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Neuhaus E, Santhosh M, Kresse A, Aylward E, Bernier R, Bookheimer S, Jeste S, Jack A, McPartland JC, Naples A, Van Horn JD, Pelphrey K, Webb SJ. Frontal EEG alpha asymmetry in youth with autism: Sex differences and social-emotional correlates. Autism Res 2023; 16:2364-2377. [PMID: 37776030 PMCID: PMC10840952 DOI: 10.1002/aur.3032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
In youth broadly, EEG frontal alpha asymmetry (FAA) associates with affective style and vulnerability to psychopathology, with relatively stronger right activity predicting risk for internalizing and externalizing behaviors. In autistic youth, FAA has been related to ASD diagnostic features and to internalizing symptoms. Among our large, rigorously characterized, sex-balanced participant group, we attempted to replicate findings suggestive of altered FAA in youth with an ASD diagnosis, examining group differences and impact of sex assigned at birth. Second, we examined relations between FAA and behavioral variables (ASD features, internalizing, and externalizing) within autistic youth, examining effects by sex. Third, we explored whether the relation between FAA, autism features, and mental health was informed by maternal depression history. In our sample, FAA did not differ by diagnosis, age, or sex. However, youth with ASD had lower total frontal alpha power than youth without ASD. For autistic females, FAA and bilateral frontal alpha power correlated with social communication features, but not with internalizing or externalizing symptoms. For autistic males, EEG markers correlated with social communication features, and with externalizing behaviors. Exploratory analyses by sex revealed further associations between youth FAA, behavioral indices, and maternal depression history. In summary, findings suggest that individual differences in FAA may correspond to social-emotional and mental health behaviors, with different patterns of association for females and males with ASD. Longitudinal consideration of individual differences across levels of analysis (e.g., biomarkers, family factors, and environmental influences) will be essential to parsing out models of risk and resilience among autistic youth.
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Affiliation(s)
- Emily Neuhaus
- Seattle Children’s Research Institute; Center on Child Health, Behavior & Development
- University of Washington Psychiatry & Behavioral Sciences
| | - Megha Santhosh
- Seattle Children’s Research Institute; Center on Child Health, Behavior & Development
| | - Anna Kresse
- Columbia University, Mailman School of Public Health
| | - Elizabeth Aylward
- Seattle Children’s Research Institute, Center for Integrative Brain Research
| | | | - Susan Bookheimer
- University of California Los Angeles School of Medicine, Dept. of Psychiatry & Biobehavioral Sciences
- University of California Los Angeles, Intellectual and Developmental Disabilities Research Center
| | - Shafali Jeste
- University of California Los Angeles School of Medicine, Dept. of Psychiatry & Biobehavioral Sciences
- University of California Los Angeles, Intellectual and Developmental Disabilities Research Center
| | | | | | | | - John D. Van Horn
- University of Virginia, Dept. of Psychology
- University of Virginia, School of Data Science
| | - Kevin Pelphrey
- University of Virginia, Dept. of Psychology
- University of Virginia, Dept. of Neurology, Brain Institute & School of Education & Human Development
| | - Sara Jane Webb
- Seattle Children’s Research Institute; Center on Child Health, Behavior & Development
- University of Washington Psychiatry & Behavioral Sciences
- University of Washington, Intellectual and Developmental Disabilities Research Center
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2
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Jacokes Z, Jack A, Sullivan CAW, Aylward E, Bookheimer SY, Dapretto M, Bernier RA, Geschwind DH, Sukhodolsky DG, McPartland JC, Webb SJ, Torgerson CM, Eilbott J, Kenworthy L, Pelphrey KA, Van Horn JD. Linear discriminant analysis of phenotypic data for classifying autism spectrum disorder by diagnosis and sex. Front Neurosci 2022; 16:1040085. [DOI: 10.3389/fnins.2022.1040085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a developmental condition characterized by social and communication differences. Recent research suggests ASD affects 1-in-44 children in the United States. ASD is diagnosed more commonly in males, though it is unclear whether this diagnostic disparity is a result of a biological predisposition or limitations in diagnostic tools, or both. One hypothesis centers on the ‘female protective effect,’ which is the theory that females are biologically more resistant to the autism phenotype than males. In this examination, phenotypic data were acquired and combined from four leading research institutions and subjected to multivariate linear discriminant analysis. A linear discriminant model was trained on the training set and then deployed on the test set to predict group membership. Multivariate analyses of variance were performed to confirm the significance of the overall analysis, and individual analyses of variance were performed to confirm the significance of each of the resulting linear discriminant axes. Two discriminant dimensions were identified between the groups: a dimension separating groups by the diagnosis of ASD (LD1: 87% of variance explained); and a dimension reflective of a diagnosis-by-sex interaction (LD2: 11% of variance explained). The strongest discriminant coefficients for the first discriminant axis divided the sample in domains with known differences between ASD and comparison groups, such as social difficulties and restricted repetitive behavior. The discriminant coefficients for the second discriminant axis reveal a more nuanced disparity between boys with ASD and girls with ASD, including executive functioning and high-order behavioral domains as the dominant discriminators. These results indicate that phenotypic differences between males and females with and without ASD are identifiable using parent report measures, which could be utilized to provide additional specificity to the diagnosis of ASD in female patients, potentially leading to more targeted clinical strategies and therapeutic interventions. The study helps to isolate a phenotypic basis for future empirical work on the female protective effect using neuroimaging, EEG, and genomic methodologies.
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3
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Neuhaus E, Youn Kang V, Kresse A, Corrigan S, Aylward E, Bernier R, Bookheimer S, Dapretto M, Jack A, Jeste S, McPartland JC, Van Horn JD, Pelphrey K, Webb SJ. Language and Aggressive Behaviors in Male and Female Youth with Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:454-462. [PMID: 33682042 PMCID: PMC9407024 DOI: 10.1007/s10803-020-04773-0] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 01/03/2023]
Abstract
Aggressive behaviors are common among youth with autism spectrum disorder (ASD) and correlate with pervasive social-emotional difficulties. Communication skill is an important correlate of disruptive behavior in typical development, and clarification of links between communication and aggression in ASD may inform intervention methods. We investigate child/family factors and communication in relation to aggression among 145 individuals with ASD (65 female; ages 8-17 years). Overall, more severe aggression was associated with younger age, lower family income, and difficulties with communication skills. However, this pattern of results was driven by males, and aggression was unrelated to child or family characteristics for females. Future work should incorporate these predictors in conjunction with broader contextual factors to understand aggressive behavior in females with ASD.
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Affiliation(s)
- Emily Neuhaus
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development
| | - Veronica Youn Kang
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development,University of Illinois at Chicago, Department of Special Education
| | - Anna Kresse
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development
| | - Sarah Corrigan
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development
| | - Elizabeth Aylward
- Seattle Children’s Research Institute, Center for Integrative Brain Research
| | - Raphael Bernier
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development,University of Washington Psychiatry & Behavioral Sciences
| | - Susan Bookheimer
- UCLA Department of Psychiatry and Biobehavioral Sciences,UCLA Semel Institute for Neuroscience and Human Behavior
| | - Mirella Dapretto
- UCLA Department of Psychiatry and Biobehavioral Sciences,UCLA Brain Mapping Center
| | | | - Shafali Jeste
- UCLA Department of Psychiatry and Biobehavioral Sciences,UCLA Semel Institute for Neuroscience and Human Behavior
| | | | - John D. Van Horn
- University of Virginia, Department of Psychology and School of Data Science
| | | | - Sara Jane Webb
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development,University of Washington Psychiatry & Behavioral Sciences
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4
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Neuhaus E, Lowry SJ, Santhosh M, Kresse A, Edwards LA, Keller J, Libsack EJ, Kang VY, Naples A, Jack A, Jeste S, McPartland JC, Aylward E, Bernier R, Bookheimer S, Dapretto M, Van Horn JD, Pelphrey K, Webb SJ. Resting state EEG in youth with ASD: age, sex, and relation to phenotype. J Neurodev Disord 2021; 13:33. [PMID: 34517813 PMCID: PMC8439051 DOI: 10.1186/s11689-021-09390-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Identification of ASD biomarkers is a key priority for understanding etiology, facilitating early diagnosis, monitoring developmental trajectories, and targeting treatment efforts. Efforts have included exploration of resting state encephalography (EEG), which has a variety of relevant neurodevelopmental correlates and can be collected with minimal burden. However, EEG biomarkers may not be equally valid across the autism spectrum, as ASD is strikingly heterogeneous and individual differences may moderate EEG-behavior associations. Biological sex is a particularly important potential moderator, as females with ASD appear to differ from males with ASD in important ways that may influence biomarker accuracy. METHODS We examined effects of biological sex, age, and ASD diagnosis on resting state EEG among a large, sex-balanced sample of youth with (N = 142, 43% female) and without (N = 138, 49% female) ASD collected across four research sites. Absolute power was extracted across five frequency bands and nine brain regions, and effects of sex, age, and diagnosis were analyzed using mixed-effects linear regression models. Exploratory partial correlations were computed to examine EEG-behavior associations in ASD, with emphasis on possible sex differences in associations. RESULTS Decreased EEG power across multiple frequencies was associated with female sex and older age. Youth with ASD displayed decreased alpha power relative to peers without ASD, suggesting increased neural activation during rest. Associations between EEG and behavior varied by sex. Whereas power across various frequencies correlated with social skills, nonverbal IQ, and repetitive behavior for males with ASD, no such associations were observed for females with ASD. CONCLUSIONS Research using EEG as a possible ASD biomarker must consider individual differences among participants, as these features influence baseline EEG measures and moderate associations between EEG and important behavioral outcomes. Failure to consider factors such as biological sex in such research risks defining biomarkers that misrepresent females with ASD, hindering understanding of the neurobiology, development, and intervention response of this important population.
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Affiliation(s)
- Emily Neuhaus
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Sarah J Lowry
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA
| | - Megha Santhosh
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA
| | - Anna Kresse
- Mailman School of Public Health, Columbia University, New York, USA
| | - Laura A Edwards
- School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jack Keller
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, USA
| | - Erin J Libsack
- Department of Psychology, Stony Brook University, Stony Brook, USA
| | - Veronica Y Kang
- Department of Special Education, University of Illinois at Chicago, Chicago, USA
| | - Adam Naples
- Yale Child Study Center, Yale University, New Haven, USA
| | - Allison Jack
- Department of Psychology, George Mason University, Fairfax, USA
| | - Shafali Jeste
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, USA
- Intellectual and Developmental Disabilities Research Center, University of California Los Angeles, Los Angeles, USA
| | | | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, USA
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Susan Bookheimer
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, USA
- Intellectual and Developmental Disabilities Research Center, University of California Los Angeles, Los Angeles, USA
| | - Mirella Dapretto
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, USA
- Intellectual and Developmental Disabilities Research Center, University of California Los Angeles, Los Angeles, USA
| | - John D Van Horn
- Department of Psychology, University of Virginia, Charlottesville, USA
- School of Data Science, University of Virginia, Charlottesville, USA
| | - Kevin Pelphrey
- Department of Psychology, University of Virginia, Charlottesville, USA
- Department of Neurology, Brain Institute and School of Education and Human Development, University of Virginia, Charlottesville, USA
| | - Sara Jane Webb
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA.
- Intellectual and Developmental Disabilities Research Center, University of Washington, Seattle, USA.
