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McLellan J, Croen LA, Iosif AM, Ashwood P, Yoshida C, Berger K, Van de Water J. Differences in mid-gestational and early postnatal neonatal cytokines and chemokines are associated with patterns of maternal autoantibodies in the context of autism. Cereb Cortex 2024; 34:50-62. [PMID: 38696596 PMCID: PMC11065110 DOI: 10.1093/cercor/bhae082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/25/2024] [Accepted: 01/06/2024] [Indexed: 05/04/2024] Open
Abstract
Associations between maternal immune dysregulation (including autoimmunity and skewed cytokine/chemokine profiles) and offspring neurodevelopmental disorders such as autism have been reported. In maternal autoantibody-related autism, specific maternally derived autoantibodies can access the fetal compartment to target eight proteins critical for neurodevelopment. We examined the relationship between maternal autoantibodies to the eight maternal autoantibody-related autism proteins and cytokine/chemokine profiles in the second trimester of pregnancy in mothers of children later diagnosed with autism and their neonates' cytokine/chemokine profiles. Using banked maternal serum samples from 15 to 19 weeks of gestation from the Early Markers for Autism Study and corresponding banked newborn bloodspots, we identified three maternal/offspring groups based on maternal autoantibody status: (1) mothers with autoantibodies to one or more of the eight maternal autoantibody-related autismassociated proteins but not a maternal autoantibody-related autism-specific pattern, (2) mothers with a known maternal autoantibody-related autism pattern, and (3) mothers without autoantibodies to any of the eight maternal autoantibody-related autism proteins. Using a multiplex platform, we measured maternal second trimester and neonatal cytokine/chemokine levels. This combined analysis aimed to determine potential associations between maternal autoantibodies and the maternal and neonatal cytokine/chemokine profiles, each of which has been shown to have implications on offspring neurodevelopment independently.
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Affiliation(s)
- Janna McLellan
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Clinical Immunology, University of California Davis, 451 Health Sciences Drive, Suite 6505C, Davis, CA 95616, United States
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, United States
| | - Ana-Maria Iosif
- Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Medical Sciences 1C, Davis, CA, 95616, United States
| | - Paul Ashwood
- MIND Institute, University of California Davis, 2805 Wet Lab Building, Sacramento, CA 95817, United States
- Department of Medical Microbiology and Immunology, University of California Davis, 3146 One Shields Avenue, Tupper Hall, Davis, CA 95616, United States
| | - Cathleen Yoshida
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, United States
| | - Kimberly Berger
- Sequoia Foundation, 741 Addison Suite B, Berkeley, CA 94710, United States
| | - Judy Van de Water
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Clinical Immunology, University of California Davis, 451 Health Sciences Drive, Suite 6505C, Davis, CA 95616, United States
- MIND Institute, University of California Davis, 2805 Wet Lab Building, Sacramento, CA 95817, United States
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Krug MK, Takarae Y, Iosif AM, Solomon M. Decision-making under conditions of explicit risk and uncertainty in autistic and typically developing adolescents and young adults. Cereb Cortex 2024; 34:1-7. [PMID: 38696604 DOI: 10.1093/cercor/bhae097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/25/2024] [Accepted: 02/17/2024] [Indexed: 05/04/2024] Open
Abstract
Adolescence has been characterized as a period of risky and possibly suboptimal decision-making, yet the development of decision-making in autistic adolescents is not well understood. To investigate decision-making in autism, we evaluated performance on 2 computerized tasks capturing decision-making under explicit risk and uncertainty in autistic and non-autistic adolescents/young adults ages 12-22 years. Participants completed the Game of Dice Task (32 IQ-matched participant pairs) to assess decision-making under explicit risk and the modified Iowa Gambling Task (35 IQ-matched pairs) to assess decision-making under uncertainty. Autistic participants overall made riskier decisions than non-autistic participants on the Game of Dice Task, and the odds of making riskier decisions varied by age and IQ. In contrast, the autistic group showed comparable levels of learning over trial blocks to the non-autistic group on the modified Iowa Gambling Task. For both tasks, younger autistic participants performed poorer than their non-autistic counterparts, while group differences diminished in older ages. This age-related pattern suggests positive development during adolescence on risk assessment and decision-making in autism but also implies differential developmental trajectories between groups. These findings also suggest differential performance by the risk type, with additional complex influences of IQ and fluid cognition, which warrants further investigations.
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Affiliation(s)
- Marie K Krug
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, CA 95817, United States
| | - Yukari Takarae
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, CA 95817, United States
| | - Ana-Maria Iosif
- Department of Public Health Sciences and MIND Institute, University of California, Davis, CA 95616, United States
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, MIND Institute, and Imaging Research Center, University of California, Davis, CA 95817, United States
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Yellowlees PM, Burke MM, Gonzalez AD, Fisher A, Chan SR, Hilty DM, McCarron RM, Scher LM, Sciolla AF, Shore J, Xiong G, Fine J, Bannister J, Iosif AM. Patient and Provider Satisfaction with Asynchronous Versus Synchronous Telepsychiatry in Primary Care: A Secondary Mixed-Methods Analysis of a Randomized Controlled Trial. Telemed J E Health 2024; 30:e1049-e1063. [PMID: 38011623 PMCID: PMC11035926 DOI: 10.1089/tmj.2023.0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Asynchronous telepsychiatry (ATP) consultations are a novel form of psychiatric consultation. Studies comparing patient and provider satisfaction for ATP with that for synchronous telepsychiatry (STP) do not exist. Methods: This mixed-methods study is a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial of ATP compared with STP. Patients and their PCPs completed satisfaction surveys, and provided unstructured feedback about their experiences with either ATP or STP. Differences in patient satisfaction were assessed using mixed-effects logistic regression models, and the qualitative data were analyzed using thematic analysis with an inductive coding framework. Results: Patient satisfaction overall was high with 84% and 97% of respondents at 6 months reported being somewhat or completely satisfied with ATP and STP, respectively. Patients in the STP group were more likely to report being completely satisfied, to recommend the program to a friend, and to report being comfortable with their care compared with ATP (all p < 0.05). However, there was no difference between the patients in ATP and STP in perceived change in clinical outcomes (p = 0.51). The PCP quantitative data were small, and thus only summarized descriptively. Conclusions: Patients expressed their overall satisfaction with both STP and ATP. Patients in ATP reported more concerns about the process, likely because feedback after ATP was slower than that after STP consultations. PCPs had no apparent preference for STP or ATP, and reported implementing the psychiatrists' recommendations for both groups when such recommendations were made, which supports our previous findings. Trial Registration: ClinicalTrials.gov NCT02084979; https://clinicaltrials.gov/ct2/show/NCT02084979.
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Affiliation(s)
- Peter M. Yellowlees
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Michelle M. Burke
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Alvaro D. Gonzalez
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Alice Fisher
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Steven R. Chan
- Stanford University School of Medicine, Stanford, California, USA
- Veterans Administration Palo Alto Healthcare System, Palo Alto, California, USA
| | | | - Robert M. McCarron
- Department of Psychiatry, University of California, Irvine, California, USA
| | - Lorin M. Scher
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Andres F. Sciolla
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Jay Shore
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
| | - Glen Xiong
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Jeffrey Fine
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Jennifer Bannister
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, California, USA
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Elahi H, Iosif AM, Mukherjee P, Hinshaw SP, Schweitzer JB. Using Hot and Cool Measures to Phenotype and Predict Functional Outcomes Across Dimensions of ADHD and Typical Development in Adolescents. Res Child Adolesc Psychopathol 2024; 52:579-593. [PMID: 38038753 DOI: 10.1007/s10802-023-01149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/02/2023]
Abstract
Multiple pathway models propose that attention deficit hyperactivity disorder (ADHD) arises from dysfunction in separate systems comprised of a "cool" or cognitive pathway versus a "hot" or emotional/reward pathway. Interactions between these pathways and the degree of maturation may further determine functional outcomes for adolescents ranging from those diagnosed with ADHD to typical development (TD). We used a latent profile analysis on rating scales and behavioral task performance assessing emotion, irritability, impulsivity, risk-taking, future orientation, and processing speed (PS) to identify subgroups of TD adolescents and adolescents with ADHD (N = 152) based on the hot and cool pathway model. We identified four classes: 1) High-Complex Challenges; 2) Moderate-Mixed Challenges; 3) Non-Emotive Impulsivity; and 4) High Regulation and Control. A multiple pathway model of ADHD is supported with classes differing in degree of emotional lability and irritability, types of impulsivity, and ability to use future consequences to modulate impulsivity and PS. The classes differed regarding functional behavior, with the High-Complex class demonstrating the most severe functional challenges in academic-related functioning. The Moderate-Mixed class also displayed significant functional challenges but with moderate emotional lability and irritability ratings. The Non-Emotive Impulsivity class exhibited low emotionality and low irritability, yet high impulsivity with limited negative functional consequences, and was composed of a mix of ADHD and TD adolescents. Differences between classes suggest ADHD symptomatology may represent both categorical and dimensional differences. Precision health interventions may be more effective in addressing the specific challenges associated with the classes rather than a one-size-fits-all approach to treating ADHD.
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Affiliation(s)
- Heather Elahi
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, 95817, USA
- MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis, CA, USA
| | - Prerona Mukherjee
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, 95817, USA
- MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, 95817, USA.
- MIND Institute, University of California, Davis, Sacramento, CA, USA.
