1
|
Suter B, Pehlivan D, Ak M, Harris HK, Lyons-Warren AM. Sensory experiences questionnaire unravels differences in sensory profiles between MECP2-related disorders. Autism Res 2024; 17:775-784. [PMID: 38433353 DOI: 10.1002/aur.3112] [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: 10/16/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024]
Abstract
The methyl CpG-binding protein-2 (MECP2) gene is located on the Xq28 region. Loss of function mutations or increased copies of MECP2 result in Rett syndrome (RTT) and MECP2 duplication syndrome (MDS), respectively. Individuals with both disorders exhibit overlapping autism symptoms, yet few studies have dissected the differences between these gene dosage sensitive disorders. Further, research examining sensory processing patterns in persons with RTT and MDS is largely absent. Thus, the goal of this study was to analyze and compare sensory processing patterns in persons with RTT and MDS. Towards this goal, caregivers of 50 female individuals with RTT and 122 male individuals with MDS, between 1 and 46 years of age, completed a standardized measure of sensory processing, the Sensory Experiences Questionnaire. Patterns detected in both disorders were compared against each other and against normative values. We found sensory processing abnormalities for both hyper- and hypo-sensitivity in both groups. Interestingly, abnormalities in MDS were more pronounced compared with in RTT, particularly with items concerning hypersensitivity and sensory seeking, but not hyposensitivity. Individuals with MDS also exhibited greater sensory symptoms compared with RTT in the areas of tactile and vestibular sensory processing and for both social and nonsocial stimuli. This study provides a first description of sensory symptoms in individuals with RTT and individuals with MDS. Similar to other neurodevelopmental disorders, a variety of sensory processing abnormalities was found. These findings reveal a first insight into sensory processing abnormalities caused by a dosage sensitive gene and may ultimately help guide therapeutic approaches for these disorders.
Collapse
Affiliation(s)
- Bernhard Suter
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Blue Bird Circle Rett Center, Texas Children's Hospital, Houston, Texas, USA
| | - Davut Pehlivan
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Blue Bird Circle Rett Center, Texas Children's Hospital, Houston, Texas, USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
| | - Muharrem Ak
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Holly K Harris
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Ariel M Lyons-Warren
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
| |
Collapse
|
2
|
Lachiewicz AM, Stackhouse TM, Burgess K, Burgess D, Andrews HF, Choo TH, Kaufmann WE, Kidd SA. Sensory Symptoms and Signs of Hyperarousal in Individuals with Fragile X Syndrome: Findings from the FORWARD Registry and Database Multisite Study. J Autism Dev Disord 2023:10.1007/s10803-023-06135-y. [PMID: 37840096 DOI: 10.1007/s10803-023-06135-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/17/2023]
Abstract
This study was designed to increase our understanding about characteristics and the impact of sensory symptoms (SS) and signs of hyperarousal (HA) in individuals with fragile X syndrome (FXS) from childhood through early adulthood and by gender. Data derived from the Fragile X Online Registry With Accessible Research Database (FORWARD), a natural history study of FXS, were analyzed using descriptive statistics and multivariate linear and logistic regression models to examine SS and signs of HA, their impact on behavioral regulation and limitations on the subject/family. The sample (N = 933) consisted of 720 males and 213 females. More males were affected with SS (87% vs. 68%) and signs of HA (92% vs. 79%). Subjects who were endorsed as having a strong sensory response had more comorbidities, including behavioral problems. The predominant SS was difficulty with eye gaze that increased with age in both genders. As individuals age, there was less use of non-medication therapies, such as occupational therapy (OT)/physical therapy (PT), but there was more use of psychopharmacological medications and investigational drugs for behaviors. Multiple regression models suggested that endorsing SS and signs of HA was associated with statistically significantly increased ABC-C-I subscale scores and limited participation in everyday activities. This study improves our understanding of SS and signs of HA as well as their impact in FXS. It supports the need for more research regarding these clinical symptoms, especially to understand how they contribute to well-known behavioral concerns.
Collapse
Affiliation(s)
- Ave M Lachiewicz
- Department of Pediatrics, Duke University Health System, Durham, NC, USA.
| | | | | | - Debra Burgess
- Department of Pediatrics, Duke University Health System, Durham, NC, USA
| | - Howard F Andrews
- Departments of Psychiatry and Biostatistics, Mailman School of Public Health, Columbia University, Irving Medical Center, New York, NY, USA
| | - Tse-Hwei Choo
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
| | - Walter E Kaufmann
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Sharon A Kidd
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
3
|
Schwartz S, Wang L, Uribe S, Shinn-Cunningham B, Tager-Flusberg H. Auditory evoked potentials in adolescents with autism: An investigation of brain development, intellectual impairment, and neural encoding. Autism Res 2023; 16:1859-1876. [PMID: 37735966 PMCID: PMC10676753 DOI: 10.1002/aur.3003] [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: 02/07/2023] [Accepted: 07/21/2023] [Indexed: 09/23/2023]
Abstract
Limited research has evaluated neural encoding of sounds from a developmental perspective in individuals with autism (ASD), especially among those with intellectual disability. We compared auditory evoked potentials (AEPs) in autistic adolescents with a wide range of intellectual abilities (n = 40, NVIQ 30-160) to both age-matched cognitively able neurotypical adolescent controls (NT-A, n = 37) and younger neurotypical children (NT-C, n = 27) to assess potential developmental delays. In addition to a classic measure of peak amplitude, we calculated a continuous measure of intra-class correlation (ICC) between each adolescent participant's AEP and the age-normative, average AEP waveforms calculated from NT-C and NT-A to study differences in signal morphology. We found that peak amplitudes of neural responses were significantly smaller in autistic adolescents compared to NT-A. We also found that the AEP morphology of autistic adolescents looked more like NT-A peers than NT-C but was still significantly different from NT-A AEP waveforms. Results suggest that AEPs of autistic adolescents present differently from NTs, regardless of age, and differences cannot be accounted for by developmental delay. Nonverbal intelligence significantly predicted how closely each adolescent's AEP resembled the age-normed waveform. These results support an evolving theory that the degree of disruption in early neural responses to low-level inputs is reflected in the severity of intellectual impairments in autism.