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5
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Lawrence KE, Hernandez LM, Fuster E, Padgaonkar NT, Patterson G, Jung J, Okada NJ, Lowe JK, Hoekstra JN, Jack A, Aylward E, Gaab N, Van Horn JD, Bernier RA, McPartland JC, Webb SJ, Pelphrey KA, Green SA, Bookheimer SY, Geschwind DH, Dapretto M. Impact of autism genetic risk on brain connectivity: a mechanism for the female protective effect. Brain 2021; 145:378-387. [PMID: 34050743 PMCID: PMC8967090 DOI: 10.1093/brain/awab204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/21/2020] [Revised: 04/23/2021] [Accepted: 05/11/2021] [Indexed: 01/27/2023] Open
Abstract
The biological mechanisms underlying the greater prevalence of autism spectrum disorder in males than females remain poorly understood. One hypothesis posits that this female protective effect arises from genetic load for autism spectrum disorder differentially impacting male and female brains. To test this hypothesis, we investigated the impact of cumulative genetic risk for autism spectrum disorder on functional brain connectivity in a balanced sample of boys and girls with autism spectrum disorder and typically developing boys and girls (127 youth, ages 8-17). Brain connectivity analyses focused on the salience network, a core intrinsic functional connectivity network which has previously been implicated in autism spectrum disorder. The effects of polygenic risk on salience network functional connectivity were significantly modulated by participant sex, with genetic load for autism spectrum disorder influencing functional connectivity in boys with and without autism spectrum disorder but not girls. These findings support the hypothesis that autism spectrum disorder risk genes interact with sex differential processes, thereby contributing to the male bias in autism prevalence and proposing an underlying neurobiological mechanism for the female protective effect.
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Affiliation(s)
- Katherine E Lawrence
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA,Correspondence to: Mirella Dapretto Ahmanson-Lovelace Brain Mapping Center 660 Charles E. Young Drive South Los Angeles, CA 90095, USA E-mail:
| | - Leanna M Hernandez
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Emily Fuster
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Namita T Padgaonkar
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Genevieve Patterson
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Jiwon Jung
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Nana J Okada
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Jennifer K Lowe
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Jackson N Hoekstra
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Allison Jack
- Department of Psychology, George Mason University, Fairfax, VA 22030, USA
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Nadine Gaab
- Harvard Graduate School of Education, Cambridge, MA 02138, USA
| | - John D Van Horn
- Department of Psychology and School of Data Science, University of Virginia, Charlottesville, VA 22904, USA
| | - Raphael A Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
| | | | - Sara J Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA,Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Kevin A Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, VA 22904, USA
| | - Shulamite A Green
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Daniel H Geschwind
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA,Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Mirella Dapretto
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
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6
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Jack A, Sullivan CAW, Aylward E, Bookheimer SY, Dapretto M, Gaab N, Van Horn JD, Eilbott J, Jacokes Z, Torgerson CM, Bernier RA, Geschwind DH, McPartland JC, Nelson CA, Webb SJ, Pelphrey KA, Gupta AR. A neurogenetic analysis of female autism. Brain 2021; 144:1911-1926. [PMID: 33860292 PMCID: PMC8320285 DOI: 10.1093/brain/awab064] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/01/2020] [Accepted: 12/11/2020] [Indexed: 01/08/2023] Open
Abstract
Females versus males are less frequently diagnosed with autism spectrum disorder (ASD), and while understanding sex differences is critical to delineating the systems biology of the condition, female ASD is understudied. We integrated functional MRI and genetic data in a sex-balanced sample of ASD and typically developing youth (8–17 years old) to characterize female-specific pathways of ASD risk. Our primary objectives were to: (i) characterize female ASD (n = 45) brain response to human motion, relative to matched typically developing female youth (n = 45); and (ii) evaluate whether genetic data could provide further insight into the potential relevance of these brain functional differences. For our first objective we found that ASD females showed markedly reduced response versus typically developing females, particularly in sensorimotor, striatal, and frontal regions. This difference between ASD and typically developing females does not resemble differences between ASD (n = 47) and typically developing males (n = 47), even though neural response did not significantly differ between female and male ASD. For our second objective, we found that ASD females (n = 61), versus males (n = 66), showed larger median size of rare copy number variants containing gene(s) expressed in early life (10 postconceptual weeks to 2 years) in regions implicated by the typically developing female > female functional MRI contrast. Post hoc analyses suggested this difference was primarily driven by copy number variants containing gene(s) expressed in striatum. This striatal finding was reproducible among n = 2075 probands (291 female) from an independent cohort. Together, our findings suggest that striatal impacts may contribute to pathways of risk in female ASD and advocate caution in drawing conclusions regarding female ASD based on male-predominant cohorts.
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Affiliation(s)
- Allison Jack
- Department of Psychology, George Mason University, Fairfax, VA 22030, USA
| | | | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles School of Medicine, Los Angeles, CA 90095, USA
| | - Mirella Dapretto
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles School of Medicine, Los Angeles, CA 90095, USA
| | - Nadine Gaab
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA 02115 USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.,Harvard Graduate School of Education, Cambridge, MA 02138, USA
| | - John D Van Horn
- Department of Psychology, University of Virginia, Charlottesville, VA, USA.,School of Data Science, University of Virginia, Charlottesville, VA, USA
| | - Jeffrey Eilbott
- Child Study Center, Yale School of Medicine, New Haven, CT 06510, USA
| | - Zachary Jacokes
- School of Data Science, University of Virginia, Charlottesville, VA, USA
| | - Carinna M Torgerson
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA 90007, USA
| | - Raphael A Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Daniel H Geschwind
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles School of Medicine, Los Angeles, CA 90095, USA.,Department of Neurology and Center for Neurobehavioral Genetics, University of California Los Angeles School of Medicine, Los Angeles, CA 90095, USA
| | | | - Charles A Nelson
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA 02115 USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Sara J Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Kevin A Pelphrey
- Department of Psychology, University of Virginia, Charlottesville, VA, USA.,Department of Neurology, Brain Institute, and School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Abha R Gupta
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06510, USA.,Child Study Center, Yale School of Medicine, New Haven, CT 06510, USA.,Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
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7
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Lawrence KE, Hernandez LM, Eilbott J, Jack A, Aylward E, Gaab N, Van Horn JD, Bernier RA, Geschwind DH, McPartland JC, Nelson CA, Webb SJ, Pelphrey KA, Bookheimer SY, Dapretto M. Neural responsivity to social rewards in autistic female youth. Transl Psychiatry 2020; 10:178. [PMID: 32488083 PMCID: PMC7266816 DOI: 10.1038/s41398-020-0824-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 01/25/2023] Open
Abstract
Autism is hypothesized to be in part driven by a reduced sensitivity to the inherently rewarding nature of social stimuli. Previous neuroimaging studies have indicated that autistic males do indeed display reduced neural activity to social rewards, but it is unknown whether this finding extends to autistic females, particularly as behavioral evidence suggests that affected females may not exhibit the same reduction in social motivation as their male peers. We therefore used functional magnetic resonance imaging to examine social reward processing during an instrumental implicit learning task in 154 children and adolescents (ages 8-17): 39 autistic girls, 43 autistic boys, 33 typically developing girls, and 39 typically developing boys. We found that autistic girls displayed increased activity to socially rewarding stimuli, including greater activity in the nucleus accumbens relative to autistic boys, as well as greater activity in lateral frontal cortices and the anterior insula compared with typically developing girls. These results demonstrate for the first time that autistic girls do not exhibit the same reduction in activity within social reward systems as autistic boys. Instead, autistic girls display increased neural activation to such stimuli in areas related to reward processing and salience detection. Our findings indicate that a reduced sensitivity to social rewards, as assessed with a rewarded instrumental implicit learning task, does not generalize to affected female youth and highlight the importance of studying potential sex differences in autism to improve our understanding of the condition and its heterogeneity.
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Affiliation(s)
- Katherine E Lawrence
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - Leanna M Hernandez
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - Jeffrey Eilbott
- Autism & Neurodevelopmental Disorders Institute, The George Washington University School of Medicine and Health Sciences, Washington D.C., USA
| | - Allison Jack
- Department of Psychology, George Mason University, Fairfax, USA
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, USA
| | - Nadine Gaab
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
- Harvard Graduate School of Education, Cambridge, USA
| | - John D Van Horn
- Department of Psychology, University of Virginia, Charlottesville, USA
| | - Raphael A Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Daniel H Geschwind
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
- Department of Neurology and Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, USA
| | - James C McPartland
- Department of Pediatrics, Yale School of Medicine, New Haven, USA
- Child Study Center, Yale School of Medicine, New Haven, USA
| | - Charles A Nelson
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Sara J Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
- Center on Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, USA
| | - Kevin A Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, USA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - Mirella Dapretto
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA.
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8
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Lawrence KE, Hernandez LM, Bowman HC, Padgaonkar NT, Fuster E, Jack A, Aylward E, Gaab N, Van Horn JD, Bernier RA, Geschwind DH, McPartland JC, Nelson CA, Webb SJ, Pelphrey KA, Green SA, Bookheimer SY, Dapretto M. Sex Differences in Functional Connectivity of the Salience, Default Mode, and Central Executive Networks in Youth with ASD. Cereb Cortex 2020; 30:5107-5120. [PMID: 32350530 DOI: 10.1093/cercor/bhaa105] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/10/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023] Open
Abstract
Autism spectrum disorder (ASD) is associated with the altered functional connectivity of 3 neurocognitive networks that are hypothesized to be central to the symptomatology of ASD: the salience network (SN), default mode network (DMN), and central executive network (CEN). Due to the considerably higher prevalence of ASD in males, however, previous studies examining these networks in ASD have used primarily male samples. It is thus unknown how these networks may be differentially impacted among females with ASD compared to males with ASD, and how such differences may compare to those observed in neurotypical individuals. Here, we investigated the functional connectivity of the SN, DMN, and CEN in a large, well-matched sample of girls and boys with and without ASD (169 youth, ages 8-17). Girls with ASD displayed greater functional connectivity between the DMN and CEN than boys with ASD, whereas typically developing girls and boys differed in SN functional connectivity only. Together, these results demonstrate that youth with ASD exhibit altered sex differences in these networks relative to what is observed in typical development, and highlight the importance of considering sex-related biological factors and participant sex when characterizing the neural mechanisms underlying ASD.
