research have undergone a shift towards the inclusion of a larger population, paralleled by increasing, but variable, estimates of autism prevalence across clinical settings and continents. A categorical diagnosis of autism spectrum disorder is now consistent with large variations in language, intelligence, comorbidity, and severity, leading to a heterogeneous sample of individuals, increasingly distant from the initial prototypical descriptions. We review the history of autism diagnosis and subtyping, and the evidence of heterogeneity in autism at the cognitive, neurological, and genetic levels. We describe two strategies to address the problem of heterogeneity: clustering, and truncated-compartmentalized enrollment strategy based on prototype recognition. The advances made using clustering methods have been modest. We present an alternative, new strategy for dissecting autism heterogeneity, emphasizing incorporation of prototypical samples in research cohorts, comparison of subgroups defined by specific ranges of values for the clinical specifiers, and retesting the generality of neurobiological results considered to be acquired from the entire autism spectrum on prototypical cohorts defined by narrow specifiers values.
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Affiliation(s)
| | - Eya-Mist Rødgaard
- Department of Psychology, Copenhagen University, Copenhagen, Denmark,.
| | - Ridha Joober
- Neurological Institute and Hospital, McGill University, Montreal, Quebec, H4H 1R3, Canada,.
| | - Guillaume Dumas
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada,.
| | - Danilo Bzdok
- Mila - Quebec Artificial Intelligence Institute, Montreal, Canada, Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, H3A 2B4, QC, Canada,.
| | - Boris Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, McGill University, Montreal, QC, H3A 2B4, Canada,.
| | - Sebastien Jacquemont
- Department of Pediatrics, University of Montreal, Montréal, Quebec, H3T 1C5, Canada,.
| | - Laurent Mottron
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, CIUSSS-NIM, Research Center, Montréal, QC, H1E 1A4, Canada,.
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17
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Brucar LR, Feczko E, Fair DA, Zilverstand A. Current Approaches in Computational Psychiatry for the Data-Driven Identification of Brain-Based Subtypes. Biol Psychiatry 2023; 93:704-716. [PMID: 36841702 PMCID: PMC10038896 DOI: 10.1016/j.biopsych.2022.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
The ability of our current psychiatric nosology to accurately delineate clinical populations and inform effective treatment plans has reached a critical point with only moderately successful interventions and high relapse rates. These challenges continue to motivate the search for approaches to better stratify clinical populations into more homogeneous delineations, to better inform diagnosis and disease evaluation, and prescribe and develop more precise treatment plans. The promise of brain-based subtyping based on neuroimaging data is that finding subgroups of individuals with a common biological signature will facilitate the development of biologically grounded, targeted treatments. This review provides a snapshot of the current state of the field in empirical brain-based subtyping studies in child, adolescent, and adult psychiatric populations published between 2019 and March 2022. We found that there is vast methodological exploration and a surprising number of new methods being created for the specific purpose of brain-based subtyping. However, this methodological exploration and advancement is not being met with rigorous validation approaches that assess both reproducibility and clinical utility of the discovered brain-based subtypes. We also found evidence for a collaboration crisis, in which methodological exploration and advancements are not clearly grounded in clinical goals. We propose several steps that we believe are crucial to address these shortcomings in the field. We conclude, and agree with the authors of the reviewed studies, that the discovery of biologically grounded subtypes would be a significant advancement for treatment development in psychiatry.
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Affiliation(s)
- Leyla R Brucar
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Eric Feczko
- Masonic Institute for the Developing Brain, University of Minnesota Medical School, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Damien A Fair
- Masonic Institute for the Developing Brain, University of Minnesota Medical School, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota; Institute of Child Development, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Anna Zilverstand
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota; Medical Discovery Team on Addiction, University of Minnesota Medical School, Minneapolis, Minnesota.
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18
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Chetcuti L, Uljarević M, Varcin KJ, Boutrus M, Dimov S, Pillar S, Barbaro J, Dissanayake C, Green J, Whitehouse AJO, Hudry K. Continuity of temperament subgroup classifications from infancy to toddlerhood in the context of early autism traits. Autism Res 2023; 16:591-604. [PMID: 36511365 DOI: 10.1002/aur.2874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
Our previous cross-sectional investigation (Chetcuti et al., 2020) showed that infants with autism traits could be divided into distinct subgroups based on temperament. This longitudinal study builds on this existing work by exploring the continuity of temperament subgroup classifications and their associations with behavioral/clinical phenotypic features from infancy to toddlerhood. 103 infants (68% male) showing early signs of autism were referred to the study by community healthcare professionals and seen for assessments when aged around 12-months (Time 1), 18-months (Time 2), and 24-months (Time 3). Latent profile analysis revealed inhibited/low positive, active/negative reactive, and sociable/well-regulated subgroups at each timepoint, and a unique reactive/regulated subgroup at Time 3. Cross-tabulations indicated a significant likelihood of children having a recurrent subgroup classification from one timepoint to the next, and no apparent patterns to the movement of children who did change from one subgroup to another over time. Temperament subgroups were associated with concurrent child social-emotional functioning and autism traits, but unrelated to child age, sex, or developmental level. These findings suggest that temperament subgroup classifications might represent a reliable and very early indicator of autism characteristics and social-emotional functioning among infants/toddlers with autism traits.