Collapse
Affiliation(s)
- Sophie Schwartz
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Le Wang
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Sofia Uribe
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | | | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| |
Collapse
|
4
|
Bindels-de Heus KGCB, Hagenaar DA, Dekker I, van der Kaay DCM, Kerkhof GF, Elgersma Y, de Wit MCY, Mous SE, Moll HA. Hyperphagia, Growth, and Puberty in Children with Angelman Syndrome. J Clin Med 2023; 12:5981. [PMID: 37762921 PMCID: PMC10532359 DOI: 10.3390/jcm12185981] [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: 07/28/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Angelman Syndrome (AS) is a rare genetic disorder caused by lack of maternal UBE3A protein due to a deletion of the chromosome 15q11.2-q13 region, uniparental paternal disomy, imprinting center defect, or pathogenic variant in the UBE3A gene. Characteristics are developmental delay, epilepsy, behavioral, and sleep problems. There is some evidence for hyperphagia, shorter stature, and higher BMI compared to neurotypical children, but longitudinal studies on growth are lacking. In this study, we analyzed prospectively collected data of 145 children with AS, who visited the ENCORE Expertise Center between 2010 and 2021, with a total of 853 visits. Children showed an elevated mean score of 25 on the Dykens Hyperphagia questionnaire (range 11-55) without genotype association. Higher scores were significantly associated with higher body mass index (BMI) standard deviation scores (SDS) (p = 0.004). Mean height was -1.2 SDS (SD 1.3), mean BMI-SDS was 0.6 (SD 1.7); 43% had a BMI-SDS > 1 and 20% had a BMI-SDS > 2. Higher BMI-SDS was significantly associated with non-deletion genotype (p = 0.037) and walking independently (p = 0.023). Height SDS decreased significantly with age (p < 0.001) and BMI-SDS increased significantly with age (p < 0.001. Onset of puberty was normal. In conclusion, children with AS showed moderate hyperphagia, lower height SDS, and higher BMI-SDS compared to norm data, with increasing deviation from the norm with age. It is uncertain how loss of maternal UBE3A function may influence growth. Attention to diet, exercise, and hyperphagia from an early age is recommended to prevent obesity and associated health problems.
Collapse
Affiliation(s)
- Karen G. C. B. Bindels-de Heus
- Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (D.A.H.); (I.D.); (H.A.M.)
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (M.-C.Y.d.W.); (S.E.M.)
| | - Doesjka A Hagenaar
- Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (D.A.H.); (I.D.); (H.A.M.)
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (M.-C.Y.d.W.); (S.E.M.)
- Department of Child- and Adolescent Psychiatry and Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Ilonka Dekker
- Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (D.A.H.); (I.D.); (H.A.M.)
| | - Danielle C. M. van der Kaay
- Department of Pediatric Endocrinology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (D.C.M.v.d.K.); (G.F.K.)
| | - Gerthe F. Kerkhof
- Department of Pediatric Endocrinology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (D.C.M.v.d.K.); (G.F.K.)
| | - ENCORE Expertise Center for AS
- ENCORE Expertise Center for Neurodevelopmental Disorders, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Ype Elgersma
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (M.-C.Y.d.W.); (S.E.M.)
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Marie-Claire Y. de Wit
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (M.-C.Y.d.W.); (S.E.M.)
- Department of Neurology and Pediatric Neurology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Sabine E. Mous
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (M.-C.Y.d.W.); (S.E.M.)
- Department of Child- and Adolescent Psychiatry and Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Henriette A. Moll
- Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (D.A.H.); (I.D.); (H.A.M.)
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands (M.-C.Y.d.W.); (S.E.M.)
| |
Collapse
|
5
|
Abstract
INTRODUCTION Angelman syndrome (AS) is a neurodevelopmental disorder characterized by intellectual disability, limited expressive language, epilepsy, and motor impairment. Angelman syndrome is caused by haploinsufficiency of the UBE3A gene on the maternal copy of chromosome 15. There have been ongoing advances in the understanding of neurological, behavioral, and sleep-based problems and associated treatments for patients with AS. These results along with gene-based therapies entering into clinical development prompted this review. AREAS COVERED The authors summarize the research basis describing phenomenology of epilepsy and behavioral concerns such as hyperactivity behavior, aggression, self-injury, repetitive behavior, and sleep disorder. The evidence for recent treatment advances in these target symptom domains of concern is reviewed, and the potential for emerging gene therapy treatments is considered. EXPERT OPINION The prospect for emerging gene therapies means that increasing efforts should be directed toward the early identification of AS implemented equitably. Recent studies emphasize the important role of behavioral therapy in addressing mental health concerns such as aggression and disordered sleep.
Collapse
Affiliation(s)
- Christopher J Keary
- Department is department of psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Lurie Center for Autism, Lexington, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Angelman Syndrome Program, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Christopher J McDougle
- Department is department of psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Lurie Center for Autism, Lexington, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
6
|
Crawford H. Social Anxiety in Neurodevelopmental Disorders: The Case of Fragile X Syndrome. Am J Intellect Dev Disabil 2023; 128:302-318. [PMID: 37470255 DOI: 10.1352/1944-7558-128.4.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 10/04/2022] [Indexed: 07/21/2023]
Abstract
Despite significant advances in understanding and treating social anxiety in the general population, progress in this area lags behind for individuals with intellectual disability. Fragile X syndrome is the most common cause of inherited intellectual disability and is associated with an elevated prevalence rate of social anxiety. The phenotype of fragile X syndrome encompasses multiple clinically significant characteristics that are posed as risk markers for social anxiety in other populations. Here, evidence is reviewed that points to physiological hyperarousal, sensory sensitivity, emotion dysregulation, cognitive inflexibility, and intolerance of uncertainty as primary candidates for underlying mechanisms of heightened social anxiety in fragile X syndrome. A multilevel model is presented that provides a framework for future research to test associations.