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Affiliation(s)
- Katherine E Lawrence
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Leanna M Hernandez
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Hilary C Bowman
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Namita T Padgaonkar
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Emily Fuster
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Allison Jack
- Autism & Neurodevelopmental Disorders Institute, The George Washington University, Washington, DC 20052, USA.,Dept. of Pharmacology & Physiology, The George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington 98195, USA
| | - Nadine Gaab
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Cambridge, MA 02138, USA.,Harvard Graduate School of Education, Cambridge, MA 02138, USA
| | - John D Van Horn
- Department of Psychology, University of Virginia, Charlottesville, VA 22904, USA
| | - Raphael A Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington 98195, USA
| | - Daniel H Geschwind
- Department of Neurology and Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - James C McPartland
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA.,Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
| | - Charles A Nelson
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Cambridge, MA 02138, USA
| | - Sara J Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington 98195, USA.,Center on Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington 98195, USA
| | - Kevin A Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, VA 22904, USA
| | - Shulamite A Green
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Mirella Dapretto
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
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9
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Hernandez LM, Lawrence KE, Padgaonkar NT, Inada M, Hoekstra JN, Lowe JK, Eilbott J, Jack A, Aylward E, Gaab N, Van Horn JD, Bernier RA, McPartland JC, Webb SJ, Pelphrey KA, Green SA, Geschwind DH, Bookheimer SY, Dapretto M. Imaging-genetics of sex differences in ASD: distinct effects of OXTR variants on brain connectivity. Transl Psychiatry 2020; 10:82. [PMID: 32127526 PMCID: PMC7054353 DOI: 10.1038/s41398-020-0750-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/19/2019] [Accepted: 01/08/2020] [Indexed: 01/07/2023] Open
Abstract
Autism spectrum disorder (ASD) is more prevalent in males than in females, but the neurobiological mechanisms that give rise to this sex-bias are poorly understood. The female protective hypothesis suggests that the manifestation of ASD in females requires higher cumulative genetic and environmental risk relative to males. Here, we test this hypothesis by assessing the additive impact of several ASD-associated OXTR variants on reward network resting-state functional connectivity in males and females with and without ASD, and explore how genotype, sex, and diagnosis relate to heterogeneity in neuroendophenotypes. Females with ASD who carried a greater number of ASD-associated risk alleles in the OXTR gene showed greater functional connectivity between the nucleus accumbens (NAcc; hub of the reward network) and subcortical brain areas important for motor learning. Relative to males with ASD, females with ASD and higher OXTR risk-allele-dosage showed increased connectivity between the NAcc, subcortical regions, and prefrontal brain areas involved in mentalizing. This increased connectivity between NAcc and prefrontal cortex mirrored the relationship between genetic risk and brain connectivity observed in neurotypical males showing that, under increased OXTR genetic risk load, females with ASD and neurotypical males displayed increased connectivity between reward-related brain regions and prefrontal cortex. These results indicate that females with ASD differentially modulate the effects of increased genetic risk on brain connectivity relative to males with ASD, providing new insights into the neurobiological mechanisms through which the female protective effect may manifest.
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Affiliation(s)
- Leanna M Hernandez
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Katherine E Lawrence
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - N Tanya Padgaonkar
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Marisa Inada
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jackson N Hoekstra
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jennifer K Lowe
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jeffrey Eilbott
- Autism & Neurodevelopmental Disorders Institute, The George Washington University, Washington, DC, USA
| | - Allison Jack
- Autism & Neurodevelopmental Disorders Institute, The George Washington University, Washington, DC, USA
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Nadine Gaab
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - John D Van Horn
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Laboratory of Neuro Imaging, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Raphael A Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | | | - Sara J Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Kevin A Pelphrey
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Shulamite A Green
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Daniel H Geschwind
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Mirella Dapretto
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
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10
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Roth CL, Melhorn SJ, Elfers CT, Scholz K, De Leon MRB, Rowland M, Kearns S, Aylward E, Grabowski TJ, Saelens BE, Schur EA. Central Nervous System and Peripheral Hormone Responses to a Meal in Children. J Clin Endocrinol Metab 2019; 104:1471-1483. [PMID: 30418574 PMCID: PMC6435098 DOI: 10.1210/jc.2018-01525] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/05/2018] [Indexed: 12/14/2022]
Abstract
CONTEXT Behavioral studies suggest that responses to food consumption are altered in children with obesity (OB). OBJECTIVE To test central nervous system and peripheral hormone response by functional MRI and satiety-regulating hormone levels before and after a meal. DESIGN AND SETTING Cross-sectional study comparing children with OB and children of healthy weight (HW) recruited from across the Puget Sound region of Washington. PARTICIPANTS Children (9 to 11 years old; OB, n = 54; HW, n = 22), matched for age and sex. INTERVENTION AND OUTCOME MEASURES Neural activation to images of high- and low-calorie food and objects was evaluated across a set of a priori appetite-processing regions that included the ventral and dorsal striatum, amygdala, substantia nigra/ventral tegmental area, insula, and medial orbitofrontal cortex. Premeal and postmeal hormones (insulin, peptide YY, glucagon-like peptide-1, active ghrelin) were measured. RESULTS In response to a meal, average brain activation by high-calorie food cues vs objects in a priori regions was reduced after meals in children of HW (Z = -3.5, P < 0.0001), but not in children with OB (z = 0.28, P = 0.78) despite appropriate meal responses by gut hormones. Although premeal average brain activation by high-calorie food cues was lower in children with OB vs children of HW, postmeal activation was higher in children with OB (Z = -2.1, P = 0.04 and Z = 2.3, P = 0.02, respectively). An attenuated central response to a meal was associated with greater degree of insulin resistance. CONCLUSIONS Our data suggest that children with OB exhibit an attenuated central, as opposed to gut hormone, response to a meal, which may predispose them to overconsumption of food or difficulty with weight loss.
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Affiliation(s)
- Christian L Roth
- Seattle Children’s Research Institute, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
- Correspondence and Reprint Requests: Christian L. Roth, MD, Seattle Children’s Research Institute, 1900 Ninth Avenue, Seattle, Washington 98101. E-mail:
| | - Susan J Melhorn
- Department of Medicine, General Internal Medicine, University of Washington, Seattle, Washington
| | | | - Kelley Scholz
- Seattle Children’s Research Institute, Seattle, Washington
| | - Mary Rosalynn B De Leon
- Department of Medicine, General Internal Medicine, University of Washington, Seattle, Washington
| | - Maya Rowland
- Seattle Children’s Research Institute, Seattle, Washington
| | - Sue Kearns
- Seattle Children’s Research Institute, Seattle, Washington
| | | | - Thomas J Grabowski
- Department of Radiology, Magnetic Resonance Research Laboratory, University of Washington, Seattle, Washington
| | | | - Ellen A Schur
- Department of Medicine, General Internal Medicine, University of Washington, Seattle, Washington
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11
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Eapen V, Grove R, Aylward E, Joosten AV, Miller SI, Van Der Watt G, Fordyce K, Dissanayake C, Maya J, Tucker M, DeBlasio A. Transition from early intervention program to primary school in children with autism spectrum disorder. World J Clin Pediatr 2017; 6:169-175. [PMID: 29259892 PMCID: PMC5695075 DOI: 10.5409/wjcp.v6.i4.169] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/14/2017] [Accepted: 09/04/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism.
METHODS Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child’s school adjustment. The relationship between child characteristics and school outcomes was evaluated.
RESULTS Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement.
CONCLUSION Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, L1, Liverpool Hospital, Liverpool 2170, Australia
- School of Psychiatry, University of New South Wales, Sydney 2052, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
| | - Rachel Grove
- School of Psychiatry, University of New South Wales, Sydney 2052, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
| | - Elizabeth Aylward
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- KU Marcia Burgess Autism Specific Early Learning and Care Centre, Liverpool 2170, Australia
| | - Annette V Joosten
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- School of Occupational Therapy and Social Work, Curtin University, Perth 6000, Australia
| | - Scott I Miller
- Western Australia Autism Specific Early Learning and Care Centre, Bedford 6052, Australia
- Autism Association of Western Australia, Perth 6000, Australia
| | - Gerdamari Van Der Watt
- Western Australia Autism Specific Early Learning and Care Centre, Bedford 6052, Australia
- Autism Association of Western Australia, Perth 6000, Australia
| | - Kathryn Fordyce
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- St Giles Society North West Tasmania Autism Specific Early Learning and Care Centre, Burnie 7320, Australia
| | - Cheryl Dissanayake
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- La Trobe University, Melbourne 3000, Australia
| | - Jacqueline Maya
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- La Trobe University, Melbourne 3000, Australia
| | - Madonna Tucker
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- AEIOU Foundation, Nathan 4111, Australia
| | - Antonia DeBlasio
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- AnglicareSA Daphne St Autism Specific Early Learning and Care Centre, Prospect 5082, Australia
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12
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Frost C, Mulick A, Scahill RI, Owen G, Aylward E, Leavitt BR, Durr A, Roos RAC, Borowsky B, Stout JC, Reilmann R, Langbehn DR, Tabrizi SJ, Sampaio C. Design optimization for clinical trials in early-stage manifest Huntington's disease. Mov Disord 2017; 32:1610-1619. [PMID: 28906031 DOI: 10.1002/mds.27122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 03/04/2016] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The purpose of this study was to inform the design of randomized clinical trials in early-stage manifest Huntington's disease through analysis of longitudinal data from TRACK-Huntington's Disease (TRACK-HD), a multicenter observational study. METHODS We compute sample sizes required for trials with candidate clinical, functional, and imaging outcomes, whose aims are to reduce rates of change. The calculations use a 2-stage approach: first using linear mixed models to estimate mean rates of change and components of variability from TRACK-HD data and second using these to predict sample sizes for a range of trial designs. RESULTS For each outcome, the primary drivers of the required sample size were the anticipated treatment effect and the duration of treatment. Extending durations from 1 to 2 years yielded large sample size reductions. Including interim visits and incorporating stratified randomization on predictors of outcome together with covariate adjustment gave more modest, but nontrivial, benefits. Caudate atrophy, expressed as a percentage of its baseline, was the outcome that gave smallest required sample sizes. DISCUSSION Here we consider potential required sample sizes for clinical trials estimated from naturalistic observation of longitudinal change. Choice among outcome measures for a trial must additionally consider their relevance to patients and the expected effect of the treatment under study. For all outcomes considered, our results provide compelling arguments for 2-year trials, and we also demonstrate the benefits of incorporating stratified randomization coupled with covariate adjustment, particularly for trials with caudate atrophy as the primary outcome. The benefits of enrichment are more debatable, with statistical benefits offset by potential recruitment difficulties and reduced generalizability. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Chris Frost
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Amy Mulick
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachael I Scahill
- Huntington's Disease Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, UK
| | - Gail Owen
- Huntington's Disease Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, UK
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Blair R Leavitt
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexandra Durr
- Brain and Spine Institute, INSERM U1127, Centre National de la Recherche Scientifique, UMR7225, Sorbonne Universités, University Pierre and Marie Curie, Paris VI UMR_S1127, Paris, France
- Assistance Publique - Hôpitaux de Paris, Genetic Department, Pitié -Salpêtrière University Hospital, Paris, France
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Beth Borowsky
- CHDI Management, CHDI Foundation, Princeton, New Jersey, USA
- Clinical Development, Neurodegenerative Diseases, Teva Pharmaceuticals, Malvern Pennsylvania, USA
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Ralf Reilmann
- George Huntington Institute, Muenster, Germany
- Institute for Clinical Radiology, University of Muenster, Muenster, Germany
- Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | | | - Sarah J Tabrizi
- Huntington's Disease Centre, UCL Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, UK
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13
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Velasquez F, Qin XA, Reilly MA, Neuhaus E, Estes A, Aylward E, Kleinhans NM. Neural correlates of emotional inhibitory control in autism spectrum disorders. Res Dev Disabil 2017; 64:64-77. [PMID: 28359873 DOI: 10.1016/j.ridd.2017.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/09/2017] [Accepted: 03/15/2017] [Indexed: 06/07/2023]
Abstract
Atypical inhibitory function is often present in individuals with autism spectrum disorder (ASD), who may have difficulty suppressing context-inappropriate behaviors. We investigated the neural correlates of inhibition in ASD in response to both emotional and non-emotional stimuli using an fMRI Go/NoGo inhibition task with human faces and letters. We also related neural activation to behavioral dysfunction in ASD. Our sample consisted of 19 individuals with ASD (mean age=25.84) and 22 typically developing (TD) control participants (mean age=29.03). As expected, no group differences in task performance (inhibition accuracy and response time) were found. However, adults with ASD exhibited greater angular gyrus activation in face response inhibition blocks, as well as greater fusiform gyrus activation than controls, in a condition comparing face inhibition to letter inhibition. In contrast, control participants yielded significantly greater anterior cingulate cortex (ACC) activation in letter inhibition blocks. A positive relationship between communication and language impairment and angular gyrus activation during face inhibition was also found. Group activation differences during inhibition tasks in the context of comparable task performance and the relationship between activation and dysfunction highlight brain regions that may be related to ASD-specific dysfunction.