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Affiliation(s)
- Lacey Chetcuti
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Mirko Uljarević
- Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, School of Medicine, Stanford University, Palo Alto, USA.,Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kandice J Varcin
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - Maryam Boutrus
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - Stefanie Dimov
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Sarah Pillar
- Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - Josephine Barbaro
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Cheryl Dissanayake
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Andrew J O Whitehouse
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - Kristelle Hudry
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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19
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Montgomery A, Masi A, Whitehouse A, Veenstra-VanderWeele J, Shuffrey L, Shen MD, Karlov L, Uljarevic M, Alvares G, Woolfenden S, Silove N, Eapen V. Identification of subgroups of children in the Australian Autism Biobank using latent class analysis. Child Adolesc Psychiatry Ment Health 2023; 17:27. [PMID: 36805686 DOI: 10.1186/s13034-023-00565-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The identification of reproducible subtypes within autistic populations is a priority research area in the context of neurodevelopment, to pave the way for identification of biomarkers and targeted treatment recommendations. Few previous studies have considered medical comorbidity alongside behavioural, cognitive, and psychiatric data in subgrouping analyses. This study sought to determine whether differing behavioural, cognitive, medical, and psychiatric profiles could be used to distinguish subgroups of children on the autism spectrum in the Australian Autism Biobank (AAB). METHODS Latent profile analysis was used to identify subgroups of children on the autism spectrum within the AAB (n = 1151), utilising data on social communication profiles and restricted, repetitive, and stereotyped behaviours (RRBs), in addition to their cognitive, medical, and psychiatric profiles. RESULTS Our study identified four subgroups of children on the autism spectrum with differing profiles of autism traits and associated comorbidities. Two subgroups had more severe clinical and cognitive phenotype, suggesting higher support needs. For the 'Higher Support Needs with Prominent Language and Cognitive Challenges' subgroup, social communication, language and cognitive challenges were prominent, with prominent sensory seeking behaviours. The 'Higher Support Needs with Prominent Medical and Psychiatric and Comorbidity' subgroup had the highest mean scores of challenges relating to social communication and RRBs, with the highest probability of medical and psychiatric comorbidity, and cognitive scores similar to the overall group mean. Individuals within the 'Moderate Support Needs with Emotional Challenges' subgroup, had moderate mean scores of core traits of autism, and the highest probability of depression and/or suicidality. A fourth subgroup contained individuals with fewer challenges across domains (the 'Fewer Support Needs Group'). LIMITATIONS Data utilised to identify subgroups within this study was cross-sectional as longitudinal data was not available. CONCLUSIONS Our findings support the holistic appraisal of support needs for children on the autism spectrum, with assessment of the impact of co-occurring medical and psychiatric conditions in addition to core autism traits, adaptive functioning, and cognitive functioning. Replication of our analysis in other cohorts of children on the autism spectrum is warranted, to assess whether the subgroup structure we identified is applicable in a broader context beyond our specific dataset.
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20
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Spackman E, Smillie LD, Frazier TW, Hardan AY, Alvares GA, Whitehouse A, Uljarević M. Profiles of circumscribed interests in autistic youth. Front Behav Neurosci 2023; 17:1037967. [PMID: 36844650 PMCID: PMC9947294 DOI: 10.3389/fnbeh.2023.1037967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Circumscribed interests (CI) encompass a range of different interests and related behaviors that can be characterized by either a high intensity but otherwise usual topic [referred to as restricted interests (RI)] or by a focus on topics that are not salient outside of autism [referred to as unusual interests (UI)]. Previous research has suggested that there is pronounced variability across individuals in terms of the endorsement of different interests, however, this variability has not been quantified using formal subtyping approaches. Therefore, using Latent Profile Analysis in a sample of 1,892 autistic youth (Mage = 10.82, SDage = 4.14; 420 females), this study aimed to identify subgroups based on the RU and UI profiles. Three profiles of autistic individuals were identified. They were characterized as Low CI, Predominantly RI, and Predominantly UI. Importantly, profiles differed on several key demographic and clinical variables, including age, sex composition, IQ, language level, social and communication abilities, anxiety, and obsessive-compulsive behaviors. Although replication across other samples is needed, the profiles identified in this study are potentially promising for future research given their distinct profiles of RI and UI and unique patterns of associations with key cognitive and clinical variables. Therefore, this study represents an important initial step towards more individualized assessment and support for diverse presentations of CI in autistic youth.