Collapse
|
7
|
Bindels-de Heus KGCB, Hooven-Radstaake MT, Legerstee JS, Hoopen LWT, Dieleman GC, Moll HA, Mous SE, de Wit MCY. Sleep problems in children with Angelman Syndrome: The effect of a behavioral intervention program. Res Dev Disabil 2023; 135:104444. [PMID: 36753818 DOI: 10.1016/j.ridd.2023.104444] [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] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND & AIMS The aim of this study was to investigate the effect of a behavioral intervention on sleep problems, which are significant and an unmet clinical need in children with Angelman Syndrome (AS). METHODS & PROCEDURES Children (2-18 years) with AS and sleep problems were randomized to a behavioral intervention program or a control group. Intervention consisted of a standardized program including home visits, psycho-education, feedback based on direct observation of bedtime routine and video footage of the night and behavioral treatment techniques by a behavioral therapist. Change in sleep duration (primary) and parental sleep, nighttime visits, sleep hygiene, daytime behavior, parental stress and quality of life (secondary) were assessed post-intervention and at follow-up using questionnaires, diary, actigraphy and videosomnography. OUTCOMES & RESULTS The groups, 9 children in each, did not differ at baseline. We found a significant effect of intervention on wake after sleep onset with classical statistical analysis (videosomnography). With single case analysis we found a positive effect on total sleep time (diary and actigraphy) and wake after sleep onset (diary) with a persistent effect on total sleep time (actigraphy) and wake after sleep onset (diary). On secondary outcome there was a significant and persistent effect on sleep hygiene and several quality of life domains. CONCLUSIONS & IMPLICATIONS Behavioral intervention has a positive and persistent effect on sleep problems in children with AS. We advise psycho-education for all parents and use of videosomnography for both evaluation of and feedback on sleep behavior patterns, individual behavioral advice and specific behavioral techniques for children with sleep problems.
Collapse
Affiliation(s)
- Karen G C B Bindels-de Heus
- Erasmus MC Sophia Children's Hospital, Dept. of Pediatrics, the Netherlands; ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands.
| | - Maartje Ten Hooven-Radstaake
- Erasmus MC Sophia Children's Hospital, Dept. of Pediatrics, the Netherlands; ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands; Radboud University, Dept. of Social Sciences, Nijmegen, the Netherlands
| | - Jeroen S Legerstee
- ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands; Erasmus MC Sophia Children's Hospital, Dept. of Child, and Adolescent Psychiatry and Psychology, the Netherlands
| | - Leontine W Ten Hoopen
- ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands; Erasmus MC Sophia Children's Hospital, Dept. of Child, and Adolescent Psychiatry and Psychology, the Netherlands
| | - Gwen C Dieleman
- ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands; Erasmus MC Sophia Children's Hospital, Dept. of Child, and Adolescent Psychiatry and Psychology, the Netherlands
| | - Henriette A Moll
- Erasmus MC Sophia Children's Hospital, Dept. of Pediatrics, the Netherlands; ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands
| | - Sabine E Mous
- ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands; Erasmus MC Sophia Children's Hospital, Dept. of Child, and Adolescent Psychiatry and Psychology, the Netherlands
| | - Marie-Claire Y de Wit
- ENCORE Expertise Center for Neurodevelopmental Disorders, the Netherlands; Erasmus MC Sophia Children's Hospital, Dept. of Neurology and Pediatric Neurology, the Netherlands
| |
Collapse
|
8
|
Schwarzlose RF, Tillman R, Hoyniak CP, Luby JL, Barch DM. Sensory Over-responsivity: A Feature of Childhood Psychiatric Illness Associated With Altered Functional Connectivity of Sensory Networks. Biol Psychiatry 2023; 93:92-101. [PMID: 36357217 PMCID: PMC10308431 DOI: 10.1016/j.biopsych.2022.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 04/26/2022] [Revised: 08/20/2022] [Accepted: 09/21/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Sensory over-responsivity (SOR) is recognized as a common feature of autism spectrum disorder. However, SOR is also common among typically developing children, in whom it is associated with elevated levels of psychiatric symptoms. The clinical significance and neurocognitive bases of SOR in these children remain poorly understood and actively debated. METHODS This study used linear mixed-effects models to identify psychiatric symptoms and network-level functional connectivity (FC) differences associated with parent-reported SOR in the Adolescent Brain Cognitive Development (ABCD) Study, a large community sample (9 to 12 years of age) (N = 11,210). RESULTS Children with SOR constituted 18% of the overall sample but comprised more than half of the children with internalizing or externalizing scores in the clinical range. Controlling for autistic traits, both mild and severe SOR were associated with greater concurrent symptoms of depression, anxiety, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder. Controlling for psychiatric symptoms and autistic traits, SOR predicted increased anxiety, attention-deficit/hyperactivity disorder, and prodromal psychosis symptoms 1 year later and was associated with FC differences in brain networks supporting sensory and salience processing in datasets collected 2 years apart. Differences included reduced FC within and between sensorimotor networks, enhanced sensorimotor-salience FC, and altered FC between sensory networks and bilateral hippocampi. CONCLUSIONS SOR is a common, clinically relevant feature of childhood psychiatric illness that provides unique predictive information about risk. It is associated with differences in brain networks that subserve tactile processing, implicating a neural basis for sensory differences in affected children.
Collapse
Affiliation(s)
- Rebecca F Schwarzlose
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| |
Collapse
|
9
|
Lyons-Warren AM, Wangler MF, Wan YW. Cluster Analysis of Short Sensory Profile Data Reveals Sensory-Based Subgroups in Autism Spectrum Disorder. Int J Mol Sci 2022; 23. [PMID: 36361815 DOI: 10.3390/ijms232113030] [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] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/24/2022] [Indexed: 01/27/2023] Open
Abstract
Autism spectrum disorder is a common, heterogeneous neurodevelopmental disorder lacking targeted treatments. Additional features include restricted, repetitive patterns of behaviors and differences in sensory processing. We hypothesized that detailed sensory features including modality specific hyper- and hypo-sensitivity could be used to identify clinically recognizable subgroups with unique underlying gene variants. Participants included 378 individuals with a clinical diagnosis of autism spectrum disorder who contributed Short Sensory Profile data assessing the frequency of sensory behaviors and whole genome sequencing results to the Autism Speaks' MSSNG database. Sensory phenotypes in this cohort were not randomly distributed with 10 patterns describing 43% (162/378) of participants. Cross comparison of two independent cluster analyses on sensory responses identified six distinct sensory-based subgroups. We then characterized subgroups by calculating the percent of patients in each subgroup who had variants with a Combined Annotation Dependent Depletion (CADD) score of 15 or greater in each of 24,896 genes. Each subgroup exhibited a unique pattern of genes with a high frequency of variants. These results support the use of sensory features to identify autism spectrum disorder subgroups with shared genetic variants.