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Lesh TA, Iosif AM, Tanase C, Vlasova RM, Ryan AM, Bennett J, Hogrefe CE, Maddock RJ, Geschwind DH, Van de Water J, McAllister AK, Styner MA, Bauman MD, Carter CS. Extracellular free water elevations are associated with brain volume and maternal cytokine response in a longitudinal nonhuman primate maternal immune activation model. Mol Psychiatry 2023; 28:4185-4194. [PMID: 37582858 PMCID: PMC10867284 DOI: 10.1038/s41380-023-02213-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 08/17/2023]
Abstract
Maternal infection has emerged as an important environmental risk factor for neurodevelopmental disorders, including schizophrenia and autism spectrum disorders. Animal model systems of maternal immune activation (MIA) suggest that the maternal immune response plays a significant role in the offspring's neurodevelopment and behavioral outcomes. Extracellular free water is a measure of freely diffusing water in the brain that may be associated with neuroinflammation and impacted by MIA. The present study evaluates the brain diffusion characteristics of male rhesus monkeys (Macaca mulatta) born to MIA-exposed dams (n = 14) treated with a modified form of the viral mimic polyinosinic:polycytidylic acid at the end of the first trimester. Control dams received saline injections at the end of the first trimester (n = 10) or were untreated (n = 4). Offspring underwent diffusion MRI scans at 6, 12, 24, 36, and 45 months. Offspring born to MIA-exposed dams showed significantly increased extracellular free water in cingulate cortex gray matter starting as early as 6 months of age and persisting through 45 months. In addition, offspring gray matter free water in this region was significantly correlated with the magnitude of the maternal IL-6 response in the MIA-exposed dams. Significant correlations between brain volume and extracellular free water in the MIA-exposed offspring also indicate converging, multimodal evidence of the impact of MIA on brain development. These findings provide strong evidence for the construct validity of the nonhuman primate MIA model as a system of relevance for investigating the pathophysiology of human neurodevelopmental psychiatric disorders. Elevated free water in individuals exposed to immune activation in utero could represent an early marker of a perturbed or vulnerable neurodevelopmental trajectory.
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Affiliation(s)
- Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Costin Tanase
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Roza M Vlasova
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Amy M Ryan
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
- MIND Institute, University of California, Davis, CA, USA
- California National Primate Research Center, Davis, CA, USA
| | - Jeffrey Bennett
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | | | - Richard J Maddock
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Daniel H Geschwind
- Neurogenetics Program, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Judy Van de Water
- MIND Institute, University of California, Davis, CA, USA
- Rheumatology/Allergy and Clinical Immunology, University of California, Davis, CA, USA
| | - A Kimberley McAllister
- MIND Institute, University of California, Davis, CA, USA
- Center for Neuroscience, University of California, Davis, CA, USA
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa D Bauman
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
- MIND Institute, University of California, Davis, CA, USA
- California National Primate Research Center, Davis, CA, USA
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA.
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Davis K, Iosif AM, Nordahl CW, Solomon M, Krug MK. Video Game Use, Aggression, and Social Impairment in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3567-3580. [PMID: 35821547 PMCID: PMC10465670 DOI: 10.1007/s10803-022-05649-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
We used parent report data to investigate video game playing, aggression, and social impairment in adolescents with autism spectrum disorder. Parents of autistic adolescents were more likely to report that their child plays video games as a hobby compared to parents of adolescents with typical development and also reported that their children spent more time playing video games. For autistic participants, we found no differences in aggression levels or social impairment when comparing players versus non-players. However, playing video games "more than average," as compared to "average" was associated with greater aggression and greater social impairment on "awareness" and "mannerisms" subscales. Future studies should focus on how type of video game(s) played is associated with these clinically important variables.
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Affiliation(s)
- Konnor Davis
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Sacramento, USA
| | - Christine Wu Nordahl
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
- Imaging Research Center, University of California Davis, Sacramento, USA
| | - Marie K Krug
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA.
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA.
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Minor GN, Hannula DE, Gordon A, Ragland JD, Iosif AM, Solomon M. Relational memory weakness in autism despite the use of a controlled encoding task. Front Psychol 2023; 14:1210259. [PMID: 37691809 PMCID: PMC10484720 DOI: 10.3389/fpsyg.2023.1210259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Recent work challenged past findings that documented relational memory impairments in autism. Previous studies often relied solely on explicit behavioral responses to assess relational memory integrity, but successful performance on behavioral tasks may rely on other cognitive abilities (e.g., executive functioning) that are impacted in some autistic individuals. Eye-tracking tasks do not require explicit behavioral responses, and, further, eye movements provide an indirect measure of memory. The current study examined whether memory-specific viewing patterns toward scenes differ between autistic and non-autistic individuals. Methods Using a long-term memory paradigm that equated for complexity between item and relational memory tasks, participants studied a series of scenes. Following the initial study phase, scenes were re-presented, accompanied by an orienting question that directed participants to attend to either features of an item (i.e., in the item condition) or spatial relationships between items (i.e., in the relational condition) that might be subsequently modified during test. At test, participants viewed scenes that were unchanged (i.e., repeated from study), scenes that underwent an "item" modification (an exemplar switch) or a "relational" modification (a location switch), and scenes that had not been presented before. Eye movements were recorded throughout. Results During study, there were no significant group differences in viewing directed to regions of scenes that might be manipulated at test, suggesting comparable processing of scene details during encoding. However, there was a group difference in explicit recognition accuracy for scenes that underwent a relational change. Marginal group differences in the expression of memory-based viewing effects during test for relational scenes were consistent with this behavioral outcome, particularly when analyses were limited to scenes recognized correctly with high confidence. Group differences were also evident in correlational analyses that examined the association between study phase viewing and recognition accuracy and between performance on the Picture Sequence Memory Test and recognition accuracy. Discussion Together, our findings suggest differences in the integrity of relational memory representations and/or in the relationships between subcomponents of memory in autism.
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Affiliation(s)
- Greta N. Minor
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Deborah E. Hannula
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Andrew Gordon
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
| | - J. Daniel Ragland
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
| | - Ana-Maria Iosif
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
| | - Marjorie Solomon
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
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Kim DHJ, Iosif AM, Ramirez-Celis A, Ashwood P, Ames JL, Lyall K, Berger K, Croen LA, Van de Water J. Neonatal immune signatures differ by sex regardless of neurodevelopmental disorder status: Macrophage migration inhibitory factor (MIF) alone reveals a sex by diagnosis interaction effect. Brain Behav Immun 2023; 111:328-333. [PMID: 37164311 PMCID: PMC10796272 DOI: 10.1016/j.bbi.2023.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/10/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023] Open
Abstract
Immune dysregulation, including aberrant peripheral cytokine/chemokine levels, is implicated in neurodevelopmental disorders (NDD) such as autism spectrum disorder (ASD). While the diagnosis of ASD is more common in males compared to females, sex effects in immune dysregulation related to neurodevelopment remain understudied. The aim of this exploratory study was to determine whether there are sex-specific effects in neonatal immune dysregulation with respect to an ASD or delayed development (DD) diagnosis. We utilized the data from the Early Markers for Autism study, a population based case-control study of prenatal and neonatal biomarkers of ASD. The immune profile of newborns later diagnosed with ASD (n = 482, 91 females), DD (n = 140, 61 females) and sex-matched general population controls (GP; n = 378, 67 females) were analyzed using neonatal bloodspots (NBS) via 42-plex multiplex assay. Multiple linear regression analysis was performed to identify whether sex was associated with differences in cytokine/chemokine levels of children with ASD, DD, and GP. A sex by diagnosis interaction effect was observed only for the chemokine macrophage migration inhibitory factor (MIF), with males displaying higher levels of NBS MIF than females in the GP control group (p = 0.02), but not in ASD (p = 0.52) or DD (p = 0.29) groups. We found that regardless of child diagnosis, newborn bloodspot eluates from females had a significantly higher concentration than males with the same diagnosis of the chemokines granulocyte chemotactic protein 2 (GCP-2; p < 0.0001), macrophage inflammatory protein 2-alpha (GROβ; p = 0.002), interferon-inducible t-cell alpha chemoattractant (I-TAC; p < 0.0001), stromal cell-derived factor 1 alpha and beta (SDF-1α-β; p = 0.03), innate inflammatory chemokines interferon-gamma induced protein 10 (IP-10; p = 0.02), macrophage inflammatory protein 1-alpha (MIP-1α; p = 0.02), and Th1-related pro-inflammatory cytokine interleukin-12 active heterodimer (IL-12p70; p = 0.002). In contrast, males had a higher concentration than females of secondary lymphoid-tissue chemokine (6CKINE; p = 0.02), monocyte chemotactic protein 1 (MCP-1; p = 0.005) and myeloid progenitor inhibitory factor 1 (MPIF-1; p = 0.03). Results were similar when analyses were restricted to NBS from DD and ASD further classified as ASD with intellectual disability (ID), ASD without ID, and DD (GCP-2, p = 0.007; I-TAC, p = 0.001; IP-10, p = 0.005; IL-12p70, p = 0.03 higher in females; MPIF-1, p = 0.03 higher in male). This study is the first to examine sex differences in neonatal cytokine/chemokine concentrations, and whether these differences are associated with neurodevelopmental outcomes. Results highlight the importance of considering sex as a critical factor in understanding the immune system as it relates to child development.
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Affiliation(s)
- Danielle H J Kim
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Alexandra Ramirez-Celis
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA, USA
| | - Paul Ashwood
- MIND Institute, University of California, Davis, CA, USA
| | | | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | | | - Lisa A Croen
- Kaiser Permanente Northern California-Oakland, USA
| | - Judy Van de Water
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA, USA; MIND Institute, University of California, Davis, CA, USA.
