1
|
Alsayouf HA, Alsarhan O, Khreisat W, Daoud A. Atomoxetine Treatment of Attention Deficit/Hyperactivity Disorder Symptoms in 3-6-Year-Old Children with Autism Spectrum Disorder: A Retrospective Cohort Study. Children (Basel) 2024; 11:163. [PMID: 38397275 PMCID: PMC10887200 DOI: 10.3390/children11020163] [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] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Atomoxetine is indicated for the management of attention deficit/hyperactivity disorder (ADHD) in children and adolescents aged 6 to 18 years. Few studies have assessed the safety and tolerability of atomoxetine in younger patients. This retrospective cohort study included 133 children aged 3-6 years who were diagnosed with ADHD comorbid with autism spectrum disorder (ASD). The primary endpoint was the evaluation of the safety profile of atomoxetine. In total, 50 patients (37.6%) experienced adverse events (AEs), which led to treatment discontinuation in 23 patients (17.3%). The most common AEs were gastrointestinal (24.1%), aggression or hostility (12.8%), and increased hyperactivity (9.0%). In the 23 patients who discontinued treatment, all the AEs resolved after treatment ceased. Among the 110 patients who completed at least 6 months' treatment, atomoxetine titrated to a dose of 1.2-1.8 mg/kg/day appeared to be well tolerated and effective. The Clinical Global Impression-Improvement score improved to 1 ("very much improved") and 2 ("much improved") in 62.4% and 20.3% of children, respectively, at their last visit. Overall, atomoxetine appeared to be well tolerated in younger children with comorbid ADHD and ASD. Nevertheless, close patient monitoring remains essential, and the study limitations necessitate caution in generalizing these findings to broader populations. Long-term prospective studies are required.
Collapse
Affiliation(s)
| | | | | | - Azhar Daoud
- The Specialty Hospital, Amman 11942, Jordan;
| |
Collapse
|
2
|
Koutra K, Margetaki K, Kampouri M, Kyriklaki A, Roumeliotaki T, Vafeiadi M, Bitsios P, Kogevinas M, Chatzi L. Maternal sleep disturbances during late pregnancy and child neuropsychological and behavioral development in early childhood. Eur Child Adolesc Psychiatry 2023; 32:2139-2150. [PMID: 35927528 DOI: 10.1007/s00787-022-02053-z] [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: 10/29/2021] [Accepted: 07/16/2022] [Indexed: 11/25/2022]
Abstract
The present study aims to explore the association of maternal sleep disturbances during late pregnancy on child neuropsychological and behavioral development in preschool years. The study included 638 mother-child pairs from the prospective Rhea mother-child cohort in Crete, Greece. Information on antenatal sleep disturbances was collected through a computer-assisted interview. Children's neuropsychological and behavioral development was assessed using the McCarthy Scales of Children's Abilities (MSCA), the Attention-Deficit Hyperactivity Disorder Test (ADHDT), and the Strengths and Difficulties Questionnaire (SDQ). Multivariate analysis showed that maternal sleep duration less than 8 h was associated with reduced scores in the general cognitive scale (β = -2.28, 95% CI -4.54, -0.02, R2 = 0.417) and memory span (β = -3.24, 95% CI -5.72, -0.77, R2 = 0.304), while mild-severe daytime sleepiness was associated with reduced scores in the memory scale (β = -5.42, 95% CI -10.47, -0.37, R2 = 0.304), memory span (β = -5.44, 95% CI -10.68, -0.21, R2 = 0.304), nd functions of posterior cortex (β = -5.55, 95% CI -10.40, -0.70, R2 = 0.393) of MSCA. Snoring in late pregnancy was related to higher child hyperactivity scores in SDQ (β = 1.05, 95% CI 0.16, 1.95, R2 = 0.160). An interaction between child sex and maternal sleep duration in response to ADHD symptoms was also found (p for interaction < 0.05). Stratified analysis revealed increased hyperactivity, inattention, and ADHD total scores for girls of mothers with sleep duration less than 8 h. Maternal sleep disturbances during pregnancy may be associated with impaired child neuropsychological and behavioral development during the preschool years. Early detection and intervention is necessary to reduce sleep disturbances habits in pregnancy and improve child neurodevelopment.
Collapse
Affiliation(s)
- Katerina Koutra
- Department of Psychology, School of Social Sciences, University of Crete, Gallos Campus Crete, 74100, Rethymno, Greece.
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
| | - Katerina Margetaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
- Department of Preventive Medicine, Division of Environmental Health, University of Southern California, Los Angeles, CA, USA
| | - Mariza Kampouri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andriani Kyriklaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Panos Bitsios
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Division of Environmental Health, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
3
|
Li J, Wang W, Cheng J, Li H, Feng L, Ren Y, Liu L, Qian Q, Wang Y. Relationships between sensory integration and the core symptoms of attention-deficit/hyperactivity disorder: the mediating effect of executive function. Eur Child Adolesc Psychiatry 2023; 32:2235-2246. [PMID: 35999304 DOI: 10.1007/s00787-022-02069-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/14/2022] [Indexed: 11/03/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by executive function deficits and functional alterations in sensory integration. The present study aimed to investigate the relationship between ADHD core symptoms, executive function, and sensory integration in children with ADHD. A total of 228 children with ADHD were recruited for our study. The Sensory Organization Test (SOT) and Child Sensory Integration Scale (CSIS) evaluated the sensory integration ability from lab-based and scaled-based perspectives, respectively. Three core components of executive functions (inhibition, working memory, and set-shifting) were assessed using both lab-based tests and the relevant factors from the behavior rating inventory of executive function (BRIEF). Partial correlation analysis was performed to explore the correlation of sensory integration with EF and ADHD core symptoms. Based on the observed significant correlation, bootstrap analyses were further conducted to explore the potential mediating effect of EF on the relationship between sensory integration and ADHD core symptoms. ADHD symptoms and EF were significantly correlated with CSIS scores; no factors were significantly correlated with SOT performance. In detail, the vestibular-balance score was negatively correlated with both inattention and hyperactivity/impulsivity symptoms, while the hyper-sensory and proprioception scores were negatively correlated with only inattention symptoms. For the scaled-based EF, vestibular-balance was negatively correlated with inhibition and working memory, and the hyper-sensory score was negatively correlated with shift factor. No correlation was found for the lab-based EF tests. The subsequent mediation analysis found that inhibition partially mediated the relationship between vestibular balance and hyperactivity/impulsivity symptoms. Working memory completely mediated the relationship between vestibular-balance, hyper-sensory, proprioception, and inattention symptoms. These results were well validated in an independent sample. Our present findings demonstrated that the functional alteration in basic sensory integration might be associated with impairments of executive functions and then lead to the behavioral expression of ADHD. The present findings might provide a new perspective to understand the occurrence of ADHD symptoms and potential precise intervention methods.
Collapse
Affiliation(s)
- Jing Li
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wenchen Wang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Jia Cheng
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Haimei Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Lei Feng
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuanchun Ren
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, 100191, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| |
Collapse
|
4
|
Masters EC, Antshel KM, Kates WR, Russo N. Brief Report: Sensory Features Associated with Autism After Controlling for ADHD Symptoms. J Autism Dev Disord 2023:10.1007/s10803-023-06046-y. [PMID: 37393371 DOI: 10.1007/s10803-023-06046-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: 06/09/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Sensory processing differences are reported both in children with ADHD and in children with autism. Given the substantial overlap between autism and ADHD, the current study examined which sensory features were uniquely predictive of autistic traits after controlling for ADHD symptoms, age, IQ, and sex in a sample of children and adolescents with autism aged 6-17 years. METHODS The sample included 61 children and adolescents with autism. The Sensory Profile was used to examine Dunn's quadrant model (seeking, sensitivity, avoiding, registration), ADHD symptoms were measured using hyperactivity and attention problems BASC-2 T-scores, and autistic traits were measured using the AQ. RESULTS After controlling for age, IQ, sex, and ADHD symptoms, Dunn's sensitivity quadrant predicted autistic traits. CONCLUSIONS Findings provide insight into the phenotype of autism and ADHD. Sensory sensitivity may be unique to autism over and above elevated ADHD symptoms that are commonly seen in this population.
Collapse
Affiliation(s)
- Ellen C Masters
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244 2340, USA
| | - Kevin M Antshel
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244 2340, USA
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, USA
| | - Natalie Russo
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244 2340, USA.
| |
Collapse
|
5
|
Cremone-Caira A, Braverman Y, MacNaughton GA, Nikolaeva JI, Faja S. Reduced Visual Evoked Potential Amplitude in Autistic Children with Co-Occurring Features of Attention-Deficit/Hyperactivity Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06005-7. [PMID: 37249694 DOI: 10.1007/s10803-023-06005-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/31/2023]
Abstract
Provided the significant overlap in features of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), there is a critical need to identify transdiagnostic markers that could meaningfully stratify subgroups. The objective of this study was to compare the visual evoked potential (VEP) between 30 autistic children, 17 autistic children with co-occurring ADHD presentation (ASD + ADHD), and 21 neurotypical children (NTC). Electroencephalography was recorded while children passively viewed a pattern-reversal stimulus. Mean amplitude of the P1 event-related potential was extracted from a midline occipital channel and compared between groups. P1 mean amplitude was reduced in the ASD + ADHD group compared to the ASD and NTC groups, indicating a distinct pattern of brain activity in autistic children with co-occurring ADHD features.
Collapse
Affiliation(s)
- Amanda Cremone-Caira
- Department of Psychology, Assumption University, Worcester, USA
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 2 Brookline Place, Brookline, MA, 02445, USA
| | - Yael Braverman
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 2 Brookline Place, Brookline, MA, 02445, USA
- Department of Neurology, Boston Children's Hospital, Boston, USA
| | | | - Julia I Nikolaeva
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, USA
| | - Susan Faja
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 2 Brookline Place, Brookline, MA, 02445, USA.
- Department of Neurology, Boston Children's Hospital, Boston, USA.
| |
Collapse
|
6
|
Harkins C, Mazurek MO. The Impact of Co-occurring ADHD on Social Competence Intervention Outcomes in Youth with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-05987-8. [PMID: 37142907 PMCID: PMC10624644 DOI: 10.1007/s10803-023-05987-8] [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: 04/04/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The co-occurrence of autism spectrum disorder (ASD) and attention- deficit/hyperactivity disorder (ADHD) is significant and associated with a host of negative outcomes. Studies investigating social functioning in the presence of the ASD/ADHD co-occurrence have produced mixed findings. The present study further evaluated the impact of co-occurring ADHD on social functioning among youth with ASD and compared treatment response to a social competence intervention between youth with ASD and ASD + ADHD. METHODS Two-way repeated measures analyses of variance (ANOVAs) were computed with diagnostic group and time as the independent variables and measures of social functioning as dependent variables. Group and Time effects and Group by Time interactions were examined. RESULTS Youth with co-occurring ADHD displayed more impairments related to social awareness, but not in other social areas. Participants in both the ASD and ASD + ADHD groups demonstrated significant improvement following a social competence intervention. CONCLUSION Co-occurring ADHD did not negatively affect treatment response. Youth with ASD + ADHD may benefit highly structured interventions with a scaffolded teaching design.