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Affiliation(s)
- Emily Spackman
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia,*Correspondence: Emily Spackman
| | - Luke D. Smillie
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Antonio Y. Hardan
- Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Gail A. Alvares
- UWA Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Andrew Whitehouse
- UWA Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Mirko Uljarević
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia,Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford University, Stanford, CA, United States
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21
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Fiksinski AM, Hoftman GD, Vorstman JAS, Bearden CE. A genetics-first approach to understanding autism and schizophrenia spectrum disorders: the 22q11.2 deletion syndrome. Mol Psychiatry 2023; 28:341-353. [PMID: 36192458 PMCID: PMC9812786 DOI: 10.1038/s41380-022-01783-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 02/03/2023]
Abstract
Recently, increasing numbers of rare pathogenic genetic variants have been identified that are associated with variably elevated risks of a range of neurodevelopmental outcomes, notably including Autism Spectrum Disorders (ASD), Schizophrenia Spectrum Disorders (SSD), and Intellectual Disability (ID). This review is organized along three main questions: First, how can we unify the exclusively descriptive basis of our current psychiatric diagnostic classification system with the recognition of an identifiable, highly penetrant genetic risk factor in an increasing proportion of patients with ASD or SSD? Second, what can be learned from studies of individuals with ASD or SSD who share a common genetic basis? And third, what accounts for the observed variable penetrance and pleiotropy of neuropsychiatric phenotypes in individuals with the same pathogenic variant? In this review, we focus on findings of clinical and preclinical studies of the 22q11.2 deletion syndrome (22q11DS). This particular variant is not only one of the most common among the increasing list of known rare pathogenic variants, but also one that benefits from a relatively long research history. Consequently, 22q11DS is an appealing model as it allows us to: (1) elucidate specific genotype-phenotype associations, (2) prospectively study behaviorally defined classifications, such as ASD or SSD, in the context of a known, well-characterized genetic basis, and (3) elucidate mechanisms underpinning variable penetrance and pleiotropy, phenomena with far-reaching ramifications for research and clinical practice. We discuss how findings from animal and in vitro studies relate to observations in human studies and can help elucidate factors, including genetic, environmental, and stochastic, that impact the expression of neuropsychiatric phenotypes in 22q11DS, and how this may inform mechanisms underlying neurodevelopmental expression in the general population. We conclude with research priorities for the field, which may pave the way for novel therapeutics.
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Affiliation(s)
- Ania M Fiksinski
- Department of Psychology and Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNS, Maastricht University, Maastricht, The Netherlands
| | - Gil D Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jacob A S Vorstman
- Program in Genetics and Genome Biology, Research Institute, and Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
- Department of Psychology, University of California, Los Angeles, CA, USA.
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22
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Guo X, Zhai G, Liu J, Cao Y, Zhang X, Cui D, Gao L. Inter-individual heterogeneity of functional brain networks in children with autism spectrum disorder. Mol Autism 2022; 13:52. [PMID: 36572935 DOI: 10.1186/s13229-022-00535-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder with considerable clinical heterogeneity. This study aimed to explore the heterogeneity of ASD based on inter-individual heterogeneity of functional brain networks. METHODS Resting-state functional magnetic resonance imaging data from the Autism Brain Imaging Data Exchange database were used in this study for 105 children with ASD and 102 demographically matched typical controls (TC) children. Functional connectivity (FC) networks were first obtained for ASD and TC groups, and inter-individual deviation of functional connectivity (IDFC) from the TC group was then calculated for each individual with ASD. A k-means clustering algorithm was used to obtain ASD subtypes based on IDFC patterns. The FC patterns were further compared between ASD subtypes and the TC group from the brain region, network, and whole-brain levels. The relationship between IDFC and the severity of clinical symptoms of ASD for ASD subtypes was also analyzed using a support vector regression model. RESULTS Two ASD subtypes were identified based on the IDFC patterns. Compared with the TC group, the ASD subtype 1 group exhibited a hypoconnectivity pattern and the ASD subtype 2 group exhibited a hyperconnectivity pattern. IDFC for ASD subtype 1 and subtype 2 was found to predict the severity of social communication impairments and the severity of restricted and repetitive behaviors in ASD, respectively. LIMITATIONS Only male children were selected for this study, which limits the ability to study the effects of gender and development on ASD heterogeneity. CONCLUSIONS These results suggest the existence of subtypes with different FC patterns in ASD and provide insight into the complex pathophysiological mechanism of clinical manifestations of ASD.
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Agelink van Rentergem JA, Bathelt J, Geurts HM. Clinical subtyping using community detection: Limited utility? Int J Methods Psychiatr Res 2022:e1951. [PMID: 36415153 DOI: 10.1002/mpr.1951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/13/2022] [Accepted: 09/25/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To discover psychiatric subtypes, researchers are adopting a method called community detection. This method was not subjected to the same scrutiny in the psychiatric literature as traditional clustering methods. Furthermore, many community detection algorithms have been developed without psychiatric sample sizes and variable numbers in mind. We aim to provide clarity to researchers on the utility of this method. METHODS We provide an introduction to community detection algorithms, specifically describing the crucial differences between correlation-based and distance-based community detection. We compare community detection results to results of traditional methods in a simulation study representing typical psychiatry settings, using three conceptualizations of how subtypes might differ. RESULTS We discovered that the number of recovered subgroups was often incorrect with several community detection algorithms. Correlation-based community detection fared better than distance-based community detection, and performed relatively well with smaller sample sizes. Latent profile analysis was more consistent in recovering subtypes. Whether methods were successful depended on how differences were introduced. CONCLUSIONS Traditional methods like latent profile analysis remain reasonable choices. Furthermore, results depend on assumptions and theoretical choices underlying subtyping analyses, which researchers need to consider before drawing conclusions on subtypes. Employing multiple subtyping methods to establish method dependency is recommended.