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Smucny J, Vlasova RM, Lesh TA, Rowland DJ, Wang G, Chaudhari AJ, Chen S, Iosif AM, Hogrefe CE, Bennett JL, Shumann CM, Van de Water JA, Maddock RJ, Styner MA, Geschwind DH, McAllister AK, Bauman MD, Carter CS. Increased Striatal Presynaptic Dopamine in a Nonhuman Primate Model of Maternal Immune Activation: A Longitudinal Neurodevelopmental Positron Emission Tomography Study With Implications for Schizophrenia. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:505-513. [PMID: 36805246 PMCID: PMC10164700 DOI: 10.1016/j.bpsc.2022.10.012] [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] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Epidemiological studies suggest that maternal immune activation (MIA) is a significant risk factor for future neurodevelopmental disorders, including schizophrenia (SZ), in offspring. Consistent with findings in SZ research and work in rodent systems, preliminary cross-sectional findings in nonhuman primates suggest that MIA is associated with dopaminergic hyperfunction in young adult offspring. METHODS In this unique prospective longitudinal study, we used [18F]fluoro-l-m-tyrosine positron emission tomography to examine the developmental time course of striatal presynaptic dopamine synthesis in male rhesus monkeys born to dams (n = 13) injected with a modified form of the inflammatory viral mimic, polyinosinic:polycytidylic acid [poly(I:C)], in the late first trimester. Striatal (caudate, putamen, and nucleus accumbens) dopamine from these animals was compared with that of control offspring born to dams that received saline (n = 10) or no injection (n = 4). Dopamine was measured at 15, 26, 38, and 48 months of age. Prior work with this cohort found decreased prefrontal gray matter volume in MIA offspring versus controls between 6 and 45 months of age. Based on theories of the etiology and development of SZ-related pathology, we hypothesized that there would be a delayed (relative to the gray matter decrease) increase in striatal fluoro-l-m-tyrosine signal in the MIA group versus controls. RESULTS [18F]fluoro-l-m-tyrosine signal showed developmental increases in both groups in the caudate and putamen. Group comparisons revealed significantly greater caudate dopaminergic signal in the MIA group at 26 months. CONCLUSIONS These findings are highly relevant to the known pathophysiology of SZ and highlight the translational relevance of the MIA model in understanding mechanisms by which MIA during pregnancy increases risk for later illness in offspring.
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California.
| | - Roza M Vlasova
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California; Center for Neuroscience, University of California, Davis, California
| | - Douglas J Rowland
- Center for Genomic and Molecular Imaging, University of California, Davis, California
| | - Guobao Wang
- Department of Radiology, University of California, Davis, California
| | - Abhijit J Chaudhari
- Center for Genomic and Molecular Imaging, University of California, Davis, California; Department of Radiology, University of California, Davis, California
| | - Shuai Chen
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, California
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, California
| | - Casey E Hogrefe
- California National Primate Research Center, University of California, Davis, California
| | - Jeffrey L Bennett
- Department of Psychology, University of California, Davis, California
| | - Cynthia M Shumann
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Judy A Van de Water
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, California
| | - Richard J Maddock
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina; Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina
| | - Daniel H Geschwind
- Department of Neurology, University of California, Los Angeles, Los Angeles, California
| | | | - Melissa D Bauman
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California; California National Primate Research Center, University of California, Davis, California
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California; Center for Neuroscience, University of California, Davis, California.
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10
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Kadlaskar G, Mao PH, Iosif AM, Amaral D, Nordahl CW, Miller M. Patterns of sensory processing in young children with autism: Differences in autism characteristics, adaptive skills, and attentional problems. Autism 2023; 27:723-736. [PMID: 35999699 PMCID: PMC9947195 DOI: 10.1177/13623613221115951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
LAY ABSTRACT Research has found differences in responding to various sensory stimuli among autistic individuals, which are associated with social and adaptive skills. However, our understanding of sensory profiles in autism has been complicated due to the variable presentation of sensory symptoms. One way to better understand variability in sensory symptoms is to use advanced statistical approaches, such as latent profile analysis, that allow for the identification of more similar sensory classes in otherwise variable groups. We used the Short Sensory Profile to identify homogeneous classes of sensory reactivity in autistic children based on both severity and modality and examined whether sensory classes differed in terms of autism characteristics, adaptive skills, and attention-deficit/hyperactivity disorder symptoms. Based on the pattern of both severity and modality, four sensory classes emerged and were named Moderate/Mixed (35.5%; probable-to-definite differences in all modalities except in movement sensitivity and low energy/weakness), Severe/Mixed (8.5%; definite sensory differences in all modalities except in low energy/weakness), Moderate/Broad (14.6%; probable-to-definite differences in all modalities), and Low/Mixed (41.1%; typical scores in most modalities with probable differences in taste/smell sensitivity, under-responsive/seeks sensation, and auditory filtering). The Severe/Mixed class exhibited greater problems in a variety of areas such as social, adaptive, and attention-deficit/hyperactivity disorder symptoms, whereas the Low/Mixed class showed overall fewer problems. This may provide insight for clinicians and researchers aiming to understand whether autistic children who exhibit distinct sensory patterns are more or less likely to also experience social, adaptive, and/or attention/behavior-related difficulties.
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Affiliation(s)
- Girija Kadlaskar
- MIND Institute, School of Medicine, University of California, Davis
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis
| | - Pin-Hsun Mao
- Graduate Program in Statistics, University of California, Davis
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis
| | - David Amaral
- MIND Institute, School of Medicine, University of California, Davis
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis
| | - Christine Wu Nordahl
- MIND Institute, School of Medicine, University of California, Davis
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis
| | - Meghan Miller
- MIND Institute, School of Medicine, University of California, Davis
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis
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11
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Hanson KL, Weir RK, Iosif AM, Van de Water J, Carter CS, McAllister AK, Bauman MD, Schumann CM. Altered dendritic morphology in dorsolateral prefrontal cortex of nonhuman primates prenatally exposed to maternal immune activation. Brain Behav Immun 2023; 109:92-101. [PMID: 36610487 PMCID: PMC10023379 DOI: 10.1016/j.bbi.2023.01.003] [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: 08/23/2022] [Revised: 12/06/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Women who contract a viral or bacterial infection during pregnancy have an increased risk of giving birth to a child with a neurodevelopmental or psychiatric disorder. The effects of maternal infection are likely mediated by the maternal immune response, as preclinical animal models have confirmed that maternal immune activation (MIA) leads to long lasting changes in offspring brain and behavior development. The present study sought to determine the impact of MIA-exposure during the first or second trimester on neuronal morphology in dorsolateral prefrontal cortex (DLPFC) and hippocampus from brain tissue obtained from MIA-exposed and control male rhesus monkey (Macaca mulatta) during late adolescence. MIA-exposed offspring display increased neuronal dendritic branching in pyramidal cells in DLPFC infra- and supragranular layers relative to controls, with no significant differences observed between offspring exposed to maternal infection in the first and second trimester. In addition, the diameter of apical dendrites in DLPFC infragranular layer is significantly decreased in MIA-exposed offspring relative to controls, irrespective of trimester exposure. In contrast, alterations in hippocampal neuronal morphology of MIA-exposed offspring were not evident. These findings demonstrate that a maternal immune challenge during pregnancy has long-term consequences for primate offspring dendritic structure, selectively in a brain region vital for socioemotional and cognitive development.
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Affiliation(s)
- Kari L Hanson
- Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, United States; MIND Institute, University of California, Davis, United States
| | - Ruth K Weir
- Innovation & Enterprise Department, University College London, United Kingdom
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, United States
| | - Judy Van de Water
- MIND Institute, University of California, Davis, United States; Rheumatology/Allergy and Clinical Immunology, University of California, Davis, United States
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, United States; Center for Neuroscience, University of California, Davis, United States
| | | | - Melissa D Bauman
- Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, United States; MIND Institute, University of California, Davis, United States; California National Primate Research Center, University of California, Davis, United States.
| | - Cynthia M Schumann
- Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, United States; MIND Institute, University of California, Davis, United States.
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12
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Davis K, Iosif AM, Nordahl CW, Solomon M, Krug MK. Correction: Video Game Use, Aggression, and Social Impairment in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:1301. [PMID: 35904651 PMCID: PMC9986198 DOI: 10.1007/s10803-022-05694-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Konnor Davis
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Sacramento, USA
| | - Christine Wu Nordahl
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
- Imaging Research Center, University of California Davis, Sacramento, USA
| | - Marie K Krug
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA.
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA.
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13
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Wulff RA, Iosif AM, Krug MK, Harvey PD, Solomon M. Piloting a Novel Daily Living Skills Assessment in Autistic Adolescents and Young Adults. Autism Adulthood 2023; 5:86-92. [PMID: 36941860 PMCID: PMC10024265 DOI: 10.1089/aut.2021.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background There are a few ecologically valid measurements of Daily Living Skills (DLS)-a critical component of adaptive functioning (AF)-for autistic adolescents and young adults. This is particularly important given that DLS predict outcomes as autistic adolescents transition to adulthood. Methods We pilot-tested the assessment section of two modules of the Computerized Functional Skills Assessment and Training program (CFSAT) in 25 autistic (n = 4 female) and 25 non-autistic (n = 6 female) adolescents and young adults to evaluate preliminary feasibility in an autistic sample. Tasks involved using an ATM and ticket-buying machine. We also assessed AF and DLS with a well-validated self-report questionnaire. We examined group differences in performance and relationships between performance on CFSAT and an existing measure of AF and DLS. We also conducted regression analyses to investigate the associations between age, IQ, executive functioning (EF), and CFSAT task performance. Results All but one autistic participant were able to complete the CFSAT tasks. Autistic participants made more errors, but did not take longer to complete the task, than non-autistic participants. Performance correlated strongly with self-reported AF generally and DLS specifically. The regression analyses revealed that task performance was associated with EF in the autistic group, but not the non-autistic group. Conclusions These results provide preliminary support for the use of a new performance-based ecologically valid assessment of DLS in an autistic population. Two CFSAT modules were well-tolerated and detected differences in DLS ability. Strong correlations with an existing measure of AF suggest evidence of construct validity. The EF was associated with CFSAT task performance in autistic individuals. Such a tool could help identify individuals who would benefit from a DLS intervention.
