1
|
Morgado F, Vandewouw MM, Hammill C, Kelley E, Crosbie J, Schachar R, Ayub M, Nicolson R, Georgiades S, Arnold P, Iaboni A, Kushki A, Taylor MJ, Anagnostou E, Lerch JP. Behaviour-correlated profiles of cerebellar-cerebral functional connectivity observed in independent neurodevelopmental disorder cohorts. Transl Psychiatry 2024; 14:173. [PMID: 38570480 PMCID: PMC10991387 DOI: 10.1038/s41398-024-02857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/05/2024] Open
Abstract
The cerebellum, through its connectivity with the cerebral cortex, plays an integral role in regulating cognitive and affective processes, and its dysregulation can result in neurodevelopmental disorder (NDD)-related behavioural deficits. Identifying cerebellar-cerebral functional connectivity (FC) profiles in children with NDDs can provide insight into common connectivity profiles and their correlation to NDD-related behaviours. 479 participants from the Province of Ontario Neurodevelopmental Disorders (POND) network (typically developing = 93, Autism Spectrum Disorder = 172, Attention Deficit/Hyperactivity Disorder = 161, Obsessive-Compulsive Disorder = 53, mean age = 12.2) underwent resting-state functional magnetic resonance imaging and behaviour testing (Social Communication Questionnaire, Toronto Obsessive-Compulsive Scale, and Child Behaviour Checklist - Attentional Problems Subscale). FC components maximally correlated to behaviour were identified using canonical correlation analysis. Results were then validated by repeating the investigation in 556 participants from an independent NDD cohort provided from a separate consortium (Healthy Brain Network (HBN)). Replication of canonical components was quantified by correlating the feature vectors between the two cohorts. The two cerebellar-cerebral FC components that replicated to the greatest extent were correlated to, respectively, obsessive-compulsive behaviour (behaviour feature vectors, rPOND-HBN = -0.97; FC feature vectors, rPOND-HBN = -0.68) and social communication deficit contrasted against attention deficit behaviour (behaviour feature vectors, rPOND-HBN = -0.99; FC feature vectors, rPOND-HBN = -0.78). The statistically stable (|z| > 1.96) features of the FC feature vectors, measured via bootstrap re-sampling, predominantly comprised of correlations between cerebellar attentional and control network regions and cerebral attentional, default mode, and control network regions. In both cohorts, spectral clustering on FC loading values resulted in subject clusters mixed across diagnostic categories, but no cluster was significantly enriched for any given diagnosis as measured via chi-squared test (p > 0.05). Overall, two behaviour-correlated components of cerebellar-cerebral functional connectivity were observed in two independent cohorts. This suggests the existence of generalizable cerebellar network differences that span across NDD diagnostic boundaries.
Collapse
Affiliation(s)
- Felipe Morgado
- Dept. Medical Biophysics, University of Toronto, Toronto, Canada.
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada.
| | - Marlee M Vandewouw
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Christopher Hammill
- Data Science & Advanced Analytics, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | | | - Jennifer Crosbie
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Russell Schachar
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Muhammad Ayub
- Department of Psychiatry, University College London, London, UK
| | - Robert Nicolson
- Department of Psychiatry, University of Western Ontario, London, Canada
- Lawson Research Institute, London, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Paul Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Alana Iaboni
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Azadeh Kushki
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Margot J Taylor
- Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
- Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Jason P Lerch
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| |
Collapse
|
2
|
Mo K, Anagnostou E, Lerch JP, Taylor MJ, VanderLaan DP, Szatmari P, Crosbie J, Nicolson R, Georgiadis S, Kelley E, Ayub M, Brian J, Lai MC, Palmert MR. Gender diversity is correlated with dimensional neurodivergent traits but not categorical neurodevelopmental diagnoses in children. J Child Psychol Psychiatry 2024. [PMID: 38433429 DOI: 10.1111/jcpp.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Gender clinic and single-item questionnaire-based data report increased co-occurrence of gender diversity and neurodevelopmental conditions. The nuances of these associations are under-studied. We used a transdiagnostic approach, combining categorical and dimensional characterization of neurodiversity, to further the understanding of its associations with gender diversity in identity and expression in children. METHODS Data from 291 children (Autism N = 104, ADHD N = 104, Autism + ADHD N = 17, neurotypical N = 66) aged 4-12 years enrolled in the Province of Ontario Neurodevelopmental Network were analyzed. Gender diversity was measured multi-dimensionally using a well-validated parent-report instrument, the Gender Identity Questionnaire for Children (GIQC). We used gamma regression models to determine the significant correlates of gender diversity among age, puberty, sex-assigned-at-birth, categorical neurodevelopmental diagnoses, and dimensional neurodivergent traits (using the Social Communication Questionnaire and the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scales). Internalizing and externalizing problems were included as covariates. RESULTS Neither a categorical diagnosis of autism nor ADHD significantly correlated with current GIQC-derived scores. Instead, higher early-childhood dimensional autistic social-communication traits correlated with higher current overall gender incongruence (as defined by GIQC-14 score). This correlation was potentially moderated by sex-assigned-at-birth: greater early-childhood autistic social-communication traits were associated with higher current overall gender incongruence in assigned-males-at-birth, but not assigned-females-at-birth. For fine-grained gender diversity domains, greater autistic restricted-repetitive behavior traits were associated with greater diversity in gender identity across sexes-assigned-at-birth; greater autistic social-communication traits were associated with lower stereotypical male expression across sexes-assigned-at-birth. CONCLUSIONS Dimensional autistic traits, rather than ADHD traits or categorical neurodevelopmental diagnoses, were associated with gender diversity domains across neurodivergent and neurotypical children. The association between early-childhood autistic social-communication traits and overall current gender diversity was most evident in assigned-males-at-birth. Nuanced interrelationships between neurodivergence and gender diversity should be better understood to clarify developmental links and to offer tailored support for neurodivergent and gender-diverse populations.
Collapse
Affiliation(s)
- Kelly Mo
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jason P Lerch
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Oxford, Oxford, UK
| | - Margot J Taylor
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Doug P VanderLaan
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | | | - Jessica Brian
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Cambridge, Cambridge, UK
- National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Mark R Palmert
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Scheerer NE, Pourtousi A, Yang C, Ding Z, Stojanoski B, Anagnostou E, Nicolson R, Kelley E, Georgiades S, Crosbie J, Schachar R, Ayub M, Stevenson RA. Transdiagnostic Patterns of Sensory Processing in Autism and ADHD. J Autism Dev Disord 2024; 54:280-292. [PMID: 36306002 DOI: 10.1007/s10803-022-05798-3] [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] [Accepted: 10/13/2022] [Indexed: 11/24/2022]
Abstract
Sensory processing abilities are highly variable within and across people diagnosed with autism and attention-deficit/hyperactivity disorder (ADHD). This study examined the transdiagnostic nature of sensory processing abilities, and their association with features of autism and ADHD, in a large sample of autistic people (n = 495) and people with ADHD (n = 461). Five similar data-driven sensory phenotypes characterized sensory processing abilities, and showed similar patterns of association with features of autism and ADHD, across both diagnostic groups. These results demonstrate the transdiagnostic nature of sensory processing abilities, while contributing to a growing body of literature that suggests the autism and ADHD diagnostic labels have poor explanatory power.
Collapse
Affiliation(s)
- Nichole E Scheerer
- Wilfrid Laurier University, 75 University Ave West, Waterloo, ON, N2L 3C5, Canada.
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada.
| | - Anahid Pourtousi
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Connie Yang
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Zining Ding
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Bobby Stojanoski
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
- University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, ON, L1H 7K4, Canada
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, East York, ON, M4G 1R8, Canada
| | - Robert Nicolson
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | | | | | - Jennifer Crosbie
- The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Russell Schachar
- The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Muhammad Ayub
- Queens University, 62 Arch St, Kingston, ON, K7L 3N6, Canada
| | - Ryan A Stevenson
- Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| |
Collapse
|
4
|
Baribeau DA, Arneja J, Wang X, Howe J, McLaughlin JR, Tu K, Guan J, Iaboni A, Kelley E, Ayub M, Nicolson R, Georgiades S, Scherer SW, Bronskill SE, Anagnostou E, Brooks JD. Linkage of whole genome sequencing and administrative health data in autism: A proof of concept study. Autism Res 2023; 16:1600-1608. [PMID: 37526168 DOI: 10.1002/aur.2999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/15/2023] [Indexed: 08/02/2023]
Abstract
Whether genetic testing in autism can help understand longitudinal health outcomes and health service needs is unclear. The objective of this study was to determine whether carrying an autism-associated rare genetic variant is associated with differences in health system utilization by autistic children and youth. This retrospective cohort study examined 415 autistic children/youth who underwent genome sequencing and data collection through a translational neuroscience program (Province of Ontario Neurodevelopmental Disorders Network). Participant data were linked to provincial health administrative databases to identify historical health service utilization, health care costs, and complex chronic medical conditions during a 3-year period. Health administrative data were compared between participants with and without a rare genetic variant in at least 1 of 74 genes associated with autism. Participants with a rare variant impacting an autism-associated gene (n = 83, 20%) were less likely to have received psychiatric care (at least one psychiatrist visit: 19.3% vs. 34.3%, p = 0.01; outpatient mental health visit: 66% vs. 77%, p = 0.04). Health care costs were similar between groups (median: $5589 vs. $4938, p = 0.4) and genetic status was not associated with odds of being a high-cost participant (top 20%) in this cohort. There were no differences in the proportion with complex chronic medical conditions between those with and without an autism-associated genetic variant. Our study highlights the feasibility and potential value of genomic and health system data linkage to understand health service needs, disparities, and health trajectories in individuals with neurodevelopmental conditions.