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Affiliation(s)
- Joost A Agelink van Rentergem
- Department of Psychology, Dutch Autism & ADHD Research Centre (d'Arc), University of Amsterdam, Amsterdam, The Netherlands
| | - Joe Bathelt
- Department of Psychology, Dutch Autism & ADHD Research Centre (d'Arc), University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Hilde M Geurts
- Department of Psychology, Dutch Autism & ADHD Research Centre (d'Arc), University of Amsterdam, Amsterdam, The Netherlands.,Leo Kannerhuis (Youz/Parnassia Groep), Amsterdam, The Netherlands
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24
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Horien C, Floris DL, Greene AS, Noble S, Rolison M, Tejavibulya L, O'Connor D, McPartland JC, Scheinost D, Chawarska K, Lake EMR, Constable RT. Functional Connectome-Based Predictive Modeling in Autism. Biol Psychiatry 2022; 92:626-642. [PMID: 35690495 PMCID: PMC10948028 DOI: 10.1016/j.biopsych.2022.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 01/08/2023]
Abstract
Autism is a heterogeneous neurodevelopmental condition, and functional magnetic resonance imaging-based studies have helped advance our understanding of its effects on brain network activity. We review how predictive modeling, using measures of functional connectivity and symptoms, has helped reveal key insights into this condition. We discuss how different prediction frameworks can further our understanding of the brain-based features that underlie complex autism symptomatology and consider how predictive models may be used in clinical settings. Throughout, we highlight aspects of study interpretation, such as data decay and sampling biases, that require consideration within the context of this condition. We close by suggesting exciting future directions for predictive modeling in autism.
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Affiliation(s)
- Corey Horien
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut; MD-PhD Program, Yale School of Medicine, New Haven, Connecticut.
| | - Dorothea L Floris
- Methods of Plasticity Research, Department of Psychology, University of Zürich, Zurich, Switzerland; Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Abigail S Greene
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut; MD-PhD Program, Yale School of Medicine, New Haven, Connecticut
| | - Stephanie Noble
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Max Rolison
- Yale Child Study Center, New Haven, Connecticut
| | - Link Tejavibulya
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut
| | - David O'Connor
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - James C McPartland
- Department of Psychology, Yale University, New Haven, Connecticut; Yale Child Study Center, New Haven, Connecticut
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Biomedical Engineering, Yale University, New Haven, Connecticut; Department of Statistics and Data Science, Yale University, New Haven, Connecticut; Yale Child Study Center, New Haven, Connecticut
| | - Katarzyna Chawarska
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut; Department of Statistics and Data Science, Yale University, New Haven, Connecticut; Yale Child Study Center, New Haven, Connecticut
| | - Evelyn M R Lake
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut; Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Biomedical Engineering, Yale University, New Haven, Connecticut.
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25
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Andreou M, Skrimpa V. Re-Examining Labels in Neurocognitive Research: Evidence from Bilingualism and Autism as Spectrum-Trait Cases. Brain Sci 2022; 12:1113. [PMID: 36009175 PMCID: PMC9405985 DOI: 10.3390/brainsci12081113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/10/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the fact that the urge to investigate bilingualism and neurodevelopmental disorders as continuous indices rather than categorical ones has been well-voiced among researchers with respect to research methodological approaches, in the recent literature, when it comes to examining language, cognitive skills and neurodivergent characteristics, it is still the case that the most prevalent view is the categorisation of adults or children into groups. In other words, there is a categorisation of individuals, e.g., monolingual vs. bilingual children or children with typical and atypical/non-typical/non-neurotypical development. We believe that this labelling is responsible for the conflicting results that we often come across in studies. The aim of this review is to bring to the surface the importance of individual differences through the study of relevant articles conducted in bilingual children and children with autism, who are ideal for this study. We concur with researchers who already do so, and we further suggest moving away from labels and instead shift towards the view that not everything is either white or black. We provide suggestions as to how this shift could be implemented in research, while mostly aiming at starting a discourse rather than offering a definite path.
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Affiliation(s)
- Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, 24100 Kalamata, Greece
| | - Vasileia Skrimpa
- Department of English, School of Arts and Humanities, University of Cologne, 50931 Cologne, Germany
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26
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Brown RE. Genetically modified mice for research on human diseases: A triumph for Biotechnology or a work in progress? The EuroBiotech Journal 2022; 6:61-88. [DOI: 10.2478/ebtj-2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022] Open
Abstract
Abstract
Genetically modified mice are engineered as models for human diseases. These mouse models include inbred strains, mutants, gene knockouts, gene knockins, and ‘humanized’ mice. Each mouse model is engineered to mimic a specific disease based on a theory of the genetic basis of that disease. For example, to test the amyloid theory of Alzheimer’s disease, mice with amyloid precursor protein genes are engineered, and to test the tau theory, mice with tau genes are engineered. This paper discusses the importance of mouse models in basic research, drug discovery, and translational research, and examines the question of how to define the “best” mouse model of a disease. The critiques of animal models and the caveats in translating the results from animal models to the treatment of human disease are discussed. Since many diseases are heritable, multigenic, age-related and experience-dependent, resulting from multiple gene-gene and gene-environment interactions, it will be essential to develop mouse models that reflect these genetic, epigenetic and environmental factors from a developmental perspective. Such models would provide further insight into disease emergence, progression and the ability to model two-hit and multi-hit theories of disease. The summary examines the biotechnology for creating genetically modified mice which reflect these factors and how they might be used to discover new treatments for complex human diseases such as cancers, neurodevelopmental and neurodegenerative diseases.