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Affiliation(s)
- Rachel A. Wulff
- Department of Psychiatry, MIND Institute, University of California, Davis. Sacramento, California, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis. Sacramento, California, USA
| | - Marie K. Krug
- Department of Psychiatry, MIND Institute, University of California, Davis. Sacramento, California, USA
| | - Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Marjorie Solomon
- Department of Psychiatry, MIND Institute, University of California, Davis. Sacramento, California, USA
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14
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Granillo L, Iosif AM, Goodrich A, Snyder NW, Schmidt RJ. Maternal androgens and autism spectrum disorder in the MARBLES prospective cohort study. Res Autism Spectr Disord 2022; 99:102054. [PMID: 36938498 PMCID: PMC10022653 DOI: 10.1016/j.rasd.2022.102054] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Maternal hormonal risk factors for autism spectrum disorder (ASD) in offspring could intersect genetic and environmental risk factors. Objectives This analysis explored ASD risk in association with maternal testosterone, androstenedione, and dehydroepiandrosterone (DHEA) measured in first, second, and third trimesters of pregnancy. Methods MARBLES is a prospective pregnancy cohort study based at the MIND Institute in Northern California that enrolls mothers who have at least one child previously diagnosed with ASD and are expecting, or planning to have another child. At 36 months the younger sibling is clinically classified as having ASD, or as non-typically developing (Non-TD), or typically developing (TD). Maternal androgens during pregnancy were measured in serum samples from 196 mothers. Multivariable logistic regression models estimated risk of ASD and Non-TD in offspring compared to TD, in relation to the log-transformed maternal androgen concentrations, at each trimester. Results Non-significant associations were observed, and borderline significant associations were only observed in some stratified unadjusted models. Second trimester maternal testosterone was non-significantly associated with ASD in female offspring, although not after adjustment, aRR 1.54 (95% CI 0.71, 3.33), and second trimester maternal DHEA was non-significantly associated with non-TD in male offspring, again not after adjustment, aRR 0.50 (95% CI 0.21, 1.21). Secondary analysis suggested that third trimester androgen concentrations in mothers with male offspring had significant or near significant associations with their child's Social Responsiveness Scale score. Conclusion No significant associations were found between maternal androgen concentrations and risk of ASD or Non-TD in the child.
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Affiliation(s)
- Lauren Granillo
- Graduate Group in Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
- MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Amanda Goodrich
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Nathaniel W. Snyder
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
- Center for Metabolic Disease Research, Department of Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
- MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
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15
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Calub CA, Benyakorn S, Sun S, Iosif AM, Boyle LH, Solomon M, Hessl D, Schweitzer JB. Working Memory Training in Youth With Autism, Fragile X, and Intellectual Disability: A Pilot Study. Am J Intellect Dev Disabil 2022; 127:369-389. [PMID: 36018768 PMCID: PMC9915337 DOI: 10.1352/1944-7558-127.5.369] [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] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 08/03/2021] [Indexed: 06/15/2023]
Abstract
This pilot study sought to identify potential markers of improvement from pre-post treatment in response to computerized working memory (WM) training for youth (ages 8-18) with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) in a single arm, pre-post design. Participants included 26 children with ASD and 18 with comorbid ASD and fragile X syndrome (ASD+FXS). Analyses were adjusted for age and IQ. The ASD group demonstrated greater improvement on WM training relative to the ASD+FXS group. Participants improved on WM and far transfer outcomes, however, there were no significant group differences in improvement except for repetitive behavior. Higher hyperactivity/impulsivity ratings predicted lower performance on visuospatial WM. Findings suggest cognitive training may be beneficial for youth with ASD and ID, warranting further exploration.
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16
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Reetzke R, Iosif AM, Hatch B, de la Paz L, Chuang A, Ozonoff S, Miller M. Patterns of objectively measured motor activity among infants developing ASD and concerns for ADHD. J Child Psychol Psychiatry 2022; 63:663-673. [PMID: 34387359 PMCID: PMC8841001 DOI: 10.1111/jcpp.13504] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Heightened motor activity is a hallmark of attention-deficit/hyperactivity disorder (ADHD), yet high activity levels are also often reported in young children with autism spectrum disorder (ASD). It is currently unclear whether increased motor activity represents a distinct versus shared early predictor of ASD and ADHD; no prior studies have directly examined this prospectively. We investigated differences in longitudinal patterns of objectively measured motor activity during early development. METHODS Participants included 113 infants at high and low risk for ASD or ADHD. Continuous motion-based activity was recorded using tri-axial accelerometers at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into one of three outcome groups: ASD (n = 19), ADHD Concerns (n = 17), and Typically Developing (TD; n = 77). Group differences in trajectories of motor activity were examined in structured and semistructured contexts. Associations with behaviors relevant to ASD, ADHD, and general development were also examined. RESULTS In both structured and semistructured contexts, both the ASD and ADHD Concerns groups exhibited heightened activity relative to the TD group by 18 months; the ASD group exhibited higher activity than the ADHD Concerns group at 24-36 months in the structured context only. Attention/behavior regulation, nonverbal, and verbal development-but not social engagement-were differentially associated with objectively measured activity by outcome group across contexts. CONCLUSIONS Overactivity may be a shared, rather than distinct, precursor of atypical development in infants/toddlers developing ASD and concerns for ADHD, emerging as early as 18 months. Group differences in overactivity may be context-specific and associated with different underlying mechanisms.
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Affiliation(s)
- Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - Burt Hatch
- Institute for Social Neuroscience, Ivanhoe, Victoria, Australia
| | - Leiana de la Paz
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Annie Chuang
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis, Sacramento, CA, USA
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17
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Vlasova RM, Iosif AM, Ryan AM, Funk LH, Murai T, Chen S, Lesh TA, Rowland DJ, Bennett J, Hogrefe CE, Maddock RJ, Gandal MJ, Geschwind DH, Schumann CM, Van de Water J, McAllister AK, Carter CS, Styner MA, Amaral DG, Bauman MD. Maternal Immune Activation during Pregnancy Alters Postnatal Brain Growth and Cognitive Development in Nonhuman Primate Offspring. J Neurosci 2021; 41:9971-9987. [PMID: 34607967 PMCID: PMC8638691 DOI: 10.1523/jneurosci.0378-21.2021] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/28/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022] Open
Abstract
Human epidemiological studies implicate exposure to infection during gestation in the etiology of neurodevelopmental disorders. Animal models of maternal immune activation (MIA) have identified the maternal immune response as the critical link between maternal infection and aberrant offspring brain and behavior development. Here we evaluate neurodevelopment of male rhesus monkeys (Macaca mulatta) born to MIA-treated dams (n = 14) injected with a modified form of the viral mimic polyinosinic:polycytidylic acid at the end of the first trimester. Control dams received saline injections at the same gestational time points (n = 10) or were untreated (n = 4). MIA-treated dams exhibited a strong immune response as indexed by transient increases in sickness behavior, temperature, and inflammatory cytokines. Although offspring born to control or MIA-treated dams did not differ on measures of physical growth and early developmental milestones, the MIA-treated animals exhibited subtle changes in cognitive development and deviated from species-typical brain growth trajectories. Longitudinal MRI revealed significant gray matter volume reductions in the prefrontal and frontal cortices of MIA-treated offspring at 6 months that persisted through the final time point at 45 months along with smaller frontal white matter volumes in MIA-treated animals at 36 and 45 months. These findings provide the first evidence of early postnatal changes in brain development in MIA-exposed nonhuman primates and establish a translationally relevant model system to explore the neurodevelopmental trajectory of risk associated with prenatal immune challenge from birth through late adolescence.SIGNIFICANCE STATEMENT Women exposed to infection during pregnancy have an increased risk of giving birth to a child who will later be diagnosed with a neurodevelopmental disorder. Preclinical maternal immune activation (MIA) models have demonstrated that the effects of maternal infection on fetal brain development are mediated by maternal immune response. Since the majority of MIA models are conducted in rodents, the nonhuman primate provides a unique system to evaluate the MIA hypothesis in a species closely related to humans. Here we report the first longitudinal study conducted in a nonhuman primate MIA model. MIA-exposed offspring demonstrate subtle changes in cognitive development paired with marked reductions in frontal gray and white matter, further supporting the association between prenatal immune challenge and alterations in offspring neurodevelopment.
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Affiliation(s)
- Roza M Vlasova
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, 27514
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Amy M Ryan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, 95817
- California National Primate Research Center, University of California, Davis, California, 95616
| | - Lucy H Funk
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Takeshi Murai
- California National Primate Research Center, University of California, Davis, California, 95616
| | - Shuai Chen
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Douglas J Rowland
- Center for Genomic and Molecular Imaging, University of California, Davis, California, 95616
| | - Jeffrey Bennett
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Casey E Hogrefe
- California National Primate Research Center, University of California, Davis, California, 95616
| | - Richard J Maddock
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Michael J Gandal
- Neurogenetics Program, Department of Neurology, University of California, Los Angeles, California, 90095
| | - Daniel H Geschwind
- Neurogenetics Program, Department of Neurology, University of California, Los Angeles, California, 90095
| | - Cynthia M Schumann
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Judy Van de Water
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, 95817
- Rheumatology/Allergy and Clinical Immunology, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - A Kimberley McAllister
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, 95817
- Center for Neuroscience, University of California, Davis, California, 95618
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, 27514
- Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina, 27599
| | - David G Amaral
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, 95817
- California National Primate Research Center, University of California, Davis, California, 95616
| | - Melissa D Bauman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, California, 95817
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California, 95817
- California National Primate Research Center, University of California, Davis, California, 95616
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18
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Yu A, Wilkes M, Iosif AM, Rea M, Fisher A, Fine J, Perry R, Rice E, Jandrey K, Griffin E, Sciolla A. Exploring the Relationships Between Resilience and News Monitoring with COVID Distress in Health Profession Students. Acad Psychiatry 2021; 45:566-574. [PMID: 33928535 PMCID: PMC8083098 DOI: 10.1007/s40596-021-01444-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/22/2021] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Alarming rates of anxiety and burnout in pre-clinical health profession trainees are now challenged by additional COVID-19 stressors. This study explored COVID-related stressors among first-year medical, physician assistant, nurse practitioner, and veterinary medical students. The authors examined associations between resilience, news monitoring, and COVID stress. METHODS Students completed an online questionnaire that included the Brief Resilience Scale at their matriculation in August 2019. Survey results were linked to demographic information collected by all schools. A follow-up survey in May 2020 included original questions on COVID-19 stressors and news monitoring. Statistical analyses included descriptive statistics and multivariable linear regression models. RESULTS Across schools, 74% (266/360) provided consent for the 2019 survey, and 76% (201/264) responded to COVID-19 questions in the follow-up 2020 survey. Students were "extremely" or "very" concerned about family members getting infected (n = 71, 76% School of Medicine (SOM); n = 31, 76% School of Nursing (SON); n = 50, 75% School of Veterinary Medicine (SVM)) and curriculum schedule changes (n = 72, 78%, SOM; n = 28, 68% SON; n = 52, 79% SVM). Greater frequency of COVID news monitoring was associated with greater COVID-related stress (p = 0.02). Higher resilience at matriculation was associated with lower COVID-related stress ten months later (p < 0.001). CONCLUSIONS Amid COVID-19 uncertainty, health science schools should address the immense student stress regarding curriculum disruptions. The results of this study underscore the powerful role of resilience in protecting against stress not only during the known academic rigor of health professions training but also during unprecedented crises.