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Affiliation(s)
- Francisco Velasquez
- Department of Radiology, University of Washington, Seattle, WA, USA; Integrative Brain Imaging Center, University of Washington, Seattle, WA, USA.
| | - Xiaoyan Angela Qin
- Department of Radiology, University of Washington, Seattle, WA, USA; Integrative Brain Imaging Center, University of Washington, Seattle, WA, USA
| | - Melissa A Reilly
- Department of Radiology, University of Washington, Seattle, WA, USA; Integrative Brain Imaging Center, University of Washington, Seattle, WA, USA
| | - Emily Neuhaus
- Autism Center, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA
| | - Annette Estes
- Autism Center, University of Washington, Seattle, WA, USA; Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | | | - Natalia M Kleinhans
- Department of Radiology, University of Washington, Seattle, WA, USA; Integrative Brain Imaging Center, University of Washington, Seattle, WA, USA; Autism Center, University of Washington, Seattle, WA, USA
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14
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Faja S, Dawson G, Aylward E, Wijsman EM, Webb SJ. Early event-related potentials to emotional faces differ for adults with autism spectrum disorder and by serotonin transporter genotype. Clin Neurophysiol 2016; 127:2436-47. [PMID: 27178863 DOI: 10.1016/j.clinph.2016.02.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 05/11/2015] [Revised: 01/11/2016] [Accepted: 02/11/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To test differences in neural sensitivity to facial expressions, including expressions with open versus closed mouths, exhibited by (1) adults with autism spectrum disorder (ASD) compared to neurotypical adults, and by (2) short versus long serotonin transporter allele (SLC6A4) carriers. METHODS Event related potentials (ERPs) to happy, fearful, and neutral expressions were collected from neurotypical adults (n=25) and adults with ASD (n=27)-of whom 32 had short and 13 had homozygous long SLC6A4 alleles. RESULTS In the neurotypical group, we confirmed that the N170, VPP and EPN, but not the P1, were influenced by emotional expressions, and determined the EPN was the earliest component modulated by open mouth. Compared to the neurotypical group, individuals with ASD exhibited differences in EPN amplitude in response to open versus closed mouths and in hemispheric distribution. Across groups, short serotonin transporter allele carriers had reduced P1 amplitude compared to long allele carriers. CONCLUSIONS Individuals with ASD exhibited a different pattern of neural response when encoding and recognizing facial expressions at the EPN component. Across groups, SLC6A4 allele type modulated early sensory attention at the P1. SIGNIFICANCE These results provide insight into the nature of early responses to emotional information according to genetic variation and clinical condition.
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Affiliation(s)
- Susan Faja
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, USA
| | - Geraldine Dawson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, USA; University of Washington, Department of Psychiatry and Behavioral Sciences, Box 356560, Room BB1644, Seattle, WA 98195, USA
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Ellen M Wijsman
- University of Washington, Department of Medicine, Division of Medical Genetics, Box 356420, Seattle, WA 98195, USA; University of Washington, Department of Biostatistics, Box 357232, Seattle, WA 98195, USA
| | - Sara Jane Webb
- University of Washington, Department of Psychiatry and Behavioral Sciences, Box 356560, Room BB1644, Seattle, WA 98195, USA.
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15
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D’Angelo D, Lebon S, Chen Q, Martin-Brevet S, Snyder LG, Hippolyte L, Hanson E, Maillard AM, Faucett WA, Macé A, Pain A, Bernier R, Chawner SJRA, David A, Andrieux J, Aylward E, Baujat G, Caldeira I, Conus P, Ferrari C, Forzano F, Gérard M, Goin-Kochel RP, Grant E, Hunter JV, Isidor B, Jacquette A, Jønch AE, Keren B, Lacombe D, Le Caignec C, Martin CL, Männik K, Metspalu A, Mignot C, Mukherjee P, Owen MJ, Passeggeri M, Rooryck-Thambo C, Rosenfeld JA, Spence SJ, Steinman KJ, Tjernagel J, Van Haelst M, Shen Y, Draganski B, Sherr EH, Ledbetter DH, van den Bree MBM, Beckmann JS, Spiro JE, Reymond A, Jacquemont S, Chung WK. Defining the Effect of the 16p11.2 Duplication on Cognition, Behavior, and Medical Comorbidities. JAMA Psychiatry 2016; 73:20-30. [PMID: 26629640 PMCID: PMC5894477 DOI: 10.1001/jamapsychiatry.2015.2123] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The 16p11.2 BP4-BP5 duplication is the copy number variant most frequently associated with autism spectrum disorder (ASD), schizophrenia, and comorbidities such as decreased body mass index (BMI). OBJECTIVES To characterize the effects of the 16p11.2 duplication on cognitive, behavioral, medical, and anthropometric traits and to understand the specificity of these effects by systematically comparing results in duplication carriers and reciprocal deletion carriers, who are also at risk for ASD. DESIGN, SETTING, AND PARTICIPANTS This international cohort study of 1006 study participants compared 270 duplication carriers with their 102 intrafamilial control individuals, 390 reciprocal deletion carriers, and 244 deletion controls from European and North American cohorts. Data were collected from August 1, 2010, to May 31, 2015 and analyzed from January 1 to August 14, 2015. Linear mixed models were used to estimate the effect of the duplication and deletion on clinical traits by comparison with noncarrier relatives. MAIN OUTCOMES AND MEASURES Findings on the Full-Scale IQ (FSIQ), Nonverbal IQ, and Verbal IQ; the presence of ASD or other DSM-IV diagnoses; BMI; head circumference; and medical data. RESULTS Among the 1006 study participants, the duplication was associated with a mean FSIQ score that was lower by 26.3 points between proband carriers and noncarrier relatives and a lower mean FSIQ score (16.2-11.4 points) in nonproband carriers. The mean overall effect of the deletion was similar (-22.1 points; P < .001). However, broad variation in FSIQ was found, with a 19.4- and 2.0-fold increase in the proportion of FSIQ scores that were very low (≤40) and higher than the mean (>100) compared with the deletion group (P < .001). Parental FSIQ predicted part of this variation (approximately 36.0% in hereditary probands). Although the frequency of ASD was similar in deletion and duplication proband carriers (16.0% and 20.0%, respectively), the FSIQ was significantly lower (by 26.3 points) in the duplication probands with ASD. There also were lower head circumference and BMI measurements among duplication carriers, which is consistent with the findings of previous studies. CONCLUSIONS AND RELEVANCE The mean effect of the duplication on cognition is similar to that of the reciprocal deletion, but the variance in the duplication is significantly higher, with severe and mild subgroups not observed with the deletion. These results suggest that additional genetic and familial factors contribute to this variability. Additional studies will be necessary to characterize the predictors of cognitive deficits.
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Affiliation(s)
- Debra D’Angelo
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Sébastien Lebon
- Pediatric Neurology Unit, Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Sandra Martin-Brevet
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Loyse Hippolyte
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ellen Hanson
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anne M. Maillard
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - W. Andrew Faucett
- Genomic Medicine Institute, Geisinger Clinic, Danville, Pennsylvania
| | - Aurélien Macé
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland7Swiss Institute of Bioinformatics, University of Lausanne, Lausanne, Switzerland
| | - Aurélie Pain
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Science, University of Washington, Seattle
| | - Samuel J. R. A. Chawner
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, Wales
| | - Albert David
- Service de Génétique Médicale, Faculté de Médecine, Centre Hospitalier Universitaire (CHU) Nantes, Institut National de la Santé et de la Recherche Medicale (INSERM) Unités Mixtes de Recherche 957, Nantes, France
| | - Joris Andrieux
- Institut de Génétique Médicale, Hospital Jeanne de Flandre, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Lille, France
| | - Elizabeth Aylward
- Center for Integrative Brain Research, Children’s Research Institute, Seattle, Washington
| | - Genevieve Baujat
- Département de Génétique, Hôpital Necker–Enfants Malades, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France 14INSERM U1163, Hôpital Necker–Enfants Malades, Paris, France15Institut Imagine, Université Paris Descartes-Sorbonne Paris Cité, Paris
| | - Ines Caldeira
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Cery Hospital, CHU Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Carrina Ferrari
- Department of Psychiatry, Cery Hospital, CHU Vaudois and University of Lausanne, Lausanne, Switzerland
| | | | - Marion Gérard
- Departement de Génétique, AP-HP, Hôpital Robert Debré, Université Paris VII-Paris Diderot, Paris, France
| | - Robin P. Goin-Kochel
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Ellen Grant
- Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jill V. Hunter
- Department of Radiology, Baylor College of Medicine, Houston, Texas
| | - Bertrand Isidor
- Service de Génétique Médicale, Faculté de Médecine, Centre Hospitalier Universitaire (CHU) Nantes, Institut National de la Santé et de la Recherche Medicale (INSERM) Unités Mixtes de Recherche 957, Nantes, France
| | - Aurélia Jacquette
- Département de Génétique et de Cytogénétique, Unité fonctionnelle de Génétique Clinique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France23Centre de Référence Déficiences Intellectuelles de Causes Rares, Paris, France24Groupe de Recherche Clinique, Déficie
| | - Aia E. Jønch
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Boris Keren
- Department of Genetics and Cytogenetics, Groupe Hospitalier Pitié Salpêtrière, AP-HP, Paris, France
| | - Didier Lacombe
- Service de Génétique Médicale, Faculté de Médecine, Centre Hospitalier Universitaire (CHU) Nantes, Institut National de la Santé et de la Recherche Medicale (INSERM) Unités Mixtes de Recherche 957, Nantes, France26Service de Génétique Médicale, CHU de Bor
| | - Cédric Le Caignec
- Service de Génétique Médicale, Faculté de Médecine, Centre Hospitalier Universitaire (CHU) Nantes, Institut National de la Santé et de la Recherche Medicale (INSERM) Unités Mixtes de Recherche 957, Nantes, France
| | - Christa Lese Martin
- Autism and Developmental Medicine Institute, Geisinger Health System, Danville, Pennsylvania
| | - Katrin Männik
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland29Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Tartu, Estonia30Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Cyril Mignot
- Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Michael J. Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, Wales
| | - Marzia Passeggeri
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Caroline Rooryck-Thambo
- Service de Génétique Médicale, CHU de Bordeaux, Bordeaux, France32Laboratoire Maladies Rares: Génétique et Métabolisme, Université de Bordeaux, Bordeaux, France
| | | | - Sarah J. Spence
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kyle J. Steinman
- Department of Neurology, Seattle Children’s Research Institute and University of Washington, Seattle
| | | | - Mieke Van Haelst
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Yiping Shen
- Genetic Diagnostic Laboratory, Department of Laboratory Medicine, Children’s Hospital, Boston, Massachusetts
| | - Bogdan Draganski
- Laboratoire de Recherche en Neuroimagerie, Department for Clinical Neurosciences, Centre Hospitalo-Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Elliott H. Sherr
- Department of Neurology, University of California, San Francisco
| | - David H. Ledbetter
- Autism and Developmental Medicine Institute, Geisinger Health System, Danville, Pennsylvania
| | - Marianne B. M. van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, Wales
| | - Jacques S. Beckmann
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland7Swiss Institute of Bioinformatics, University of Lausanne, Lausanne, Switzerland
| | | | - Alexandre Reymond
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Sébastien Jacquemont
- Department of Medical Genetics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland41CHU Sainte-Justine Research Center, Montreal, Canada42Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Wendy K. Chung
- Division of Molecular Genetics, Department of Pediatrics, Columbia University, New York, New York44Department of Medicine, Columbia University, New York, New York
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Paulsen J, Long J, Ross C, Harrington D, Erwin C, Williams J, Westervelt H, Johnson H, Aylward E, Zhang Y, Bockholt J, Barker R. J01 Improving Prediction Of Huntington Disease Onset With Clinical And Imaging Measures: A 10-year Preopective Study Of Converters. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Aylward E, Long J, MacDonald M, Lee JM, Paulsen J, Gusella J. E01 CAG Repeat Length Predicts Rate of Striatal Atrophy, but Relationship is Nonlinear. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Zufferey F, Sherr EH, Beckmann ND, Hanson E, Maillard AM, Hippolyte L, Macé A, Ferrari C, Kutalik Z, Andrieux J, Aylward E, Barker M, Bernier R, Bouquillon S, Conus P, Delobel B, Faucett WA, Goin-Kochel RP, Grant E, Harewood L, Hunter JV, Lebon S, Ledbetter DH, Martin CL, Männik K, Martinet D, Mukherjee P, Ramocki MB, Spence SJ, Steinman KJ, Tjernagel J, Spiro JE, Reymond A, Beckmann JS, Chung WK, Jacquemont S. A 600 kb deletion syndrome at 16p11.2 leads to energy imbalance and neuropsychiatric disorders. J Med Genet 2013; 49:660-8. [PMID: 23054248 PMCID: PMC3494011 DOI: 10.1136/jmedgenet-2012-101203] [Citation(s) in RCA: 196] [Impact Index Per Article: 17.8] [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] [Indexed: 12/29/2022]
Abstract
Background The recurrent ∼600 kb 16p11.2 BP4-BP5 deletion is among the most frequent known genetic aetiologies of autism spectrum disorder (ASD) and related neurodevelopmental disorders. Objective To define the medical, neuropsychological, and behavioural phenotypes in carriers of this deletion. Methods We collected clinical data on 285 deletion carriers and performed detailed evaluations on 72 carriers and 68 intrafamilial non-carrier controls. Results When compared to intrafamilial controls, full scale intelligence quotient (FSIQ) is two standard deviations lower in carriers, and there is no difference between carriers referred for neurodevelopmental disorders and carriers identified through cascade family testing. Verbal IQ (mean 74) is lower than non-verbal IQ (mean 83) and a majority of carriers require speech therapy. Over 80% of individuals exhibit psychiatric disorders including ASD, which is present in 15% of the paediatric carriers. Increase in head circumference (HC) during infancy is similar to the HC and brain growth patterns observed in idiopathic ASD. Obesity, a major comorbidity present in 50% of the carriers by the age of 7 years, does not correlate with FSIQ or any behavioural trait. Seizures are present in 24% of carriers and occur independently of other symptoms. Malformations are infrequently found, confirming only a few of the previously reported associations. Conclusions The 16p11.2 deletion impacts in a quantitative and independent manner FSIQ, behaviour and body mass index, possibly through direct influences on neural circuitry. Although non-specific, these features are clinically significant and reproducible. Lastly, this study demonstrates the necessity of studying large patient cohorts ascertained through multiple methods to characterise the clinical consequences of rare variants involved in common diseases.