Collapse
Affiliation(s)
- Christina Harkins
- Department of Human Services, School of Education and Human Development, University of Virginia, Charlottesville, VA, USA.
| | - Micah O Mazurek
- Department of Human Services, School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
7
|
Yang Y, Ye C, Ma T. A deep connectome learning network using graph convolution for connectome-disease association study. Neural Netw 2023; 164:91-104. [PMID: 37148611 DOI: 10.1016/j.neunet.2023.04.025] [Citation(s) in RCA: 1] [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: 09/20/2022] [Revised: 02/01/2023] [Accepted: 04/16/2023] [Indexed: 05/08/2023]
Abstract
Multivariate analysis approaches provide insights into the identification of phenotype associations in brain connectome data. In recent years, deep learning methods including convolutional neural network (CNN) and graph neural network (GNN), have shifted the development of connectome-wide association studies (CWAS) and made breakthroughs for connectome representation learning by leveraging deep embedded features. However, most existing studies remain limited by potentially ignoring the exploration of region-specific features, which play a key role in distinguishing brain disorders with high intra-class variations, such as autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD). Here, we propose a multivariate distance-based connectome network (MDCN) that addresses the local specificity problem by efficient parcellation-wise learning, as well as associating population and parcellation dependencies to map individual differences. The approach incorporating an explainable method, parcellation-wise gradient and class activation map (p-GradCAM), is feasible for identifying individual patterns of interest and pinpointing connectome associations with diseases. We demonstrate the utility of our method on two largely aggregated multicenter public datasets by distinguishing ASD and ADHD from healthy controls and assessing their associations with underlying diseases. Extensive experiments have demonstrated the superiority of MDCN in classification and interpretation, where MDCN outperformed competitive state-of-the-art methods and achieved a high proportion of overlap with previous findings. As a CWAS-guided deep learning method, our proposed MDCN framework may narrow the bridge between deep learning and CWAS approaches, and provide new insights for connectome-wide association studies.
Collapse
Affiliation(s)
- Yanwu Yang
- Department of Electronic and Information Engineering, Harbin Institute of Technology at Shenzhen, Shenzhen, China; Peng Cheng Laboratory, Shenzhen, China.
| | - Chenfei Ye
- Peng Cheng Laboratory, Shenzhen, China; International Research Institute for Artificial Intelligence, Harbin Institute of Technology at Shenzhen, Shenzhen, China.
| | - Ting Ma
- Department of Electronic and Information Engineering, Harbin Institute of Technology at Shenzhen, Shenzhen, China; Peng Cheng Laboratory, Shenzhen, China; International Research Institute for Artificial Intelligence, Harbin Institute of Technology at Shenzhen, Shenzhen, China; Guangdong Provincial Key Laboratory of Aerospace Communication and Networking Technology, Harbin Institute of Technology (Shenzhen), Shenzhen, China.
| |
Collapse
|
8
|
Pettine WW, Raman DV, Redish AD, Murray JD. Human generalization of internal representations through prototype learning with goal-directed attention. Nat Hum Behav 2023; 7:442-463. [PMID: 36894642 DOI: 10.1038/s41562-023-01543-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/31/2023] [Indexed: 03/11/2023]
Abstract
The world is overabundant with feature-rich information obscuring the latent causes of experience. How do people approximate the complexities of the external world with simplified internal representations that generalize to novel examples or situations? Theories suggest that internal representations could be determined by decision boundaries that discriminate between alternatives, or by distance measurements against prototypes and individual exemplars. Each provide advantages and drawbacks for generalization. We therefore developed theoretical models that leverage both discriminative and distance components to form internal representations via action-reward feedback. We then developed three latent-state learning tasks to test how humans use goal-oriented discrimination attention and prototypes/exemplar representations. The majority of participants attended to both goal-relevant discriminative features and the covariance of features within a prototype. A minority of participants relied only on the discriminative feature. Behaviour of all participants could be captured by parameterizing a model combining prototype representations with goal-oriented discriminative attention.
Collapse
Affiliation(s)
| | | | - A David Redish
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - John D Murray
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| |
Collapse
|
9
|
Varbanov V, Overton PG, Stafford T. ADHD and ASD traits are indirectly associated with sensory changes through anxiety. Curr Psychol 2023. [DOI: 10.1007/s12144-022-04217-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
10
|
Tirani SA, Balali A, Askari G, Saneei P. Maternal serum 25-hydroxy vitamin D levels and risk of autism spectrum and attention-deficit hyperactivity disorders in offspring: A systematic review and dose-response meta-analysis. Psychiatry Res 2023; 319:114977. [PMID: 36470163 DOI: 10.1016/j.psychres.2022.114977] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Shahnaz Amani Tirani
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arghavan Balali
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
11
|
Potharst ES, Truijens D, Seegers ICM, Spaargaren JF, van Steensel FJA, Bögels SM. BOAM: A Visual, Explanatory Diagnostic and Psychoeducation System Used in Collaboration with Families-Feasibility and Acceptability for Children Who Are Non-Responsive to Treatment as Usual. Int J Environ Res Public Health 2022; 19:14693. [PMID: 36429410 PMCID: PMC9691191 DOI: 10.3390/ijerph192214693] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
Many children referred to mental health services have neurodevelopmental problems, which are not always recognized because the resulting emotional and behavioral problems dominate diagnosis and treatment. BOAM (Basic needs, Order, Autonomy and Meaning) is a new diagnostic system consisting of imaginative models that explain the complexity of symptoms and underlying neuropsychological problems in a simple way. It is designed to be used in a transparent, collaborative process with families, so that family members can better understand the nature of mental health problems, thus increasing self-knowledge and mutual understanding. In this study, the feasibility of the BOAM diagnostic trajectory and subsequent treatment informed by this trajectory are evaluated clinically in 34 children who have not responded to or relapsed after treatment as usual (TAU). Parents completed questionnaires pre-test, post-test and at a 3-month follow-up. The treatment drop-out rate was 2.9%. Post-test, parents rated the BOAM trajectory positively. The questionnaires (measuring child psychopathology, attention, executive functioning, family functioning, partner relationships and parenting stress) demonstrated sensitivity to change, and therefore, seems appropriate for a future effectiveness study. A limitation was the high percentage of missing measurements both post-test (41%) and at the follow-up (41%). The BOAM diagnostic trajectory and subsequent treatment may be a feasible alternative for children who do not respond to or relapse after TAU.
Collapse
Affiliation(s)
- Eva S. Potharst
- UvA Minds, Academic Outpatient (Child and Adolescent) Treatment Centre of the University of Amsterdam, Banstraat 29, 1071 JW Amsterdam, The Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands
| | - Damiët Truijens
- UvA Minds, Academic Outpatient (Child and Adolescent) Treatment Centre of the University of Amsterdam, Banstraat 29, 1071 JW Amsterdam, The Netherlands
| | - Isabelle C. M. Seegers
- UvA Minds, Academic Outpatient (Child and Adolescent) Treatment Centre of the University of Amsterdam, Banstraat 29, 1071 JW Amsterdam, The Netherlands
| | - Julia F. Spaargaren
- UvA Minds, Academic Outpatient (Child and Adolescent) Treatment Centre of the University of Amsterdam, Banstraat 29, 1071 JW Amsterdam, The Netherlands
| | - Francisca J. A. van Steensel
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands
| | - Susan M. Bögels
- Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, The Netherlands
| |
Collapse
|
12
|
de Lima TA, Zuanetti PA, Nunes MEN, Hamad APA. Differential diagnosis between autism spectrum disorder and other developmental disorders with emphasis on the preschool period. World J Pediatr 2022. [PMID: 36282408 DOI: 10.1007/s12519-022-00629-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/27/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and behavioral changes. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in communication and social interaction and by repetitive and restricted patterns of behavior, interests and activities. The aim of this review is to discuss the clinical features of the differential diagnoses of ASD that are prevalent among preschoolers, focusing on their similarities and disparities. DATA SOURCES The international medical literature search was conducted using PubMed and was revised regarding the subject using single and/or combined keywords as follows: differential diagnosis, preschoolers, diagnostic challenge, attention deficit hyperactivity disorder, intellectual disability, high abilities/giftedness, childhood apraxia of speech, social communication disorder, Landau-Kleffner syndrome, stereotyped movement disorder and excessive screen time. RESULTS We describe conditions commonly found in clinical practice, taking ASD as a reference. We addressed converging and divergent aspects of behavior, cognition, communication, language, speech, socialization, and stereotypes for the diagnosis of ASD and other disorders identified as potential differential or comorbid diagnoses. CONCLUSIONS The ranking and characterization of symptoms appear to be essential for better understanding the underlying common ground between children with developmental disorders and children with ASD, thus properly diagnosing and directing social, professional, or medication interventions. This detailed discussion adds to the literature since, although ASD differential diagnoses are frequently mentioned and discussed in textbooks and journal articles, they rarely occupy a prominent place as we aimed herein.
Collapse
|
13
|
Liloia D, Crocetta A, Cauda F, Duca S, Costa T, Manuello J. Seeking Overlapping Neuroanatomical Alterations between Dyslexia and Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Replication Study. Brain Sci 2022; 12:brainsci12101367. [PMID: 36291301 PMCID: PMC9599506 DOI: 10.3390/brainsci12101367] [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: 08/30/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 01/18/2023] Open
Abstract
The present work is a replication article based on the paper “Are there shared neural correlates between dyslexia and ADHD? A meta-analysis of voxel-based morphometry studies” by McGrath and Stoodley (2019). In the original research, the authors used activation likelihood estimation (ALE), a technique to perform coordinate-based meta-analysis (CBMA), to investigate the existence of brain regions undergoing gray matter alteration in association with both attention-deficit/hyper-activity disorder (ADHD) and dyslexia. Here, the same voxel-based morphometry dataset was analyzed, while using the permutation-subject images version of signed differential mapping (PSI-SDM) in place of ALE. Overall, the replication converged with the original paper in showing a limited overlap between the two conditions. In particular, no significant effect was found for dyslexia, therefore precluding any form of comparison between the two disorders. The possible influences of biological sex, age, and medication status were also ruled out. Our findings are in line with literature about gray matter alteration associated with ADHD and dyslexia, often showing conflicting results. Therefore, although neuropsychological and clinical evidence suggest some convergence between ADHD and dyslexia, more future research is sorely needed to reach a consensus on the neuroimaging domain in terms of patterns of gray matter alteration.
Collapse
Affiliation(s)
- Donato Liloia
- GCS fMRI Koelliker Group, Koelliker Hospital and University of Turin, 10124 Turin, Italy
- FOCUS Laboratory, Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Annachiara Crocetta
- FOCUS Laboratory, Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Franco Cauda
- GCS fMRI Koelliker Group, Koelliker Hospital and University of Turin, 10124 Turin, Italy
- FOCUS Laboratory, Department of Psychology, University of Turin, 10124 Turin, Italy
- Neuroscience Institute of Turin, 10043 Turin, Italy
- Correspondence: ; Tel.: +39-011-670-29-80; Fax: +39-011-814-62-31
| | - Sergio Duca
- GCS fMRI Koelliker Group, Koelliker Hospital and University of Turin, 10124 Turin, Italy
- FOCUS Laboratory, Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Tommaso Costa
- GCS fMRI Koelliker Group, Koelliker Hospital and University of Turin, 10124 Turin, Italy
- FOCUS Laboratory, Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Jordi Manuello
- GCS fMRI Koelliker Group, Koelliker Hospital and University of Turin, 10124 Turin, Italy
- FOCUS Laboratory, Department of Psychology, University of Turin, 10124 Turin, Italy
| |
Collapse
|
14
|
Tang Y, Zheng S, Tian Y, Cavaliere C. Resting-State fMRI Whole Brain Network Function Plasticity Analysis in Attention Deficit Hyperactivity Disorder. Neural Plast 2022; 2022:1-15. [PMID: 36199291 PMCID: PMC9529483 DOI: 10.1155/2022/4714763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/08/2022] [Indexed: 12/03/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common mental disorder in children, which is related to inattention and hyperactivity. These symptoms are associated with abnormal interactions of brain networks. We used resting-state functional magnetic resonance imaging (rs-fMRI) based on the graph theory to explore the topology property changes of brain networks between an ADHD group and a normal group. The more refined AAL_1024 atlas was used to construct the functional networks with high nodal resolution, for detecting more subtle changes in brain regions and differences among groups. We compared altered topology properties of brain network between the groups from multilevel, mainly including modularity at mesolevel. Specifically, we analyzed the similarities and differences of module compositions between the two groups. The results found that the ADHD group showed stronger economic small-world network property, while the clustering coefficient was significantly lower than the normal group; the frontal and occipital lobes showed smaller node degree and global efficiency between disease statuses. The modularity results also showed that the module number of the ADHD group decreased, and the ADHD group had short-range overconnectivity within module and long-range underconnectivity between modules. Moreover, modules containing long-range connections between the frontal and occipital lobes disappeared, indicating that there was lack of top-down control information between the executive control region and the visual processing region in the ADHD group. Our results suggested that these abnormal regions were related to executive control and attention deficit of ADHD patients. These findings helped to better understand how brain function correlates with the ADHD symptoms and complement the fewer modularity elaboration of ADHD research.