Collapse
Affiliation(s)
- Danielle A Baribeau
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jasleen Arneja
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | | | - Jennifer Howe
- The Centre for Applied Genomics, Department of Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - John R McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Karen Tu
- North York General Hospital and Toronto Western Family Health Team, University Health Network, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Alana Iaboni
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Elizabeth Kelley
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Muhammad Ayub
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- University College London, London, UK
| | - Robert Nicolson
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, Department of Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics and McLaughlin Centre, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Hurvitz Brain Sciences Program & Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jennifer D Brooks
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| |
Collapse
|
5
|
Cleary S, Teskey G, Mathews C, Sachachar RJ, Nicolson R, Weksberg R, Anagnostou E, Bowdish DME, Foster JA. Assessment of a multisite standardized biospecimen collection protocol for immune phenotyping in neurodevelopmental disorders. Sci Rep 2023; 13:6971. [PMID: 37117247 PMCID: PMC10147654 DOI: 10.1038/s41598-023-33380-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 04/12/2023] [Indexed: 04/30/2023] Open
Abstract
Multisite collection and preservation of peripheral blood mononuclear cells (PBMCs) for centralized analysis is an indispensable strategy for large cohort immune phenotyping studies. However, the absence of cross-site standardized protocols introduces unnecessary sample variance. Here we describe the protocol implemented by the Province of Ontario Neurodevelopmental Disorders (POND) Network's immune platform for the multisite collection, processing, and cryopreservation of PBMCs. We outline quality control standards and evaluate the performance of our PBMC processing and storage protocol. We also describe the Child Immune History Questionnaire results, an assessment tool evaluating pre-existing immune conditions in children with neurodevelopmental disorders (NDDs). Cell viability was assessed in samples from 178 participants based on strict quality control criteria. Overall, 83.1% of samples passed quality control standards. Samples collected and processed at the same site had higher quality control pass rates than samples that were collected and subsequently shipped to another site for processing. We investigated if freezer time impacted sample viability and found no difference in mean freezer time between samples that passed and failed quality control. The Child Immune History Questionnaire had a response rate of 87.1%. The described protocol produces viable samples that may be used in future immune phenotyping experiments.
Collapse
Affiliation(s)
- Shane Cleary
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- The Research Institute at St. Joe's, Hamilton, ON, Canada
| | - Grace Teskey
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Craig Mathews
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- The Research Institute at St. Joe's, Hamilton, ON, Canada
| | - Russell J Sachachar
- Department of Psychiatry, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - Robert Nicolson
- Lawson Health Research Institute and Western University, London, ON, Canada
| | - Rosanna Weksberg
- Division of Clinical and Metabolic Genetics and Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
- Departments of Pediatrics, University of Toronto, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Institiute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Departments of Pediatrics, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Dawn M E Bowdish
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | - Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
- The Research Institute at St. Joe's, Hamilton, ON, Canada.
| |
Collapse
|
6
|
Vandewouw MM, Brian J, Crosbie J, Schachar RJ, Iaboni A, Georgiades S, Nicolson R, Kelley E, Ayub M, Jones J, Taylor MJ, Lerch JP, Anagnostou E, Kushki A. Identifying Replicable Subgroups in Neurodevelopmental Conditions Using Resting-State Functional Magnetic Resonance Imaging Data. JAMA Netw Open 2023; 6:e232066. [PMID: 36912839 PMCID: PMC10011941 DOI: 10.1001/jamanetworkopen.2023.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
IMPORTANCE Neurodevelopmental conditions, such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD), have highly heterogeneous and overlapping phenotypes and neurobiology. Data-driven approaches are beginning to identify homogeneous transdiagnostic subgroups of children; however, findings have yet to be replicated in independently collected data sets, a necessity for translation into clinical settings. OBJECTIVE To identify subgroups of children with and without neurodevelopmental conditions with shared functional brain characteristics using data from 2 large, independent data sets. DESIGN, SETTING, AND PARTICIPANTS This case-control study used data from the Province of Ontario Neurodevelopmental (POND) network (study recruitment began June 2012 and is ongoing; data were extracted April 2021) and the Healthy Brain Network (HBN; study recruitment began May 2015 and is ongoing; data were extracted November 2020). POND and HBN data are collected from institutions across Ontario and New York, respectively. Participants who had diagnoses of ASD, ADHD, and OCD or were typically developing (TD); were aged between 5 and 19 years; and successfully completed the resting-state and anatomical neuroimaging protocol were included in the current study. MAIN OUTCOMES AND MEASURES The analyses consisted of a data-driven clustering procedure on measures derived from each participant's resting-state functional connectome, performed independently on each data set. Differences between each pair of leaves in the resulting clustering decision trees in the demographic and clinical characteristics were tested. RESULTS Overall, 551 children and adolescents were included from each data set. POND included 164 participants with ADHD; 217 with ASD; 60 with OCD; and 110 with TD (median [IQR] age, 11.87 [9.51-14.76] years; 393 [71.2%] male participants; 20 [3.6%] Black, 28 [5.1%] Latino, and 299 [54.2%] White participants) and HBN included 374 participants with ADHD; 66 with ASD; 11 with OCD; and 100 with TD (median [IQR] age, 11.50 [9.22-14.20] years; 390 [70.8%] male participants; 82 [14.9%] Black, 57 [10.3%] Hispanic, and 257 [46.6%] White participants). In both data sets, subgroups with similar biology that differed significantly in intelligence as well as hyperactivity and impulsivity problems were identified, yet these groups showed no consistent alignment with current diagnostic categories. For example, there was a significant difference in Strengths and Weaknesses ADHD Symptoms and Normal Behavior Hyperactivity/Impulsivity subscale (SWAN-HI) between 2 subgroups in the POND data (C and D), with subgroup D having increased hyperactivity and impulsivity traits compared with subgroup C (median [IQR], 2.50 [0.00-7.00] vs 1.00 [0.00-5.00]; U = 1.19 × 104; P = .01; η2 = 0.02). A significant difference in SWAN-HI scores between subgroups g and d in the HBN data was also observed (median [IQR], 1.00 [0.00-4.00] vs 0.00 [0.00-2.00]; corrected P = .02). There were no differences in the proportion of each diagnosis between the subgroups in either data set. CONCLUSIONS AND RELEVANCE The findings of this study suggest that homogeneity in the neurobiology of neurodevelopmental conditions transcends diagnostic boundaries and is instead associated with behavioral characteristics. This work takes an important step toward translating neurobiological subgroups into clinical settings by being the first to replicate our findings in independently collected data sets.
Collapse
Affiliation(s)
- Marlee M. Vandewouw
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Brian
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Russell J. Schachar
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alana Iaboni
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Robert Nicolson
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen’s University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
| | - Jessica Jones
- Department of Psychology, Queen’s University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
| | - Margot J. Taylor
- Program in Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Jason P. Lerch
- Program in Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Program in Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Azadeh Kushki
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
7
|
LaForge-MacKenzie K, Tombeau Cost K, Tsujimoto KC, Crosbie J, Charach A, Anagnostou E, Birken CS, Monga S, Kelley E, Burton CL, Nicolson R, Georgiades S, Korczak DJ. Participating in extracurricular activities and school sports during the COVID-19 pandemic: Associations with child and youth mental health. Front Sports Act Living 2022; 4:936041. [PMID: 36105001 PMCID: PMC9464933 DOI: 10.3389/fspor.2022.936041] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022] Open
Abstract
In Ontario, Canada, school extracurricular activities and sports were modified or canceled for a prolonged period due to public health restrictions resulting from the COVID-19 pandemic. The present study aims to examine the association of changes to extracurricular and sport participation and child and youth mental health. Data were collected on child and youth mental health symptoms (n = 908) and participation in extracurricular activities and sports in the 2019–2020 and 2020–2021 academic years. Results indicated that pre-COVID (2019–2020) participation in either extracurricular activities or sports was associated with reduced anxiety, inattention, and hyperactivity during the pandemic (β range −0.08 to −0.11, p < 0.05). Participation in either extracurricular activities or sports during-COVID (2020–2021) was associated with lower depressive symptoms (β range −0.09 to −0.10, p < 0.05). Findings suggest that participation in extracurricular activities and/or school sports both before or during the COVID-19 pandemic were associated with better mental health outcomes in children and youth. Implications of this work consider future situations where restrictions on extracurricular and sport participation are reinstated and the impact of child and youth mental health.
Collapse
Affiliation(s)
- Kaitlyn LaForge-MacKenzie
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Katherine Tombeau Cost
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Kimberley C. Tsujimoto
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alice Charach
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Holland Bloorview Research Institute, Toronto, ON, Canada
| | - Catherine S. Birken
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Suneeta Monga
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Kelley
- Department of Psychiatry, Queens University, Kingston, ON, Canada
- Department of Psychology, Faculty of Arts and Science, Queens University, Kingston, ON, Canada
| | - Christie L. Burton
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Robert Nicolson
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, Neuroscience and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Daphne J. Korczak
| |
Collapse
|
8
|
Penner M, Dupuis A, Arnold P, Ayub M, Crosbie J, Georgiades S, Kelley E, Nicolson R, Schachar R, Anagnostou E. Pubertal stage, sex and behaviour in neurodevelopmental disorders versus typical development: a cross-sectional study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001469. [PMID: 36053642 PMCID: PMC9403165 DOI: 10.1136/bmjpo-2022-001469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/15/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To determine the association between pubertal stage, sex and behavioural profile across and within neurodevelopmental disorders (NDDs) compared with typically developing (TD) youth. METHODS This was a cross-sectional study from the Province of Ontario Neurodevelopmental Disorders network, including children/youth with various NDDs and TD controls. Caregivers completed the Child Behavior Checklist (CBCL). Participants were grouped into three puberty stages: prepuberty (Tanner stage 1), early puberty (Tanner stages 2-3) and late puberty (Tanner stages 4-5). The association between pubertal stage and CBCL scores was assessed controlling for sex and diagnosis. RESULTS The analysis included 1043 participants (male=733; 70.3%). A three-way interaction between pubertal status, sex and diagnosis was not significant for internalising or externalising behaviour. Diagnosis was significantly associated with CBCL scores for both internalising (p<0.0001) and externalising (p<0.0001) behaviours, with lower scores for TD children than for NDD groups. Late pubertal females showed higher levels of internalising behaviour compared with prepubertal females (p=0.001); males showed no differences. Early pubertal males showed lower levels of externalising behaviour compared with prepubertal males (p=0.01); early pubertal females trended towards higher levels compared with prepubertal females (p=0.051). CONCLUSIONS Internalising/externalising patterns of behaviours across pubertal stages did not differ based on diagnosis. Pubertal females are at higher risk for internalising behaviours.