Collapse
|
10
|
Agar G, Oliver C, Richards C. Direct assessment of overnight parent-child proximity in children with behavioral insomnia: Extending models of operant and classical conditioning. Behav Sleep Med 2022; 21:254-272. [PMID: 35796281 DOI: 10.1080/15402002.2022.2076681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Explanatory models of behavioral insomnia typically draw on operant learning theory with behavioral techniques focused on altering parent-child interactions to improve sleep. However, there are no data describing parent-child interactions overnight beyond parent report. In this study we used radio frequency identification technology to quantify parent-child proximity overnight in two groups at elevated risk of behavioral insomnia, Angelman syndrome (AS) and Smith-Magenis syndrome (SMS). MATERIALS AND METHODS Nineteen children aged 4-15 years (8 with AS, 11 with SMS) participated in a week-long at-home assessment of sleep and overnight parent-child proximity. Sleep parameters were recorded using the Philips Actiwatch 2 and proximity data were recorded using custom-built radio frequency identification watches. RESULTS Three patterns of proximity data between parent-child dyads overnight were evident: "checking" (six with AS, five with SMS), "co-sleeping" (four with SMS) and those who had "no proximity" overnight (two with AS, two with SMS). In the AS group, 25.45% of actigraphy-defined wakes resulted in a parent-child interaction. In the SMS group, 39.34% of wakes resulted in a parent-child interaction. Children who interacted with their parents when settling to sleep were not significantly more likely to interact at waking. DISCUSSION The novel application of radio frequency identification technology is a feasible method for studying overnight parent-child proximity. Profiles of proximity between participants that are not closely aligned with operant models of behavioral insomnia were evident. These results have significant implications for the etiology of poor sleep and the application of behavioral sleep interventions.
Collapse
Affiliation(s)
- Georgie Agar
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, UK
| | | |
Collapse
|
11
|
Duker LIS, Martinez M, Lane CJ, Polido JC, Cermak SA. Association between oral care challenges and sensory over-responsivity in children with Down syndrome. Int J Paediatr Dent 2022; 32:546-557. [PMID: 34622519 PMCID: PMC8989722 DOI: 10.1111/ipd.12933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/18/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sensory over-responsivity has been linked to oral care challenges in children with special healthcare needs. Parents of children with Down syndrome (cDS) have reported sensory over-responsivity in their children, but the link between this and oral care difficulties has not been explored. AIM To investigate the relationship between sensory over-responsivity and oral care challenges in cDS. DESIGN An online survey examined parent-reported responses describing the oral care of their cDS (5-14 years; n = 367). Children were categorized as either sensory over-responders (SORs) or sensory not over-responders (SNORs). Chi-square analyses tested associations between groups (SORs vs. SNORs) and dichotomous oral care variables. RESULTS More parents of SOR children than of SNOR reported that child behavior (SOR:86%, SNOR:77%; p < .05) and sensory sensitivities (SOR:34%, SNOR:18%; p < .001) make dental care challenging, their child complains about ≥3 types of sensory stimuli encountered during care (SOR:39%, SNOR:28%; p = .04), their dentist is specialized in treating children with special healthcare needs (SOR:45%, SNOR:33%; p = .03), and their child requires full assistance to brush teeth (SOR:41%, SNOR:28%; p = .008). No intergroup differences were found in items examining parent-reported child oral health or care access. CONCLUSIONS Parents of SOR children reported greater challenges than parents of SNOR children at the dentist's office and in the home, including challenging behaviors and sensory sensitivities.
Collapse
Affiliation(s)
- Leah I. Stein Duker
- Chan Division of Occupational Science and Occupational Therapy at the Ostrow School of Dentistry, University of Southern California, 1540 Alcazar St, CHP 133, Los Angeles, CA, 90089
| | - Melissa Martinez
- Chan Division of Occupational Science and Occupational Therapy at the Ostrow School of Dentistry, University of Southern California, 1540 Alcazar St, CHP 133, Los Angeles, CA, 90089
| | - Christianne J. Lane
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto St., SSB 220X, Los Angeles, CA, 90089
| | - José C. Polido
- Children’s Hospital Los Angeles and Associate Professor of Clinical Dentistry at the Ostrow School of Dentistry of the University of Southern California, 4650 Sunset Blvd, MS#116, Los Angeles, CA, 90027
| | - Sharon A. Cermak
- Chan Division of Occupational Science and Occupational Therapy at the Ostrow School of Dentistry, and Professor of Pediatrics at the USC Keck School of Medicine, University of Southern California, 1540 Alcazar St, CHP 133, Los Angeles, CA, 90089
| |
Collapse
|
12
|
Chung JCY, Mevorach C, Woodcock KA. Establishing the transdiagnostic contextual pathways of emotional outbursts. Sci Rep 2022; 12:7414. [PMID: 35523842 DOI: 10.1038/s41598-022-11474-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/22/2022] [Indexed: 12/27/2022] Open
Abstract
Emotional outbursts or temper outbursts are challenging behaviours commonly experienced by people with neurodevelopmental disorders and people who have experienced childhood adversity, which can negatively impact individuals and their families. Emotional outbursts may manifest in different situations via unique pathways distinguished by context-specific differences in the regulation and expression of emotions. Caregivers (N = 268) of young people (6-25 years) with emotional outbursts completed a bespoke caregiver-report questionnaire. Potential pathways were identified by examining the patterns of antecedents and setting events related to outbursts through factor and cluster analyses. Six contextual factors were derived from the Emotional Outburst Questionnaire. Based on these factors, the responses were classified into three clusters, which may represent potential pathways of emotional outbursts. The three clusters were characterized by the increased likelihood of outbursts: (1) across all setting events and triggers; (2) in safe setting events; (3) in unsafe setting events. These potential pathways may be related to: (1) differences in sensory processing; (2) masking of emotions in unsafe environments; (3) differences in safety perception. This framework supports a transdiagnostic account of emotional outbursts and may facilitate the development of pathway-specific intervention strategies.