Collapse
|
15
|
Sobhy N, Afsah O, Baz H. Developing an arabic questionnaire to assess sensory processing disorders among preschool Egyptian children. Res Dev Disabil 2022; 126:104238. [PMID: 35487049 DOI: 10.1016/j.ridd.2022.104238] [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: 03/16/2021] [Revised: 03/27/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sensory processing disorder (SPD) is a neurophysiologic disorder in which sensory input is poorly detected, modulated, interpreted and/or to which atypical responses occur. The objective of this study was to validate an Arabic questionnaire for identification of SPD among preschool Arabic-speaking children with Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). METHODS A newly constructed Arabic questionnaire for assessment of SPD was completed by parents of 100 Egyptian Arabic-speaking children including 40 typically-developing children (control group), 30 children with ASD, and 30 children with ADHD in the age range 3-6 years RESULTS AND CONCLUSION: Sensory processing differences were detected between typically-developing children and children with ASD and ADHD. Significant differences were found in auditory processing, visual processing, oral sensory processing, olfactory processing, total scores and emotional/social response. The current study revealed non-significant differences between ASD and ADHD children as regards auditory, visual, touch, oral sensory, olfactory and total processing scores. On the other hand, ASD children showed higher scores in proprioceptive processing and lower scores in emotional/social response than children with ADHD. The designed Arabic questionnaire is a valid and reliable assessment tool for identification of SPD in preschool Arabic-speaking children.
Collapse
Affiliation(s)
- Nora Sobhy
- Phoniatric Unit, ORL Department, Elsenbelawin General Hospital, Elsenbelawin, Egypt.
| | - Omayma Afsah
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
| | - Hemmat Baz
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
| |
Collapse
|
16
|
Dellapiazza F, Michelon C, Picot MC, Baghdadli A. Early risk factors for anxiety disorders in children with autism spectrum disorders: results from the ELENA Cohort. Sci Rep 2022; 12:10914. [PMID: 35764687 PMCID: PMC9239987 DOI: 10.1038/s41598-022-15165-y] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
Anxiety in children with autism spectrum disorder (ASD) negatively affects their social interactions, and quality of life. It is necessary to identify early risk factors for anxiety to tailor prevention and interventions. We aimed to examine the clinical level of anxiety in children with ASD from 5 to 10 years of age and identify potential early risk factors 3 years earlier. Participants were ASD children included in ELENA, a French prospective cohort. In this study, we used the collection of data at Time 1-T1 (at baseline) and Time 2-T2 (3 years after T1). Two groups were identified at T2 according to the threshold for anxiety on the CBCL: ASD-only group and ASD + anxiety group. Our results showed that half of the children in our sample had a clinical level of anxiety at T2. Regression analysis showed that greater ASD severity and lower sensory processing difficulties predicted lower anxiety, whereas higher levels of restricted and repetitive behaviours tended to predict higher levels of anxiety. The high prevalence of clinical-level anxiety in our sample suggests the need for specific assessment and targeted treatment of anxiety on a routine basis.
Collapse
Affiliation(s)
- Florine Dellapiazza
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France
| | - Cécile Michelon
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France
| | - Marie-Christine Picot
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France.,Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Amaria Baghdadli
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France. .,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France. .,Faculté de Médecine, Université de Montpellier, Montpellier, France.
| |
Collapse
|
17
|
Ip A, Poon BT, Hanley G, Guhn M, Oberlander TF. Developmental profiles of children at risk for autism spectrum disorder at school entry. Autism Res 2022; 15:1301-1310. [PMID: 35586913 PMCID: PMC9322442 DOI: 10.1002/aur.2742] [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: 10/06/2021] [Accepted: 04/28/2022] [Indexed: 11/11/2022]
Abstract
Functional abilities in children with autism spectrum disorder (ASD) are highly heterogenous, and impairments can overlap with non-ASD neurodevelopmental disorders. We compared the profiles of children assessed for ASD with and without an ASD diagnosis using a retrospective cohort study of 101,739 children born in British Columbia (2000-2008). The children were grouped into the following five comparison groups: (1) ASD- (n = 1131), (2) ASD+ (n = 1583), (3) Ministry of Education designated ASD+ (n = 654), (4) special need other than ASD (n = 11,663), and (5) typically developing (n = 86,708). Five developmental domains were assessed using the Early Development Instrument. ANCOVA was used to control for covariates, Tukey's HSD test for multiple comparisons, and Cohen's d for effect size. The ASD- group had slightly higher scores than the ASD+ group with small to medium effect sizes in all domains (d = 0.20-0.48). The ASD- group had slightly higher scores than the Ministry of Education ASD+ group in only three domains with small effect sizes (d = 0.21-0.25). The ASD- group had lower scores in all domains compared to the typically developing group with large effect sizes in all domains (d = 1.12-1.77). The ASD- group received less education funding at school entry than both ASD+ groups. Overall, only small to medium differences in development were detected between the ASD- and ASD+ groups. While these children differ diagnostically, they share similar functional profiles and have substantially more difficulties than typically developing children. Therefore, differences in levels of support at school entry raise critical questions of equity. LAY SUMMARY: Comparison of children in British Columbia who have been referred for an autism assessment, with or without a diagnosis, shows similarities in their functional and developmental profiles in kindergarten. Furthermore, both groups of children have more difficulties than typically developing children. However, children who have been referred for assessment without an autism diagnosis receive less financial support at school entry, raising important questions on equity.
Collapse
Affiliation(s)
- Angie Ip
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Sunny Hill Health Centre, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Brenda T Poon
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Human Early Learning Partnership, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gillian Hanley
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Guhn
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Human Early Learning Partnership, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim F Oberlander
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Sunny Hill Health Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
18
|
Anobile G, Bartoli M, Pfanner C, Masi G, Cioni G, Tinelli F. Auditory time thresholds in the range of milliseconds but not seconds are impaired in ADHD. Sci Rep 2022; 12:1352. [PMID: 35079097 DOI: 10.1038/s41598-022-05425-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/11/2022] [Indexed: 11/08/2022] Open
Abstract
The literature on time perception in individuals with ADHD is extensive but inconsistent, probably reflecting the use of different tasks and performances indexes. A sample of 40 children/adolescents (20 with ADHD, 20 neurotypical) was engaged in two identical psychophysical tasks measuring auditory time thresholds in the milliseconds (0.25–1 s) and seconds (0.75–3 s) ranges. Results showed a severe impairment in ADHD for milliseconds thresholds (Log10BF = 1.9). The deficit remained strong even when non-verbal IQ was regressed out and correlation with age suggests a developmental delay. In the seconds range, thresholds were indistinguishable between the two groups (Log10BF = − 0.5) and not correlated with milliseconds thresholds. Our results largely confirm previous evidence suggesting partially separate mechanisms for time perception in the ranges of milliseconds and seconds. Moreover, since the evidence suggests that time perception of milliseconds stimuli might load relatively less on cognitive control and working memory, compared to longer durations, the current results are consistent with a pure timing deficit in individuals with ADHD.
Collapse
|
19
|
Wiwe Lipsker C, Hirvikoski T, Balter LJT, Bölte S, Lekander M, Holmström L, Wicksell RK. Autistic Traits and Attention-Deficit Hyperactivity Disorder Symptoms Associated With Greater Pain Interference and Depression, and Reduced Health-Related Quality of Life in Children With Chronic Pain. Front Neurosci 2021; 15:716887. [PMID: 34790087 PMCID: PMC8591303 DOI: 10.3389/fnins.2021.716887] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 10/07/2021] [Indexed: 12/14/2022] Open
Abstract
Previous research indicates elevated levels of clinically significant traits and symptoms of autism spectrum disorder and attention-deficit hyperactivity disorder (ADHD) in children with chronic pain, but associations with functioning and depression are yet unclear. The current study examined the relationships of autistic traits and ADHD symptoms with pain interference, depression, and health-related quality of life, as well as the mediating roles of insomnia and psychological inflexibility, in children with chronic pain (n = 146, 8–17 years, 102 girls) presenting at a tertiary pain clinic. Children completed measures of pain intensity, depression, pain interference, health-related quality of life, insomnia, and psychological inflexibility. Parents (n = 146, 111 mothers) completed measures to assess autistic traits and ADHD symptoms in their children. Children with clinically significant autistic traits and ADHD symptoms presented with significantly higher levels of depressive symptoms and pain interference, and significantly lower health-related quality of life, than did the other children. Autistic traits and ADHD symptoms contributed significantly to the prediction of pain interference and depressive symptoms, as well as health-related quality of life. Psychological inflexibility mediated the relationships between ADHD symptoms and autistic traits on the one hand and depression, pain interference, and health-related quality of life on the other, while insomnia mediated the relationships between ADHD symptoms and depression, pain interference, and health-related quality of life. All analyses were adjusted for demographics and pain intensity. Results suggest the utility of screening for neurodevelopmental disorders in children with chronic pain. Furthermore, the findings may indicate insomnia and skills related to psychological flexibility as potential treatment targets in interventions aiming at improving functioning and health-related quality of life in children with chronic pain and co-occurring symptoms of neurodevelopmental disorders.