Collapse
Affiliation(s)
- Melanie Penner
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada .,Paediatrics, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Annie Dupuis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul Arnold
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Muhammad Ayub
- Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Jennifer Crosbie
- Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Russell Schachar
- Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| |
Collapse
|
9
|
Safar K, Vandewouw MM, Pang EW, de Villa K, Crosbie J, Schachar R, Iaboni A, Georgiades S, Nicolson R, Kelley E, Ayub M, Lerch JP, Anagnostou E, Taylor MJ. Shared and Distinct Patterns of Functional Connectivity to Emotional Faces in Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder Children. Front Psychol 2022; 13:826527. [PMID: 35356352 PMCID: PMC8959934 DOI: 10.3389/fpsyg.2022.826527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Impairments in emotional face processing are demonstrated by individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which is associated with altered emotion processing networks. Despite accumulating evidence of high rates of diagnostic overlap and shared symptoms between ASD and ADHD, functional connectivity underpinning emotion processing across these two neurodevelopmental disorders, compared to typical developing peers, has rarely been examined. The current study used magnetoencephalography to investigate whole-brain functional connectivity during the presentation of happy and angry faces in 258 children (5–19 years), including ASD, ADHD and typically developing (TD) groups to determine possible differences in emotion processing. Data-driven clustering was also applied to determine whether the patterns of connectivity differed among diagnostic groups. We found reduced functional connectivity in the beta band in ASD compared to TD, and a further reduction in the ADHD group compared to the ASD and the TD groups, across emotions. A group-by-emotion interaction in the gamma frequency band was also observed. Greater connectivity to happy compared to angry faces was found in the ADHD and TD groups, while the opposite pattern was seen in ASD. Data-driven subgrouping identified two distinct subgroups: NDD-dominant and TD-dominant; these subgroups demonstrated emotion- and frequency-specific differences in connectivity. Atypicalities in specific brain networks were strongly correlated with the severity of diagnosis-specific symptoms. Functional connectivity strength in the beta network was negatively correlated with difficulties in attention; in the gamma network, functional connectivity strength to happy faces was positively correlated with adaptive behavioural functioning, but in contrast, negatively correlated to angry faces. Our findings establish atypical frequency- and emotion-specific patterns of functional connectivity between NDD and TD children. Data-driven clustering further highlights a high degree of comorbidity and symptom overlap between the ASD and ADHD children.
Collapse
Affiliation(s)
- Kristina Safar
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Marlee M Vandewouw
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Elizabeth W Pang
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON, Canada.,Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kathrina de Villa
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Alana Iaboni
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Robert Nicolson
- Department of Psychiatry, Western University, London, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Department of Psychiatry,Queen's University, Kingston, ON, Canada
| | - Muhammed Ayub
- Department of Psychiatry,Queen's University, Kingston, ON, Canada
| | - Jason P Lerch
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON, Canada.,Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
10
|
Lambe LJ, Burton CL, Anagnostou E, Kelley E, Nicolson R, Georgiades S, Soreni N, Schachar RJ, Hanna GL, Arnold PD, Crosbie J. Clinical validation of the parent‐report Toronto Obsessive–Compulsive Scale (TOCS): A pediatric open‐source rating scale. JCPP Advances 2021. [DOI: 10.1002/jcv2.12056] [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: 11/06/2022] Open
Affiliation(s)
- Laura J. Lambe
- Program of Neurosciences and Mental Health Hospital for Sick Children Toronto Ontario Canada
| | - Christie L. Burton
- Program of Neurosciences and Mental Health Hospital for Sick Children Toronto Ontario Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute Holland Bloorview Kids Rehabilitation Hospital Toronto Ontario Canada
- Department of Pediatrics University of Toronto Toronto Ontario Canada
| | - Elizabeth Kelley
- Department of Psychology Queen's University Kingston Ontario Canada
| | - Robert Nicolson
- Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada
| | - Stelios Georgiades
- Department of Psychiatry & Behavioural Neurosciences McMaster University Hamilton Ontario Canada
| | - Noam Soreni
- Department of Psychiatry & Behavioural Neurosciences McMaster University Hamilton Ontario Canada
- Department of Psychiatry St. Joe's Healthcare Hamilton Ontario Canada
| | - Russell J. Schachar
- Program of Neurosciences and Mental Health Hospital for Sick Children Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Gregory L. Hanna
- Department of Psychiatry University of Michigan Ann Arbor Michigan USA
| | - Paul D. Arnold
- The Mathison Centre for Mental Health Research & Education Calgary Alberta Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Program of Genetics and Genome Biology Hospital for Sick Children Toronto Ontario Canada
| | - Jennifer Crosbie
- Program of Neurosciences and Mental Health Hospital for Sick Children Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| |
Collapse
|
11
|
Kuenzel E, Seguin D, Nicolson R, Duerden EG. Early adversity and positive parenting: Association with cognitive outcomes in children with autism spectrum disorder. Autism Res 2021; 14:2654-2662. [PMID: 34549545 DOI: 10.1002/aur.2613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/30/2021] [Accepted: 08/30/2021] [Indexed: 01/30/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and repetitive behaviors. Children with ASD are statistically more likely to experience early adversity; however, little is known about the types of early adversity that place these children at risk, the role of parenting as a protective factor, and how this early life stress impacts cognitive outcomes. We assessed early adversity in 302 children (ASD = 98) aged 6-16 years old, using parent-based report. To identify protective factors, we assessed parenting styles using parent surveys. Executive functions were assessed in the children using the WISC-V. Children with ASD had an increased incidence of familial stressors compared to the typically developing (TD) group. Positive parenting was associated with a significant decrease in the incidence of familial adverse events for both children with ASD and TD children. Examining the relationship between adversity and cognitive outcomes, in young children (6-11 years) with ASD, environmental stressors were associated with cognitive impairments. Findings suggest children with ASD may be at higher risk for familial adversity than their TD peers. However, all children benefit from positive parenting styles, which may mitigate the adverse effects of family-based early life stress. LAY SUMMARY: Some key features of Autism Spectrum Disorder (ASD) include difficulties with communication and social impairments. This means that children with ASD may be more likely to experience early adversity (stressful social interactions which take place during childhood) than children without ASD. Research in typically developing (TD) children has shown that experiencing more stressful events in childhood can cause changes in the brain, which can potentially impact the child's memory, reasoning, and decision-making skills later in life. However, there is evidence to suggest that having a nurturing relationship with a parent can offset some of the negative impacts of childhood adversity. In our study, we found that children with ASD are more likely to experience family-related stress compared to TD children. Having a positive relationship with a parent, however, was linked to experiencing this type of stress less often for all children, regardless of whether they were diagnosed with ASD. We also found that stressors related to environmental factors like financial instability were associated with lower cognitive abilities in children with ASD under 12 years of age. Understanding how these factors interact and differ in children with ASD can help to build stronger families and help children with ASD to thrive throughout their development.
Collapse
Affiliation(s)
- Elizabeth Kuenzel
- Applied Psychology, Faculty of Education, University of Western Ontario, London, Ontorio, Canada
| | - Diane Seguin
- Applied Psychology, Faculty of Education, University of Western Ontario, London, Ontorio, Canada.,Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontorio, Canada
| | - Robert Nicolson
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontorio, Canada
| | - Emma G Duerden
- Applied Psychology, Faculty of Education, University of Western Ontario, London, Ontorio, Canada.,Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontorio, Canada
| |
Collapse
|
12
|
Kushki A, Cardy RE, Panahandeh S, Malihi M, Hammill C, Brian J, Iaboni A, Taylor MJ, Schachar R, Crosbie J, Arnold P, Kelley E, Ayub M, Nicolson R, Georgiades S, Lerch JP, Anagnostou E. Cross-Diagnosis Structural Correlates of Autistic-Like Social Communication Differences. Cereb Cortex 2021; 31:5067-5076. [PMID: 34080611 PMCID: PMC8491692 DOI: 10.1093/cercor/bhab142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/10/2021] [Accepted: 04/27/2021] [Indexed: 11/14/2022] Open
Abstract
Social communication differences are seen in autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and obsessive–compulsive disorder (OCD), but the brain mechanisms contributing to these differences remain largely unknown. To address this gap, we used a data-driven and diagnosis-agnostic approach to discover brain correlates of social communication differences in ASD, ADHD, and OCD, and subgroups of individuals who share similar patterns of brain-behavior associations. A machine learning pipeline (regression clustering) was used to discover the pattern of association between structural brain measures (volume, surface area, and cortical thickness) and social communication abilities. Participants (n = 416) included children with a diagnosis of ASD (n = 192, age = 12.0[5.6], 19% female), ADHD (n = 109, age = 11.1[4.1], 18% female), or OCD (n = 50, age = 12.3[4.2], 42% female), and typically developing controls (n = 65, age = 11.6[7.1], 48% female). The analyses revealed (1) associations with social communication abilities in distributed cortical and subcortical networks implicated in social behaviors, language, attention, memory, and executive functions, and (2) three data-driven, diagnosis-agnostic subgroups based on the patterns of association in the above networks. Our results suggest that different brain networks may contribute to social communication differences in subgroups that are not diagnosis-specific.