Collapse
|
13
|
Neklyudova A, Smirnov K, Rebreikina A, Martynova O, Sysoeva O. Electrophysiological and Behavioral Evidence for Hyper- and Hyposensitivity in Rare Genetic Syndromes Associated with Autism. Genes (Basel) 2022; 13:671. [PMID: 35456477 PMCID: PMC9027402 DOI: 10.3390/genes13040671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 01/27/2023] Open
Abstract
Our study reviewed abnormalities in spontaneous, as well as event-related, brain activity in syndromes with a known genetic underpinning that are associated with autistic symptomatology. Based on behavioral and neurophysiological evidence, we tentatively subdivided the syndromes on primarily hyper-sensitive (Fragile X, Angelman) and hypo-sensitive (Phelan–McDermid, Rett, Tuberous Sclerosis, Neurofibromatosis 1), pointing to the way of segregation of heterogeneous idiopathic ASD, that includes both hyper-sensitive and hypo-sensitive individuals. This segmentation links abnormalities in different genes, such as FMR1, UBE3A, GABRB3, GABRA5, GABRG3, SHANK3, MECP2, TSC1, TSC2, and NF1, that are causative to the above-mentioned syndromes and associated with synaptic transmission and cell growth, as well as with translational and transcriptional regulation and with sensory sensitivity. Excitation/inhibition imbalance related to GABAergic signaling, and the interplay of tonic and phasic inhibition in different brain regions might underlie this relationship. However, more research is needed. As most genetic syndromes are very rare, future investigations in this field will benefit from multi-site collaboration with a common protocol for electrophysiological and event-related potential (EEG/ERP) research that should include an investigation into all modalities and stages of sensory processing, as well as potential biomarkers of GABAergic signaling (such as 40-Hz ASSR).
Collapse
|
14
|
Fetta A, Soliani L, Trevisan A, Pugliano R, Ricci E, Di Pisa V, Pignataro V, Angotti M, Rocca A, Salce B, Mancardi MM, Giordano L, Pruna D, Parmeggiani A, Cordelli DM. Cognitive, Behavioral, and Sensory Profile of Pallister–Killian Syndrome: A Prospective Study of 22 Individuals. Genes (Basel) 2022; 13:genes13020356. [PMID: 35205401 PMCID: PMC8872298 DOI: 10.3390/genes13020356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Developmental delay and intellectual disability are two pivotal elements of the phenotype of Pallister–Killian Syndrome (PKS). Our study aims to define the cognitive, adaptive, behavioral, and sensory profile of these patients and to evaluate possible correlations between the different aspects investigated and with the main clinical and demographic variables. Methods: Individuals of any age with genetically confirmed PKS were recruited. Those ≤ 42 months were administered the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III), and those > 42 months the Vineland Adaptive Behavior Scales—Second Edition (Vineland-II). Stereotyped behaviors (Stereotypy Severity Scale, SSS) and aggressive behaviors (Behavior Problems Inventory—Short Version, BPIs) were assessed in all subjects > 1 year; sensory profile (Child Sensory Profile 2, C-SP2) in all aged 2–18 years. Results: Twenty-two subjects were enrolled (11 F/11 M; age 9 months to 28 years). All subjects ≤ 42 months had psychomotor developmental delay. Of the subjects > 42 months, 15 had low IQ deviation, and 1 in the normal range. Stereotypies were frequent (median SSS-total score 25/68). Lower Vineland-II values corresponded to greater intensity and frequency of stereotypies (p = 0.004 and p = 0.003), and self-injurious behaviors (p = 0.002 and p = 0.002). Patients with severe low vision had greater interference of stereotypies (p = 0.027), and frequency and severity of aggressive behaviors (p = 0.026; p = 0.032). The C-SP2, while not homogeneous across subjects, showed prevalence of low registration and sensory seeking profiles and hypersensitivity to tactile and auditory stimuli. Lower Vineland-II scores correlated with higher Registration scores (p = 0.041), while stereotypies were more frequent and severe in case of high auditory sensitivity (p = 0.019; p = 0.007). Finally, greater sleep impairment correlated with stereotypies and self-injurious behaviors, and lower Vineland-II scores. Conclusions: The present study provides a further step in the investigation of the etiopathogenesis of the syndrome. Furthermore, these aspects could guide rehabilitation therapy through the identification of targeted protocols.