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Affiliation(s)
- Flore Zufferey
- Service de Génétique Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Georgiou-Karistianis N, Scahill R, Tabrizi SJ, Squitieri F, Aylward E. Structural MRI in Huntington's disease and recommendations for its potential use in clinical trials. Neurosci Biobehav Rev 2013; 37:480-90. [PMID: 23376047 DOI: 10.1016/j.neubiorev.2013.01.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 01/02/2013] [Accepted: 01/22/2013] [Indexed: 01/18/2023]
Abstract
Huntington's disease (HD) results in progressive impairment of motor and cognitive function and neuropsychiatric disturbance. There are no disease-modifying treatments available, but HD research is entering a critical phase where promising disease-specific therapies are on the horizon. Thus, a pressing need exists for biomarkers capable of monitoring progression and ultimately determining drug efficacy. Neuroimaging provides a powerful tool for assessing disease progression. However, in order to be accepted as biomarkers for clinical trials, imaging measures must be reproducible, robust to scanner differences, sensitive to disease-related change and demonstrate a relationship to clinically meaningful measures. We provide a review of the current structural imaging literature in HD and highlight inconsistencies between studies. We make recommendations for the standardisation of reporting for future studies, such as appropriate cohort characterisation and documentation of methodologies to facilitate comparisons and inform trial design. We also argue for an intensified effort to consider issues highlighted here so that we have the best chance of assessing the efficacy of the therapeutic benefit in forestalling this devastating disease.
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20
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Younes L, Ratnanather JT, Brown T, Aylward E, Nopoulos P, Johnson H, Magnotta VA, Paulsen JS, Margolis RL, Albin RL, Miller MI, Ross CA. Regionally selective atrophy of subcortical structures in prodromal HD as revealed by statistical shape analysis. Hum Brain Mapp 2012; 35:792-809. [PMID: 23281100 DOI: 10.1002/hbm.22214] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [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: 04/10/2012] [Revised: 09/10/2012] [Accepted: 10/01/2012] [Indexed: 11/06/2022] Open
Abstract
Huntington disease (HD) is a neurodegenerative disorder that involves preferential atrophy in the striatal complex and related subcortical nuclei. In this article, which is based on a dataset extracted from the PREDICT-HD study, we use statistical shape analysis with deformation markers obtained through "Large Deformation Diffeomorphic Metric Mapping" of cortical surfaces to highlight specific atrophy patterns in the caudate, putamen, and globus pallidus, at different prodromal stages of the disease. On the basis of the relation to cortico-basal ganglia circuitry, we propose that statistical shape analysis, along with other structural and functional imaging studies, may help expand our understanding of the brain circuitry affected and other aspects of the neurobiology of HD, and also guide the most effective strategies for intervention.
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Affiliation(s)
- Laurent Younes
- Center for Imaging Science, Institute for Computational Medicine and Department of Applied Mathematics and Statistics, Johns Hopkins University, WSE, Baltimore, Maryland
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21
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Madhyastha T, Borghesani P, Aylward E, Cherrier M, Askren K, Grabowski T, Schaie KW, Willis S. P4‐189: Effect of the APOE‐ε4 allele on longitudinal changes in cortical thickness in normal aging. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | - Katie Askren
- University of WashingtonSeattleWashingtonUnited States
| | | | - K. Warner Schaie
- Seattle Children's Research InstituteSeattleWashingtonUnited States
| | - Sherry Willis
- University of WashingtonSeattleWashingtonUnited States
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22
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Aylward E. S3‐01‐03: Huntington's disease. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Sauder CL, Beauchaine TP, Gatzke-Kopp LM, Shannon KE, Aylward E. Neuroanatomical Correlates of Heterotypic Comorbidity in Externalizing Male Adolescents. Journal of Clinical Child & Adolescent Psychology 2012; 41:346-52. [DOI: 10.1080/15374416.2012.658612] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | | | - Lisa M. Gatzke-Kopp
- c Department of Human Development and Family Studies , The Pennsylvania State University
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24
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Roth CL, Aylward E, Liang O, Kleinhans NM, Pauley G, Schur EA. Functional neuroimaging in craniopharyngioma: a useful tool to better understand hypothalamic obesity? Obes Facts 2012; 5:243-53. [PMID: 22647305 PMCID: PMC6902258 DOI: 10.1159/000338695] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 11/08/2011] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To use functional magnetic resonance imaging (fMRI) in craniopharyngioma (CP) patients to examine the hypothesis that hypothalamic damage due to CP and its treatment results in enhanced perception of food reward and/or impaired central satiety processing. METHODS Pre- and post-meal responses to visual food cues in brain regions of interest (ROI; bilateral nucleus accumbens, bilateral insula, and medial orbitofrontal cortex) were assessed in 4 CP patients versus 4 age- and weight-matched controls. Stimuli consisted of images of high- ('fattening') and low-calorie ('non-fattening') foods in blocks, alternating with non-food object blocks. After the first fMRI scan, subjects drank a high-calorie test meal to suppress appetite, then completed a second fMRI scan. Within each ROI, we calculated mean z-scores for activation by fattening as compared to non-fattening food images. RESULTS Following the test meal, controls showed suppression of activation by food cues while CP patients showed trends towards higher activation. CONCLUSION These data, albeit in a small group of patients, support our hypothesis that perception of food cues may be altered in hypothalamic obesity (HO), especially after eating, i.e. in the satiated state. The fMRI approach is encouraging for performing future mechanistic studies of the brain response to food cues and satiety in patients with hypothalamic or other forms of childhood obesity.
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Affiliation(s)
- Christian L. Roth
- Seattle Children's Research Institute, Center of Integrative Brain Research, Seattle, WA, USA
- *Christian L. Roth, MD, Division of Endocrinology, Seattle Children's Hospital Research Institute, 1900 Ninth Avenue, Seattle, WA 98101 (USA), Tel. +1 206 987 5428, E-Mail
| | - Elizabeth Aylward
- Seattle Children's Research Institute, Center of Integrative Brain Research, Seattle, WA, USA
| | - Olivia Liang
- Department of Radiology and Integrated Brain Imaging Center, Seattle, WA, USA
| | | | - Gregory Pauley
- Department of Radiology and Integrated Brain Imaging Center, Seattle, WA, USA
| | - Ellen A. Schur
- Department of Medicine, University of Washington, Seattle, WA, USA
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Magnotta VA, Matsui JT, Liu D, Johnson HJ, Long JD, Bolster BD, Mueller BA, Lim K, Mori S, Helmer KG, Turner JA, Reading S, Lowe MJ, Aylward E, Flashman LA, Bonett G, Paulsen JS. Multicenter reliability of diffusion tensor imaging. Brain Connect 2012; 2:345-55. [PMID: 23075313 PMCID: PMC3623569 DOI: 10.1089/brain.2012.0112] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A number of studies are now collecting diffusion tensor imaging (DTI) data across sites. While the reliability of anatomical images has been established by a number of groups, the reliability of DTI data has not been studied as extensively. In this study, five healthy controls were recruited and imaged at eight imaging centers. Repeated measures were obtained across two imaging protocols allowing intra-subject and inter-site variability to be assessed. Regional measures within white matter were obtained for standard rotationally invariant measures: fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity. Intra-subject coefficient of variation (CV) was typically <1% for all scalars and regions. Inter-site CV increased to ~1%-3%. Inter-vendor variation was similar to inter-site variability. This variability includes differences in the actual implementation of the sequence.