Collapse
Affiliation(s)
| | - Tatja Hirvikoski
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden.,Habilitation and Health, Stockholm, Sweden
| | - Leonie J T Balter
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden.,Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Linda Holmström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medical Psychology, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Rikard K Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Pain Clinic, Capio St. Göran's Hospital, Stockholm, Sweden
| |
Collapse
|
20
|
Skogheim TS, Weyde KVF, Aase H, Engel SM, Surén P, Øie MG, Biele G, Reichborn-Kjennerud T, Brantsæter AL, Haug LS, Sabaredzovic A, Auyeung B, Villanger GD. Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and associations with attention-deficit/hyperactivity disorder and autism spectrum disorder in children. Environ Res 2021; 202:111692. [PMID: 34293314 DOI: 10.1016/j.envres.2021.111692] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 03/12/2021] [Revised: 07/10/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may be a risk factor for neurodevelopmental deficits and disorders, but evidence is inconsistent. OBJECTIVES We investigated whether prenatal exposure to PFAS were associated with childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). METHODS This study was based on the Norwegian Mother, Father and Child Cohort Study and included n = 821 ADHD cases, n = 400 ASD cases and n = 980 controls. Diagnostic cases were identified by linkage with the Norwegian Patient Registry. In addition, we used data from the Medical Birth Registry of Norway. The study included the following PFAS measured in maternal plasma sampled mid-pregnancy: Perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorohexane sulfonate (PFHxS), perfluoroheptanesulfonic acid (PFHpS), and perfluorooctane sulfonate (PFOS). Relationships between individual PFAS and ADHD or ASD diagnoses were examined using multivariable adjusted logistic regression models. We also tested for possible non-linear exposure-outcome associations. Further, we investigated the PFAS mixture associations with ASD and ADHD diagnoses using a quantile-based g-computation approach. RESULTS Odds of ASD was significantly elevated in PFOA quartile 2 [OR = 1.71 (95% CI: 1.20, 2.45)] compared to quartile 1, and PFOA appeared to have a non-linear, inverted U-shaped dose-response relationship with ASD. PFOA was also associated with increased odds of ADHD, mainly in quartile 2 [OR = 1.54 (95% CI: 1.16, 2.04)] compared to quartile 1, and displayed a non-linear relationship in the restricted cubic spline model. Several PFAS (PFUnDA, PFDA, and PFOS) were inversely associated with odds of ADHD and/or ASD. Some of the associations were modified by child sex and maternal education. The overall PFAS mixture was inversely associated with ASD [OR = 0.76 (95% CI: 0.64, 0.90)] as well as the carboxylate mixture [OR = 0.79 (95% CI: 0.68, 0.93)] and the sulfonate mixture [OR = 0.84 (95% CI: 0.73, 0.96)]. CONCLUSION Prenatal exposure to PFOA was associated with increased risk of ASD and ADHD in children. For some PFAS, as well as their mixtures, there were inverse associations with ASD and/or ADHD. However, the inverse associations reported herein should not be interpreted as protective effects, but rather that there could be some unresolved confounding for these relationships. The epidemiologic literature linking PFAS exposures with neurodevelopmental outcomes is still inconclusive, suggesting the need for more research to elucidate the neurotoxicological potential of PFAS during early development.
Collapse
Affiliation(s)
- Thea S Skogheim
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
| | - Kjell Vegard F Weyde
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Heidi Aase
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Stephanie M Engel
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599-7435, USA
| | - Pål Surén
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Merete G Øie
- Department of Psychology, University of Oslo, PO Box 1094, Blindern, N-0317, Oslo, Norway
| | - Guido Biele
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, PO Box 1171, Blindern, N-0318, Oslo, Norway
| | - Anne Lise Brantsæter
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Line S Haug
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Azemira Sabaredzovic
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| | - Bonnie Auyeung
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK; Department of Psychiatry, Autism Research Centre, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK
| | - Gro D Villanger
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway
| |
Collapse
|
21
|
Guttentag S, Bishop S, Doggett R, Shalev R, Kaplan M, Dyson M, Cohen M, Lord C, Di Martino A. The utility of parent-report screening tools in differentiating autism versus attention-deficit/hyperactivity disorder in school-age children. Autism 2021; 26:473-487. [PMID: 34219504 DOI: 10.1177/13623613211030071] [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: 11/17/2022]
Abstract
LAY ABSTRACT We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview - School-Age, the Social Responsiveness Scale - 2nd Edition, and the Social Communication Questionnaire - Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire - Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.
Collapse
Affiliation(s)
- Sara Guttentag
- Child Mind Institute, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, USA.,Hassenfeld Children's Hospital at NYU Langone, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Skogheim TS, Weyde KVF, Engel SM, Aase H, Surén P, Øie MG, Biele G, Reichborn-Kjennerud T, Caspersen IH, Hornig M, Haug LS, Villanger GD. Metal and essential element concentrations during pregnancy and associations with autism spectrum disorder and attention-deficit/hyperactivity disorder in children. Environ Int 2021; 152:106468. [PMID: 33765546 DOI: 10.1016/j.envint.2021.106468] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [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: 10/15/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Prenatal exposure to toxic metals or variations in maternal levels of essential elements during pregnancy may be a risk factor for neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in offspring. OBJECTIVES We investigated whether maternal levels of toxic metals and essential elements measured in mid-pregnancy, individually and as mixtures, were associated with childhood diagnosis of ADHD or ASD. METHODS This study is based on the Norwegian Mother, Father and Child Cohort Study and included 705 ADHD cases, 397 ASD cases and 1034 controls. Cases were identified through linkage with the Norwegian Patient Registry. Maternal concentrations of 11 metals/elements were measured in blood at week 17 of gestation; cadmium; cesium; cobalt; copper; lead; magnesium; manganese; selenium; zinc; total arsenic; and total mercury. Multivariable adjusted logistic regression models were used to examine associations between quartile levels of individual metals/elements and outcomes. We also investigated non-linear associations using restricted cubic spline models. The joint effects of the metal/element mixture on ASD and ADHD diagnoses were estimated using a quantile-based g-computation approach. RESULTS For ASD, we identified positive associations (increased risks) in the second quartile of arsenic [OR = 1.77 (CI: 1.26, 2.49)] and the fourth quartiles of cadmium and manganese [OR = 1.57 (CI: 1.07 2.31); OR = 1.84 (CI: 1.30, 2.59)], respectively. In addition, there were negative associations between cesium, copper, mercury, and zinc and ASD. For ADHD, we found increased risk in the fourth quartiles of cadmium and magnesium [OR = 1.59 (CI: 1.15, 2.18); [OR = 1.42 (CI: 1.06, 1.91)]. There were also some negative associations, among others with mercury. In addition, we identified non-linear associations between ASD and arsenic, mercury, magnesium, and lead, and between ADHD and arsenic, copper, manganese, and mercury. There were no significant findings in the mixture approach analyses. CONCLUSION Results from the present study show several associations between levels of metals and elements during gestation and ASD and ADHD in children. The most notable ones involved arsenic, cadmium, copper, mercury, manganese, magnesium, and lead. Our results suggest that even population levels of these compounds may have negative impacts on neurodevelopment. As we observed mainly similarities among the metals' and elements' impact on ASD and ADHD, it could be that the two disorders share some neurochemical and neurodevelopmental pathways. The results warrant further investigation and replication, as well as studies of combined effects of metals/elements and mechanistic underpinnings.
Collapse
Affiliation(s)
- Thea S Skogheim
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway.
| | - Kjell Vegard F Weyde
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Stephanie M Engel
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC 27599-7435, USA
| | - Heidi Aase
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Pål Surén
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Merete G Øie
- Department of Psychology, University of Oslo, PO Box 1094 Blindern, 0317 Oslo, Norway
| | - Guido Biele
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway
| | - Ida H Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Mady Hornig
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, Rm. 736, New York, NY 10032, USA
| | - Line S Haug
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Gro D Villanger
- Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| |
Collapse
|
23
|
Ardulov V, Martinez VR, Somandepalli K, Zheng S, Salzman E, Lord C, Bishop S, Narayanan S. Robust diagnostic classification via Q-learning. Sci Rep 2021; 11:11730. [PMID: 34083579 PMCID: PMC8175431 DOI: 10.1038/s41598-021-90000-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/30/2021] [Indexed: 12/04/2022] Open
Abstract
Machine learning (ML) models have demonstrated the power of utilizing clinical instruments to provide tools for domain experts in gaining additional insights toward complex clinical diagnoses. In this context these tools desire two additional properties: interpretability, being able to audit and understand the decision function, and robustness, being able to assign the correct label in spite of missing or noisy inputs. This work formulates diagnostic classification as a decision-making process and utilizes Q-learning to build classifiers that meet the aforementioned desired criteria. As an exemplary task, we simulate the process of differentiating Autism Spectrum Disorder from Attention Deficit-Hyperactivity Disorder in verbal school aged children. This application highlights how reinforcement learning frameworks can be utilized to train more robust classifiers by jointly learning to maximize diagnostic accuracy while minimizing the amount of information required.
Collapse
Affiliation(s)
| | | | | | - Shuting Zheng
- University of California San Francisco, San Francisco, USA
| | - Emma Salzman
- University of California San Francisco, San Francisco, USA
| | | | - Somer Bishop
- University of California San Francisco, San Francisco, USA
| | | |
Collapse
|
24
|
Dellapiazza F, Audras-Torrent L, Michelon C, Baghdadli A. Clinical characteristics of children with ASD and comorbid ADHD: Association with social impairment and externalizing and internalizing behaviours. Res Dev Disabil 2021; 113:103930. [PMID: 33690105 DOI: 10.1016/j.ridd.2021.103930] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 11/05/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are frequently occurring conditions that are often associated (ASD + ADHD). However, there are few comparative studies concerning the clinical presentation in patients formally diagnosed with both ASD and ADHD. Here, we aimed to 1) compare social impairment and externalizing/internalizing behavioural problems across four groups of children: ASD + ADHD, ASD alone, ADHD alone, and typical development and 2) examine their bidirectional relationship with ASD and/or ADHD symptoms. METHODS This study included 186 participants from 6 to 12 years of age: single ASD (n = 98), ASD + ADHD (n = 29), single ADHD (n = 28), and TD (n = 31). RESULTS The results showed that children in the ASD + ADHD and single ASD groups had a higher level of social impairment than those in the single ADHD group. In addition, children in the single ADHD group presented a greater attention deficit than those in the single ASD group. Externalizing /internalizing behaviours were more frequent in all groups with neuro-developmental disorders than in typical development. In addition, externalizing behavioural problems were related to ADHD severity in the ASD + ADHD and single ADHD groups, whereas internalizing behaviours were related to ASD severity. CONCLUSIONS These findings highlight the specific needs of children who have both ASD and ADHD and underscore the necessity of individualizing their interventions.
Collapse
Affiliation(s)
- Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France; Faculté de Médecine, Université de Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| |
Collapse
|
25
|
Dellapiazza F, Michelon C, Vernhet C, Muratori F, Blanc N, Picot MC, Baghdadli A. Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort. Eur Child Adolesc Psychiatry 2021; 30:283-291. [PMID: 32215734 DOI: 10.1007/s00787-020-01516-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 07/22/2019] [Accepted: 03/16/2020] [Indexed: 01/02/2023]
Abstract
Autism-spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are early neurodevelopmental conditions that share clinical characteristics, raising important issues in clinical diagnosis. We aimed to compare (1) sensory processing in four groups of children: ASD alone, ASD + ADHD, ADHD alone, and typical development (TD) and (2) the association between sensory processing and attention in the three groups with neurodevelopmental disorders. Our sample included 120 children aged from 6 to 12 years divided into four groups: ASD alone (N = 43), ASD + ADHD (N = 18), ADHD alone (N = 28), and TD (N = 31). Atypical sensory processing was more frequent in ASD and/or ADHD than in TD, without a significant difference between ASD and ADHD. However, the variance analysis of attention problems revealed differences between the ADHD and ASD groups. Thus, the rate of atypical sensory processing was comparable between the ASD and ADHD groups, suggesting that further studies are needed to explore atypical SP in all neurodevelopmental disorders.