Collapse
Affiliation(s)
- Anna Fetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Luca Soliani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Alessia Trevisan
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Rosa Pugliano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Emilia Ricci
- Child Neuropsychiatry Unit, Epilepsy Center, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università di Milano, 98051 Milan, Italy;
| | - Veronica Di Pisa
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
| | - Veronica Pignataro
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
| | - Marida Angotti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
| | - Alessandro Rocca
- UO di Pediatria d’Urgenza, IRCCS Policlinico Sant’Orsola, 40138 Bologna, Italy;
| | - Bianca Salce
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Maria Margherita Mancardi
- Child Neuropsychiatry Unit, Department of Medical and Surgical Neurosciences and Rehabilitation, IRCCS Istituto Giannina Gaslini, 16128 Genova, Italy;
| | - Lucio Giordano
- Child Neuropsychiatric Division, Spedali Civili, 25123 Brescia, Italy;
| | - Dario Pruna
- Department of Pediatric Neurology and Epileptology, Pediatric Depatment, ARNAS Brotzu, 09134 Cagliari, Italy;
| | - Antonia Parmeggiani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Duccio Maria Cordelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
- Correspondence:
| |
Collapse
|
15
|
Cosgrove JA, Kelly LK, Kiffmeyer EA, Kloth AD. Sex-dependent influence of postweaning environmental enrichment in Angelman syndrome model mice. Brain Behav 2022; 12:e2468. [PMID: 34985196 PMCID: PMC8865162 DOI: 10.1002/brb3.2468] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/09/2021] [Accepted: 12/12/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Angelman syndrome (AS) is a rare neurodevelopmental disorder caused by mutation or loss of UBE3A and marked by intellectual disability, ataxia, autism-like symptoms, and other atypical behaviors. One route to treatment may lie in the role that environment plays early in postnatal life. Environmental enrichment (EE) is one manipulation that has shown therapeutic potential in preclinical models of many brain disorders, including neurodevelopmental disorders. Here, we examined whether postweaning EE can rescue behavioral phenotypes in Ube3a maternal deletion mice (AS mice), and whether any improvements are sex-dependent. METHODS Male and female mice (C57BL/6J Ube3atm1Alb mice and wild-type (WT) littermates; ≥10 mice/group) were randomly assigned to standard housing (SH) or EE at weaning. EE had a larger footprint, a running wheel, and a variety of toys that promoted foraging, burrowing, and climbing. Following 6 weeks of EE, animals were submitted to a battery of tests that reliably elicit behavioral deficits in AS mice, including rotarod, open field, marble burying, and forced swim; weights were also monitored. RESULTS In male AS-EE mice, we found complete restoration of motor coordination, marble burying, and forced swim behavior to the level of WT-SH mice. We also observed a complete normalization of exploratory distance traveled in the open field, but we found no rescue of vertical behavior or center time. AS-EE mice also had weights comparable to WT-SH mice. Intriguingly, in the female AS-EE mice, we found a failure of EE to rescue the same behavioral deficits relative to female WT-SH mice. CONCLUSIONS Environmental enrichment is an effective route to correcting the most penetrant phenotypes in male AS mice but not female AS mice. This finding has important implications for the translatability of early behavioral intervention for AS patients, most importantly the potential dependency of treatment response on sex.
Collapse
Affiliation(s)
- Jameson A. Cosgrove
- Department of BiologyAugustana University2001 S. Summit AvenueSioux FallsSouth DakotaUSA
| | - Lauren K. Kelly
- Department of BiologyAugustana University2001 S. Summit AvenueSioux FallsSouth DakotaUSA
| | - Elizabeth A. Kiffmeyer
- Department of BiologyAugustana University2001 S. Summit AvenueSioux FallsSouth DakotaUSA
| | - Alexander D. Kloth
- Department of BiologyAugustana University2001 S. Summit AvenueSioux FallsSouth DakotaUSA
| |
Collapse
|
16
|
Lyons-warren AM, Mccormack MC, Holder JL. Sensory Processing Phenotypes in Phelan-McDermid Syndrome and SYNGAP1-Related Intellectual Disability. Brain Sci 2022; 12:137. [PMID: 35203901 PMCID: PMC8869824 DOI: 10.3390/brainsci12020137] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
Sensory processing differences are an established feature of both syndromic and non-syndromic Autism Spectrum Disorders (ASDs). Significant work has been carried out to characterize and classify specific sensory profiles in non-syndromic autism. However, it is not known if syndromic autism disorders, such as Phelan-McDermid Syndrome (PMD) or SYNGAP1-related Intellectual Disability (SYNGAP1-ID), have unique sensory phenotypes. Understanding the sensory features of these disorders is important for providing appropriate care and for understanding their underlying mechanisms. Our objective in this work was to determine the sensory processing abnormalities present in two syndromic ASDs: Phelan-McDermid Syndrome and SYNGAP1-related Intellectual Disability. Using a standardized instrument, the Short Sensory Profile-2, we characterized sensory features in 41 patients with PMD and 24 patients with SYNGAP1-ID, and sub-scores were then calculated for seeking, avoiding, sensitivity and registration, as well as overall sensory and behavior scores. We found both patient groups exhibited atypical sensory features, including high scores in the areas of avoiding and seeking. Thus, we discovered significant sensory processing abnormalities are common in these syndromic ASDs. Measurements of sensory processing could serve as useful clinical endpoints for trials of novel therapeutics for these populations.
Collapse
|
17
|
Lubbers K, Stijl EM, Dierckx B, Hagenaar DA, Ten Hoopen LW, Legerstee JS, de Nijs PFA, Rietman AB, Greaves-Lord K, Hillegers MHJ, Dieleman GC, Mous SE. Autism Symptoms in Children and Young Adults With Fragile X Syndrome, Angelman Syndrome, Tuberous Sclerosis Complex, and Neurofibromatosis Type 1: A Cross-Syndrome Comparison. Front Psychiatry 2022; 13:852208. [PMID: 35651825 PMCID: PMC9149157 DOI: 10.3389/fpsyt.2022.852208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/26/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The etiology of autism spectrum disorder (ASD) remains unclear, due to genetic heterogeneity and heterogeneity in symptoms across individuals. This study compares ASD symptomatology between monogenetic syndromes with a high ASD prevalence, in order to reveal syndrome specific vulnerabilities and to clarify how genetic variations affect ASD symptom presentation. METHODS We assessed ASD symptom severity in children and young adults (aged 0-28 years) with Fragile X Syndrome (FXS, n = 60), Angelman Syndrome (AS, n = 91), Neurofibromatosis Type 1 (NF1, n = 279) and Tuberous Sclerosis Complex (TSC, n = 110), using the Autism Diagnostic Observation Schedule and Social Responsiveness Scale. Assessments were part of routine clinical care at the ENCORE expertise center in Rotterdam, the Netherlands. First, we compared the syndrome groups on the ASD classification prevalence and ASD severity scores. Then, we compared individuals in our syndrome groups with an ASD classification to a non-syndromic ASD group (nsASD, n = 335), on both ASD severity scores and ASD symptom profiles. Severity scores were compared using MANCOVAs with IQ and gender as covariates. RESULTS Overall, ASD severity scores were highest for the FXS group and lowest for the NF1 group. Compared to nsASD, individuals with an ASD classification in our syndrome groups showed less problems on the instruments' social domains. We found a relative strength in the AS group on the social cognition, communication and motivation domains and a relative challenge in creativity; a relative strength of the NF1 group on the restricted interests and repetitive behavior scale; and a relative challenge in the FXS and TSC groups on the restricted interests and repetitive behavior domain. CONCLUSION The syndrome-specific strengths and challenges we found provide a frame of reference to evaluate an individual's symptoms relative to the larger syndromic population and to guide treatment decisions. Our findings support the need for personalized care and a dimensional, symptom-based diagnostic approach, in contrast to a dichotomous ASD diagnosis used as a prerequisite for access to healthcare services. Similarities in ASD symptom profiles between AS and FXS, and between NF1 and TSC may reflect similarities in their neurobiology. Deep phenotyping studies are required to link neurobiological markers to ASD symptomatology.