Collapse
Affiliation(s)
- Azadeh Kushki
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada.,University of Toronto, Institute of Biomedical Engineering, Toronto, Ontario M5S 3G9, Canada
| | - Robyn E Cardy
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada.,University of Toronto, Institute of Biomedical Engineering, Toronto, Ontario M5S 3G9, Canada
| | - Sina Panahandeh
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada.,University of Toronto, Institute of Biomedical Engineering, Toronto, Ontario M5S 3G9, Canada
| | - Mahan Malihi
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada.,University of Toronto, Institute of Biomedical Engineering, Toronto, Ontario M5S 3G9, Canada
| | - Christopher Hammill
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario M5T 3H7, Canada
| | - Jessica Brian
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario M5G 1X8, Canada
| | - Alana Iaboni
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada
| | - Margot J Taylor
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada.,Department of Medical Imaging, University of Toronto, Toronto M5T 1W7, Canada
| | - Russell Schachar
- Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
| | - Paul Arnold
- Hotchkiss Brain Institute, Departments of Psychiatry & Medical Genetics, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Elizabeth Kelley
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, Ontario K7L 7X3, Canada
| | - Robert Nicolson
- Department of Psychiatry, Western University, London, Ontario M6c 0A7, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Jason P Lerch
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario M5T 3H7, Canada.,Program in Neuroscience and Mental Health, The Hospital for Sick Children, Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 0A4, Canada.,Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - Evdokia Anagnostou
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario M5G 1X8, Canada
| |
Collapse
|
13
|
Sanjeevan T, Hammill C, Brian J, Crosbie J, Schachar R, Kelley E, Liu X, Nicolson R, Iaboni A, Day Fragiadakis S, Ristic L, Lerch JP, Anagnostou E. Exploring the Neural Structures Underlying the Procedural Memory Network as Predictors of Language Ability in Children and Adolescents With Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder. Front Hum Neurosci 2020; 14:587019. [PMID: 33362492 PMCID: PMC7759764 DOI: 10.3389/fnhum.2020.587019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/17/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: There is significant overlap in the type of structural language impairments exhibited by children with autism spectrum disorder (ASD) and children with attention deficit hyperactivity disorder (ADHD). This similarity suggests that the cognitive impairment(s) contributing to the structural language deficits in ASD and ADHD may be shared. Previous studies have speculated that procedural memory deficits may be the shared cognitive impairment. The procedural deficit hypothesis (PDH) argues that language deficits can be explained by differences in the neural structures underlying the procedural memory network. This hypothesis is based on the premise that the neural structures comprising the procedural network support language learning. In this study, we aimed to test the PDH in children with ASD, ADHD, and typical development (TD). Methods: One hundred and sixty-three participants (ages 10–21): 91 with ASD, 26 with ADHD, and 46 with TD, completed standardized measures of cognitive and language ability as well as structural magnetic resonance imaging. We compared the structural language abilities, the neural structures underlying the procedural memory network, and the relationship between structural language and neural structure across diagnostic groups. Results: Our analyses revealed that while the structural language abilities differed across ASD, ADHD, and TD groups, the thickness, area, and volume of the structures supporting the procedural memory network were not significantly different between diagnostic groups. Also, several neural structures were associated with structural language abilities across diagnostic groups. Only two of these structures, the inferior frontal gyrus, and the left superior parietal gyrus, are known to be linked to the procedural memory network. Conclusions: The inferior frontal gyrus and the left superior parietal gyrus, have well-established roles in language learning independent of their role as part of the procedural memory system. Other structures such as the caudate and cerebellum, with critical roles in the procedural memory network, were not associated with structural language abilities across diagnostic groups. It is unclear whether the procedural memory network plays a fundamental role in language learning in ASD, ADHD, and TD.
Collapse
Affiliation(s)
- Teenu Sanjeevan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Jessica Brian
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Paediatrics, Medical Sciences Building, University of Toronto, Toronto, ON, Canada
| | - Jennifer Crosbie
- Psychiatry Research, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Russell Schachar
- Psychiatry Research, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Robert Nicolson
- Department of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Alana Iaboni
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Leanne Ristic
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jason P Lerch
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Paediatrics, Medical Sciences Building, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
14
|
Brierley NJ, McDonnell CG, Parks KMA, Schulz SE, Dalal TC, Kelley E, Anagnostou E, Nicolson R, Georgiades S, Crosbie J, Schachar R, Liu X, Stevenson RA. Factor Structure of Repetitive Behaviors Across Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. J Autism Dev Disord 2020; 51:3391-3400. [PMID: 33236274 DOI: 10.1007/s10803-020-04800-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 12/15/2022]
Abstract
Restricted interests and repetitive behaviors (RRBs) are core symptoms of autism spectrum disorder (ASD), and commonly occur in attention-deficit/hyperactivity disorder (ADHD). Little is known about how RRBs manifest in ADHD. We quantified and compared factor structures of RRBs in children with ASD (n = 634) or ADHD (n = 448), and related factors to sex and IQ. A four-factor solution emerged, including Stereotypy, Self-Injury, Compulsions, and Ritualistic/Sameness. Factor structures were equivalent across diagnoses, though symptoms were more severe in ASD. IQ negatively correlated with Stereotypy, Self-Injury, and Compulsions in ASD, and negatively correlated with Compulsions and Ritualistic/Sameness behaviors in ADHD. In ASD only, females exhibited higher Self-Injury. Thus, patterns of RRBs are preserved across ASD and ADHD, but severity and relationship with IQ differed.
Collapse
Affiliation(s)
- Noah J Brierley
- Department of Psychology, Western University, London, ON, Canada.
| | - Christina G McDonnell
- Department of Psychology, Western University, London, ON, Canada
- Brain and Mind Institute, Western University, London, ON, Canada
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Kaitlyn M A Parks
- Department of Psychology, Western University, London, ON, Canada
- Brain and Mind Institute, Western University, London, ON, Canada
| | - Samantha E Schulz
- Department of Psychology, Western University, London, ON, Canada
- Brain and Mind Institute, Western University, London, ON, Canada
| | - Tyler C Dalal
- Department of Psychology, Western University, London, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queens University, Kingston, ON, Canada
| | | | - Robert Nicolson
- Department of Psychiatry, Western University, London, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | | | - Xudong Liu
- Department of Psychiatry, Queens University, Kingston, ON, Canada
| | - Ryan A Stevenson
- Department of Psychology, Western University, London, ON, Canada
- Brain and Mind Institute, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Program in Neuroscience, Western University, London, ON, Canada
| |
Collapse
|
15
|
Siu MT, Butcher DT, Turinsky AL, Cytrynbaum C, Stavropoulos DJ, Walker S, Caluseriu O, Carter M, Lou Y, Nicolson R, Georgiades S, Szatmari P, Anagnostou E, Scherer SW, Choufani S, Brudno M, Weksberg R. Functional DNA methylation signatures for autism spectrum disorder genomic risk loci: 16p11.2 deletions and CHD8 variants. Clin Epigenetics 2019; 11:103. [PMID: 31311581 PMCID: PMC6636171 DOI: 10.1186/s13148-019-0684-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 05/15/2019] [Indexed: 12/19/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is a common and etiologically heterogeneous neurodevelopmental disorder. Although many genetic causes have been identified (> 200 ASD-risk genes), no single gene variant accounts for > 1% of all ASD cases. A role for epigenetic mechanisms in ASD etiology is supported by the fact that many ASD-risk genes function as epigenetic regulators and evidence that epigenetic dysregulation can interrupt normal brain development. Gene-specific DNAm profiles have been shown to assist in the interpretation of variants of unknown significance. Therefore, we investigated the epigenome in patients with ASD or two of the most common genomic variants conferring increased risk for ASD. Genome-wide DNA methylation (DNAm) was assessed using the Illumina Infinium HumanMethylation450 and MethylationEPIC arrays in blood from individuals with ASD of heterogeneous, undefined etiology (n = 52), and individuals with 16p11.2 deletions (16p11.2del, n = 9) or pathogenic variants in the chromatin modifier CHD8 (CHD8+/−, n = 7). Results DNAm patterns did not clearly distinguish heterogeneous ASD cases from controls. However, the homogeneous genetically-defined 16p11.2del and CHD8+/− subgroups each exhibited unique DNAm signatures that distinguished 16p11.2del or CHD8+/− individuals from each other and from heterogeneous ASD and control groups with high sensitivity and specificity. These signatures also classified additional 16p11.2del (n = 9) and CHD8 (n = 13) variants as pathogenic or benign. Our findings that DNAm alterations in each signature target unique genes in relevant biological pathways including neural development support their functional relevance. Furthermore, genes identified in our CHD8+/− DNAm signature in blood overlapped differentially expressed genes in CHD8+/− human-induced pluripotent cell-derived neurons and cerebral organoids from independent studies. Conclusions DNAm signatures can provide clinical utility complementary to next-generation sequencing in the interpretation of variants of unknown significance. Our study constitutes a novel approach for ASD risk-associated molecular classification that elucidates the vital cross-talk between genetics and epigenetics in the etiology of ASD. Electronic supplementary material The online version of this article (10.1186/s13148-019-0684-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- M T Siu
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - D T Butcher
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - A L Turinsky
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Centre for Computational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - C Cytrynbaum
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - D J Stavropoulos
- Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - S Walker
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - O Caluseriu
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - M Carter
- Department of Genetics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Y Lou
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - R Nicolson
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - S Georgiades
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - P Szatmari
- Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - E Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - S W Scherer
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.,The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - S Choufani
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - M Brudno
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Centre for Computational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - R Weksberg
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada. .,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada. .,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada. .,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. .,Institute of Medical Science, School of Graduate Studies, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
16
|
Mahendiran T, Dupuis A, Crosbie J, Georgiades S, Kelley E, Liu X, Nicolson R, Schachar R, Anagnostou E, Brian J. Sex Differences in Social Adaptive Function in Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder. Front Psychiatry 2019; 10:607. [PMID: 31572228 PMCID: PMC6751776 DOI: 10.3389/fpsyt.2019.00607] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Social-communication difficulties, a hallmark of ASD, autism spectrum disorder (ASD) are often observed in attention - deficit/ hyperactivity disorder (ADHD), although are not part of its diagnostic criteria. Despite sex differences in the prevalence of ASD and ADHD, research examining how sex differences manifest in social and communication functions in these disorders remains limited, and findings are mixed. This study investigated potential sex differences with age in social adaptive function across these disorders, relative to controls. Method: One hundred fifteen youth with ASD, 172 youth with ADHD, and 63 typically developing controls (age range 7-13 years, 75% males) were recruited from the Province of Ontario Neurodevelopmental Disorder (POND) Network. Social adaptive function was assessed using the Adaptive Behavior Assessment System-Second Edition (ABAS-II). The proportions of adaptive behaviors present in each skill area were analyzed as a binomial outcome using logistic regression, controlling for age, and testing for an age-by-sex interaction. In an exploratory analysis, we examined the impact of controlling for core symptom severity on the sex effect. Results: Significant sex-by-age interactions were seen within ASD in the communication (p = 0.005), leisure (p = 0.003), and social skill areas (p < 0.0001). In all three areas, lower scores (indicating poorer function) were found in females compared to males at older ages despite females performing better at younger ages. There were significant differences in the sex-by-age interactions in the social and leisure domains between those with ASD and typically developing controls, with typically developing females showing better scores at older, compared to younger, ages. There were also significant differences in the sex-by-age interactions between ASD and ADHD on the social and leisure domains, as females with ADHD consistently scored higher on social skills than males across all ages, unlike those with ASD. Sex differences across age in the social domains for ADHD were similar to those in the typically developing group. Conclusion: Sex differences in social and communication skill areas were observed between ASD and ADHD, and typically developing controls, with females with ASD performing worse than males at older ages, despite an earlier advantage. These findings reinforce the need to take a developmental approach to understanding sex differences which may have diagnostic, prognostic, and treatment implications.