Collapse
Affiliation(s)
- Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France.,Centre de Recherche en Épidémiologie Et Santé Des Populations, U1178, INSERM, Paris, France.,Université Paul Valéry Montpellier 3, Université Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France
| | - Christelle Vernhet
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France.,Centre de Recherche en Épidémiologie Et Santé Des Populations, U1178, INSERM, Paris, France.,Université Paul Valéry Montpellier 3, Université Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Nathalie Blanc
- Université Paul Valéry Montpellier 3, Université Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | | | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France. .,Centre de Recherche en Épidémiologie Et Santé Des Populations, U1178, INSERM, Paris, France. .,School of Medicine, Montpellier University, Montpellier, France.
| | | |
Collapse
|
26
|
Abstract
'Hyperfocus' is a phenomenon that reflects one's complete absorption in a task, to a point where a person appears to completely ignore or 'tune out' everything else. Hyperfocus is most often mentioned in the context of autism, schizophrenia, and attention deficit hyperactivity disorder, but research into its effect on cognitive and neural functioning is limited. We propose that hyperfocus is a critically important aspect of cognition, particularly with regard to clinical populations, and that it warrants significant investigation. Hyperfocus, though ostensibly self-explanatory, is poorly defined within the literature. In many cases, hyperfocus goes undefined, relying on the assumption that the reader inherently knows what it entails. Thus, there is no single consensus to what constitutes hyperfocus. Moreover, some studies do not refer to hyperfocus by name, but describe processes that may be related. In this paper, we review how hyperfocus (as well as possibly related phenomena) has been defined and measured, the challenges associated with hyperfocus research, and assess how hyperfocus affects both neurotypical and clinical populations. Using this foundation, we provide constructive criticism about previously used methods and analyses. We also propose an operational definition of hyperfocus for researchers to use moving forward.
Collapse
Affiliation(s)
- Brandon K Ashinoff
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY, 10032, USA.
- Centre for Human Brain Health (CHBH), School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Ahmad Abu-Akel
- Institute of Psychology, University of Lausanne, Quartier UNIL-Mouline, Geopolis, Lausanne, 1015, Switzerland
| |
Collapse
|
27
|
Bhat AN. Motor Impairment Increases in Children With Autism Spectrum Disorder as a Function of Social Communication, Cognitive and Functional Impairment, Repetitive Behavior Severity, and Comorbid Diagnoses: A SPARK Study Report. Autism Res 2021; 14:202-219. [PMID: 33300285 PMCID: PMC8176850 DOI: 10.1002/aur.2453] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [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: 08/20/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/15/2022]
Abstract
Eighty-seven percent of a large sample of children with autism spectrum disorder (ASD) are at risk for motor impairment (Bhat, Physical Therapy, 2020, 100, 633-644). In spite of the high prevalence for motor impairment in children with ASD, it is not considered among the diagnostic criteria or specifiers within DSM-V. In this article, we analyzed the SPARK study dataset (n = 13,887) to examine associations between risk for motor impairment using the Developmental Coordination Disorder-Questionnaire (DCD-Q), social communication impairment using the Social Communication Questionnaire (SCQ), repetitive behavior severity using the Repetitive Behaviors Scale - Revised (RBS-R), and parent-reported categories of cognitive, functional, and language impairments. Upon including children with ASD with cognitive impairments, 88.2% of the SPARK sample was at risk for motor impairment. The relative risk ratio for motor impairment in children with ASD was 22.2 times greater compared to the general population and that risk further increased up to 6.2 with increasing social communication (5.7), functional (6.2), cognitive (3.8), and language (1.6) impairments as well as repetitive behavior severity (5.0). Additionally, the magnitude of risk for motor impairment (fine- and gross-motor) increased with increasing severity of all impairment types with medium to large effects. These findings highlight the multisystem nature of ASD, the need to recognize motor impairments as one of the diagnostic criteria or specifiers for ASD, and the need for appropriate motor screening and assessment of children with ASD. Interventions must address not only the social communication and cognitive/behavioral challenges of children with ASD but also their motor function and participation. LAY ABSTRACT: Eighty-eight percent of the SPARK sample of children with ASD were at risk for motor impairment. The relative risk for motor impairment was 22.2 times greater in children with ASD compared to the general population and the risk increased with more social communication, repetitive behavior, cognitive, and functional impairment. It is important to recognize motor impairments as one of the diagnostic criteria or specifiers for ASD and there is a need to administer appropriate motor screening, assessment, and interventions in children with ASD.
Collapse
Affiliation(s)
- Anjana N Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA
- Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| |
Collapse
|
28
|
Abstract
This paper presents a unifying theory for autism by applying the framework of a pathogenetic triad to the scientific literature. It proposes a deconstruction of autism into three contributing features (an autistic personality dimension, cognitive compensation, and neuropathological risk factors), and delineates how they interact to cause a maladaptive behavioral phenotype that may require a clinical diagnosis. The autistic personality represents a common core condition, which induces a set of behavioral issues when pronounced. These issues are compensated for by cognitive mechanisms, allowing the individual to remain adaptive and functional. Risk factors, both exogenous and endogenous ones, show pathophysiological convergence through their negative effects on neurodevelopment. This secondarily affects cognitive compensation, which disinhibits a maladaptive behavioral phenotype. The triad is operationalized and methods for quantification are presented. With respect to the breadth of findings in the literature that it can incorporate, it is the most comprehensive model yet for autism. Its main implications are that (1) it presents the broader autism phenotype as a non-pathological core personality domain, which is shared across the population and uncoupled from associated features such as low cognitive ability and immune dysfunction, (2) it proposes that common genetic variants underly the personality domain, and that rare variants act as risk factors through negative effects on neurodevelopment, (3) it outlines a common pathophysiological mechanism, through inhibition of neurodevelopment and cognitive dysfunction, by which a wide range of endogenous and exogenous risk factors lead to autism, and (4) it suggests that contributing risk factors, and findings of immune and autonomic dysfunction are clinically ascertained rather than part of the core autism construct.
Collapse
Affiliation(s)
- Darko Sarovic
- Gillberg Neuropsychiatry Centre, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,MedTech West, Gothenburg, Sweden
| |
Collapse
|
29
|
Kuwagata M, Muneoka K, Honda K, Miyazaki A. Hypothalamic Monoaminergic Pathology in a Neurodevelopmental Rat Model Showing Prenatal 5-Bromo-2'-Deoxyuridine Treatment-Induced Hyperactivity and Hyporeproductivity. Neuropsychobiology 2020; 79:161-169. [PMID: 31822012 DOI: 10.1159/000504552] [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: 02/19/2019] [Accepted: 11/03/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Prenatal treatment of rats with 5-bromo-2'-deoxyuridine (BrdU) is a neurodevelopmental model showing hyperactivity and impaired sexual activity. Human neurodevelopmental disorders, such as autism, exhibit sex-related pathology, but sex-related neurodevelopment has not been fully investigated in this model. We conducted this study to facilitate the understanding of the pathophysiology of neurodevelopmental disorders. METHODS Pregnant rats received 50 mg/kg BrdU on gestational days 9-15. The tissue content of dopamine (DA), serotonin (5-HT), and their metabolites dihydroxyphenylacetic acid, homovanillic acid, and 5-hydroxyindoleacetic acid were measured in male and female offspring at 3 weeks (juveniles) and 10 weeks (adults) of age. RESULTS Prenatally BrdU-treated rats had reduced DA metabolism or DA content in the hypothalamus from the juvenile through the adult period without sex differences, but sex-specific striatal DA abnormalities emerged after maturation. A reduction in 5-HT metabolism was measured in the hypothalamus without sex differences throughout development. Developmental alterations in the striatal 5-HT states were sex-dependent. Temporal changes in DA or 5-HT metabolism were found in the frontal cortex and midbrain. CONCLUSION The sex-specific influence of a genotoxic factor on the development of the DA and 5-HT systems was clarified in the hypothalamus and striatum. The results suggest that the observed sex dependence and region specificity are related to the pathology of social dysfunction in neurodevelopmental disorders.
Collapse
Affiliation(s)
- Makiko Kuwagata
- Department of Anatomy, Showa University School of Medicine, Tokyo, Japan.,Laboratory of Safety Evaluation, Division of Safety, Hatano Research Institute, Food and Drug Safety Center, Hadano, Japan.,Division of Cellular and Molecular Toxicology, Center for Biological Safety and Research, National Institute of Health Science, Kawasaki, Japan
| | - Katsumasa Muneoka
- Department of Anatomy, Showa University School of Medicine, Tokyo, Japan, .,Department of Biochemistry, Showa University School of Medicine, Tokyo, Japan,
| | - Kazuho Honda
- Department of Anatomy, Showa University School of Medicine, Tokyo, Japan
| | - Akira Miyazaki
- Department of Biochemistry, Showa University School of Medicine, Tokyo, Japan
| |
Collapse
|
30
|
Tinkov AA, Mazaletskaya AL, Ajsuvakova OP, Bjørklund G, Huang PT, Chernova LN, Skalny AA, Skalny AV. ICP-MS Assessment of Hair Essential Trace Elements and Minerals in Russian Preschool and Primary School Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Biol Trace Elem Res 2020; 196:400-409. [PMID: 31691190 DOI: 10.1007/s12011-019-01947-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 12/15/2022]
Abstract
The objective of the present study was to investigate the relationship between hair essential trace element and mineral content and ADHD in preschool (4-6 years old) and primary school children (6-10 years old) in relation to age and gender. Hair essential trace element and mineral content in 90 Russian children with ADHD and 90 age- and gender-matched neurotypical controls were assessed using inductively coupled plasma mass-spectrometry after microwave digestion. The obtained data demonstrate that hair Co, Cu, Mn, Si, and Zn contents in ADHD children was significantly reduced by 18%, 10%, 27%, 16%, and 19% as compared to the control values, respectively. The most significant decrease in children with ADHD was observed for hair Mg levels, being 29% lower than those in neurotypical children. After adjustment for age and gender, the observed difference in hair element content was more characteristic for preschool children and girls, respectively. Multiple linear regression analysis demonstrated that in a crude model (hair element levels as predictors), only hair Zn content was significantly inversely associated with ADHD (β = - 0.169; p = 0.025). Adjustment for anthropometric parameters (model 2) did not increase the predictive ability of the model, although it improved the association between hair Zn and ADHD in children (β = - 0.194; p = 0.014). Hypothetically, the observed alterations may at least partially contribute to neurobehavioral disturbances in children with ADHD. Moreover, the results of the present study raise the question about the potential benefits of Zn and Mg supplementation in children with ADHD. However, further detailed studies are required to investigate micronutrient deficiencies in ADHD.
Collapse
Affiliation(s)
- Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia, 150003.
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia, 119146.
- RUDN University, Moscow, Russia.
| | | | - Olga P Ajsuvakova
- Yaroslavl State University, Yaroslavl, Russia, 150003
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia, 119146
- RUDN University, Moscow, Russia
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | | | | | - Andrey A Skalny
- Yaroslavl State University, Yaroslavl, Russia, 150003
- RUDN University, Moscow, Russia
| | - Anatoly V Skalny
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia, 119146
- RUDN University, Moscow, Russia
- Federal Scientific Center of Biological Systems and Agrotechnologies of the Russian Academy of Sciences, Orenburg, Russia, 460000
| |
Collapse
|
31
|
McBride NM, Weinzimmer SA, La Buissonnière-Ariza V, Schneider SC, Ehrenreich May J, Lewin AB, McGuire JF, Goodman WK, Wood JJ, Storch EA. The Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Youth with Anxiety and Autism Spectrum Disorder. Child Psychiatry Hum Dev 2020; 51:625-635. [PMID: 32026260 DOI: 10.1007/s10578-020-00961-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 12/28/2022]
Abstract
The impact of externalizing comorbidity on treatment outcome was examined in 104 youth ages 7-16 (M = 11.09 years) with autism spectrum disorder and primary anxiety/obsessive compulsive disorder who completed modular cognitive behavioral therapy (CBT) for anxiety/OCD. Three comorbidity profiles were utilized for group comparisons: participants with oppositional defiant or conduct disorder with attention-deficit hyperactivity disorder (ODD; CD; ADHD; group EXT, n = 25); those without ODD/CD and only ADHD (group ADHD, n = 46); and those without externalizing comorbidity (NO-EXT, n = 33). Post-treatment outcomes were measured continuously (Pediatric Anxiety Rating Scale, Clinical Global Impression-Severity) and categorically (treatment response, remission). The ADHD group was four times more likely of being a treatment responder compared to NO-EXT (OR 4.05). Comorbidity group did not impact remission. After controlling for pre-treatment scores, there was a significantly greater reduction of the CGI-S for ADHD versus NO-EXT and EXT versus NO-EXT, but results did not significantly differ for the PARS. Results suggest that a modular CBT approach yields positive impact for treatment outcomes in youth with comorbid externalizing problems, particularly among those with comorbid ADHD.