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Affiliation(s)
- Allison Yu
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Michael Wilkes
- University of California, Davis School of Medicine, Sacramento, CA, USA.
| | - Ana-Maria Iosif
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Margaret Rea
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Alice Fisher
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Jeffrey Fine
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Ross Perry
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Elizabeth Rice
- University of California, Davis School of Nursing, Sacramento, CA, USA
| | - Karl Jandrey
- University of California, Davis School of Veterinary Medicine, Davis, CA, USA
| | - Erin Griffin
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Andres Sciolla
- University of California, Davis School of Medicine, Sacramento, CA, USA
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19
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Miller M, Iosif AM, Bell LJ, Farquhar-Leicester A, Hatch B, Hill A, Hill MM, Solis E, Young GS, Ozonoff S. Can Familial Risk for ADHD Be Detected in the First Two Years of Life? J Clin Child Adolesc Psychol 2021; 50:619-631. [PMID: 31951755 PMCID: PMC7365744 DOI: 10.1080/15374416.2019.1709196] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: We evaluated trajectories of attention-deficit/hyperactivity (ADHD)-relevant behaviors in a sample of infants at high and low familial risk for ADHD who were prospectively evaluated at 12, 18, and 24 months of age.Method: Participants included 43 infants at risk for ADHD based on family history (i.e., diagnosed first-degree relative) and 40 low-risk infants (i.e., no family history of ADHD). Instances of inattention, out-of-seat, and grabbing behavior were coded from video; analogous constructs were rated by examiners unaware of familial risk status after completing structured standardized assessments with the infants/toddlers. At the end of each study visit, examiners solicited parents' concerns about their child's behavior. Differences in ADHD-related behaviors and parent concerns were examined between 12 and 24 months of age.Results: Infants with an older sibling or parent diagnosed with ADHD were distinguishable from infants with no family history of ADHD as early as 12 months of age based on directly observed and examiner reports of behavior, particularly with respect to hyperactive-impulsive behavior. Parents of infants at familial risk for ADHD also reported significantly more behavior/temperament concerns as early as 12 months of age compared to parents of infants at low risk for ADHD.Conclusions: These findings highlight the ability to detect genetic liability for ADHD by the end of the first year of life, suggesting that well-designed family risk studies of ADHD are feasible and may be clinically valuable. They also suggest the potential for earlier detection of risk for ADHD than has previously been possible.
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Affiliation(s)
- Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis
| | - Laura J Bell
- Department of Psychology, University of California, Berkeley
| | | | - Burt Hatch
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Alesha Hill
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Monique Moore Hill
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Erika Solis
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Gregory S Young
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
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Miller M, Sun S, Iosif AM, Young GS, Belding A, Tubbs A, Ozonoff S. Repetitive behavior with objects in infants developing autism predicts diagnosis and later social behavior as early as 9 months. J Abnorm Psychol 2021; 130:665-675. [PMID: 34553961 PMCID: PMC8480432 DOI: 10.1037/abn0000692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We evaluated repetitive behavior with objects in infants at risk for autism spectrum disorder (ASD) from 9 to 36 months of age, and associations between early repetitive behavior and social engagement. Infant siblings of children with ASD (high-risk) or typical development (low-risk) were administered a task eliciting repetitive object use at 9, 12, 15, 18, 24, and 36 months of age. Infants (n = 147) were classified into 1 of 3 outcome groups at 36 months: Low-Risk Non-ASD (n = 58), High-Risk Non-ASD (n = 72), and ASD (n = 17). Behavior was coded from video for frequencies of unusual visual inspection, spinning, and rotating behaviors. Differences in unusual visual inspection were most prominent, consistent, and present earliest: At 9 months, the ASD group engaged in this behavior more frequently than both other groups, persisting through 36 months. Differences in frequencies of spinning and rotating were later-appearing, more time-limited, and/or related to familial ASD risk rather than ultimate diagnosis. Sensitivity and specificity estimates for the presence of unusual visual inspection at 9 months of age were in the moderate range (.60 and .68, respectively) for ASD versus Low-Risk Non-ASD comparisons, generally increasing over time. Unusual visual inspection at 9 months predicted 12-month social behavior controlling for 9-month social behavior, but not vice versa, with no evidence of moderation by ASD diagnosis. In summary, unusual visual inspection of objects is present and stable by 9 months of age in infants developing ASD and predicts reduced social engagement three-months later. Close monitoring of this behavior may aid early detection. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Ana-Maria Iosif
- Department of Public Health Sciences, Division of Biostatistics
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21
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Yellowlees PM, Parish MB, Gonzalez AD, Chan SR, Hilty DM, Yoo BK, Leigh JP, McCarron RM, Scher LM, Sciolla AF, Shore J, Xiong G, Soltero KM, Fisher A, Fine JR, Bannister J, Iosif AM. Clinical Outcomes of Asynchronous Versus Synchronous Telepsychiatry in Primary Care: Randomized Controlled Trial. J Med Internet Res 2021; 23:e24047. [PMID: 33993104 PMCID: PMC8335606 DOI: 10.2196/24047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/26/2021] [Accepted: 05/16/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Asynchronous telepsychiatry (ATP; delayed-time) consultations are a novel form of psychiatric consultation in primary care settings. Longitudinal studies comparing clinical outcomes for ATP with synchronous telepsychiatry (STP) are lacking. OBJECTIVE This study aims to determine the effectiveness of ATP in improving clinical outcomes in English- and Spanish-speaking primary care patients compared with STP, the telepsychiatry usual care method. METHODS Overall, 36 primary care physicians from 3 primary care clinics referred a heterogeneous sample of 401 treatment-seeking adult patients with nonurgent psychiatric disorders. A total of 184 (94 ATP and 90 STP) English- and Spanish-speaking participants (36/184, 19.6% Hispanic) were enrolled and randomized, and 160 (80 ATP and 80 STP) of them completed baseline evaluations. Patients were treated by their primary care physicians using a collaborative care model in consultation with the University of California Davis Health telepsychiatrists, who consulted with patients every 6 months for up to 2 years using ATP or STP. Primary outcomes (the clinician-rated Clinical Global Impressions [CGI] scale and the Global Assessment of Functioning [GAF]) and secondary outcomes (patients' self-reported physical and mental health and depression) outcomes were assessed every 6 months. RESULTS For clinician-rated primary outcomes, ATP did not promote greater improvement than STP at 6-month follow-up (ATP vs STP, adjusted difference in follow-up at 6 months vs baseline differences for CGI: 0.2, 95% CI -0.2 to 0.6; P=.28; and GAF: -0.6, 95% CI -3.1 to 1.9; P=.66) or 12-month follow-up (ATP vs STP, adjusted difference in follow-up at 12 months vs baseline differences for CGI: 0.4, 95% CI -0.04 to 0.8; P=.07; and GAF: -0.5, 95% CI -3.3 to 2.2; P=.70), but patients in both arms had statistically and clinically significant improvements in both outcomes. There were no significant differences in improvement from baseline between ATP and STP on any patient self-reported ratings at any follow-up (all P values were between .17 and .96). Dropout rates were higher than predicted but similar between the 2 arms. Of those with baseline visits, 46.8% (75/160) did not have a follow-up at 1 year, and 72.7% (107/147) did not have a follow-up at 2 years. No serious adverse events were associated with the intervention. CONCLUSIONS This is the first longitudinal study to demonstrate that ATP can improve clinical outcomes in English- and Spanish-speaking primary care patients. Although we did not find evidence that ATP is superior to STP in improving clinical outcomes, it is potentially a key part of stepped mental health interventions available in primary care. ATP presents a possible solution to the workforce shortage of psychiatrists and a strategy for improving existing systems of care. TRIAL REGISTRATION ClinicalTrials.gov NCT02084979; https://clinicaltrials.gov/ct2/show/NCT02084979.