Collapse
Affiliation(s)
- Kyra Lubbers
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eefje M Stijl
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bram Dierckx
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Doesjka A Hagenaar
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of General Paediatrics, Erasmus MC, Rotterdam, Netherlands
| | - Leontine W Ten Hoopen
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jeroen S Legerstee
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Pieter F A de Nijs
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - André B Rietman
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Kirstin Greaves-Lord
- Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Clinical Psychology and Experimental Psychopathology Unit, Department of Psychology, Rijksuniversiteit Groningen, Groningen, Netherlands.,Yulius Mental Health, Dordrecht, Netherlands.,Jonx Autism Team Northern-Netherlands, Lentis Mental Health, Groningen, Netherlands
| | - Manon H J Hillegers
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Gwendolyn C Dieleman
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sabine E Mous
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child- and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, Netherlands.,Child Brain Center, Erasmus University Medical Center, Rotterdam, Netherlands
| | | |
Collapse
|
18
|
Abstract
PURPOSE OF REVIEW While previous reviews have extended descriptions of the behavioural phenotype of Cornelia de Lange syndrome (CdLS) significantly, potential changes with age across the lifespan have been neglected. Age-related difference in the behavioural phenotype constitutes preliminary evidence of change with age. Documenting and understanding the developmental trajectories of behaviours is informative as it enables identification of risk periods for behavioural challenges and compromised mental health. RECENT FINDINGS Recent cross sectional, longitudinal and mixed design studies report differing presentations of the behavioural phenotype across the lifespan. Of particular interest are autistic characteristics and behaviours consistent with compromised mental health, particularly anxiety and negative affect, which are reported to be more common and severe in older individuals. Preliminary evidence for identified causal pathways with consideration of biological, cognitive and environmental factors are discussed. SUMMARY Older individuals with CdLS appear to be at greater risk of poorer psychological wellbeing than younger peers with significant implications for risk informed preventive and early interventions. Further work is required to document the behavioural phenotype across the lifespan with consideration of multiple factors that may influence the trajectory and extent of negative outcomes.
Collapse
|
19
|
Heald M, Adams D, Walls E, Oliver C. Refining the Behavioral Phenotype of Angelman Syndrome: Examining Differences in Motivation for Social Contact Between Genetic Subgroups. Front Behav Neurosci 2021; 15:618271. [PMID: 33664655 PMCID: PMC7921159 DOI: 10.3389/fnbeh.2021.618271] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/18/2021] [Indexed: 11/30/2022] Open
Abstract
Angelman syndrome (AS) is caused by loss of information from the 15q11.2-13 region on the maternal chromosome with striking phenotypic difference from Prader–Willi syndrome in which information is lost from the same region on the paternal chromosome. Motivation for social contact and sensory seeking behaviors are often noted as characteristics of the phenotype of AS and it has been argued that the strong drive for social contact supports a kinship theory interpretation of genomic imprinting. In this study we developed an experimental paradigm for quantifying the motivation for social contact in AS and examined differences across the genetic subtypes that cause AS [deletion, imprinting centre defect (ICD), uniparental disomy and UBE3A mutation]. Using single case experimental designs we examined the rate of acquisition of behavioral responses using operant learning paradigms for 21 children with AS whilst systematically varying the nature of social and sensory reinforcement. Variability in rates of acquisition was influenced by the nature of rewarding stimuli. Across the total sample both sensory stimuli and social contact could increase the rate of rewarded behavior with difference between children in the most effective reward. A striking difference in the rewarding properties of social contact across genetic subtypes was evidenced by non-deletion genetic causes of AS showing significantly higher rates of responding than the deletion cause in the social reinforcement paradigm. The results indicate that reinforcer assessment can beneficially inform behavioral interventions and that within syndrome variability in the behavioral phenotype of AS is likely driven by genetic difference. The non-deletion cause of AS, and particularly the ICD group, may be the optimal group for further study of genomic imprinting.
Collapse
Affiliation(s)
- Mary Heald
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Mount Gravatt, QLD, Australia
| | - Emily Walls
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Christopher Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
20
|
Osório JMA, Rodríguez-Herreros B, Romascano D, Junod V, Habegger A, Pain A, Richetin S, Yu P, Isidor B, Van Maldergem L, Pons L, Manificat S, Chabane N, Jequier Gygax M, Maillard AM. Touch and olfaction/taste differentiate children carrying a 16p11.2 deletion from children with ASD. Mol Autism 2021; 12:8. [PMID: 33546725 PMCID: PMC7863523 DOI: 10.1186/s13229-020-00410-w] [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: 07/16/2020] [Accepted: 12/22/2020] [Indexed: 11/24/2022] Open
Abstract
Background Sensory processing atypicalities are frequent in Autism Spectrum Disorder (ASD) and neurodevelopmental disorders (NDD). Different domains of sensory processing appear to be differentially altered in these disorders. In this study, we explored the sensory profile of two clinical cohorts, in comparison with a sample of typically developing children. Methods Behavioral responses to sensory stimuli were assessed using the Sensory Processing Measure (parent-report questionnaire). We included 121 ASD children, 17 carriers of the 16p11.2 deletion (Del 16p11.2) and 45 typically developing (TD) children. All participants were aged between 2 and 12 years. Additional measures included the Tactile Defensiveness and Discrimination Test-Revised, Wechsler Intelligence Scales and Autism Diagnostic Observation Schedule (ADOS-2). Statistical analyses included MANCOVA and regression analyses. Results ASD children score significantly higher on all SPM subscales compared to TD. Del16p11.2 also scored higher than TD on all subscales except for tactile and olfactory/taste processing, in which they score similarly to TD. When assessing sensory modulation patterns (hyper-, hypo-responsiveness and seeking), ASD did not significantly differ from del16p11.2. Both groups had significantly higher scores across all patterns than the TD group. There was no significant association between the SPM Touch subscale and the TDDT-R. Limitations Sensory processing was assessed using a parent-report questionnaire. Even though it captures observable behavior, a questionnaire does not assess sensory processing in all its complexity. The sample size of the genetic cohort and the small subset of ASD children with TDDT-R data render some of our results exploratory. Divergence between SPM Touch and TDDT-R raises important questions about the nature of the process that is assessed. Conclusions Touch and olfaction/taste seem to be particularly affected in ASD children compared to del16p11.2. These results indicate that parent report measures can provide a useful perspective on behavioral expression. Sensory phenotyping, when combined with neurobiological and psychophysical methods, might have the potential to provide a better understanding of the sensory processing in ASD and in other NDD.