Collapse
Affiliation(s)
- Tania Mahendiran
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada
| | - Annie Dupuis
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Robert Nicolson
- Department of Psychiatry, Western University and Children's Health Research Institute, London, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Jessica Brian
- Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
17
|
Lowther C, Speevak M, Armour C, Goh E, Graham G, Li C, Zeesman S, Nowaczyk MJM, Schultz LA, Morra A, Nicolson R, Rajguru M, Goobie S, Tarnopolsky MA, Prasad C, Dick PT, Hussain AS, Gazzellone M, Lionel AC, Marshall CR, Scherer SW, Stavropoulos DJ, McCready E, Bassett AS. MG-123 Exonic and intronic NRXN1 deletions: Novel genotype-phenotype correlations. J Med Genet 2015. [DOI: 10.1136/jmedgenet-2015-103578.23] [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: 11/03/2022]
|
18
|
Leow A, Yu CL, Lee SJ, Huang SC, Protas H, Nicolson R, Hayashi KM, Toga AW, Thompson PM. Brain structural mapping using a novel hybrid implicit/explicit framework based on the level-set method. Neuroimage 2005; 24:910-27. [PMID: 15652325 DOI: 10.1016/j.neuroimage.2004.09.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [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: 07/29/2004] [Revised: 09/08/2004] [Accepted: 09/15/2004] [Indexed: 10/26/2022] Open
Abstract
This paper presents a novel approach to feature-based brain image warping, by using a hybrid implicit/explicit framework, which unifies many prior approaches in a common framework. In the first step, we develop links between image warping and the level-set method, and we formulate the fundamental mathematics required for this hybrid implicit/explicit approach. In the second step, we incorporate the large-deformation models into these formulations, leading to a complete and elegant treatment of anatomical structure matching. In this latest approach, exact matching of anatomy is achieved by comparing the target to the warped source structure under the forward mapping and the source to the warped target structure under the backward mapping. Because anatomy is represented nonparametrically, a path is constructed linking the source to the target structure without prior knowledge of their point correspondence. The final point correspondence is constructed based on the linking path with the minimal energy. Intensity-similarity measures can be naturally incorporated in the same framework as landmark constraints by combining them in the gradient descent body forces. We illustrate the approach with two applications: (1) tensor-based morphometry of the corpus callosum in autistic children; and (2) matching cortical surfaces to measure the profile of cortical anatomic variation. In summary, the new mathematical techniques introduced here contribute fundamentally to the mapping of brain structure and its variation and provide a framework that unites feature and intensity-based image registration techniques.
Collapse
Affiliation(s)
- A Leow
- Department of Neurology, Laboratory of Neuro Imaging, UCLA School of Medicine, Los Angeles, CA 90095, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Calderoni D, Wudarsky M, Bhangoo R, Dell ML, Nicolson R, Hamburger SD, Gochman P, Lenane M, Rapoport JL, Leibenluft E. Differentiating childhood-onset schizophrenia from psychotic mood disorders. J Am Acad Child Adolesc Psychiatry 2001; 40:1190-6. [PMID: 11589532 DOI: 10.1097/00004583-200110000-00013] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The authors systematically examined a sample of patients who were referred to an ongoing National Institute of Mental Health (NIMH) study of childhood-onset schizophrenia (COS), but who received diagnoses of mood disorders at the NIMH, to analyze the reliability of these research-setting diagnoses and to characterize the patients clinically. Pilot data regarding the clinical course of these patients over a 2- to 7-year follow-up period were also obtained. METHOD Thirty-three cases were selected from the 215 pediatric patients who had been screened in person from 1991 to 1999 for admission to the COS study. These 33 patients had been excluded from the COS study on the basis of a day-long evaluation, including a structured diagnostic interview, which yielded a diagnosis of a mood disorder rather than schizophrenia. This subgroup, together with six COS subjects (for a total N= 39), were included in a diagnostic reliability study in which they were reevaluated by three psychiatrists who were blind to the initial research diagnosis. In addition, pilot follow-up data regarding current function and treatment status were obtained for 25 of the 33 patients with mood disorders. RESULTS Overall, the interrater reliability of the three raters was excellent (kappa = 0.90). Global reliability between these raters and the NIMH research diagnoses was good (average kappa across diagnoses = 0.61), and agreement for those patients who had mood disorders was good (86% agreement; kappa = 0.60). Pilot follow-up data indicate that none of the subjects with a diagnosed mood disorder developed a clinical course resembling schizophrenia. CONCLUSIONS Many of the patients referred to the NIMH COS study with clinical diagnoses of schizophrenia had psychotic mood disorders diagnosed on the basis of a comprehensive research evaluation including structured diagnostic interviews, and these research diagnoses were reliable. The diagnosis of COS is difficult and requires a time-consuming evaluation process.
Collapse
Affiliation(s)
- D Calderoni
- Child Psychiatry Branch, NIMH, Bethesda, MD 20892-1255, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Thompson PM, Vidal C, Giedd JN, Gochman P, Blumenthal J, Nicolson R, Toga AW, Rapoport JL. Mapping adolescent brain change reveals dynamic wave of accelerated gray matter loss in very early-onset schizophrenia. Proc Natl Acad Sci U S A 2001; 98:11650-5. [PMID: 11573002 PMCID: PMC58784 DOI: 10.1073/pnas.201243998] [Citation(s) in RCA: 528] [Impact Index Per Article: 23.0] [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: 11/18/2022] Open
Abstract
Neurodevelopmental models for the pathology of schizophrenia propose both polygenetic and environmental risks, as well as early (pre/perinatal) and late (usually adolescent) developmental brain abnormalities. With the use of brain mapping algorithms, we detected striking anatomical profiles of accelerated gray matter loss in very early-onset schizophrenia; surprisingly, deficits moved in a dynamic pattern, enveloping increasing amounts of cortex throughout adolescence. Early-onset patients were rescanned prospectively with MRI, at 2-year intervals at three time points, to uncover the dynamics and timing of disease progression during adolescence. The earliest deficits were found in parietal brain regions, supporting visuospatial and associative thinking, where adult deficits are known to be mediated by environmental (nongenetic) factors. Over 5 years, these deficits progressed anteriorly into temporal lobes, engulfing sensorimotor and dorsolateral prefrontal cortices, and frontal eye fields. These emerging patterns correlated with psychotic symptom severity and mirrored the neuromotor, auditory, visual search, and frontal executive impairments in the disease. In temporal regions, gray matter loss was completely absent early in the disease but became pervasive later. Only the latest changes included dorsolateral prefrontal cortex and superior temporal gyri, deficit regions found consistently in adult studies. These emerging dynamic patterns were (i) controlled for medication and IQ effects, (ii) replicated in independent groups of males and females, and (iii) charted in individuals and groups. The resulting mapping strategy reveals a shifting pattern of tissue loss in schizophrenia. Aspects of the anatomy and dynamics of disease are uncovered, in a changing profile that implicates genetic and nongenetic patterns of deficits.
Collapse
Affiliation(s)
- P M Thompson
- Laboratory of Neuro Imaging, Department of Neurology, Division of Brain Mapping, 4238 Reed Neurology, University of California School of Medicine, Los Angeles, CA 90095-1761, USA.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
|
22
|
Kumra S, Sporn A, Hommer DW, Nicolson R, Thaker G, Israel E, Lenane M, Bedwell J, Jacobsen LK, Gochman P, Rapoport JL. Smooth pursuit eye-tracking impairment in childhood-onset psychotic disorders. Am J Psychiatry 2001; 158:1291-8. [PMID: 11481165 DOI: 10.1176/appi.ajp.158.8.1291] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although childhood-onset schizophrenia is relatively rare, a sizable group of children with severe emotional disturbances have transient psychotic symptoms that fall outside of current syndrome boundaries. The relationship of this group of children to those with childhood-onset schizophrenia and other childhood psychiatric disorders is unclear. In this study, the authors compared smooth pursuit eye tracking, a biological trait marker associated with schizophrenia, of children and adolescents with psychotic disorder not otherwise specified to that of children with childhood-onset schizophrenia and healthy comparison subjects. METHOD By means of infrared oculography, smooth pursuit eye movements during a 17 degrees /second visual pursuit task were quantitatively and qualitatively compared in 55 young adolescents (29 with childhood-onset schizophrenia and 26 with psychotic disorder not otherwise specified) and their respective independent healthy comparison groups (a total of 38 healthy subjects). RESULTS Subjects with childhood-onset schizophrenia had qualitatively poorer eye tracking, higher root mean square error, lower gain, and a greater frequency of catch-up saccades than healthy children. Subjects with psychotic disorder not otherwise specified also had qualitatively poorer eye tracking, higher root mean square error, and lower gain than healthy children, but saccade frequency did not differ significantly. CONCLUSIONS Children with childhood-onset schizophrenia exhibit a pattern of eye-tracking dysfunction similar to that reported for adult patients. Similar abnormalities were seen in the subjects with psychotic disorder not otherwise specified except that they did not exhibit a greater frequency of catch-up saccades. Prospective longitudinal neurobiological and clinical follow-up studies of both groups are currently underway to further validate the distinction between these two disorders. Also, family studies are planned to establish whether eye-tracking dysfunction represents a trait- or state-related phenomenon in subjects with psychotic disorder not otherwise specified.