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Affiliation(s)
- Vincent A. Magnotta
- Department of Radiology, The University of Iowa, Iowa City, Iowa
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
| | - Joy T. Matsui
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
- John A. Burns School of Medicine, The University of Hawaii, Honolulu, Hawaii
| | - Dawei Liu
- Department of Biostatistics, The University of Iowa, Iowa City, Iowa
| | - Hans J. Johnson
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
| | - Jeffrey D. Long
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
| | - Bradley D. Bolster
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Rochester, Minnesota
| | - Bryon A. Mueller
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota
| | - Kelvin Lim
- Department of Psychiatry, The University of Minnesota, Minneapolis, Minnesota
| | - Susumu Mori
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | - Karl G. Helmer
- Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | | | - Sarah Reading
- Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland
- Mental Health and Behavioral Science Service, James A. Haley Veterans' Hospital, Tampa, Florida
- Department of Psychiatry and Neurosciences, University of South Florida, Tampa, Florida
| | - Mark J. Lowe
- Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Elizabeth Aylward
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Laura A. Flashman
- Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire
| | - Greg Bonett
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
- The University of California Los Angeles, Los Angeles, California
| | - Jane S. Paulsen
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
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Aylward E, Mills J, Liu D, Nopoulos P, Ross CA, Pierson R, Paulsen JS. Association between Age and Striatal Volume Stratified by CAG Repeat Length in Prodromal Huntington Disease. PLoS Curr 2011; 3:RRN1235. [PMID: 21593963 PMCID: PMC3092625 DOI: 10.1371/currents.rrn1235] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/11/2011] [Indexed: 11/19/2022]
Abstract
Background: Longer CAG repeat length is associated with faster clinical progression in Huntington disease, although the effect of higher repeat length on brain atrophy is not well documented. Method: Striatal volumes were obtained from MRI scans of 720 individuals with prodromal Huntington disease. Striatal volume was plotted against age separately for groups with CAG repeat lengths of 38–39, 40, 41, 42, 43, 44, 45, 46, and 47–54. Results: Slopes representing the association between age and striatal volume were significantly steeper as CAG repeat length increased. Discussion: Although cross-sectional, these data suggest that striatal atrophy, like clinical progression, may occur faster with higher CAG repeat lengths.
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Affiliation(s)
- Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute; Department of Psychiatry, The University of Iowa Carver College of Medicine; Department of Biostatistics, The University of Iowa, College of Public Health; Department of Psychiatry, Pediatrics, and Neurology, The University of Iowa Carver College of Medicine and Division of Neurobiology, Department of Psychiatry, Johns Hopkins University
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Kleinhans NM, Richards T, Johnson LC, Weaver KE, Greenson J, Dawson G, Aylward E. fMRI evidence of neural abnormalities in the subcortical face processing system in ASD. Neuroimage 2010; 54:697-704. [PMID: 20656041 DOI: 10.1016/j.neuroimage.2010.07.037] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 07/15/2010] [Accepted: 07/19/2010] [Indexed: 11/25/2022] Open
Abstract
Recent evidence suggests that a rapid, automatic face detection system is supported by subcortical structures including the amygdala, pulvinar, and superior colliculus. Early-emerging abnormalities in these structures may be related to reduced social orienting in children with autism, and subsequently, to aberrant development of cortical circuits involved in face processing. Our objective was to determine whether functional abnormalities in the subcortical face processing system are present in adults with autism spectrum disorders (ASD) during supraliminal fearful face processing. Participants included twenty-eight individuals with ASD and 25 controls group-matched on age, IQ, and behavioral performance. The ASD group met diagnostic criteria on the ADI-R, ADOS-G, and DSM-IV. Both the ASD and control groups showed significant activation in bilateral fusiform gyri. The control group exhibited additional significant responses in the right amygdala, right pulvinar, and bilateral superior colliculi. In the direct group comparison, the controls showed significantly greater activation in the left amygdala, bilateral fusiform gyrus, right pulvinar, and bilateral superior colliculi. No brain region showed significantly greater activation in the ASD group compared to the controls. Thus, basic rapid face identification mechanisms appear to be functional in ASD. However, individuals with ASD failed to engage the subcortical brain regions involved in face detection and automatic emotional face processing, suggesting a core mechanism for impaired socioemotional processing in ASD. Neural abnormalities in this system may contribute to early-emerging deficits in social orienting and attention, the putative precursors to abnormalities in social cognition and cortical face processing specialization.
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28
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Webb SJ, Jones EJH, Merkle K, Murias M, Greenson J, Richards T, Aylward E, Dawson G. Response to familiar faces, newly familiar faces, and novel faces as assessed by ERPs is intact in adults with autism spectrum disorders. Int J Psychophysiol 2010; 77:106-17. [PMID: 20452382 DOI: 10.1016/j.ijpsycho.2010.04.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 04/23/2010] [Accepted: 04/28/2010] [Indexed: 01/19/2023]
Abstract
Individuals with autism spectrum disorders (ASD) have pervasive impairments in social functioning, which may include problems with processing and remembering faces. In this study, we examined whether posterior ERP components associated with identity processing (P2, N250 and face-N400) and components associated with early-stage face processing (P1 and N170) are atypical in ASD. We collected ERP responses to a familiar repeated face (Familiar), an unfamiliar repeated face (Other) and novel faces (Novels) in 29 high-functioning adults with ASD and matched controls. For both groups, the P2 and N250 were sensitive to repetition (Other vs. Novels) and personal familiarity (Familiar vs. Other), and the face-N400 was sensitive to repetition. Adults with ASD did not show significantly atypical processing of facial familiarity and repetition in an ERP paradigm, despite showing significantly poorer performance than controls on a behavioral test of face memory. This study found no evidence that early-stage facial identity processing is a primary contributor to the face recognition deficit in high-functioning ASD.
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Affiliation(s)
- Sara J Webb
- University of Washington Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA.
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29
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Paulsen JS, Nopoulos PC, Aylward E, Ross CA, Johnson H, Magnotta VA, Juhl A, Pierson RK, Mills J, Langbehn D, Nance M. Striatal and white matter predictors of estimated diagnosis for Huntington disease. Brain Res Bull 2010; 82:201-7. [PMID: 20385209 DOI: 10.1016/j.brainresbull.2010.04.003] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 03/19/2010] [Accepted: 04/01/2010] [Indexed: 01/28/2023]
Abstract
Previous MRI studies with participants prior to manifest Huntington disease have been conducted in small single-site samples. The current study reports data from a systematic multi-national study during the prodromal period of Huntington disease and examines whether various brain structures make unique predictions about the proximity to manifest disease. MRI scans were acquired from 657 participants enrolled at 1 of 32 PREDICT-HD research sites. Only prodromal Huntington disease participants (those not meeting motor criteria for diagnosis) were included and subgrouped by estimated diagnosis proximity (Near, Mid, and Far) based upon a formula incorporating age and CAG-repeat length. Results show volumes of all three subgroups differed significantly from Controls for total brain tissue, cerebral spinal fluid, white matter, cortical gray matter, thalamus, caudate, and putamen. Total striatal volume demonstrated the largest differences between Controls and all three prodromal subgroups. Cerebral white matter offered additional independent power in the prediction of estimated proximity to diagnosis. In conclusion, this large cross-sectional study shows that changes in brain volume are detectable years to decades prior to estimated motor diagnosis of Huntington disease. This suggests that a clinical trial of a putative neuroprotective agent could begin as much as 15 years prior to estimated motor diagnosis in a cohort of persons at risk for but not meeting clinical motor diagnostic criteria for Huntington disease, and that neuroimaging (striatal and white matter volumes) may be among the best predictors of diagnosis proximity.
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Affiliation(s)
- Jane S Paulsen
- University of Iowa Roy and Lucille Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States.
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Conley K, Jubrias S, Siegel M, Syrjala K, Remmen H, Aylward E, Marcinek D. Mitochondria co‐opt exercise adaptations in defense against oxidative stress in vivo. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.801.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Aylward E, Nopoulos P, Ross C, Pierson R, Mills J, Langbehn D, Magnotta V, Johnson H, Paulsen J. Poster 11: Striatal Volume Distinguishes Converters from Non-Converters: Findings from PREDICT-HD. Neurotherapeutics 2010. [DOI: 10.1016/j.nurt.2009.09.013] [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: 11/26/2022] Open
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Duff K, Paulsen JS, Beglinger LJ, Langbehn DR, Wang C, Stout JC, Ross CA, Aylward E, Carlozzi NE, Queller S, Group PHDIOTH. "Frontal" behaviors before the diagnosis of Huntington's disease and their relationship to markers of disease progression: evidence of early lack of awareness. J Neuropsychiatry Clin Neurosci 2010; 22:196-207. [PMID: 20463114 PMCID: PMC2871328 DOI: 10.1176/jnp.2010.22.2.196] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Huntington's disease has been linked with fronto-subcortical neuropathology and behaviors consistent with this dysfunction. Little is known about these "frontal" behaviors in the earliest phase of the illness. Comparisons between participants in the Predict-HD study (745 "expansion-positive" and 163 "expansion-negative" control subjects) on the Frontal System Behavior Scale looked for evidence of frontal behaviors, including apathy, disinhibition, and executive dysfunction. The authors were also able to compare participant and companion reporting of these frontal behaviors as a possible indication of awareness of behaviors. Expansion-positive individuals reported significantly more of these frontal behaviors than expansion-negative peers. Self- and companion-reported frontal behaviors were related to other Huntington's disease markers. Expansion-positive participants closest to Huntington's disease diagnosis showed greater discrepancies with companions on ratings of frontal behaviors. Even though most are more than 10 years from Huntington's disease diagnosis, mild frontal behaviors were present in this prediagnosed sample, which might make these behaviors useful as markers for Huntington's disease onset. Participant/companion discrepancies, especially closest to Huntington's disease diagnosis, might suggest early lack of awareness in these individuals.
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Affiliation(s)
- Kevin Duff
- Department of Psychiatry, University of Iowa College of Medicine, Iowa City, USA.
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Gatzke-Kopp LM, Beauchaine TP, Shannon KE, Chipman J, Fleming AP, Crowell SE, Liang O, Johnson LC, Aylward E. Neurological correlates of reward responding in adolescents with and without externalizing behavior disorders. J Abnorm Psychol 2009; 118:203-13. [PMID: 19222326 DOI: 10.1037/a0014378] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Opposing theories of striatal hyper- and hypodopaminergic functioning have been suggested in the pathophysiology of externalizing behavior disorders. To test these competing theories, the authors used functional MRI to evaluate neural activity during a simple reward task in 12- to 16-year-old boys with attention-deficit/hyperactivity disorder and/or conduct disorder (n = 19) and in controls with no psychiatric condition (n = 11). The task proceeded in blocks during which participants received either (a) monetary incentives for correct responses or (b) no rewards for correct responses. Controls exhibited striatal activation only during reward, shifting to anterior cingulate activation during nonreward. In contrast, externalizing adolescents exhibited striatal activation during both reward and nonreward. Externalizing psychopathology appears to be characterized by deficits in processing the omission of predicted reward, which may render behaviors that are acquired through environmental contingencies difficult to extinguish when those contingencies change.
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Affiliation(s)
- Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA 16802, USA.
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Scheibel RS, Pearson DA, Faria LP, Kotrla KJ, Aylward E, Bachevalier J, Levin HS. An fMRI study of executive functioning after severe diffuse TBI. Brain Inj 2009. [DOI: 10.1080/ijf.18.2.219.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
PRIMARY OBJECTIVE Preliminary study of whether severe diffuse traumatic brain injury (TBI) increases extent of frontal tissue recruited by cognitive control tasks. RESEARCH DESIGN Functional magnetic resonance imaging (fMRI) on N-back working memory (WM)and arrows inhibition tasks in a 46 year old man who had severe diffuse TBI 1 year earlier, a 44 year old man (inhibition task) and three women (working memory task), age 20-26 years. Images were acquired by 1.5 T magnet with BOLD method and PRESTO pulse sequence and analysed using SPM. MAIN OUTCOMES AND RESULTS Frontal activation increased under 2-back relative to 1-back condition of working memory in all participants with more extensive activation in the TBI patient relative to controls. Frontal activation increased with inhibition on the arrows task, but was greater in the TBI patient. CONCLUSION Severe diffuse TBI results in recruitment of additional neural resources for cognitive control.