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27
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Vuijk R, de Nijs P, Arntz A, Geurts HM. An Explorative Study of Atypical Social Interaction Styles in Adult Men with Autism Spectrum Disorder, Men with Personality Disorders and Men from the General Population. J Autism Dev Disord 2022. [PMID: 35298755 DOI: 10.1007/s10803-022-05521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 10/18/2022]
Abstract
Different atypical social interaction styles (SISs) were defined and tested in children and adolescents with autism spectrum disorder (ASD). Whether these styles can also be distinguished in adults with ASD has not yet been explored. In men with ASD, men with personality disorder (PD), and men from the general population (N = 90), aged 18-65 years, we tested which SISs can be distinguished and how they relate to the presence of PD traits. We found a significant distinction in allocation to atypical SISs between the three groups. This study shows the presence of atypical SISs in adults with ASD, and complements previous SIS findings in children and adolescents with ASD.Trial registration The Netherlands National Trial Register NTR6391. Registered 04 May 2017.
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28
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Wen TH, Cheng A, Andreason C, Zahiri J, Xiao Y, Xu R, Bao B, Courchesne E, Barnes CC, Arias SJ, Pierce K. Large scale validation of an early-age eye-tracking biomarker of an autism spectrum disorder subtype. Sci Rep 2022; 12:4253. [PMID: 35277549 PMCID: PMC8917231 DOI: 10.1038/s41598-022-08102-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/28/2022] [Indexed: 01/07/2023] Open
Abstract
Few clinically validated biomarkers of ASD exist which can rapidly, accurately, and objectively identify autism during the first years of life and be used to support optimized treatment outcomes and advances in precision medicine. As such, the goal of the present study was to leverage both simple and computationally-advanced approaches to validate an eye-tracking measure of social attention preference, the GeoPref Test, among 1,863 ASD, delayed, or typical toddlers (12-48 months) referred from the community or general population via a primary care universal screening program. Toddlers participated in diagnostic and psychometric evaluations and the GeoPref Test: a 1-min movie containing side-by-side dynamic social and geometric images. Following testing, diagnosis was denoted as ASD, ASD features, LD, GDD, Other, typical sibling of ASD proband, or typical. Relative to other diagnostic groups, ASD toddlers exhibited the highest levels of visual attention towards geometric images and those with especially high fixation levels exhibited poor clinical profiles. Using the 69% fixation threshold, the GeoPref Test had 98% specificity, 17% sensitivity, 81% PPV, and 65% NPV. Sensitivity increased to 33% when saccades were included, with comparable validity across sex, ethnicity, or race. The GeoPref Test was also highly reliable up to 24 months following the initial test. Finally, fixation levels among twins concordant for ASD were significantly correlated, indicating that GeoPref Test performance may be genetically driven. As the GeoPref Test yields few false positives (~ 2%) and is equally valid across demographic categories, the current findings highlight the ability of the GeoPref Test to rapidly and accurately detect autism before the 2nd birthday in a subset of children and serve as a biomarker for a unique ASD subtype in clinical trials.
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Affiliation(s)
- Teresa H Wen
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA.
| | - Amanda Cheng
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Charlene Andreason
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Javad Zahiri
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Yaqiong Xiao
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Ronghui Xu
- Herbert Wertheim School of Public Health and Department of Mathematics, University of California, San Diego, La Jolla, CA, USA
| | - Bokan Bao
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
- Department of Bioinformatics and Systems Biology, University of California, San Diego, La Jolla, CA, USA
| | - Eric Courchesne
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Cynthia Carter Barnes
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Steven J Arias
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Karen Pierce
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA.
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29
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Al-Shawwa B, Sharma M, Ingram DG. Subtypes of childhood insomnia. J Clin Sleep Med 2022; 18:1477. [PMID: 35216653 PMCID: PMC9059605 DOI: 10.5664/jcsm.9958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Baha Al-Shawwa
- Division of Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, MO.,University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Mukta Sharma
- University of Missouri-Kansas City School of Medicine, Kansas City, MO.,Division of Hematology, Children's Mercy-Kansas City, Kansas City, MO
| | - David G Ingram
- Division of Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, MO.,University of Missouri-Kansas City School of Medicine, Kansas City, MO
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30
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Nordahl CW, Andrews DS, Dwyer P, Waizbard-Bartov E, Restrepo B, Lee JK, Heath B, Saron C, Rivera SM, Solomon M, Ashwood P, Amaral DG. The Autism Phenome Project: Toward Identifying Clinically Meaningful Subgroups of Autism. Front Neurosci 2022; 15:786220. [PMID: 35110990 PMCID: PMC8801875 DOI: 10.3389/fnins.2021.786220] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 12/23/2022] Open
Abstract
One of the most universally accepted facts about autism is that it is heterogenous. Individuals diagnosed with autism spectrum disorder have a wide range of behavioral presentations and a variety of co-occurring medical and mental health conditions. The identification of more homogenous subgroups is likely to lead to a better understanding of etiologies as well as more targeted interventions and treatments. In 2006, we initiated the UC Davis MIND Institute Autism Phenome Project (APP) with the overarching goal of identifying clinically meaningful subtypes of autism. This ongoing longitudinal multidisciplinary study now includes over 400 children and involves comprehensive medical, behavioral, and neuroimaging assessments from early childhood through adolescence (2-19 years of age). We have employed several strategies to identify sub-populations within autistic individuals: subgrouping by neural, biological, behavioral or clinical characteristics as well as by developmental trajectories. In this Mini Review, we summarize findings to date from the APP cohort and describe progress made toward identifying meaningful subgroups of autism.