Collapse
Affiliation(s)
- Nicole M McBride
- Division of Child and Adolescent Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Saira A Weinzimmer
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | | | - Sophie C Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | | | - Adam B Lewin
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Joseph F McGuire
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey J Wood
- Department of Educational Psychology, University of California, Los Angeles, CA, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza MS:350, Houston, TX, 77030, USA.
| |
Collapse
|
32
|
Young S, Hollingdale J, Absoud M, Bolton P, Branney P, Colley W, Craze E, Dave M, Deeley Q, Farrag E, Gudjonsson G, Hill P, Liang HL, Murphy C, Mackintosh P, Murin M, O'Regan F, Ougrin D, Rios P, Stover N, Taylor E, Woodhouse E. Guidance for identification and treatment of individuals with attention deficit/hyperactivity disorder and autism spectrum disorder based upon expert consensus. BMC Med 2020; 18:146. [PMID: 32448170 PMCID: PMC7247165 DOI: 10.1186/s12916-020-01585-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that will aid healthcare practitioners and allied professionals when working with this complex and vulnerable population. METHOD UK experts from multiple disciplines in the fields of ADHD and ASD convened in London in December 2017. The meeting provided the opportunity to address the complexities of ADHD and ASD as a co-occurring presentation from different perspectives and included presentations, discussion and group work. The authors considered the clinical challenges of working with this complex group of individuals, producing a consensus for a unified approach when working with male and female, children, adolescents and adults with co-occurring ADHD and ASD. This was written up, circulated and endorsed by all authors. RESULTS The authors reached a consensus of practical recommendations for working across the lifespan with males and females with ADHD and ASD. Consensus was reached on topics of (1) identification and assessment using rating scales, clinical diagnostic interviews and objective supporting assessments; outcomes of assessment, including standards of clinical reporting; (2) non-pharmacological interventions and care management, including psychoeducation, carer interventions/carer training, behavioural/environmental and Cognitive Behavioural Therapy (CBT) approaches; and multi-agency liaison, including educational interventions, career advice, occupational skills and training, and (3) pharmacological treatments. CONCLUSIONS The guidance and practice recommendations (Tables 1, 4, 5, 7, 8 and 10) will support healthcare practitioners and allied professionals to meet the needs of this complex group from a multidisciplinary perspective. Further research is needed to enhance our understanding of the diagnosis, treatment and management of individuals presenting with comorbid ADHD and ASD.
Collapse
Affiliation(s)
| | - Jack Hollingdale
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Women & Children's Health, King's College, London, UK
| | - Patrick Bolton
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | | | | | - Emily Craze
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Mayuri Dave
- Positive Behaviour, Learning Disability, Autism and Mental Health Service (PALMS) Hertfordshire Communication Disorders Clinics, Hertfordshire Community NHS Trust, St Albans, UK
| | - Quinton Deeley
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Clodagh Murphy
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism and ADHD Service, South London and Maudsley Foundation NHS Trust, London, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peri Mackintosh
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | | | | | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patricia Rios
- Diagnostic Assessments and Treatment Services (DATS), Hertfordshire, UK
| | | | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Woodhouse
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
33
|
Wendt FR, Pathak GA, Tylee DS, Goswami A, Polimanti R. Heterogeneity and Polygenicity in Psychiatric Disorders: A Genome-Wide Perspective. ACTA ACUST UNITED AC 2020; 4:2470547020924844. [PMID: 32518889 PMCID: PMC7254587 DOI: 10.1177/2470547020924844] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/17/2020] [Indexed: 12/15/2022]
Abstract
Genome-wide association studies (GWAS) have been performed for many psychiatric disorders and revealed a complex polygenic architecture linking mental and physical health phenotypes. Psychiatric diagnoses are often heterogeneous, and several layers of trait heterogeneity may contribute to detection of genetic risks per disorder or across multiple disorders. In this review, we discuss these heterogeneities and their consequences on the discovery of risk loci using large-scale genetic data. We primarily highlight the ways in which sex and diagnostic complexity contribute to risk locus discovery in schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorder, posttraumatic stress disorder, major depressive disorder, obsessive-compulsive disorder, Tourette’s syndrome and chronic tic disorder, anxiety disorders, suicidality, feeding and eating disorders, and substance use disorders. Genetic data also have facilitated discovery of clinically relevant subphenotypes also described here. Collectively, GWAS of psychiatric disorders revealed that the understanding of heterogeneity, polygenicity, and pleiotropy is critical to translate genetic findings into treatment strategies.
Collapse
Affiliation(s)
- Frank R Wendt
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, USA
| | - Gita A Pathak
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, USA
| | - Daniel S Tylee
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, USA
| | - Aranyak Goswami
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine and VA CT Healthcare Center, West Haven, CT, USA
| |
Collapse
|
34
|
Skalny AV, Mazaletskaya AL, Ajsuvakova OP, Bjørklund G, Skalnaya MG, Notova SV, Chernova LN, Skalny AA, Burtseva TI, Tinkov AA. Hair trace element concentrations in autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). J Trace Elem Med Biol 2020; 61:126539. [PMID: 32438295 DOI: 10.1016/j.jtemb.2020.126539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 01/12/2020] [Revised: 04/09/2020] [Accepted: 04/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The existing data demonstrate that alteration of trace element and mineral status in children with neurodevelopmental disorders including ASD and ADHD. However, comparative analysis of the specific patterns of trace element and mineral metabolism in children with ASD and ADHD was not performed. Therefore, the primary objective of the present study was to assess hair trace element and mineral levels in boys with ADHD, ASD, as well as ADHD with ASD. METHODS Boys with ADHD (n = 52), ASD (n = 53), both ADHD and ASD (n = 52), as well as neurotypical controls (n = 52) were examined. Hair analysis was performed using inductively-coupled plasma mass-spectrometry. RESULTS The obtained data demonstrate that hair Co, Mg, Mn, and V levels were significantly reduced in children with ADHD and ASD, and especially in boys with ADHD + ASD. Hair Zn was found to be reduced by 20% (p = 0.009) only in children with ADHD + ASD as compared to healthy controls. Factor analysis demonstrated that ASD was associated with significant alteration of hair Co, Fe, Mg, Mn, and V levels, whereas impaired hair Mg, Mn, and Zn content was also significantly associated with ADHD. In regression models hair Zn and Mg were negatively associated with severity of neurodevelopmental disorders. The revealed similarity of trace element and mineral disturbances in ASD and ADHD may be indicative of certain similar pathogenetic features. CONCLUSION The obtained data support the hypothesis that trace elements and minerals, namely Mg, Mn, and Zn, may play a significant role in development of both ADHD and ASD. Improvement of Mg, Mn, and Zn status in children with ASD and ADHD may be considered as a nutritional strategy for improvement of neurodevelopmental disturbances, although clinical trials and experimental studies are highly required to support this hypothesis.
Collapse
Affiliation(s)
- Anatoly V Skalny
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | | | - Olga P Ajsuvakova
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, 8602, Mo i Rana, Norway
| | - Margarita G Skalnaya
- IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | - Svetlana V Notova
- IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, 9 Yanvarya St., 29, 460000, Orenburg, Russia
| | | | - Andrey A Skalny
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia
| | - Tatiana I Burtseva
- IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; Orenburg State University, Pobedy Ave., 46, 460000, Orenburg, Russia
| | - Alexey A Tinkov
- Yaroslavl State University, Sovetskaya St., 14, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya St., 9, 119146, Moscow, Russia; RUDN University, Miklukho-Maklaya St., 6, 117198, Moscow, Russia.
| |
Collapse
|
35
|
Skalny AV, Mazaletskaya AL, Ajsuvakova OP, Bjørklund G, Skalnaya MG, Chao JCJ, Chernova LN, Shakieva RA, Kopylov PY, Skalny AA, Tinkov AA. Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD). J Trace Elem Med Biol 2020; 58:126445. [PMID: 31869738 DOI: 10.1016/j.jtemb.2019.126445] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 09/16/2019] [Revised: 11/07/2019] [Accepted: 12/05/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Essential trace elements and minerals play a significant role in neurodevelopment. Although certain studies demonstrated impaired essential trace element and mineral status in children with ADHD, the existing data are insufficient. The objective of the present study was to assess serum trace element and mineral levels in children with ADHD. METHODS Serum trace element and mineral levels in 68 children with ADHD and 68 neurotypical controls were assessed using ICP-MS at NexION 300D (PerkinElmer Inc., USA) equipped with ESI SC-2 DX4 autosampler (Elemental Scientific Inc., USA). RESULTS Serum Cr, Mg, and Zn levels in children with ADHD were 21 % (p = 0.010), 4 % (p = 0.005), and 7 % (p = 0. 001) lower as compared to the healthy controls, respectively. In turn, serum Cu/Zn values were 11 % higher than those in the control group. Age and gender had a significant impact on serum element levels in ADHD. Particularly, preschool children were characterized by significantly increased Cu (+8 %; p = 0.034), and Cu/Zn (+19 %; p < 0.001) values, whereas serum Zn (-9 %; p = 0.004) level was decreased. In primary school-aged children only 6 % (p = 0.007) lower Mg levels were observed. Both boys and girls with ADHD were characterized by 8 % (p = 0.016) lower serum Zn levels and 10 % (p = 0.049) higher Cu/Zn values when compared to neurotypical girls. Boys with ADHD also had significantly higher Cu/Zn, exceeding the respective control values by 12 % (p = 0.021), predominantly due to a 7 % (p = 0.035) decrease in serum Zn. Serum Mg levels were also found to be significantly lower than those in neurotypical children by 5 % (p = 0.007). In adjusted regression models serum Cr (β=-0.234; p = 0.009) and Cu/Zn (β = 0.245; p = 0.029) values were significantly associated with ADHD, respectively. Two-way ANOVA revealed a significant impact of ADHD on Cr, Mg, Zn, and Cu/Zn, whereas age was associated with Cu, I, Mg, Mo, and Cu/Zn, whereas gender accounted only for variability in serum Mn levels. Principal component analysis (PCA) also revealed significant contributions of Mg, Zn, and Cu/Zn values to ADHD variability. CONCLUSIONS Hypothetically, the observed decrease of essential trace elements, namely Mg and Zn, and elevation of Cu/Zn may significantly contribute to the risk of ADHD or its severity and/or comorbidity.