Collapse
Affiliation(s)
- S Kumra
- NIMH Child Psychiatry Branch, 10 Center Dr., Building 10, Rm. 3N202, Bethesda, MD 20892-1600, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Nicolson R, Lenane M, Brookner F, Gochman P, Kumra S, Spechler L, Giedd JN, Thaker GK, Wudarsky M, Rapoport JL. Children and adolescents with psychotic disorder not otherwise specified: a 2- to 8-year follow-up study. Compr Psychiatry 2001; 42:319-25. [PMID: 11458307 DOI: 10.1053/comp.2001.24573] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Although psychotic phenomena in children with disruptive behavior disorders are more common than expected, their prognostic significance is unknown. To examine the outcome of pediatric patients with atypical psychoses, a group of 26 patients with transient psychotic symptoms were evaluated with clinical and structured interviews at the time of initial contact (mean age, 11.6 +/- 2.7 years) and at follow-up 2 to 8 years later. Measures of functioning and psychopathology were also completed at their initial assessment. Risk factors associated with adult psychotic disorders (familial psychopathology, eyetracking dysfunction in patients and their relatives, obstetrical complications, and premorbid developmental course in the proband) had been obtained at study entry. On follow-up examination (mean age, 15.7 +/- 3.4 years), 13 patients (50%) met diagnostic criteria for a major axis I disorder: three for schizoaffective disorder, four for bipolar disorder, and six for major depressive disorder. The remaining 13 patients again received a diagnosis of psychotic disorder not otherwise specified (NOS), with most being in remission from their psychotic symptoms. Among this group who had not developed a mood or psychotic disorder, disruptive behavior disorders were exceedingly common at follow-up and were the focus of their treatment. Higher initial levels of psychopathology, lower cognitive abilities, and more developmental motor abnormalities were found in patients with a poor outcome. Obstetrical, educational, and family histories did not differ significantly between the groups. Through systematic diagnostic evaluation, children and adolescents with atypical psychotic disorders can be distinguished from those with schizophrenia, a difference with important treatment and prognostic implications. Further research is needed to delineate the course and outcome of childhood-onset atypical psychoses, but preliminary data indicate improvement in psychotic symptoms in the majority of patients and the development of chronic mood disorders in a substantial subgroup.
Collapse
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892-1600, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Yan WL, Guan XY, Green ED, Nicolson R, Yap TK, Zhang J, Jacobsen LK, Krasnewich DM, Kumra S, Lenane MC, Gochman P, Damschroder-Williams PJ, Esterling LE, Long RT, Martin BM, Sidransky E, Rapoport JL, Ginns EI. Childhood-onset schizophrenia/autistic disorder and t(1;7) reciprocal translocation: identification of a BAC contig spanning the translocation breakpoint at 7q21. Am J Med Genet 2000; 96:749-53. [PMID: 11121174 DOI: 10.1002/1096-8628(20001204)96:6<749::aid-ajmg10>3.0.co;2-k] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Childhood-onset schizophrenia (COS) is defined by the development of first psychotic symptoms by age 12. While recruiting patients with COS refractory to conventional treatments for a trial of atypical antipsychotic drugs, we discovered a unique case who has a familial t(1;7)(p22;q21) reciprocal translocation and onset of psychosis at age 9. The patient also has symptoms of autistic disorder, which are usually transient before the first psychotic episode among 40-50% of the childhood schizophrenics but has persisted in him even after the remission of psychosis. Cosegregating with the translocation, among the carriers in the family available for the study, are other significant psychopathologies, including alcohol/drug abuse, severe impulsivity, and paranoid personality and language delay. This case may provide a model for understanding the genetic basis of schizophrenia or autism. Here we report the progress toward characterization of genomic organization across the translocation breakpoint at 7q21. The polymorphic markers, D7S630/D7S492 and D7S2410/D7S646, immediately flanking the breakpoint, may be useful for further confirming the genetic linkage for schizophrenia or autism in this region. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:749-753, 2000. Published 2000 Wiley-Liss, Inc.
Collapse
Affiliation(s)
- W L Yan
- Child Psychiatry, National Institute of Mental Health, Bethesda, Maryland 20892-4405, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Nicolson R, Swedo SE, Lenane M, Bedwell J, Wudarsky M, Gochman P, Hamburger SD, Rapoport JL. An open trial of plasma exchange in childhood-onset obsessive-compulsive disorder without poststreptococcal exacerbations. J Am Acad Child Adolesc Psychiatry 2000; 39:1313-5. [PMID: 11026187 DOI: 10.1097/00004583-200010000-00020] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with childhood-onset obsessive-compulsive disorder (OCD) with symptom exacerbations following streptococcal infections benefit from treatment with plasma exchange. In this study, 5 patients with treatment-refractory OCD without a history of streptococcus-related exacerbations underwent an open 2-week course of therapeutic plasma exchange. Behavioral ratings, completed at baseline and 4 weeks after the initial treatment, included the Clinical Global Impressions Scale and the Yale-Brown Obsessive Compulsive Scale. All 5 patients completed the trial with few side effects, but none showed significant improvement. Plasma exchange does not benefit children and adolescents with OCD who do not have streptococcus-related exacerbations.
Collapse
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD, USA.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Nicolson R, Castellanos FX. Commentary: considerations on the pharmacotherapy of attention deficits and hyperactivity in children with autism and other pervasive developmental disorders. J Autism Dev Disord 2000; 30:461-2. [PMID: 11098884 DOI: 10.1023/a:1005511809545] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | | |
Collapse
|
27
|
Lougee L, Perlmutter SJ, Nicolson R, Garvey MA, Swedo SE. Psychiatric disorders in first-degree relatives of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). J Am Acad Child Adolesc Psychiatry 2000; 39:1120-6. [PMID: 10986808 DOI: 10.1097/00004583-200009000-00011] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the rates of psychiatric disorders in the first-degree relatives of children with infection-triggered obsessive-compulsive disorder (OCD) and/or tics (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections; PANDAS). METHOD The probands of this study were 54 children with PANDAS (n = 24 with a primary diagnosis of OCD; n = 30 with a primary diagnosis of a tic disorder). One hundred fifty-seven first-degree relatives (100 parents [93%] and 57 siblings [100%]) were evaluated for the presence of a tic disorder. One hundred thirty-nine first-degree relatives (100 parents [93%] and 39 of 41 siblings over the age of 6 [95%]) were evaluated with clinical and structured psychiatric interviews to determine the presence of subclinical OCD, OCD, and other DSM-IV Axis I disorders. RESULTS Twenty-one probands (39%) had at least one first-degree relative with a history of a motor or vocal tic; 6 mothers (11%), 9 fathers (19%), and 8 siblings (16%) received this diagnosis. Fourteen probands (26%) had at least one first-degree relative with OCD; 10 mothers (19%), 5 fathers (11%), and 2 siblings (5%), received this diagnosis. An additional 8 parents (8%) and 3 siblings (8%) met criteria for subclinical OCD. Eleven parents (11%) had obsessive-compulsive personality disorder. CONCLUSIONS The rates of tic disorders and OCD in first-degree relatives of pediatric probands with PANDAS are higher than those reported in the general population and are similar to those reported previously for tic disorders and OCD. Further study is warranted to determine the nature of the relationship between genetic and environmental factors in PANDAS.
Collapse
Affiliation(s)
- L Lougee
- Pediatrics and Developmental Neuropsychiatry Branch, NIMH, Bethesda, MD 20892-1255, USA.
| | | | | | | | | |
Collapse
|
28
|
|
29
|
|
30
|
Nicolson R, Lenane M, Singaracharlu S, Malaspina D, Giedd JN, Hamburger SD, Gochman P, Bedwell J, Thaker GK, Fernandez T, Wudarsky M, Hommer DW, Rapoport JL. Premorbid speech and language impairments in childhood-onset schizophrenia: association with risk factors. Am J Psychiatry 2000; 157:794-800. [PMID: 10784474 DOI: 10.1176/appi.ajp.157.5.794] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE As both premorbid neurodevelopmental impairments and familial risk factors for schizophrenia are prominent in childhood-onset cases (with onset of psychosis by age 12), their relationship was examined. METHOD Premorbid language, motor, and social impairments were assessed in a cohort of 49 patients with childhood-onset schizophrenia. Familial loading for schizophrenia spectrum disorders, familial eye-tracking dysfunction, and obstetrical complications were assessed without knowledge of premorbid abnormalities and were compared in the patients with and without developmental impairments. RESULTS Over one-half of the patients in this group had developmental dysfunction in each domain assessed. The patients with premorbid speech and language impairments had higher familial loading scores for schizophrenia spectrum disorders and more obstetrical complications, and their relatives had worse smooth-pursuit eye movements. The boys had more premorbid motor abnormalities, but early language and social impairments did not differ significantly between genders. There were no other significant relationships between premorbid social or motor abnormalities and the risk factors assessed here. CONCLUSIONS Premorbid developmental impairments are common in childhood-onset schizophrenia. The rates of three risk factors for schizophrenia (familial loading for schizophrenia spectrum disorders, familial eye-tracking dysfunction, and obstetrical complications) were increased for the probands with premorbid speech and language impairments, suggesting that the pathophysiology of schizophrenia involves the abnormal development of language-related brain regions.
Collapse
Affiliation(s)
- R Nicolson
- The Child Psychiatry Branch, NIMH, Bethesda, MD 20892-1600, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
|
32
|
Abstract
Childhood-onset schizophrenia (with an onset of psychosis by age 12) is a rare and severe form of the disorder which is clinically and neurobiologically continuous with the adult-onset disorder. Very early onset diseases provide an opportunity to look for more salient or striking risk or etiologic factors in a possibly more homogenous patient population. For the 47 patients with very early onset schizophrenia studied to date, there were more severe premorbid neurodevelopmental abnormalities, more cytogenetic anomalies, and potentially greater family histories of schizophrenia and associated spectrum disorders than later onset cases. There was no evidence for relatively increased obstetrical complications or environmental stress. These data, while preliminary, suggest a very early age of onset of schizophrenia may be secondary to greater genetic vulnerability. It is anticipated that future genetic studies of these patients may provide important etiologic information.