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Affiliation(s)
- Christine Wu Nordahl
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Derek Sayre Andrews
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Patrick Dwyer
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Einat Waizbard-Bartov
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Bibiana Restrepo
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Pediatrics, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Joshua K. Lee
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Brianna Heath
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Clifford Saron
- MIND Institute, University of California, Davis, Davis, CA, United States
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States
| | - Susan M. Rivera
- MIND Institute, University of California, Davis, Davis, CA, United States
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Marjorie Solomon
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Paul Ashwood
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - David G. Amaral
- MIND Institute, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
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31
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Abstract
Despite decades of investigation into the genetics of autism spectrum disorder (ASD), a current consensus in the field persists that ASD risk is too heterogeneous to be diagnosed by a single set of genetic variants. As such, ASD research has broadened to include assessment of other molecular biomarkers implicated in the condition that may be reflective of environmental exposures or gene by environment interactions. Epigenetic variance, and specifically differential DNA methylation, have emerged as areas of particularly high interest to ASD, as the epigenetic markers from specific chromatin loci collectively can reflect influences of multiple genetic and environmental factors and can also result in differential gene expression patterns. This review examines recent studies of the ASD epigenome, detailing common gene pathways found to be differentially methylated in people with ASD, and considers how these discoveries may inform our understanding of ASD etiology. We also consider future applications of epigenetics in ASD research and clinical practice, focusing on substratification, biomarker development, and experimental preclinical models of ASD that test causality. In combination with other -omics approaches, epigenomics allows an improved conceptualization of the multifactorial nature of ASD, and opens future lines of inquiry for both basic research and clinical practice.
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Affiliation(s)
- Logan A. Williams
- grid.27860.3b0000 0004 1936 9684Department of Medical Microbiology and Immunology, University of California Davis School of Medicine, Davis, CA USA ,grid.27860.3b0000 0004 1936 9684Perinatal Origins of Disparities Center, University of California Davis, Davis, CA USA ,grid.27860.3b0000 0004 1936 9684MIND Institute, University of California Davis, Davis, CA USA ,grid.27860.3b0000 0004 1936 9684Genome Center, University of California Davis, Davis, CA USA
| | - Janine M. LaSalle
- grid.27860.3b0000 0004 1936 9684Department of Medical Microbiology and Immunology, University of California Davis School of Medicine, Davis, CA USA ,grid.27860.3b0000 0004 1936 9684Perinatal Origins of Disparities Center, University of California Davis, Davis, CA USA ,grid.27860.3b0000 0004 1936 9684MIND Institute, University of California Davis, Davis, CA USA ,grid.27860.3b0000 0004 1936 9684Genome Center, University of California Davis, Davis, CA USA
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32
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Abstract
Many researchers now believe that autism heterogeneity is likely to include many disorders, but most research is based on samples defined by the DSM-5 Autism Spectrum Disorder (ASD) criteria. However, individuals diagnosed with autism have complex and varied biological causes for their symptoms. Therefore, autism is not a unitary biological entity. And although autism is significantly different from typical development, autism is not a unitary clinical disorder because diagnosed individuals vary in symptom patterns, comorbidities, biomarkers, and gene variants. The DSM-5 ASD criteria were designed to reduce heterogeneity, and there have been many other efforts to reduce autism heterogeneity including using more stringent clinical criteria, dividing autism into low and high functioning groups, creating subgroups, and by studying larger samples. However, to date these efforts have not been successful. Heterogeneity is extensive and remains unexplained, and no autism pathophysiology has been discovered. Most importantly, heterogeneity has hindered the explanatory power of the autism diagnosis to discover drug regimens and effective behavioral treatments. The paper proposes that possible transdiagnostic endophenotypes may reduce autism heterogeneity. Searching for transdiagnostic endophenotypes requires exploring autism symptoms outside of the framework of the DSM-5 autism diagnosis. This paper proposes that researchers relax diagnostic criteria to increase the range of phenotypes to support the search for transdiagnostic endophenotypes. The paper proposes possible candidates for transdiagnostic endophenotypes. These candidates are taken from DSM-5 ASD criteria, from concepts that have resulted from researched theories, and from symptoms that are the result of subtyping. The paper then sketches a possible basis for a future transdiagnostic endophenotypes screening tool that includes symptoms of autism and other neurodevelopmental disorders.