Collapse
Affiliation(s)
- Joana Maria Almeida Osório
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Borja Rodríguez-Herreros
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - David Romascano
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Vincent Junod
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Aline Habegger
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Aurélie Pain
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Sonia Richetin
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Paola Yu
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland.,Laboratory for Investigative Neurophysiology (LINE), Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Lionel Van Maldergem
- Centre de Génétique Humaine, Centre Hospitalier Régional Universitaire, Université de Franche-Comté, Besançon, France.,Unité de recherche en neurosciences intégratives et cognitives EA481, Université de Franche-Comté, Besançon, France.,Centre d'investigation clinique 1431, INSERM, Besançon, France
| | - Linda Pons
- Service Génopsy - Pôle Hospitalo-Universitaire ADIS, Centre hospitalier Le Vinatier, Bron, France
| | - Sabine Manificat
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Nadia Chabane
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Marine Jequier Gygax
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland
| | - Anne Manuela Maillard
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l'Autisme et apparentés, Lausanne University Hospital, Les Allières - Av. Beaumont 23, 1011, Lausanne, Switzerland.
| |
Collapse
|
21
|
Adams D, Roche L, Heussler H. Parent perceptions, beliefs, and fears around genetic treatments and cures for children with Angelman syndrome. Am J Med Genet A 2020; 182:1716-1724. [PMID: 32449301 DOI: 10.1002/ajmg.a.61631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/02/2019] [Revised: 02/27/2020] [Accepted: 04/28/2020] [Indexed: 01/21/2023]
Abstract
Genetic therapies have shown recent promise in alleviating some of the cognitive issues associated with some genetic disorders; however, these therapies may come with significant health and socio-ethical concerns, particularly when they involve child participants. Little is known about what parents of children with genetic disorders think about genetic therapies, or about their knowledge of how genetic-based therapy might treat their child's symptoms. Forty-two parents of children with Angelman syndrome (AS) and 27 parents of a mixed etiology comparison group completed an online survey reporting on their perceptions of, and priorities for, genetic therapy. Almost all parents of children with AS (95%) and the comparison group (89%) agreed that treatments aiming to reduce symptoms associated with their child's syndrome were positive. However, significantly more parents of children with AS (95%) than the comparison group (56%) felt that genetic treatment trials aiming to "cure" their child should be a research priority. AS parent priorities for the focus of clinical trials were neurology/seizures, communication skills, and motor skills/mobility. For the comparison group, the priorities were IQ, immune response, and expressive speech. Parents of both groups did not want treatments to change their child's personality or their happiness. Global assumptions cannot be made about targets for therapy between syndromes, about parental understanding of genetics, or about research evidence across syndromes. This study highlights the need for true family and patient engagement in all stages of the research design and treatment evaluation.
Collapse
Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Brisbane, Queensland, Australia
| | - Laura Roche
- Autism Centre of Excellence, Griffith University, Brisbane, Queensland, Australia
| | - Helen Heussler
- Centre for Clinical Trials in Rare Neurodevelopmental Disorders, Children's Health Queensland, Brisbane, Queensland, Australia.,Centre for Children's Health Research, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
22
|
Ridley E, Riby DM, Leekam SR. A cross-syndrome approach to the social phenotype of neurodevelopmental disorders: Focusing on social vulnerability and social interaction style. Res Dev Disabil 2020; 100:103604. [PMID: 32142968 DOI: 10.1016/j.ridd.2020.103604] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 01/31/2020] [Accepted: 02/02/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Following Annette Karmiloff-Smith's approach to cognitive research, this study applied a cross-syndrome approach to the social phenotype, focusing on social vulnerability (SV) and the factors that contribute to it. AIMS To (i) identify syndrome-specific differences in SV across four neurodevelopmental disorder (NDD) groups, (ii) determine the contribution of intellectual disability (ID), age or gender to SV, and (iii) explore its relationship with social interaction style (SIS). METHODS AND PROCEDURES 262 parents of children: Autism (n = 29), Williams syndrome (n = 29), Attention deficit hyperactivity disorder (n = 36), Fragile X syndrome (n = 18), and Neurotypical (n = 150) reported on their child's SV, quality of SIS and other factors (ID, age, gender). OUTCOMES AND RESULTS Heightened SV was not syndrome-specific. Instead it was found equally across NDD groups (and not in the neurotypical group), and independently of ID, age and gender. Different atypical SISs were also distributed across NDD groups and each were significantly related to SV, independent of the factors above and beyond neurodevelopmental diagnosis. CONCLUSIONS AND IMPLICATIONS The findings emphasise that social phenotypes are best understood as distributed across diagnostic boundaries and offer opportunities to further test the role of varied atypical SISs in the development of heightened SV.
Collapse
Affiliation(s)
- Ellen Ridley
- Centre for Developmental Disorders, Department of Psychology, Durham University, Science Site, South Road, Durham, UK.
| | - Deborah M Riby
- Centre for Developmental Disorders, Department of Psychology, Durham University, Science Site, South Road, Durham, UK
| | - Susan R Leekam
- Wales Autism Research Centre, Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| |
Collapse
|