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Affiliation(s)
- R S Scheibel
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
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Magnotta VA, Bonett GS, Turner J, Mueller B, Juhl A, Lim K, Reading S, Aylward E, Lowe M, Flashman L, Bolster B, Paulsen JS. Evaluation of Multi-Center Diffusion Tensor Imaging. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70466-5] [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: 11/29/2022] Open
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Webb SJ, Merkle K, Murias M, Richards T, Aylward E, Dawson G. ERP responses differentiate inverted but not upright face processing in adults with ASD. Soc Cogn Affect Neurosci 2009; 7:578-87. [PMID: 19454620 DOI: 10.1093/scan/nsp002] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Individuals with autism spectrum disorders (ASD) have documented deficits in face processing, face memory and abnormal activation of the neural circuitry that supports these functions. To examine speed of processing of faces in ASD, high density event-related brain potentials were recorded to images of faces, inverted faces and non-face objects from 32 high-functioning adults with ASD and controls. Participants were instructed to focus on a cross hair prior to stimulus onset; the cross-hair location directed the participant's eye gaze to the eye region at stimulus onset. Although the ASD group preformed more poorly on behavioral tests of face and object memory, both groups demonstrated similar ERP responses, characterized by greater (positive) P1 and (negative) N170 amplitude to faces vs houses. N170 speed of processing to faces did not differ between groups. However, only the control group demonstrated differential responses to upright vs inverted faces. For the ASD group, the differential response to inverted vs upright faces was associated with better performance on face memory and self-reported social skills. It is possible that the use of attention cues may facilitate face processing in high-functioning adults with ASD, suggesting that the underlying neural circuitry can be activated in adults with ASD under specific demands.
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Affiliation(s)
- Sara Jane Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
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Kleinhans NM, Johnson LC, Richards T, Mahurin R, Greenson J, Dawson G, Aylward E. Reduced neural habituation in the amygdala and social impairments in autism spectrum disorders. Am J Psychiatry 2009; 166:467-75. [PMID: 19223437 DOI: 10.1176/appi.ajp.2008.07101681] [Citation(s) in RCA: 183] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Amygdala dysfunction has been proposed as a critical component in social impairment in autism spectrum disorders. This study was designed to investigate whether abnormal habituation characterizes amygdala dysfunction in autism spectrum disorders and whether the rate of amygdala habituation is related to social impairment. METHOD Using functional MRI, the authors measured change over time in activation of the amygdala and fusiform gyrus to neutral facial stimuli in adults with autism spectrum disorders and healthy comparison adults. RESULTS The comparison group evidenced significantly greater amygdala habituation bilaterally than the autism spectrum group. There were no group differences in overall fusiform habituation. For the autism spectrum group, lower levels of habituation of the amygdala to the face stimuli were associated with more severe social impairment. CONCLUSIONS These results suggest amygdala hyperarousal in autism spectrum disorders in response to socially relevant stimuli. Further, sustained amygdala arousal may contribute to the social deficits observed in autism spectrum disorders.
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Affiliation(s)
- Natalia M Kleinhans
- Department of Radiology, University of Washington, Box 357115, Seattle, WA 98195, USA.
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Borson S, Scanlan J, Friedman S, Zuhr E, Fields J, Aylward E, Mahurin R, Richards T, Anzai Y, Yukawa M, Yeh S. Modeling the impact of COPD on the brain. Int J Chron Obstruct Pulmon Dis 2009; 3:429-34. [PMID: 18990971 PMCID: PMC2629981 DOI: 10.2147/copd.s2066] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [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] [Indexed: 12/02/2022] Open
Abstract
Previous studies have shown that COPD adversely affects distant organs and body systems, including the brain. This pilot study aims to model the relationships between respiratory insufficiency and domains related to brain function, including low mood, subtly impaired cognition, systemic inflammation, and brain structural and neurochemical abnormalities. Nine healthy controls were compared with 18 age- and education-matched medically stable COPD patients, half of whom were oxygen-dependent. Measures included depression, anxiety, cognition, health status, spirometry, oximetry at rest and during 6-minute walk, and resting plasma cytokines and soluble receptors, brain MRI, and MR spectroscopy in regions relevant to mood and cognition. ANOVA was used to compare controls with patients and with COPD subgroups (oxygen users [n = 9] and nonusers [n = 9]), and only variables showing group differences at p ≤ 0.05 were included in multiple regressions controlling for age, gender, and education to develop the final model. Controls and COPD patients differed significantly in global cognition and memory, mood, and soluble TNFR1 levels but not brain structural or neurochemical measures. Multiple regressions identified pathways linking disease severity with impaired performance on sensitive cognitive processing measures, mediated through oxygen dependence, and with systemic inflammation (TNFR1), related through poor 6-minute walk performance. Oxygen desaturation with activity was related to indicators of brain tissue damage (increased frontal choline, which in turn was associated with subcortical white matter attenuation). This empirically derived model provides a conceptual framework for future studies of clinical interventions to protect the brain in patients with COPD, such as earlier oxygen supplementation for patients with desaturation during everyday activities.
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Affiliation(s)
- Soo Borson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle,WA, USA.
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Paulsen JS, Langbehn DR, Stout JC, Aylward E, Ross CA, Nance M, Guttman M, Johnson S, MacDonald M, Beglinger LJ, Duff K, Kayson E, Biglan K, Shoulson I, Oakes D, Hayden M. Detection of Huntington's disease decades before diagnosis: the Predict-HD study. J Neurol Neurosurg Psychiatry 2008; 79:874-80. [PMID: 18096682 PMCID: PMC2569211 DOI: 10.1136/jnnp.2007.128728] [Citation(s) in RCA: 588] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The objective of the Predict-HD study is to use genetic, neurobiological and refined clinical markers to understand the early progression of Huntington's disease (HD), prior to the point of traditional diagnosis, in persons with a known gene mutation. Here we estimate the approximate onset and initial course of various measurable aspects of HD relative to the time of eventual diagnosis. METHODS We studied 438 participants who were positive for the HD gene mutation, but did not yet meet the diagnostic criteria for HD and had no functional decline. Predictability of baseline cognitive, motor, psychiatric and imaging measures was modelled non-linearly using estimated time until diagnosis (based on CAG repeat length and current age) as the predictor. RESULTS Estimated time to diagnosis was related to most clinical and neuroimaging markers. The patterns of association suggested the commencement of detectable changes one to two decades prior to the predicted time of clinical diagnosis. The patterns were highly robust and consistent, despite the varied types of markers and diverse measurement methodologies. CONCLUSIONS These findings from the Predict-HD study suggest the approximate time scale of measurable disease development, and suggest candidate disease markers for use in preventive HD trials.
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Affiliation(s)
- J S Paulsen
- University of Iowa, Roy J and Lucille A Carver College of Medicine Research, 1-305 Medical Education Building, Iowa City, IA 52242-1000, USA.
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Faja S, Aylward E, Bernier R, Dawson G. Becoming a face expert: a computerized face-training program for high-functioning individuals with autism spectrum disorders. Dev Neuropsychol 2008; 33:1-24. [PMID: 18443967 DOI: 10.1080/87565640701729573] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Typically developing individuals process faces using strategies that differ from those used for processing objects, and which tend to be holistic and based on configural information. Behavioral and neuroimaging studies suggest that individuals with autism may not utilize the same specialized strategies for face processing. The present study was designed to investigate whether computerized face-specific training, based on a modified version of Gauthier and Tarr's (1997) expertise protocol, can influence the face processing strategies and abilities of adolescents and young adults with Autism Spectrum Disorder (ASD). Ten individuals with ASD were assigned to either a training protocol designed to improve face processing (N = 5) or a control condition (N = 5). Outcomes assessed holistic processing and configural sensitivity. All trained individuals achieved a behavioral criterion of developing expertise in face recognition established in the literature. Outcome assessments indicated that the trained group showed significantly greater sensitivity to second-order configural relations compared with untrained controls, but did not differ on the measure of holistic processing. These findings suggest that face processing ability and strategies in autism can be significantly improved through training.
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Affiliation(s)
- Susan Faja
- Department of Psychology, University of Washington, USA
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Moser K, Biglan KM, Ross CA, Langbehn DR, Aylward E, Stout JC, Queller S, Carlozzi N, Duff K, Beglinger LJ, Paulsen JS, Tomusk A, Lifer S, Hastings S, Dawson J, Walker B, Whitlock K, Johnson S, Pacifici R, Hersch S, Dorsey ER, Katz R, Tempkin T, Wheelock V, Schwartz G, Corey-Bloom J, Mattis P, Feigin A, Young P, McArthur DL, Perlman S, Higginson C, Carr L, Sigvardt K, Chirieac MC, Shinaman A, Shoulson I, Kane AE, Peavy GM, Goldstein JL, Jacobson MW, Lessig S, Wasserman L, Kayson EP, Tang C, Zgaljardic D, Ma Y, Dhawan V, Guttman M, Eidelberg D, Peng S, Kingsley P, Rosas HD, Gevorkian S, Oakes D, Matson W, Massood T, Latourelle J, Mysore JS, Fossale E, Gillis T, Gusella JF, MacDonald ME, Myers RH, Yastrubetskaya O, Preston J, Chiu E, Goh A, Oster E, Bausch J, Kayson E, Quaid K, Sims S, Swenson M, Harrison J, Moskowitz C, Stepanov N, Suter G, Westphal B, Johnson SA, Langbehn D, Paulsen J, Nopoulos P, Beglinger L, Johnson H, Magnotta V, Pierson R, Lipe H, Bird TD, McCusker EA, Lownie A, Lechich AJ, Montas S, Duckett A, Klager J, Sandler S, Pae A, Apostol BL, Simmons DA, Zuccato C, Illes K, Pallos J, Casale M, Kathuria S, Cattaneo E, Marsh JL, Thompson LM, Patzke H, Chesworth R, Li Z, Rahil G, Wang J, Smith J, Huet FL, Shapiro G, Leit S, Beaulieu P, Raeppel F, Fournel M, Sainte-Croix H, Nolan SJ, Albayya FP, Barbier A, Besterman J, Ahlijanian MK, Deziel R, Aubeeluck A, Buchanan H, Ross C, Biglan K, Landwehrmeyer B, Whitlock KB, Carlozzi NE, Mickes L, Lee J, Kim RY, Toro B, Fine E, Cahill T, Johnson D, Goldstein J, Peavy G, Jacobson M, Goodman LV, Como PG, Cha JH, Beck C, Adams M, Chadwick G, Blieck EA, McCallum C, Deuel L, Clarke A, Stewart R, Adams WH, Paulson H, Fiedorowicz JG, Hanson JM, Ramza N, Priller J, Ecker D. Inaugural Huntington Disease Clinical Research Symposium Organized by the Huntington Study Group. Neurotherapeutics 2008. [DOI: 10.1016/j.nurt.2007.10.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sterling L, Dawson G, Webb S, Murias M, Munson J, Panagiotides H, Aylward E. The role of face familiarity in eye tracking of faces by individuals with autism spectrum disorders. J Autism Dev Disord 2008; 38:1666-75. [PMID: 18306030 DOI: 10.1007/s10803-008-0550-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Accepted: 02/06/2008] [Indexed: 01/19/2023]
Abstract
It has been shown that individuals with autism spectrum disorders (ASD) demonstrate normal activation in the fusiform gyrus when viewing familiar, but not unfamiliar faces. The current study utilized eye tracking to investigate patterns of attention underlying familiar versus unfamiliar face processing in ASD. Eye movements of 18 typically developing participants and 17 individuals with ASD were recorded while passively viewing three face categories: unfamiliar non-repeating faces, a repeating highly familiar face, and a repeating previously unfamiliar face. Results suggest that individuals with ASD do not exhibit more normative gaze patterns when viewing familiar faces. A second task assessed facial recognition accuracy and response time for familiar and novel faces. The groups did not differ on accuracy or reaction times.