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Affiliation(s)
- Lynn Waterhouse
- The College of New Jersey, Ewing Township, NJ, United States
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33
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Radhoe TA, Agelink van Rentergem JA, Kok AAL, Huisman M, Geurts HM. Subgroups in Late Adulthood Are Associated With Cognition and Wellbeing Later in Life. Front Psychol 2021; 12:780575. [PMID: 34925184 PMCID: PMC8671814 DOI: 10.3389/fpsyg.2021.780575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/08/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives: In this study, we aim to discover whether there are valid subgroups in aging that are defined by modifiable factors and are determinant of clinically relevant outcomes regarding healthy aging. Method: Data from interviews were collected in the Longitudinal Aging Study Amsterdam at two measurement occasions with a 3-year interval. Input for the analyses were seven well-known vulnerability and protective factors of healthy aging. By means of community detection, we tested whether we could distinguish subgroups in a sample of 1478 participants (T1-sample, aged 61–101 years). We tested both the external validity (T1) and predictive validity (T2) for wellbeing and subjective cognitive decline. Moreover, replicability and long-term stability were determined in 1186 participants (T2-sample, aged 61–101 years). Results: Three similar subgroups were identified at T1 and T2. Subgroup A was characterized by high levels of education with personal vulnerabilities, subgroup B by being physically active with low support and low levels of education, and subgroup C by high levels of support with low levels of education. Subgroup C showed the lowest wellbeing and memory profile, both at T1 and T2. On most measures of wellbeing and memory, subgroups A and B did not differ from each other. At T2, the same number of subgroups was identified and subgroup profiles at T1 and T2 were practically identical. Per T1 subgroup 47–62% retained their membership at T2. Discussion: We identified valid subgroups that replicate over time and differ on external variables at current and later measurement occasions. Individual change in subgroup membership over time shows that transitions to subgroups with better outcomes are possible.
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Affiliation(s)
- Tulsi A Radhoe
- Dutch Autism and ADHD Research Center (d'Arc), Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Joost A Agelink van Rentergem
- Dutch Autism and ADHD Research Center (d'Arc), Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Almar A L Kok
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Sociology, Amsterdam Public Health, Amsterdam, Netherlands
| | - Hilde M Geurts
- Dutch Autism and ADHD Research Center (d'Arc), Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands.,Leo Kannerhuis (Youz/Parnassia Groep), Amsterdam, Netherlands
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34
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Li D, Liu C, Huang Z, Li H, Xu Q, Zhou B, Hu C, Zhang Y, Wang Y, Nie J, Qiao Z, Yin D, Xu X. Common and Distinct Disruptions of Cortical Surface Morphology Between Autism Spectrum Disorder Children With and Without SHANK3 Deficiency. Front Neurosci 2021; 15:751364. [PMID: 34776852 PMCID: PMC8581670 DOI: 10.3389/fnins.2021.751364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
SH3 and Multiple Ankyrin Repeat Domains 3 (SHANK3)-caused autism spectrum disorder (ASD) may present a unique opportunity to clarify the heterogeneous neuropathological mechanisms of ASD. However, the specificity and commonality of disrupted large-scale brain organization in SHANK3-deficient children remain largely unknown. The present study combined genetic tests, neurobehavioral evaluations, and magnetic resonance imaging, aiming to explore the disruptions of both local and networked cortical structural organization in ASD children with and without SHANK3 deficiency. Multiple surface morphological parameters such as cortical thickness (CT) and sulcus depth were estimated, and the graph theory was adopted to characterize the topological properties of structural covariance networks (SCNs). Finally, a correlation analysis between the alterations in brain morphological features and the neurobehavioral evaluations was performed. Compared with typically developed children, increased CT and reduced nodal degree were found in both ASD children with and without SHANK3 defects mainly in the lateral temporal cortex, prefrontal cortex (PFC), temporo-parietal junction (TPJ), superior temporal gyrus (STG), and limbic/paralimbic regions. Besides commonality, our findings showed some distinct abnormalities in ASD children with SHANK3 defects compared to those without. Locally, more changes in the STG and orbitofrontal cortex were exhibited in ASD children with SHANK3 defects, while more changes in the TPJ and inferior parietal lobe (IPL) in those without SHANK3 defects were observed. For the SCNs, a trend toward regular network topology was observed in ASD children with SHANK3 defects, but not in those without. In addition, ASD children with SHANK3 defects showed more alterations of nodal degrees in the anterior and posterior cingulate cortices and right insular, while there were more disruptions in the sensorimotor areas and the left insular and dorsomedial PFC in ASD without SHANK3 defects. Our findings indicate dissociable disruptions of local and networked brain morphological features in ASD children with and without SHANK3 deficiency. Moreover, this monogenic study may provide a valuable path for parsing the heterogeneity of brain disturbances in ASD.