Collapse
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, National Institute of Mental Health, 10 Center Drive MSC 1600, Bethesda, MD, USA
| | | | | | | | | | | |
Collapse
|
33
|
Wudarsky M, Nicolson R, Hamburger SD, Spechler L, Gochman P, Bedwell J, Lenane MC, Rapoport JL. Elevated prolactin in pediatric patients on typical and atypical antipsychotics. J Child Adolesc Psychopharmacol 2000; 9:239-45. [PMID: 10630453 DOI: 10.1089/cap.1999.9.239] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
As part of systematic treatment trials of haloperidol, clozapine, and olanzapine with a total of 35 children and adolescents with early onset psychosis, prolactin was measured at baseline and week 6 of treatment. The National Institute of Mental Health patients--13 females, 22 males (mean age, 14.1+/-2.3 years; range, 9.1-19 years) with childhood onset schizophrenia (n = 32), or Psychotic Disorder not otherwise specified (NOS) (n = 3) with onset of psychosis before age 13--were recruited for open or double-blind trials of haloperidol, clozapine, or olanzapine. Baseline serum prolactin was measured after a 3-week washout period and after 6 weeks of treatment. Mean prolactin concentration after 6 weeks of treatment was significantly elevated on all three drugs; however, on clozapine, mean prolactin remained within the normal range. Prolactin was increased above the upper limit of normal for 100% of 10 patients on haloperidol, 70% of 10 patients on olanzapine, and 0% of 15 patients on clozapine (chi2 analyses: H > C, p = 0.004; O > C, p = 0.001). Given the potential endocrine and possible cardiac correlates of hyperprolactinemia, these more robust prolactin elevations in pediatric patients after short-term exposure to olanzapine than those reported for adults justify longer observation intervals with bigger samples to establish treatment safety of atypical antipsychotics in adolescents.
Collapse
Affiliation(s)
- M Wudarsky
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892-1600, USA.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Alfaro CL, Nicolson R, Lenane M, Rapoport JL. Carbamazepine and/or fluvoxamine drug interaction with risperidone in a patient on multiple psychotropic medications. Ann Pharmacother 2000; 34:122-3. [PMID: 10669197 DOI: 10.1345/aph.19223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
35
|
Usiskin SI, Nicolson R, Krasnewich DM, Yan W, Lenane M, Wudarsky M, Hamburger SD, Rapoport JL. Velocardiofacial syndrome in childhood-onset schizophrenia. J Am Acad Child Adolesc Psychiatry 1999; 38:1536-43. [PMID: 10596254 DOI: 10.1097/00004583-199912000-00015] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Deletion of chromosome 22q11 (velocardiofacial syndrome) is associated with early neurodevelopmental abnormalities and with schizophrenia in adults. The rate of 22q11 deletions was examined in a series of patients with childhood-onset schizophrenia (COS), in whom early premorbid developmental and cognitive impairments are more pronounced than in adult-onset cases. METHOD Through extensive recruiting and screening, a cohort of 47 patients was enrolled in a comprehensive study of very-early-onset schizophrenia. All were tested with fluorescence in situ hybridization for deletions on chromosome 22q11. RESULTS Three (6.4%) of 47 patients were found to have a 22q11 deletion. All 3 COS patients with 22q11 deletions had premorbid impairments of language, motor, and social development, although their physical characteristics varied. Brain magnetic resonance imaging revealed increased midbody corpus callosum area and ventricular volume in relation both to healthy controls and to other COS patients. CONCLUSIONS The rate of 22q11 deletions in COS is higher than in the general population (0.025%, p < .001) and may be higher than reported for adult-onset schizophrenia (2.0%, p = .09). These results suggest that 22q11 deletions may be associated with an earlier age of onset of schizophrenia, possibly mediated by a more salient neurodevelopmental disruption.
Collapse
Affiliation(s)
- S I Usiskin
- Child Psychiatry Branch, NIMH, Bethesda, MD, USA
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Abstract
Childhood-onset schizophrenia (defined by an onset of psychosis by age 12) is a rare and severe form of the disorder that is clinically and neurobiologically continuous with the adult-onset disorder. There is growing evidence for more salient risk or etiologic factors, particularly familial, in this possibly more homogeneous patient population. For the 49 patients with very early onset schizophrenia studied to date at the National Institute of Mental Health, there were more severe premorbid neuro-developmental abnormalities, a higher rate of cytogenetic anomalies, and a seemingly higher rate of familial schizophrenia and spectrum disorders than later onset cases. There was no evidence for increased obstetric complications or environmental stress. These data, while preliminary, suggest that a very early age of onset of schizophrenia may be secondary to greater familial vulnerability. Consequently, genetic studies of these patients may be particularly informative and may provide important etiologic information.
Collapse
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland 20892-1600, USA
| | | |
Collapse
|
37
|
Nicolson R, Malaspina D, Giedd JN, Hamburger S, Lenane M, Bedwell J, Fernandez T, Berman A, Susser E, Rapoport JL. Obstetrical complications and childhood-onset schizophrenia. Am J Psychiatry 1999; 156:1650-2. [PMID: 10518182 DOI: 10.1176/ajp.156.10.1650] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Increased obstetrical complications have been reported in individuals with adult-onset schizophrenia, with several studies finding an association between such complications and an earlier age at onset. Consequently, obstetrical records were examined for individuals with childhood-onset schizophrenia to determine if birth complications were more prevalent. METHOD The birth records of 36 patients with childhood-onset schizophrenia and 35 sibling comparison subjects were rated for birth complications by two psychiatrists who were unaware of group membership. RESULTS There were no significant differences between the groups in rates of obstetrical complications. Patients with such complications did not have a relatively earlier age at onset of schizophrenia. CONCLUSIONS A very early age at onset of schizophrenia is probably not due to birth complications.
Collapse
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, NIMH, Bethesda, Md. 20892-1600, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Giedd JN, Jeffries NO, Blumenthal J, Castellanos FX, Vaituzis AC, Fernandez T, Hamburger SD, Liu H, Nelson J, Bedwell J, Tran L, Lenane M, Nicolson R, Rapoport JL. Childhood-onset schizophrenia: progressive brain changes during adolescence. Biol Psychiatry 1999; 46:892-8. [PMID: 10509172 DOI: 10.1016/s0006-3223(99)00072-4] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Previous NIMH childhood onset schizophrenia (COS) anatomic brain MRI studies found progression of ventricular volume and other structural brain anomalies at 2-year follow up across mean ages 14 to 16 years. However, studies in adult patients generally do not show progression of ventricular volume or correlation of ventricular volume with duration of illness. To address issues of progression of brain anomalies in schizophrenia, this report extends previous studies to include a third longitudinal scan, uses a larger sample size, and includes measures of the amygdala and hippocampus. METHODS Volumes of the total cerebrum, lateral ventricles, hippocampus, and amygdala were quantified on 208 brain magnetic resonance imaging scans from 42 adolescents with COS (23 with one or more repeat scan) and 74 age- and gender-matched controls (36 with one or more repeat scan). A statistical technique permitting combined use of cross-sectional and longitudinal data was used to assess age-related changes, linearity, and diagnostic group differences. RESULTS Differential nonlinear progression of brain anomalies was seen during adolescence with the total cerebrum and hippocampus decreasing and lateral ventricles increasing in the COS group. The developmental curves for these structures reached an asymptote by early adulthood for the COS group and did not significantly change with age in the control group. CONCLUSIONS These findings reconcile less striking progression of anatomic brain images usually seen for adult schizophrenia and complement other data consistent with time-limited, diagnostic-specific decreases in brain tissue. Adolescence appears to be a unique period of differential brain development in schizophrenia.
Collapse
Affiliation(s)
- J N Giedd
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Nicolson R, Giedd JN, Lenane M, Hamburger S, Singaracharlu S, Bedwell J, Fernandez T, Thaker GK, Malaspina D, Rapoport JL. Clinical and neurobiological correlates of cytogenetic abnormalities in childhood-onset schizophrenia. Am J Psychiatry 1999; 156:1575-9. [PMID: 10518169 DOI: 10.1176/ajp.156.10.1575] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Cytogenetic abnormalities are increased in schizophrenia, suggesting a possible etiologic contribution. However, their clinical and pathophysiologic roles in the disorder are unknown. To investigate this, a group of children and adolescents participating in a comprehensive study of childhood-onset schizophrenia were screened for chromosomal abnormalities, and their clinical and neurobiological correlates were examined. METHOD Cytogenetic screening with the use of high-resolution banding, fluorescent in situ hybridization for chromosome 22q11 deletions, and molecular fragile X testing was undertaken in a group of 47 children and adolescents with very early onset of schizophrenia. Clinical, neurobiological (including brain morphometry), and risk factor measures of the subjects with cytogenetic abnormalities were compared with those of the remaining patients without cytogenetic anomalies. RESULTS Five patients had previously undiagnosed cytogenetic abnormalities. Lower performance IQ and more pronounced premorbid developmental impairments were seen in this subgroup. Rates of obstetric complications, familial schizophrenia spectrum disorders, and familial eye tracking dysfunction were similar for the patients with and without cytogenetic abnormalities. CONCLUSIONS Cytogenetic abnormalities appear to be increased in childhood-onset schizophrenia, suggesting an association with a very early age at onset. The data from the subgroup of patients with cytogenetic anomalies are consistent with a model in which a childhood onset of schizophrenia is due to a greater impairment of neurodevelopment secondary to the interaction of a number of factors, particularly genetic ones.