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Affiliation(s)
- Lindsey Sterling
- Department of Psychology, University of Washington Autism Center, University of Washington, Box 357920, Seattle, WA 98195, USA.
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Kleinhans NM, Richards T, Sterling L, Stegbauer KC, Mahurin R, Johnson LC, Greenson J, Dawson G, Aylward E. Abnormal functional connectivity in autism spectrum disorders during face processing. ACTA ACUST UNITED AC 2008; 131:1000-12. [PMID: 18234695 DOI: 10.1093/brain/awm334] [Citation(s) in RCA: 333] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Abnormalities in the interactions between functionally linked brain regions have been suggested to be associated with the clinical impairments observed in autism spectrum disorders (ASD). We investigated functional connectivity within the limbic system during face identification; a primary component of social cognition, in 19 high-functioning adults with ASD and 21 age-and IQ-matched control adults. Activation during identification of previously viewed faces and houses using a one-back paradigm was compared. The fusiform face area (FFA) was individually localized in each participant and used as the seed point for functional connectivity analyses. The degree of correlation between FFA and the extended neural circuitry involved in face identification was tested. A whole brain analysis was also conducted in order to determine whether connectivity from the FFA to aberrant brain locations was present in the ASD group. Measures of clinical severity (ADOS social score and ADI-R social score) were included as independent variables into the functional connectivity analyses. Significant FFA-amygdala and FFA-superior temporal sulcus functional connectivity was found in both the ASD and control participants. However, the control group had significantly increased connectivity to the left amygdala and the posterior cingulate compared to ASD. Post hoc analyses additionally found increased connectivity to the thalamus in the controls. A significant relationship between abnormal functional connectivity and clinical severity in the ASD group was observed. Specifically, greater social impairment was associated with reduced FFA-amygdala connectivity and increased FFA-right inferior frontal connectivity. These results suggest that abnormal neural connections within the limbic system may contribute to the social impairments observed in ASD.
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Affiliation(s)
- Natalia M Kleinhans
- Department of Radiology, University of Washington, Box 357115, Seattle, WA 98195, USA.
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Drane DL, Ojemann GA, Aylward E, Ojemann JG, Johnson LC, Silbergeld DL, Miller JW, Tranel D. Category-specific naming and recognition deficits in temporal lobe epilepsy surgical patients. Neuropsychologia 2007; 46:1242-55. [PMID: 18206185 DOI: 10.1016/j.neuropsychologia.2007.11.034] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 11/05/2007] [Accepted: 11/27/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Based upon Damasio's "convergence zone" model of semantic memory, we predicted that epilepsy surgical patients with anterior temporal lobe (TL) seizure onset would exhibit a pattern of category-specific naming and recognition deficits not observed in patients with seizures arising elsewhere. METHODS We assessed epilepsy patients with unilateral seizure onset of anterior TL or other origin (n=22), pre- or post-operatively, using a set of category-specific items and a conventional measure of visual naming (Boston Naming Test: BNT). RESULTS Category-specific naming deficits were exhibited by patients with dominant anterior TL seizure onset/resection for famous faces and animals, while category-specific recognition deficits for these same categories were exhibited by patients with nondominant anterior TL onset/resection. Patients with other seizure onset did not exhibit category-specific deficits. Naming and recognition deficits were frequently not detected by the BNT, which samples only a limited range of stimuli. INTERPRETATION Consistent with the "convergence zone" framework, results suggest that the nondominant anterior TL plays a major role in binding sensory information into conceptual percepts for certain stimuli, while dominant TL regions function to provide a link to verbal labels for these percepts. Although observed category-specific deficits were striking, they were often missed by the BNT, suggesting that they are more prevalent than recognized in both pre- and post-surgical epilepsy patients. Systematic investigation of these deficits could lead to more refined models of semantic memory, aid in the localization of seizures, and contribute to modifications in surgical technique and patient selection in epilepsy surgery to improve neurocognitive outcome.
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Affiliation(s)
- Daniel L Drane
- Department of Neurology, University of Washington, Seattle, WA, United States; UW Regional Epilepsy Center, Harborview Medical Center, Seattle, WA, United States.
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Kleinhans NM, Johnson LC, Mahurin R, Richards T, Stegbauer KC, Greenson J, Dawson G, Aylward E. Increased amygdala activation to neutral faces is associated with better face memory performance. Neuroreport 2007; 18:987-91. [PMID: 17558282 DOI: 10.1097/wnr.0b013e328165d189] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recent evidence suggests that the role of the amygdala may extend beyond threat detection to include processing socially relevant stimuli in general. Thus, we investigated perception and memory for neutral faces; a stimulus-type that lacks emotional valence yet contains relevant social information. Participants viewed neutral faces or houses when undergoing functional MRI. Neutral face memory testing was conducted outside the scanner. In the functional MRI of faces vs. houses contrast, significant bilateral activation in the amygdala and lateral fusiform gyrus was observed. Increased bilateral amygdala activation was associated with better delayed-memory performance. These findings indicate that the role of the amygdala may include processing neutral yet socially relevant stimuli. Further, amygdala activation, independent of emotional valence, appears to be associated with memory enhancement.
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Affiliation(s)
- Natalia M Kleinhans
- Department of Radiology, University of Washington, Seattle, Washington 98195, USA.
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Juul SE, Aylward E, Richards T, McPherson RJ, Kuratani J, Burbacher TM. Prenatal Cord Clamping in Newborn Macaca nemestrina: A Model of Perinatal Asphyxia. Dev Neurosci 2007; 29:311-20. [PMID: 17762199 DOI: 10.1159/000105472] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 09/08/2006] [Indexed: 11/19/2022] Open
Abstract
Our objective was to establish a nonhuman primate model of perinatal asphyxia appropriate for preclinical evaluation of neuroprotective treatment strategies under conditions that closely resemble human neonatal emergencies, and to begin testing the safety and efficacy of erythropoietin neuroprotective treatment. Prior to delivery by hysterotomy, the umbilical cords of near term Macaca nemestrina (n = 8) were clamped for times ranging between 12 and 15 min. Animals received erythropoietin (5,000 U/kg/dose x 2 i.v., n = 3), or vehicle (n = 5) after resuscitation. We assessed physiologic parameters, continuous electroencephalogram, magnetic resonance imaging/spectroscopy, safety parameters and behavior. Animals were euthanized at 4 months of age. Mean birth weight was 507 +/- 62 g. Initial arterial pH ranged from 6.75 to 7.12, with base deficits of 17-25 mEq. Animals were flaccid at birth, with attenuated electroencephalograms, and seizures occurred in 3 of 8 animals. We demonstrated magnetic resonance imaging/spectroscopy changes consistent with hypoxia (elevated lactate levels were present in some animals), significant motor and behavioral abnormalities (particularly with 15 min of cord clamping), and evidence of gliosis at the time of death. We have established a reproducible model of moderate to severe perinatal hypoxic-ischemic injury in M. nemestrina newborns. This model, which combines structural, biochemical, and behavioral assessments over time can be used to assess the safety and efficacy of neuroprotective strategies.
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Affiliation(s)
- Sandra E Juul
- University of Washington, Department of Pediatrics, Division of Neonatology, Seattle, Wash. 98195-6320, USA.
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Paulsen JS, Hayden M, Stout JC, Langbehn DR, Aylward E, Ross CA, Guttman M, Nance M, Kieburtz K, Oakes D, Shoulson I, Kayson E, Johnson S, Penziner E. Preparing for preventive clinical trials: the Predict-HD study. ACTA ACUST UNITED AC 2006; 63:883-90. [PMID: 16769871 DOI: 10.1001/archneur.63.6.883] [Citation(s) in RCA: 248] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The optimal design and outcome measures for preventive clinical trials in neurodegenerative diseases are unknown. OBJECTIVE To examine measures that may be associated with disease in the largest cohort ever recruited of prediagnosed individuals carrying the gene expansion for Huntington disease (HD). DESIGN The Predict-HD study is a multicenter observational research study in progress at 17 sites in the United States, 4 in Canada, and 3 in Australia. SETTING Genetics and HD outpatient clinics. PARTICIPANTS Five hundred five at-risk individuals who had previously undergone elective DNA analyses for the CAG expansion in the HD gene (predictive testing) and did not currently have a clinical diagnosis of HD. MAIN OUTCOME MEASURES Basal ganglia volumes on magnetic resonance images, estimated probability of diagnosis (based on CAG repeat length), performances on 21 standardized cognitive tasks, total scores on 3 scales of psychiatric distress, and motor diagnosis based on the Unified Huntington's Disease Rating Scale. RESULTS Several variables showed progressive decline as the diagnostic ratings advanced toward manifest disease. Estimated probability of diagnosis was associated with Unified Huntington's Disease Rating Scale prediagnostic stages and varied from 15% in persons with no motor abnormalities to nearly 40% in those with abnormalities suggestive of probable disease. Striatal volumes, cognitive performances, and even psychiatric ratings declined significantly with motor manifestations of disease. CONCLUSIONS The documentation of biological and refined clinical markers suggests several clinical end points for preventive clinical trials. Longitudinal study is critical to further validate possible markers for prediagnosed HD.
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Affiliation(s)
- Jane S Paulsen
- Department of Psychiatry, University of Iowa, Iowa City 52242-1000, USA.
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Khan A, Aylward E, Barta P, Miller M, Beg MF. Semi-automated basal ganglia segmentation using large deformation diffeomorphic metric mapping. ACTA ACUST UNITED AC 2006; 8:238-45. [PMID: 16685851 DOI: 10.1007/11566465_30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This paper investigates the techniques required to produce accurate and reliable segmentations via grayscale image matching. Finding a large deformation, dense, non-rigid transformation from a template image to a target image allows us to map a template segmentation to the target image space, and therefore compute the target image segmentation and labeling. We outline a semi-automated procedure involving landmark and image intensity-based matching via the large deformation diffeomorphic mapping metric (LDDMM) algorithm. Our method is applied specifically to the segmentation of the caudate nucleus in pre- and post-symptomatic Huntington's Disease (HD) patients. Our accuracy is compared against gold-standard manual segmentations and various automated segmentation tools through the use of several error metrics.
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Affiliation(s)
- Ali Khan
- School of Engineering Science, Simon Fraser University, 8888 University Drive, Burnaby BC, V5A 1S6, Canada
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Reading SAJ, Dziorny AC, Peroutka LA, Schreiber M, Gourley LM, Yallapragada V, Rosenblatt A, Margolis RL, Pekar JJ, Pearlson GD, Aylward E, Brandt J, Bassett SS, Ross CA. Functional brain changes in presymptomatic Huntington's disease. Ann Neurol 2004; 55:879-83. [PMID: 15174024 DOI: 10.1002/ana.20121] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Evidence suggests early structural brain changes in individuals with the Huntington's disease (HD) genetic mutation who are presymptomatic for the movement symptoms of the illness. The aim of this study was to investigate the presence of functional brain changes in this same population using functional magnetic resonance imaging. Subjects and matched controls underwent an functional magnetic resonance imaging "interference" protocol, a task known to be mediated in part by corticostriatal circuitry. In the setting of normal cognitive performance, presymptomatic HD subjects had significantly and specifically less activation in the left anterior cingulate cortex (BA 24, 32) compared with matched controls.
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Affiliation(s)
- Sarah A J Reading
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD 21287, USA.
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