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Affiliation(s)
- Dongyun Li
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Chunxue Liu
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Ziyi Huang
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), School of Psychology and Cognitive Science, Affiliated Mental Health Center, East China Normal University, Shanghai, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Huiping Li
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Qiong Xu
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Bingrui Zhou
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Chunchun Hu
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Zhang
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Wang
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Jingxin Nie
- School of Psychology, South China Normal University, Guangzhou, China
| | - Zhongwei Qiao
- Department of Radiology, Children's Hospital of Fudan University, Shanghai, China
| | - Dazhi Yin
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), School of Psychology and Cognitive Science, Affiliated Mental Health Center, East China Normal University, Shanghai, China
| | - Xiu Xu
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
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35
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Dwyer P, Ferrer E, Saron CD, Rivera SM. Exploring Sensory Subgroups in Typical Development and Autism Spectrum Development Using Factor Mixture Modelling. J Autism Dev Disord 2021; 52:3840-3860. [PMID: 34499275 PMCID: PMC9349169 DOI: 10.1007/s10803-021-05256-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/29/2022]
Abstract
This study uses factor mixture modelling of the Short Sensory Profile (SSP) at two time points to describe subgroups of young autistic and typically-developing children. This approach allows separate SSP subscales to influence overall SSP performance differentially across subgroups. Three subgroups were described, one including almost all typically-developing participants plus many autistic participants. SSP performance of a second, largely-autistic subgroup was predominantly shaped by a subscale indexing behaviours of low energy/weakness. Finally, the third subgroup, again largely autistic, contained participants with low (or more “atypical”) SSP scores across most subscales. In this subgroup, autistic participants exhibited large P1 amplitudes to loud sounds. Autistic participants in subgroups with more atypical SSP scores had higher anxiety and more sleep disturbances.
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Affiliation(s)
- Patrick Dwyer
- Department of Psychology, UC Davis, Davis, USA. .,Center for Mind and Brain, UC Davis, Davis, USA.
| | | | - Clifford D Saron
- Center for Mind and Brain, UC Davis, Davis, USA.,MIND Institute, UC Davis, Davis, USA
| | - Susan M Rivera
- Department of Psychology, UC Davis, Davis, USA.,Center for Mind and Brain, UC Davis, Davis, USA.,MIND Institute, UC Davis, Davis, USA
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36
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Knott R, Johnson BP, Tiego J, Mellahn O, Finlay A, Kallady K, Kouspos M, Mohanakumar Sindhu VP, Hawi Z, Arnatkeviciute A, Chau T, Maron D, Mercieca EC, Furley K, Harris K, Williams K, Ure A, Fornito A, Gray K, Coghill D, Nicholson A, Phung D, Loth E, Mason L, Murphy D, Buitelaar J, Bellgrove MA. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project design and methodologies: a dimensional approach to understanding neurobiological and genetic aetiology. Mol Autism 2021; 12:55. [PMID: 34353377 PMCID: PMC8340366 DOI: 10.1186/s13229-021-00457-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background ASD and ADHD are prevalent neurodevelopmental disorders that frequently co-occur and have strong evidence for a degree of shared genetic aetiology. Behavioural and neurocognitive heterogeneity in ASD and ADHD has hampered attempts to map the underlying genetics and neurobiology, predict intervention response, and improve diagnostic accuracy. Moving away from categorical conceptualisations of psychopathology to a dimensional approach is anticipated to facilitate discovery of data-driven clusters and enhance our understanding of the neurobiological and genetic aetiology of these conditions. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project is one of the first large-scale, family-based studies to take a truly transdiagnostic approach to ASD and ADHD. Using a comprehensive phenotyping protocol capturing dimensional traits central to ASD and ADHD, the MAGNET project aims to identify data-driven clusters across ADHD-ASD spectra using deep phenotyping of symptoms and behaviours; investigate the degree of familiality for different dimensional ASD-ADHD phenotypes and clusters; and map the neurocognitive, brain imaging, and genetic correlates of these data-driven symptom-based clusters. Methods The MAGNET project will recruit 1,200 families with children who are either typically developing, or who display elevated ASD, ADHD, or ASD-ADHD traits, in addition to affected and unaffected biological siblings of probands, and parents. All children will be comprehensively phenotyped for behavioural symptoms, comorbidities, neurocognitive and neuroimaging traits and genetics. Conclusion The MAGNET project will be the first large-scale family study to take a transdiagnostic approach to ASD-ADHD, utilising deep phenotyping across behavioural, neurocognitive, brain imaging and genetic measures. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00457-3.
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Affiliation(s)
- Rachael Knott
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia.
| | - Beth P Johnson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Olivia Mellahn
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Amy Finlay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kathryn Kallady
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Maria Kouspos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Vishnu Priya Mohanakumar Sindhu
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Ziarih Hawi
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Tracey Chau
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Dalia Maron
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Emily-Clare Mercieca
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kirsten Furley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Katrina Harris
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Department of Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Department of Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Rd, Clayton, VIC, 3168, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Alexandra Ure
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Mental Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Neurodevelopment and Disability Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kylie Gray
- Centre for Educational Development, Appraisal, and Research, University of Warwick, Coventry, CV4 7AL, UK.,Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Melbourne, VIC, 3168, Australia
| | - David Coghill
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Mental Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Neurodevelopment and Disability Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Ann Nicholson
- Faculty of Information and Technology, Monash University, Melbourne, VIC, 3800, Australia
| | - Dinh Phung
- Faculty of Information and Technology, Monash University, Melbourne, VIC, 3800, Australia
| | - Eva Loth
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Luke Mason
- Centre for Brain and Cognitive Development, Birkbeck, University of London, Henry Welcome Building, Malet Street, London, WC1E 7HX, UK
| | - Declan Murphy
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
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