Collapse
Affiliation(s)
- Anatoly V Skalny
- Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; RUDN University, Moscow, Russia; Taipei Medical University, Taipei, Taiwan
| | | | - Olga P Ajsuvakova
- Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo I Rana, Norway
| | - Margarita G Skalnaya
- IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; RUDN University, Moscow, Russia
| | | | | | | | - Philippe Yu Kopylov
- IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia
| | - Andrey A Skalny
- Yaroslavl State University, 150003, Yaroslavl, Russia; RUDN University, Moscow, Russia
| | - Alexey A Tinkov
- Yaroslavl State University, 150003, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.
| |
Collapse
|
36
|
Skalny AV, Mazaletskaya AL, Ajsuvakova OP, Bjørklund G, Skalnaya MG, Chernova LN, Skalny AA, Tinkov AA. Magnesium Status in Children with Attention-Deficit/Hyperactivity Disorder and/or Autism Spectrum Disorder. Soa Chongsonyon Chongsin Uihak 2020; 31:41-45. [PMID: 32612412 PMCID: PMC7324841 DOI: 10.5765/jkacap.190036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/28/2019] [Revised: 12/04/2019] [Accepted: 12/16/2019] [Indexed: 01/03/2023] Open
Abstract
Objective: The objective of this study was to assess serum, hair, and urinary magnesium (Mg) levels in children with attention-deficit/ hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and both ASD and ADHD to reveal potential interactive effects. Methods: A total of 148 boys aged 4–9 years old were enrolled in this study, including 44 children with ADHD, 40 pediatric patients with ASD, 32 patients with both ADHD and ASD, as well as 32 healthy neurotypical children. Hair, serum, and urinary Mg levels were assessed using inductively-coupled plasma mass spectrometry (ICP-MS). Laboratory quality control was performed using certified reference materials of human hair, plasma, and urine. Results: No significant group difference in serum Mg levels was observed. Mg content in hair was found to be reduced in children with ADHD and ADHD+ASD compared to that in healthy controls by 11% and 15%, respectively. Urinary Mg levels in children with ADHD+ASD exceeded the control, ADHD, and ASD values by 51, 76, and 65%, respectively. Factorial analysis revealed significant contribution of ADHD to hair and urinary Mg levels. Multiple regression analysis demonstrated that hair and urinary Mg levels were considered as significant predictors of neurodevelopmental disorder complexity. Conclusion: We propose that impaired Mg status may provide a link between ADHD and ASD.
Collapse
Affiliation(s)
- Anatoly V Skalny
- Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl, Russia.,Laboratory of Molecular Dietetics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Medical Elementology, RUDN University, Moscow, Russia
| | - Anna L Mazaletskaya
- Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl, Russia
| | - Olga P Ajsuvakova
- Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl, Russia.,Laboratory of Molecular Dietetics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Medical Elementology, RUDN University, Moscow, Russia
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Margarita G Skalnaya
- Laboratory of Molecular Dietetics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Medical Elementology, RUDN University, Moscow, Russia
| | | | - Andrey A Skalny
- Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl, Russia.,Department of Medical Elementology, RUDN University, Moscow, Russia
| | - Alexey A Tinkov
- Laboratory of Biotechnology and Applied Bioelementology, Yaroslavl State University, Yaroslavl, Russia.,Laboratory of Molecular Dietetics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Medical Elementology, RUDN University, Moscow, Russia
| |
Collapse
|
37
|
Austin C, Curtin P, Curtin A, Gennings C, Arora M, Tammimies K, Isaksson J, Willfors C, Bölte S. Dynamical properties of elemental metabolism distinguish attention deficit hyperactivity disorder from autism spectrum disorder. Transl Psychiatry 2019; 9:238. [PMID: 31551411 DOI: 10.1038/s41398-019-0567-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are neurodevelopmental conditions of overlapping etiologies and phenotypes. For ASD, we recently reported altered elemental metabolic patterns in the form of short and irregular zinc and copper cycles. Here, we extend the application of these biomarkers of prenatal and early postnatal elemental metabolism to distinguish between individuals diagnosed with ADHD and/or ASD and neurotypical controls. We recruited twins discordant for ADHD, ASD and other neurodevelopmental diagnoses from national twin studies in Sweden (N = 74) diagnosed according to DSM-5 clinical consensus and standardized psychiatric instruments. Detailed temporal profiles of exposure to 10 metals over the prenatal and early childhood periods were measured using tooth biomarkers. We used recurrence quantification analysis (RQA) to characterize properties of cyclical metabolic patterns of these metals. Regularity (determinism) and complexity (entropy) of elemental cycles was consistently reduced in ADHD for cobalt, lead, and vanadium (determinism: cobalt, β = -0.03, P = 0.017; lead, β = -0.03, P = 0.016; and vanadium, β = -0.03, P = 0.01. Entropy: cobalt, β = -0.13, P = 0.017; lead, β = -0.18, P = 0.016; and vanadium, β = -0.15, P = 0.008). Further, we found elemental pathways and dynamical features specific to ADHD vs ASD, and unique characteristics associated with ADHD/ASD combined presentation. Dysregulation of cyclical processes in elemental metabolism during prenatal and early postnatal development not only encompasses pathways shared by ADHD and ASD, but also comprise features specific to either condition.
Collapse
|
38
|
Lake EMR, Finn ES, Noble SM, Vanderwal T, Shen X, Rosenberg MD, Spann MN, Chun MM, Scheinost D, Constable RT. The Functional Brain Organization of an Individual Allows Prediction of Measures of Social Abilities Transdiagnostically in Autism and Attention-Deficit/Hyperactivity Disorder. Biol Psychiatry 2019; 86:315-326. [PMID: 31010580 PMCID: PMC7311928 DOI: 10.1016/j.biopsych.2019.02.019] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [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: 07/27/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD) are associated with complex changes as revealed by functional magnetic resonance imaging. To date, neuroimaging-based models are not able to characterize individuals with sufficient sensitivity and specificity. Further, although evidence shows that ADHD traits occur in individuals with autism spectrum disorder, and autism spectrum disorder traits in individuals with ADHD, the neurofunctional basis of the overlap is undefined. METHODS Using individuals from the Autism Brain Imaging Data Exchange and ADHD-200, we apply a data-driven, subject-level approach, connectome-based predictive modeling, to resting-state functional magnetic resonance imaging data to identify brain-behavior associations that are predictive of symptom severity. We examine cross-diagnostic commonalities and differences. RESULTS Using leave-one-subject-out and split-half analyses, we define networks that predict Social Responsiveness Scale, Autism Diagnostic Observation Schedule, and ADHD Rating Scale scores and confirm that these networks generalize to novel subjects. Networks share minimal overlap of edges (<2%) but some common regions of high hubness (Brodmann areas 10, 11, and 21, cerebellum, and thalamus). Further, predicted Social Responsiveness Scale scores for individuals with ADHD are linked to ADHD symptoms, supporting the hypothesis that brain organization relevant to autism spectrum disorder severity shares a component associated with attention in ADHD. Predictive connections and high-hubness regions are found within a wide range of brain areas and across conventional networks. CONCLUSIONS An individual's functional connectivity profile contains information that supports dimensional, nonbinary classification in autism spectrum disorder and ADHD. Furthermore, we can determine disorder-specific and shared neurofunctional pathology using our method.
Collapse
Affiliation(s)
- Evelyn M R Lake
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut.
| | - Emily S Finn
- Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, Maryland
| | - Stephanie M Noble
- Interdepartmental Neuroscience Program, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Tamara Vanderwal
- Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Xilin Shen
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Monica D Rosenberg
- Department of Psychology, Yale School of Medicine, Yale University, New Haven, Connecticut; Department of Psychology, University of Chicago, Chicago, Illinois
| | - Marisa N Spann
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Marvin M Chun
- Interdepartmental Neuroscience Program, Yale School of Medicine, Yale University, New Haven, Connecticut; Department of Psychology, Yale School of Medicine, Yale University, New Haven, Connecticut; Department of Neurobiology, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale School of Medicine, Yale University, New Haven, Connecticut; Department of Neurosurgery, Yale School of Medicine, Yale University, New Haven, Connecticut
| |
Collapse
|
39
|
Nankoo MMA, Palermo R, Bell JA, Pestell CM. Examining the Rate of Self-Reported ADHD-Related Traits and Endorsement of Depression, Anxiety, Stress, and Autistic-Like Traits in Australian University Students. J Atten Disord 2019; 23:869-886. [PMID: 29502467 DOI: 10.1177/1087054718758901] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the rate of ADHD-related traits among young adults in an Australian university, and to examine whether higher endorsement of ADHD-related symptoms is associated with self-reported symptoms of depression, anxiety, distress, and autistic-like traits. METHOD In total, 1,002 students aged 17 to 25 years completed the Conners' Adult ADHD Rating Scale (CAARS), the Depression, Anxiety, and Stress Scale (DASS), and the Autism Quotient (AQ). RESULTS About 17.3% of students reported "at-risk" levels of ADHD-related symptoms. Regression analyses revealed that CAARS scores explained unique variance in self-reported levels of depression, anxiety, stress, and autism-related traits. CONCLUSION The rate of self-reported ADHD symptoms is higher in Australian undergraduate students than that reported in previous studies using the CAARS to investigate rates of diagnosed students. Problems with self-concept accounted for the most unique variance in DASS subscale scores. Hyperactivity/restlessness and inattention/memory problems accounted for the most unique variance in AQ-Social and AQ-Attention-to-Detail scores, respectively.
Collapse
Affiliation(s)
| | - Romina Palermo
- 1 The University of Western Australia, Crawley, Australia
| | | | | |
Collapse
|
40
|
Baraskewich J, Mcmorris CA. Internalizing Mental Health Issues in Individuals with Neurodevelopmental Disorders: Implications for Practitioners. Curr Dev Disord Rep 2019; 6:1-8. [DOI: 10.1007/s40474-019-0154-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
41
|
Mahendiran T, Dupuis A, Crosbie J, Georgiades S, Kelley E, Liu X, Nicolson R, Schachar R, Anagnostou E, Brian J. Sex Differences in Social Adaptive Function in Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder. Front Psychiatry 2019; 10:607. [PMID: 31572228 PMCID: PMC6751776 DOI: 10.3389/fpsyt.2019.00607] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Social-communication difficulties, a hallmark of ASD, autism spectrum disorder (ASD) are often observed in attention - deficit/ hyperactivity disorder (ADHD), although are not part of its diagnostic criteria. Despite sex differences in the prevalence of ASD and ADHD, research examining how sex differences manifest in social and communication functions in these disorders remains limited, and findings are mixed. This study investigated potential sex differences with age in social adaptive function across these disorders, relative to controls. Method: One hundred fifteen youth with ASD, 172 youth with ADHD, and 63 typically developing controls (age range 7-13 years, 75% males) were recruited from the Province of Ontario Neurodevelopmental Disorder (POND) Network. Social adaptive function was assessed using the Adaptive Behavior Assessment System-Second Edition (ABAS-II). The proportions of adaptive behaviors present in each skill area were analyzed as a binomial outcome using logistic regression, controlling for age, and testing for an age-by-sex interaction. In an exploratory analysis, we examined the impact of controlling for core symptom severity on the sex effect. Results: Significant sex-by-age interactions were seen within ASD in the communication (p = 0.005), leisure (p = 0.003), and social skill areas (p < 0.0001). In all three areas, lower scores (indicating poorer function) were found in females compared to males at older ages despite females performing better at younger ages. There were significant differences in the sex-by-age interactions in the social and leisure domains between those with ASD and typically developing controls, with typically developing females showing better scores at older, compared to younger, ages. There were also significant differences in the sex-by-age interactions between ASD and ADHD on the social and leisure domains, as females with ADHD consistently scored higher on social skills than males across all ages, unlike those with ASD. Sex differences across age in the social domains for ADHD were similar to those in the typically developing group. Conclusion: Sex differences in social and communication skill areas were observed between ASD and ADHD, and typically developing controls, with females with ASD performing worse than males at older ages, despite an earlier advantage. These findings reinforce the need to take a developmental approach to understanding sex differences which may have diagnostic, prognostic, and treatment implications.