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Affiliation(s)
- Peter M Yellowlees
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | - Michelle Burke Parish
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | - Alvaro D Gonzalez
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | - Steven R Chan
- Stanford University School of Medicine, Stanford, CA, United States
- Veterans Administration Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Donald M Hilty
- Northern California Veterans Administration, Mather, CA, United States
| | - Byung-Kwang Yoo
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | - J Paul Leigh
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | | | - Lorin M Scher
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | - Andres F Sciolla
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | - Jay Shore
- University of Colorado Anschutz Medical Campus, Denver, CO, United States
| | - Glen Xiong
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | | | - Alice Fisher
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | - Jeffrey R Fine
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | - Jennifer Bannister
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
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22
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Gangi DN, Boterberg S, Schwichtenberg AJ, Solis E, Young GS, Iosif AM, Ozonoff S. Declining Gaze to Faces in Infants Developing Autism Spectrum Disorder: Evidence From Two Independent Cohorts. Child Dev 2021; 92:e285-e295. [PMID: 33615438 PMCID: PMC8169511 DOI: 10.1111/cdev.13471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/02/2020] [Accepted: 07/05/2020] [Indexed: 12/30/2022]
Abstract
Two independent cohorts (N = 155, N = 126) of infants at high and low risk for autism spectrum disorder (ASD) were followed prospectively between 6 and 36 months of age, when n = 46 were diagnosed with ASD. Gaze to adult faces was coded-during a developmental assessment (Cohort 1) or a play interaction (Cohort 2). Across both cohorts, most children developing ASD showed sharp declines in gaze to faces over time, relative to children without ASD. These findings suggest that declining developmental trajectories may be more common than previously recognized by retrospective methods. Trajectory-based screening methods could potentially identify children in the early stages of symptom onset and allow for early intervention before the full disorder has developed.
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Henry SG, Feng B, Verba S, Kravitz RL, Iosif AM. The story vs the storyteller: Factors associated with the effectiveness of brief video-recorded patient stories for promoting opioid tapering. Health Expect 2021; 24:991-999. [PMID: 33835644 PMCID: PMC8235893 DOI: 10.1111/hex.13243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/18/2021] [Accepted: 03/09/2021] [Indexed: 12/01/2022] Open
Abstract
Background Narrative communication is often more persuasive for promoting health behaviour change than communication using facts and figures; the extent to which narrative persuasiveness is due to patients’ identification with the storyteller vs engagement with the story is unclear. Objective To examine the relative impacts of patient engagement, age concordance and gender concordance on perceived persuasiveness of video‐recorded narrative clips about opioid tapering. Methods Patient raters watched and rated 48 brief video‐recorded clips featuring 1 of 7 different storytellers describing their experiences with opioid tapering. The dependent variable was clips’ perceived persuasiveness for encouraging patients to consider opioid tapering. Independent variables were rater engagement with the clip, rater‐storyteller gender concordance and rater‐storyteller age concordance (<60 vs ≥60). Covariates were rater beliefs about opioids and opioid tapering, clip duration and clip theme. Mixed‐effects models accounted for raters viewing multiple clips and clips nested within storytellers. Results In multivariable models, higher rater engagement with the clip was associated with higher perceived persuasiveness (coefficient = 0.46, 95% CI 0.39‐0.53, P < .001). Neither age concordance nor gender concordance significantly predicted perceived persuasiveness. The theme Problems with opioids also predicted perceived persuasiveness. Conclusion Highly engaging, clinically relevant stories are likely persuasive to patients regardless of the match between patient and storyteller age and gender. When using patient stories in tools to promote health behaviour change, stories that are clinically relevant and engaging are likely to be persuasive regardless of storytellers’ demographics. Patient or public contribution Patients were involved as storytellers (in each clip) and assessed the key study variables.
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Affiliation(s)
- Stephen G Henry
- Department of Internal Medicine and Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA
| | - Bo Feng
- Department of Communication, University of California, Davis, Davis, CA, USA
| | - Susan Verba
- Department of Design and Center for Design in the Public Interest, University of California, Davis, Davis, CA, USA
| | - Richard L Kravitz
- Department of Internal Medicine and Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
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24
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Mukherjee P, Hartanto T, Iosif AM, Dixon JF, Hinshaw SP, Pakyurek M, van den Bos W, Guyer AE, McClure SM, Schweitzer JB, Fassbender C. Neural basis of working memory in ADHD: Load versus complexity. Neuroimage Clin 2021; 30:102662. [PMID: 34215140 PMCID: PMC8175567 DOI: 10.1016/j.nicl.2021.102662] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 11/15/2022]
Abstract
Working memory (WM). Load versus Complexity. ADHD. FMRI. Working Memory Striatum and Cerebellum.
Working memory (WM) deficits are key in attention deficit hyperactivity disorder (ADHD). Nevertheless, WM is not universally impaired in ADHD. Additionally, the neural basis for WM deficits in ADHD has not been conclusively established, with regions including the prefrontal cortex, cerebellum, and caudate being implicated. These contradictions may be related to conceptualizations of WM capacity, such as load (amount of information) versus operational-complexity (maintenance-recall or manipulation). For instance, relative to neurotypical (NT) individuals, complex WM operations could be impaired in ADHD, while simpler operations are spared. Alternatively, all operations may be impaired at higher loads. Here, we compared the impact of these two components of WM capacity: load and operational-complexity, between ADHD and NT, behaviorally and neurally. We hypothesized that the impact of WM load would be greater in ADHD, and the neural activation would be altered. Participants (age-range 12–23 years; 50 ADHD (18 females); 82 NT (41 females)) recalled three or four objects (load) in forward or backward order (operational-complexity) during functional magnetic resonance imaging scanning. The effects of diagnosis and task were compared on performance and neural engagement. Behaviorally, we found significant interactions between diagnosis and load, and between diagnosis, load, and complexity. Neurally, we found an interaction between diagnosis and load in the right striatum, and between diagnosis and complexity in the right cerebellum and left occipital gyrus. The ADHD group displayed hypo-activation compared to NT group during higher load and greater complexity. This informs mechanisms of functional problems related to WM in adolescents and young adults with ADHD (e.g., academic performance) and remedial interventions (e.g., WM-training).
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Affiliation(s)
- Prerona Mukherjee
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA.
| | - Tadeus Hartanto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, CA 95616, USA
| | - J Faye Dixon
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, 3rd Floor, Berkeley Way West Building, 2121 Berkeley Way West, Berkeley, CA 94720, USA
| | - Murat Pakyurek
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Wouter van den Bos
- Department of Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands
| | - Amanda E Guyer
- Department of Human Ecology, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA; Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA
| | - Samuel M McClure
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Catherine Fassbender
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA; School of Psychology, Dublin City University, DCU Glasnevin Campus, Dublin 9, Ireland
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Seritan A, Iosif AM, Wang S, Dodge M, Eisendrath S. "You Can't Stop the Waves but You Can Learn to Surf": Mindfulness-Based Cognitive Therapy for People with Parkinson's Disease. The American Journal of Geriatric Psychiatry 2021. [DOI: 10.1016/j.jagp.2021.01.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Few studies have explored autism spectrum disorder (ASD) screening in the first year of life. The current investigation examines the psychometric properties of the Infant-Toddler Checklist starting in the first year of life in a sample at elevated and average risk for ASD based on family history. 283 participants were followed from 6 to 36 months, when diagnostic outcome was determined. The results indicated low to moderate sensitivity, specificity, and positive predictive value across ages for broadly distinguishing any delays from typical development, as well as for more narrowly discriminating children with ASD from those who were typically developing. Implications for utilizing ASD screening tools in the first year of life with high risk samples are discussed.
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Affiliation(s)
- Chandni Parikh
- Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California-Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California-Davis, Davis, CA, USA
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California-Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA
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27
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Hatch B, Iosif AM, Chuang A, de la Paz L, Ozonoff S, Miller M. Longitudinal Differences in Response to Name Among Infants Developing ASD and Risk for ADHD. J Autism Dev Disord 2021; 51:827-836. [PMID: 31974800 PMCID: PMC7375942 DOI: 10.1007/s10803-020-04369-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Diminished response to name, a potential early marker of autism spectrum disorder (ASD), may also indicate risk for other disorders characterized by attention problems, including attention-deficit/hyperactivity disorder (ADHD). Using a familial risk design, we examined whether response to name ability at 6, 12, 18, 24, and 36 months of age differed between three 36-month outcome groups: ASD, ADHD Concerns, or a Comparison group. Persistent differences between the ASD and Comparison groups were evident beginning at 12 months; differences between the ADHD Concerns and Comparison groups were evident between 12 and 18 months only. Results suggest that response to name may be a general marker for ASD and ADHD risk in infancy but a specific indicator of ASD by 24-months.
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Affiliation(s)
- Burt Hatch
- Department of Psychiatry & Behavioral Science, MIND Institute, University of California, Davis, Sacramento, CA, USA.
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Sacramento, CA, USA
| | - Annie Chuang
- Department of Psychiatry & Behavioral Science, MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Leiana de la Paz
- Department of Psychiatry & Behavioral Science, MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Science, MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Meghan Miller
- Department of Psychiatry & Behavioral Science, MIND Institute, University of California, Davis, Sacramento, CA, USA
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Feng B, Malloch YZ, Kravitz RL, Verba S, Iosif AM, Slavik G, Henry SG. Assessing the effectiveness of a narrative-based patient education video for promoting opioid tapering. Patient Educ Couns 2021; 104:329-336. [PMID: 32900605 PMCID: PMC7855718 DOI: 10.1016/j.pec.2020.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To compare effectiveness of a narrative-based educational video versus an informational pamphlet for increasing patients' self-efficacy and intention to taper their opioid use. METHODS Five thousand participants recruited from MTurk were screened to identify eligible patients. Eligible participants (n = 365, 49.9 % female, mean age = 37 years) were randomized to either watch the narrative video or read the pamphlet. Linear regression models were used for the main analysis. RESULTS Participants' perceptions of tapering effectiveness were higher in the video group (mean = 4.06) than the pamphlet group (mean = 3.67), adjusted mean difference = 0.34, 95 %CI 0.13 - 0.54,P < 0.001. Participants' perceptions of tapering self-efficacy were also higher in the video group (mean = 3.97) than the pamphlet group (mean = 3.60), adjusted mean difference = 0.32, 95 %CI 0.09 - 0.55, P < 0.001. Perceived tapering effectiveness and self-efficacy were both positively associated with post-intervention tapering intention (Spearman rank correlation coefficient = 0.38 and 0.53, respectively, both P < 0.001). CONCLUSION A narrative-based video about opioid tapering enhanced patients' perceptions of the effectiveness of tapering and their tapering self-efficacy. PRACTICE IMPLICATIONS Narrative-based videos may be effective for changing patient attitudes about opioid tapering.