Collapse
Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, Yale University, New Haven, Conn., USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Rapoport JL, Giedd JN, Blumenthal J, Hamburger S, Jeffries N, Fernandez T, Nicolson R, Bedwell J, Lenane M, Zijdenbos A, Paus T, Evans A. Progressive cortical change during adolescence in childhood-onset schizophrenia. A longitudinal magnetic resonance imaging study. Arch Gen Psychiatry 1999; 56:649-54. [PMID: 10401513 DOI: 10.1001/archpsyc.56.7.649] [Citation(s) in RCA: 297] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Adolescence provides a window to examine regional and disease-specific late abnormal brain development in schizophrenia. Because previous data showed progressive brain ventricular enlargement for a group of adolescents with childhood-onset schizophrenia at 2-year follow-up, with no significant changes for healthy controls, we hypothesized that there would be a progressive decrease in volume in other brain tissue in these patients during adolescence. METHODS To examine cortical change, we used anatomical brain magnetic resonance imaging scans for 15 patients with childhood-onset schizophrenia (defined as onset of psychosis by age 12 years) and 34 temporally yoked, healthy adolescents at a mean (SD) age of 13.17 (2.73) years at initial baseline scan and 17.46 (2.96) years at follow-up scan. Cortical gray and white matter volumes were obtained with an automated analysis system that classifies brain tissue into gray matter, white matter, and cerebrospinal fluid and separates the cortex into anatomically defined lobar regions. RESULTS A significant decrease in cortical gray matter volume was seen for healthy controls in the frontal (2.6%) and parietal (4.1%) regions. For the childhood-onset schizophrenia group, there was a decrease in volume in these regions (10.9% and 8.5%, respectively) as well as a 7% decrease in volume in the temporal gray matter. Thus, the childhood-onset schizophrenia group showed a distinctive disease-specific pattern (multivariate analysis of variance for change X region X diagnosis: F, 3.68; P = .004), with the frontal and temporal regions showing the greatest between-group differences. Changes in white matter volume did not differ significantly between the 2 groups. CONCLUSIONS Patients with very early-onset schizophrenia had both a 4-fold greater decrease in cortical gray matter volume during adolescence and a disease-specific pattern of change. Etiologic models for these patients' illness, which seem clinically and neurobiologically continuous with later-onset schizophrenia, must take into account both early and late disruptions of brain development.
Collapse
Affiliation(s)
- J L Rapoport
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Md., USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
OBJECTIVE The presence of a 47, XYY karyotype in boys with pervasive developmental disorders (PDDs) has rarely been described in the past. Herein, 2 boys with PDDs and a supernumerary Y chromosome are presented. METHODS The case histories of the 2 patients are described along with the results of associated testing. The literature on psychosocial development as well as brain morphology and physiology in males with 47, XYY karyotypes is reviewed. RESULTS Both boys had presentations typical of PDDs, one with autistic disorder and the other with PDD not otherwise specified. CONCLUSION The finding that, in a clinic for children with developmental disorders, 2 of 40 male referrals had 47, XYY karyotypes suggests that the rate of this sex chromosome anomaly may be increased in PDDs. An extra Y chromosome may be related to abnormal brain development, which may, in turn, predispose vulnerable males to PDDs.
Collapse
Affiliation(s)
- R Nicolson
- Department of Psychiatry, University of Toronto, Ontario.
| | | | | |
Collapse
|
42
|
Abstract
OBJECTIVE To assess the benefits and side effects of risperidone in young autistic children. METHOD In this open, prospective trial, subjects were treated with risperidone for 12 weeks. All subjects were started at 0.5 mg daily with individual titration to a maximum of 6 mg or 0.1 mg/kg daily. Behavioral ratings, completed by the investigators and the children's parents, included the Clinical Global Impressions (CGI), Children's Psychiatric Rating Scale, Conners Parent-Teacher Questionnaire, Childhood Autism Rating Scale, and Abnormal Involuntary Movement Scale. RESULTS Ten boys, aged 4.5 to 10.8 years, were enrolled in the study and all completed the 12-week protocol. The mean final dose was 1.3 mg/day (range = 1 to 2.5 mg/day). On the basis of CGI-rated improvement, 8 of the 10 children were considered to be responders. Improvement was also demonstrated on the other scales. Transient sedation was common, and the children gained an average of 3.5 kg over the 12 weeks of the study. There was no evidence of either extrapyramidal symptoms or tardive dyskinesia. CONCLUSIONS These results suggest that risperidone may be safe and leads to improvements in several behavioral symptoms in young children with autism. Controlled studies of risperidone in young autistic children are warranted.
Collapse
Affiliation(s)
- R Nicolson
- Department of Psychiatry, University of Toronto
| | | | | |
Collapse
|
43
|
|
44
|
Abstract
A computer-based tutorial for speech and language therapy students is described in which a digitized video-recording of a diagnostic interview with a voice-disordered client was dynamically linked to an on-screen transcript window. A student-centered tutorial package, which provided guidance through questions, assessment tasks, and commentary from an experienced speech and language pathologist as well as the lecturer in voice disorder, was constructed. Evaluation of the tutorial as an aid to active learning, including feedback from students and supervising clinicians, is reported and the role of this type of program as a preparation for clinical practice is discussed.
Collapse
Affiliation(s)
- M Freeman
- Philippa Cottam Clinic, Speech Science Unit, University of Sheffield, England.
| | | | | |
Collapse
|
45
|
|
46
|
Abstract
Elevation of non-esterified fatty acids (NEFA) in vivo is associated with abnormal control of TSH. To determine whether TSH secretion is directly inhibited by NEFA, as has been reported for GH, cultured rat anterior pituitary cells were exposed for 20 h to oleic acid in medium containing 7.7 x 10(-5) mol/l bovine serum albumin (BSA). In a molar ratio with albumin of 1.2 (total oleic acid 9 x 10(-5) mol/l), or greater, oleic acid inhibited basal GH secretion (maximum inhibition to 40% of control) while basal TSH was less affected, a ratio of 3 (2.3 x 10(-4) mol/l oleic acid) or greater causing a smaller degree of inhibition (maximum inhibition to 80% of control). In the presence of 10(-9) mol/l growth hormone-releasing hormone or 10(-8) mol/l TRH, inhibition was achieved at a ratio of 12 (9 x 10(-4) mol/l oleic acid) or greater. Basal TSH was less sensitive to inhibition by thyroxine (T4) in the presence of oleic acid/albumin at a ratio of 6 or greater, and inhibition by oleic acid was less than additive with T4 at a ratio of 6 or greater. Responses to tri-iodothyronine (T3) were unaffected at a ratio of 6 (4.6 x 10(-4) mol/l oleic acid), but a ratio of 12 inhibited the effects of both T3 and T4 on TSH.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- J A Kennedy
- Department of Clinical Chemistry, Queen Elizabeth Hospital, Woodville, South Australia
| | | | | |
Collapse
|
47
|
Affiliation(s)
- R Nicolson
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | | |
Collapse
|
48
|
Peakman T, Crouzet J, Mayaux JF, Busby S, Mohan S, Harborne N, Wootton J, Nicolson R, Cole J. Nucleotide sequence, organisation and structural analysis of the products of genes in the nirB-cysG region of the Escherichia coli K-12 chromosome. Eur J Biochem 1990; 191:315-23. [PMID: 2200672 DOI: 10.1111/j.1432-1033.1990.tb19125.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The DNA sequence and derived amino-acid sequence of a 5618-base region in the 74-min area of the Escherichia coli chromosome has been determined in order to locate the structural gene, nirB, for the NADH-dependent nitrite reductase and a gene, cysG, required for the synthesis of the sirohaem prosthetic group. Three additional open reading frames, nirD, nirE and nirC, were found between nirB and cysG. Potential binding sites on the NirB protein for NADH and FAD, as well as conserved central core and interface domains, were deduced by comparing the derived amino-acid sequence with those of database proteins. A directly repeated sequence, which includes the motif -Cys-Xaa-Xaa-Cys-, is suggested as the binding site for either one [4Fe-4S] or two [2Fe-2S] clusters. The nirD gene potentially encodes a soluble, cytoplasmic protein of unknown function. No significant similarities were found between the derived amino-acid sequence of NirD and either NirB or any other protein in the database. If the nirE open reading frame is translated, it would encode a 33-amino-acid peptide of unknown function which includes 8 phenylalanyl residues. The product of the nirC gene is a highly hydrophobic protein with regions of amino-acid sequence similar to cytochrome oxidase polypeptide 1.
Collapse
Affiliation(s)
- T Peakman
- School of Biochemistry, University of Birmingham, England
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
MacLennan AH, Green RC, Grant P, Nicolson R. Ripening of the human cervix and induction of labor with intracervical purified porcine relaxin. Obstet Gynecol 1986; 68:598-601. [PMID: 3531936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In a randomized double-blind placebo-controlled trial involving 71 patients, a viscous gel containing distilled water or 1 or 2 mg pure porcine relaxin was instilled in the cervical canal on the evening before the surgical induction of labor. Eleven of 48 patients receiving relaxin labored overnight, whereas only one of 23 patients went into labor. Only the 2-mg dose significantly improved the mean cervical score compared with the placebo treatment; the effect was greatest in primigravid patients with unripe cervixes. Intracervical application appeared to confer no benefit over vaginal application in effecting cervical ripening or inducing labor. Systemic absorption of the porcine relaxin after its intracervical application was confirmed by the measurement of immunoreactive relaxin in a homologous porcine relaxin radioimmunoassay. Thus, the cervical ripening effect of exogenous relaxin may be mediated either systemically or by direct action at the site of local application. This trial confirms the responsiveness of the human term cervix to exogenous relaxin and supports the suggestion that endogenous relaxin may play a similar role at term in facilitating cervical ripening and parturition.
Collapse
|
50
|
Abstract
Serum relaxin immunoreactivity was measured by means of a porcine relaxin radioimmunoassay in 35 patients with severe pelvic pain and pelvic joint instability during late pregnancy. Results were compared with a control group of 368 samples obtained throughout pregnancy from normal singleton pregnancies. Most of the relaxin concentrations in the study group were above the 95% confidence limits of the median for the corresponding gestational age in the control group. The difference in relaxin levels between the study and control groups in the third trimester was highly significant. Relaxin levels in patients with pelvic pain were close to normal non-pregnant levels by the third postnatal day. The highest relaxin levels during pregnancy were found in the patients who were the most incapacitated clinically. The results suggest that there may be an association between high serum relaxin levels and pelvic pain and joint laxity during late pregnancy.
Collapse
|