Collapse
Affiliation(s)
- Tania Mahendiran
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada
| | - Annie Dupuis
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Robert Nicolson
- Department of Psychiatry, Western University and Children's Health Research Institute, London, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Jessica Brian
- Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
42
|
Aagaard K, Bach CC, Henriksen TB, Larsen RT, Matthiesen NB. Head circumference at birth and childhood developmental disorders in a nationwide cohort in Denmark. Paediatr Perinat Epidemiol 2018; 32:458-466. [PMID: 29882976 DOI: 10.1111/ppe.12479] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early markers of Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) may improve the understanding and early recognition of these disorders. We aimed to estimate the association between head circumference at birth, a measure of cerebral size at birth, and the risk of ADHD and ASD. METHODS We present a register-based cohort study of all Danish singletons born alive between 1997 and 2013. Cox proportional hazards regression was used for the statistical analyses. Sibling-matched analyses were performed to account for unmeasured confounding shared by siblings. RESULTS The analyses included 986 909 new-borns. Compared to normocephalic children, microcephaly was associated with an increased risk of ADHD (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12, 1.32). Macrocephaly was associated with a decreased risk of ADHD (HR 0.90, 95% CI 0.82, 0.99). Neither microcephaly nor macrocephaly were associated with ASD (HR 1.06, 95% CI 0.94, 1.19 and 1.03, 95% CI 0.90, 1.19). The largest difference was found within the normocephalic children. A head circumference at the lower limit of normocephaly compared to a head circumference at the upper limit was associated with an increased risk of ADHD (HR 1.52, 95% CI 1.43, 1.63). The sibling analyses confirmed the increased risk of ADHD with decreasing head circumference in the normocephalic children. No other clear associations were present in the sibling analyses. CONCLUSIONS Within normocephalic children, smaller head circumference at birth was associated with a higher risk of ADHD. Restricted foetal brain growth may be a risk factor for the development of ADHD but not ASD.
Collapse
Affiliation(s)
- Kristina Aagaard
- Perinatal Epidemiology Research Unit, Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Cathrine Carlsen Bach
- Perinatal Epidemiology Research Unit, Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Pediatrics and Adolescent Medicine, Randers Regional Hospital, Randers, Denmark
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - René Tidemand Larsen
- Perinatal Epidemiology Research Unit, Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Bjerregård Matthiesen
- Perinatal Epidemiology Research Unit, Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Pediatrics and Adolescent Medicine, Randers Regional Hospital, Randers, Denmark
| |
Collapse
|
43
|
Sanz-Cervera P, Pastor-Cerezuela G, González-Sala F, Tárraga-Mínguez R, Fernández-Andrés MI. Sensory Processing in Children with Autism Spectrum Disorder and/or Attention Deficit Hyperactivity Disorder in the Home and Classroom Contexts. Front Psychol 2017; 8:1772. [PMID: 29075217 PMCID: PMC5641858 DOI: 10.3389/fpsyg.2017.01772] [Citation(s) in RCA: 28] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/25/2017] [Indexed: 11/13/2022] Open
Abstract
Children with neurodevelopmental disorders often show impairments in sensory processing (SP) and higher functions. The main objective of this study was to compare SP, praxis and social participation (SOC) in four groups of children: ASD Group (n = 21), ADHD Group (n = 21), ASD+ADHD Group (n = 21), and Comparison Group (n = 27). Participants were the parents and teachers of these children who were 5-8 years old (M = 6.32). They completed the Sensory Processing Measure (SPM) to evaluate the sensory profile, praxis and SOC of the children in both the home and classroom contexts. In the home context, the most affected was the ASD+ADHD group. The ADHD group obtained higher scores than the ASD group on the Body Awareness (BOD) subscale, indicating a higher level of dysfunction. The ASD group, however, did not obtain higher scores than the ADHD group on any subscale. In the classroom context, the most affected were the two ASD groups: the ASD+ADHD group obtained higher scores than the ADHD group on the Hearing (HEA) and Social Participation (SOC) subscales, and the ASD group obtained higher scores than the ADHD group on the SOC subscale. Regarding sensory modalities, difficulties in proprioception seem to be more characteristic to the ADHD condition. As for higher-level functioning, social difficulties seem to be more characteristic to the ASD condition. Differences between the two contexts were only found in the ASD group, which could be related to contextual hyperselectivity, an inherent autistic feature. Despite possible individual differences, specific intervention programs should be developed to improve the sensory challenges faced by children with different diagnoses.
Collapse
Affiliation(s)
- Pilar Sanz-Cervera
- Teaching and Scholastic Organization Department, Faculty of Philosophy and Educational Sciences, University of Valencia, Valencia, Spain
| | - Gemma Pastor-Cerezuela
- Basic Psychology Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Francisco González-Sala
- Developmental and Educational Psychology Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Raúl Tárraga-Mínguez
- Teaching and Scholastic Organization Department, Faculty of Philosophy and Educational Sciences, University of Valencia, Valencia, Spain
| | | |
Collapse
|
44
|
Geier DA, Kern JK, Hooker BS, King PG, Sykes LK, Homme KG, Geier MR. Thimerosal exposure and increased risk for diagnosed tic disorder in the United States: a case-control study. Interdiscip Toxicol 2016; 8:68-76. [PMID: 27486363 PMCID: PMC4961900 DOI: 10.1515/intox-2015-0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 02/12/2015] [Revised: 04/10/2015] [Accepted: 04/23/2015] [Indexed: 01/08/2023] Open
Abstract
A hypothesis testing, case-control study evaluated automated medical records for exposure to organic-Hg from Thimerosal-containing hepatitis B vaccines (TM-HepB) administered at specific intervals in the first six-months-of-life among cases diagnosed with a tic disorder (TD) or cerebral degeneration (CD) (an outcome not biologically plausibly linked to TM exposure) in comparison to controls; both cases and controls were continuously enrolled from birth (born from 1991-2000) within the Vaccine Safety Datalink (VSD) database. TD cases were significantly more likely than controls to have received increased organic-Hg from TM-HepB administered within the first month-of-life (odds ratio (OR)=1.59, p<0.00001), first two-months-of-life (OR=1.59, p<0.00001), and first six-months-of-life (OR=2.97, p<0.00001). Male TD cases were significantly more likely than male controls to have received increased organic-Hg from TM-HepB administered within the first month-of-life (OR =1.65, p<0.0001), first two-months-of-life (OR=1.64, p<0.0001), and first six months-of-life (OR=2.47, p<0.05), where as female TD were significantly more likely than female controls to have received increased organic-Hg from TM-HepB administered within the first six-months-of-life (OR=4.97, p<0.05). By contrast, CD cases were no more likely than controls to have received increased organic-Hg exposure from TM-HepB administered at any period studied within the first six-months-of-life. Although routine childhood vaccination is considered an important public health tool to combat infectious diseases, the present study associates increasing organic-Hg exposure from TM-HepB and the subsequent risk of a TD diagnosis.
Collapse
Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Janet K Kern
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Brian S Hooker
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Paul G King
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Lisa K Sykes
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Kristin G Homme
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| |
Collapse
|
45
|
Geier DA, Kern JK, Hooker BS, Sykes LK, Geier MR. Thimerosal-Preserved Hepatitis B Vaccine and Hyperkinetic Syndrome of Childhood. Brain Sci 2016; 6:E9. [PMID: 26999226 DOI: 10.3390/brainsci6010009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 03/06/2016] [Accepted: 03/08/2016] [Indexed: 11/16/2022] Open
Abstract
(1) BACKGROUND: Hyperkinetic syndrome of childhood (HKSoC) is an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) category in which the majority of the children are also diagnosed under the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR), where the umbrella term is "Attention-Deficit and Disruptive Behavior Disorders". The diagnostic criteria for HKSoC are developmentally inappropriate inattention, hyperactivity, and impulsivity. Some studies have implicated mercury (Hg) exposure as a risk factor. (2) METHODS: This hypothesis testing study; using the Vaccine Safety Datalink; assessed the toxicological effects of bolus exposure to organic-Hg from Thimerosal-containing vaccines (TCVs) by examining the relationship between Thimerosal-preserved hepatitis B vaccines (TM-HepB) given at varying levels and at specific intervals in the first six months after birth and the risk of a child being diagnosed with HKSoC. (3) RESULTS: Children diagnosed with HKSoC were significantly more likely to be exposed to increased organic-Hg from TM-HepB doses given within the first month (odds ratio = 1.45; 95% confidence interval (CI) = 1.30-1.62); within the first two months (odds ratio = 1.43; 95% CI = 1.28-1.59); and within the first six months (odds ratio = 4.51; 95% CI = 3.04-6.71) than controls. (4) CONCLUSION: The results indicate that increasing organic-Hg exposure from TCVs heightens the risk of a HKSoC diagnosis.
Collapse
|
46
|
Abstract
Investigators from the Division of Developmental Medicine and Clinical Research Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, studied the relationship between the timing of Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in children with Autism Spectrum Disorder (ASD) and the age at ASD diagnosis.
Collapse
Affiliation(s)
- Michelle M Yee
- Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - J Gordon Millichap
- Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
47
|
Kern JK, Geier DA, King PG, Sykes LK, Mehta JA, Geier MR. Shared Brain Connectivity Issues, Symptoms, and Comorbidities in Autism Spectrum Disorder, Attention Deficit/Hyperactivity Disorder, and Tourette Syndrome. Brain Connect 2015; 5:321-35. [PMID: 25602622 DOI: 10.1089/brain.2014.0324] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [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: 12/13/2022] Open
Abstract
The prevalence of neurodevelopmental disorders, including autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), and Tourette syndrome (TS), has increased over the past two decades. Currently, about one in six children in the United States is diagnosed as having a neurodevelopmental disorder. Evidence suggests that ASD, ADHD, and TS have similar neuropathology, which includes long-range underconnectivity and short-range overconnectivity. They also share similar symptomatology with considerable overlap in their core and associated symptoms and a frequent overlap in their comorbid conditions. Consequently, it is apparent that ASD, ADHD, and TS diagnoses belong to a broader spectrum of neurodevelopmental illness. Biologically, long-range underconnectivity and short-range overconnectivity are plausibly related to neuronal insult (e.g., neurotoxicity, neuroinflammation, excitotoxicity, sustained microglial activation, proinflammatory cytokines, toxic exposure, and oxidative stress). Therefore, these disorders may a share a similar etiology. The main purpose of this review is to critically examine the evidence that ASD, ADHD, and TS belong to a broader spectrum of neurodevelopmental illness, an abnormal connectivity spectrum disorder, which results from neural long-range underconnectivity and short-range overconnectivity. The review also discusses the possible reasons for these neuropathological connectivity findings. In addition, this review examines the role and issue of axonal injury and regeneration in order to better understand the neuropathophysiological interplay between short- and long-range axons in connectivity issues.
Collapse
Affiliation(s)
- Janet K Kern
- 1 Institute of Chronic Illnesses, Inc. , Silver Spring, Maryland
| | - David A Geier
- 1 Institute of Chronic Illnesses, Inc. , Silver Spring, Maryland
| | | | | | - Jyutika A Mehta
- 3 Communication Sciences & Disorders, Texas Woman's University , Denton, Texas
| | - Mark R Geier
- 1 Institute of Chronic Illnesses, Inc. , Silver Spring, Maryland
| |
Collapse
|