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Affiliation(s)
- Bo Feng
- Department of Communication, University of California Davis, Davis, USA.
| | - Yining Z Malloch
- Department of Communication, University of California Davis, Davis, USA
| | - Richard L Kravitz
- Department of Internal Medicine, University of California Davis, Sacramento, USA
| | - Susan Verba
- Department of Design, University of California Davis, Davis, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Sacramento, USA
| | - George Slavik
- Department of Design, University of California Davis, Davis, USA
| | - Stephen G Henry
- Department of Internal Medicine, University of California Davis, Sacramento, USA
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29
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Parish MB, Gonzalez A, Hilty D, Chan S, Xiong G, Scher L, Liu D, Sciolla A, Shore J, McCarron R, Kahn D, Iosif AM, Yellowlees P. Asynchronous Telepsychiatry Interviewer Training Recommendations: A Model for Interdisciplinary, Integrated Behavioral Health Care. Telemed J E Health 2021; 27:982-988. [PMID: 33434453 DOI: 10.1089/tmj.2020.0076] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: Asynchronous telepsychiatry (ATP) is an integrative model of behavioral health service delivery that is applicable in a variety of settings and populations, particularly consultation in primary care. This article outlines the development of a training model for ATP clinician skills. Methods: Clinical and procedural training for ATP clinicians (n = 5) was provided by master's-level, clinical mental health providers developed by three experienced telepsychiatrists (P.Y. D.H., and J.S) and supervised by a tele-psychiatrist (PY, GX, DL) through seminar, case supervision, and case discussions. A training manual and one-on-one sessions were employed for initial training. Unstructured expert discussion and feedback sessions were conducted in the training phase of the study in year 1 and annually thereafter over the remaining 4 years of the study. The notes gathered during those sessions were synthesized into themes to gain a summary of the study telepsychiatrist training recommendations for ATP interviewers. Results: Expert feedback and discussion revealed three overarching themes of recommended skill sets for ATP interviewers: (1) comprehensive skills in brief psychiatric interviewing, (2) adequate knowledge base of behavioral health conditions and therapeutic techniques, and (3) clinical documentation, integrated care/consultation practices, and e-competency skill sets. The model of training and skill requirements from expert feedback sessions included these three skill sets. Technology training recommendations were also identified and included: (1) awareness of privacy/confidentiality for electronic data gathering, storage, management, and sharing; (2) technology troubleshooting; and (3) video filming/retrieval. Conclusions: We describe and provide a suggested training model for the use of ATP integrated behavioral health. The training needs for ATP clinicians were assessed on a limited convenience sample of experts and clinicians, and more rigorous studies of training for ATP and other technology-focused, behavioral health services are needed. Clinical Trials number: NCT03538860.
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Affiliation(s)
- Michelle Burke Parish
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - Alvaro Gonzalez
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - Donald Hilty
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
- Northern California Veterans Administration, Sacramento, California, USA
| | - Steven Chan
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
- School of Medicine, Stanford University, Palo Alto, California, USA
- Addiction Treatment Services, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
| | - Glen Xiong
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - Lorin Scher
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - David Liu
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - Andres Sciolla
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - Jay Shore
- University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
| | - Robert McCarron
- Department of Psychiatry, University of California, Irvine, California, USA
| | - Debra Kahn
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Sacramento, California, USA
| | - Peter Yellowlees
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California, USA
- Division of Clinical Affairs, University of California, Davis, Sacramento, California, USA
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Nordahl CW, Iosif AM, Young GS, Hechtman A, Heath B, Lee JK, Libero L, Reinhardt VP, Winder-Patel B, Amaral DG, Rogers S, Solomon M, Ozonoff S. High Psychopathology Subgroup in Young Children With Autism: Associations With Biological Sex and Amygdala Volume. J Am Acad Child Adolesc Psychiatry 2020; 59:1353-1363.e2. [PMID: 31972262 PMCID: PMC7369216 DOI: 10.1016/j.jaac.2019.11.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 10/21/2019] [Accepted: 11/22/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aims of this study were to identify a subset of children with autism spectrum disorder (ASD) and co-occurring symptoms of psychopathology, and to evaluate associations between this subgroup and biological sex and amygdala volume. METHOD Participants included 420 children (ASD: 91 girls, 209 boys; typically developing controls: 57 girls, 63 boys). Latent profile analysis was used to identify ASD subgroups based on symptoms of psychopathology, adaptive functioning, cognitive development, and autism severity. Differences in the proportions of girls and boys across subgroups were evaluated. Magnetic resonance imaging scans were acquired (346 children); amygdala volumes were evaluated in relation to subgroups and problem behavior scores. RESULTS Three ASD subgroups were identified. One group was characterized by high levels of psychopathology and moderate impairment on other measures (High Psychopathology Moderate Impairments [HPMI], comprising 27% of the sample). The other two subgroups had lower symptoms of psychopathology but were differentiated by high and low levels of impairment on other measures. A higher proportion of girls were classified into the HPMI subgroup (40% of girls versus 22% of boys). Relative to controls, amygdala volumes were enlarged only in the HPMI subgroup. There was a positive association between right amygdala volume and internalizing behaviors in girls but not in boys with ASD. CONCLUSION A higher proportion of girls with ASD faced greater challenges with psychopathology, suggesting a need for closer evaluation and potentially earlier intervention to help improve outcomes. Amygdala enlargement was associated with co-occurring symptoms of psychopathology, and sex-specific correlations with symptoms were observed.
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Affiliation(s)
- Christine Wu Nordahl
- MIND Institute, Sacramento, CA, and the University of California at Davis School of Medicine, Sacramento, CA.
| | - Ana-Maria Iosif
- University of California at Davis School of Medicine, Sacramento, CA
| | - Gregory S. Young
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Alexa Hechtman
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Brianna Heath
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Joshua K. Lee
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Lauren Libero
- University of California at Davis School of Medicine, Sacramento, CA.,California Department of Developmental Services, Sacramento, CA.,MIND Institute, Sacramento, CA,,University of California at Davis School of Medicine, Sacramento, CA
| | - Vanessa P. Reinhardt
- University of California at Davis School of Medicine, Sacramento, CA.,Peel Children’s Center, Ontario, Canada.,MIND Institute, Sacramento CA,,University of California at Davis School of Medicine, Sacramento, CA
| | | | - David G. Amaral
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Sally Rogers
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Marjorie Solomon
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
| | - Sally Ozonoff
- University of California at Davis School of Medicine, Sacramento, CA.,MIND Institute, Sacramento, CA
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31
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Solomon M, Gordon A, Iosif AM, Geddert R, Krug MK, Mundy P, Hessl D. Using the NIH Toolbox to Assess Cognition in Adolescents and Young Adults with Autism Spectrum Disorders. Autism Res 2020; 14:500-511. [PMID: 33006263 DOI: 10.1002/aur.2399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/05/2020] [Accepted: 09/02/2020] [Indexed: 11/08/2022]
Abstract
Despite the clinically significant impact of executive dysfunction on the outcomes of adolescents and young adults with autism spectrum disorders (ASD), we lack a clear understanding of its prevalence, profile, and development. To address this gap, we administered the NIH Toolbox Cognition Battery to a cross-sectional Intelligence Quotient (IQ) case-matched cohort with ASD (n = 66) and typical development (TD; n = 66) ages 12-22. We used a general linear model framework to examine group differences in task performance and their associations with age. Latent profile analysis (LPA) was used to identify subgroups of individuals with similar cognitive profiles. Compared to IQ case-matched controls, ASD demonstrated poorer performance on inhibitory control (P < 0.001), cognitive flexibility (P < 0.001), episodic memory (P < 0.02), and processing speed (P < 0.001) (components of Fluid Cognition), but not on vocabulary or word reading (components of Crystallized Cognition). There was a significant positive association between age and Crystallized and Fluid Cognition in both groups. For Fluid (but not Crystallized) Cognition, ASD performed more poorly than TD at all ages. A four-group LPA model based on subtest scores best fit the data. Eighty percent of ASD belonged to two groups that exhibited relatively stronger Crystallized versus Fluid Cognition. Attention deficits were not associated with Toolbox subtest scores, but were lowest in the group with the lowest proportion of autistic participants. Adaptive functioning was poorer in the groups with the greatest proportion of autistic participants. Autistic persons are especially impaired on Fluid Cognition, and this more flexible form of thinking remains poorer in the ASD group through adolescence. LAY SUMMARY: A set of brief tests of cognitive functioning called the NIH Toolbox Cognition Battery was administered to adolescents and young adults with autism spectrum disorders (ASD; n = 66) and typical development (TD; n = 66) ages 12-22 years. Compared to TD, ASD showed poorer performance in inhibiting responses, acting flexibly, memorizing events, and processing information quickly (Fluid Cognition). Groups did not differ on vocabulary or word reading (Crystallized Cognition). Crystallized and Fluid Cognition increased with age in both groups, but the ASD group showed lower Fluid, but not Crystallized, Cognition than TD at all ages. A categorization analysis including all participants showed that most participants with ASD fell into one of two categories: a group characterized by poor performance across all tasks, or a group characterized by relatively stronger Crystallized compared to Fluid Cognition. Adaptive functioning was poorer for participants in these groups, which consisted of mostly individuals with ASD, while ADHD symptoms were lowest in the group with the greatest proportion of TD participants.
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Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,Imaging Research Center, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Andrew Gordon
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California-Davis, Davis, California, USA
| | - Raphael Geddert
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Marie K Krug
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Peter Mundy
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA.,School of Education, University of California-Davis, Davis, California, USA
| | - David Hessl
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
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32
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Reinhardt VP, Iosif AM, Libero L, Heath B, Rogers SJ, Ferrer E, Nordahl C, Ghetti S, Amaral D, Solomon M. Understanding Hippocampal Development in Young Children With Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:1069-1079. [PMID: 31449875 PMCID: PMC9940822 DOI: 10.1016/j.jaac.2019.08.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 12/06/2018] [Revised: 07/23/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE We examined growth trajectories of hippocampal volume (HV) in early childhood in a longitudinal cohort of male and female participants with autism spectrum disorder (ASD) and typically developing (TD) individuals, and investigated HV in those with large brains. Relations between factors potentially associated with hippocampal size and growth were investigated. METHOD Participants received 1 to 3 structural magnetic resonance imaging scans between ages 25 and 80 months (unique participants: ASD, n =200; TD, n =110; total longitudinal scans, n = 593). HV growth during this period was examined using mixed-effects linear models. Associations between early HV and growth rates, and IQ and adaptive functioning, were evaluated. RESULTS After accounting for cerebral hemisphere volume, male participants exhibited larger left and right HV than female participants. Hippocampal growth rates did not differ by sex. In children with larger hemisphere volumes, male and female participants with ASD had relatively larger HV than TD participants of similar hemisphere volume. This effect was present in a broader group than only those with disproportionate megalencephaly (male participants with large cerebral volumes relative to body size). Right hippocampi were larger than left hippocampi in both groups and sexes. Right versus left volume differences were greater for ASD. After adjusting for hemisphere volume, male participants with ASD showed a significant positive association between right hippocampal growth and adaptive behavior. CONCLUSION HV was relatively greater in ASD in analyses adjusting for hemisphere volume, whereas only subtle differences were observed in HV and growth between participants with ASD and TD participants in unadjusted analyses, suggesting that ASD involves atypical coupling between HV and brain size.
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Affiliation(s)
| | | | | | | | | | | | | | | | - David Amaral
- University of California, Davis; MIND Institute, Davis, California
| | - Marjorie Solomon
- University of California, Davis; MIND Institute, Davis, California; UC Davis Imaging Research Center, Davis, California.
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Abstract
LAY ABSTRACT Prior studies suggest that maternal polyunsaturated fatty acids intake during pregnancy may have protective effects on autism spectrum disorder in their children. However, they did not examine detailed timing of maternal polyunsaturated fatty acid intake during pregnancy, nor did they evaluate plasma concentrations. This study investigates whether maternal polyunsaturated fatty acids in defined time windows of pregnancy, assessed by both questionnaires and biomarkers, are associated with risk of autism spectrum disorder and other non-typical development in the children. Food frequency questionnaires were used to estimate maternal polyunsaturated fatty acid intake during the first and second half of pregnancy. Gas chromatography measured maternal plasma polyunsaturated fatty acid concentrations in the third trimester. In all, 258 mother-child pairs from a prospective cohort were included. All mothers already had a child with autism spectrum disorder and were planning a pregnancy or pregnant with another child. Children were clinically assessed longitudinally and diagnosed at 36 months. For polyunsaturated fatty acid intake from questionnaires, we only found mothers consuming more omega-3 in the second half of pregnancy were 40% less likely to have children with autism spectrum disorder. For polyunsaturated fatty acid concentrations in the third-trimester plasma, we did not observe any statistical significance in relation to the risk of autism spectrum disorder. However, our study confirmed associations from previous studies between higher maternal docosahexaenoic acid and eicosapentaenoic acid plasma concentrations in the late pregnancy and reduced risk for non-typical development. This study markedly advanced understandings of whether and when maternal polyunsaturated fatty acid intake influences risk for autism spectrum disorder and sets the stage for prevention at the behavioral and educational level.
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Affiliation(s)
- Yunru Huang
- Department of Public Health Sciences, School of Medicine,
University of California, Davis
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine,
University of California, Davis
| | - Robin L. Hansen
- Department of Pediatrics, School of Medicine, University of
California, Davis,Medical Investigation of Neurodevelopmental Disorder (MIND)
Institute, University of California, Davis
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, School of Medicine,
University of California, Davis,Medical Investigation of Neurodevelopmental Disorder (MIND)
Institute, University of California, Davis
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34
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Parikh C, Iosif AM, Ozonoff S. Correction to: Brief Report: Use of the Infant-Toddler Checklist in Infant Siblings of Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 51:1013. [PMID: 32314088 DOI: 10.1007/s10803-020-04497-1] [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: 11/26/2022]
Affiliation(s)
- Chandni Parikh
- Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California-Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California-Davis, Davis, CA, USA
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California-Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA
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35
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Smucny J, Iosif AM, Eaton NR, Lesh TA, Ragland JD, Barch DM, Gold JM, Strauss ME, MacDonald AW, Silverstein SM, Carter CS. Latent Profiles of Cognitive Control, Episodic Memory, and Visual Perception Across Psychiatric Disorders Reveal a Dimensional Structure. Schizophr Bull 2020; 46:154-162. [PMID: 30953588 PMCID: PMC6942157 DOI: 10.1093/schbul/sbz025] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although meta-analyses suggest that schizophrenia (SZ) is associated with a more severe neurocognitive phenotype than mood disorders such as bipolar disorder, considerable between-subject heterogeneity exists in the phenotypic presentation of these deficits across mental illnesses. Indeed, it is unclear whether the processes that underlie cognitive dysfunction in these disorders are unique to each disease or represent a common neurobiological process that varies in severity. Here we used latent profile analysis (LPA) across 3 distinct cognitive domains (cognitive control, episodic memory, and visual integration; using data from the CNTRACS consortium) to identify distinct profiles of patients across psychotic illnesses. LPA was performed on a sample of 223 psychosis patients (59 with Type I bipolar disorder, 88 with SZ, and 76 with schizoaffective disorder). Seventy-three healthy control participants were included for comparison but were not included in sample LPA. Three latent profiles ("Low," "Moderate," and "High" ability) were identified as the underlying covariance across the 3 domains. The 3-profile solution provided highly similar fit to a single continuous factor extracted by confirmatory factor analysis, supporting a unidimensional structure. Diagnostic ratios did not significantly differ between profiles, suggesting that these profiles cross diagnostic boundaries (an exception being the Low ability profile, which had only one bipolar patient). Profile membership predicted Brief Psychiatric Rating Scale and Young Mania Rating Scale symptom severity as well as everyday communication skills independent of diagnosis. Biological, clinical and methodological implications of these findings are discussed.
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - Ana-Maria Iosif
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - Nicholas R Eaton
- Department of Psychology, State University of New York Stony Brook, Stony Brook, NY
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - J Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - Deanna M Barch
- Department of Psychology, Washington University in St. Louis, St. Louis, MO
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Catonsville, MD
| | - Milton E Strauss
- Department of Psychology, University of New Mexico, Albuquerque, NM
| | | | - Steven M Silverstein
- Departments of Psychiatry and Ophthalmology, Rutgers – The State University of New Jersey, New Brunswick, NJ
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
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36
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Xiong GL, Iosif AM, Godwin HT, Khan M, Parish MB, Yellowlees P, Kahn D. A Pilot Randomized Trial of Asynchronous and Synchronous Telepsychiatry in Skilled Nursing Facilities. J Am Med Dir Assoc 2019; 19:461-462. [PMID: 29704928 DOI: 10.1016/j.jamda.2018.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Glen L Xiong
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
| | - Ana-Maria Iosif
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
| | - Haley T Godwin
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
| | - Murtaza Khan
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
| | - Michelle B Parish
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
| | - Peter Yellowlees
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
| | - Debra Kahn
- Department of Psychiatry and Behavioral Sciences University of California at Davis, Sacramento, California
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37
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Zhang D, Bedogni F, Boterberg S, Camfield C, Camfield P, Charman T, Curfs L, Einspieler C, Esposito G, De Filippis B, Goin-Kochel RP, Höglinger GU, Holzinger D, Iosif AM, Lancioni GE, Landsberger N, Laviola G, Marco EM, Müller M, Neul JL, Nielsen-Saines K, Nordahl-Hansen A, O'Reilly MF, Ozonoff S, Poustka L, Roeyers H, Rankovic M, Sigafoos J, Tammimies K, Townend GS, Zwaigenbaum L, Zweckstetter M, Bölte S, Marschik PB. Towards a consensus on developmental regression. Neurosci Biobehav Rev 2019; 107:3-5. [PMID: 31442516 DOI: 10.1016/j.neubiorev.2019.08.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Dajie Zhang
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany; iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria; Leibniz ScienceCampus Primate Cognition, Goettingen, Germany
| | - Francesco Bedogni
- Neuroscience Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sofie Boterberg
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Carol Camfield
- Department of Pediatrics, Dalhousie University and the IWK Health Centre, Canada
| | - Peter Camfield
- Department of Pediatrics, Dalhousie University and the IWK Health Centre, Canada
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Leopold Curfs
- Rett Expertise Centre-GKC, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Christa Einspieler
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Gianluca Esposito
- Social & Affiliative Neuroscience Lab, Psychology Program, Nanyang Technological University, Singapore; Affiliative Behaviour & Physiology Lab, Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
| | - Bianca De Filippis
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Robin P Goin-Kochel
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Autism Center, Texas Children's Hospital, Houston, TX, USA
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Germany; Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Daniel Holzinger
- Hospital of St. John of God, Institute for Neurology of Senses and Language, Linz, Austria; Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis CA, USA
| | - Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | | | - Giovanni Laviola
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Eva M Marco
- Department of Genetics, Physiology and Microbiology, Faculty of Biological Sciences, Universidad Complutense de Madrid, Madrid, Spain
| | - Michael Müller
- Institute of Neuro- and Sensory Physiology, University Medical Center Goettingen, Georg-August-University Goettingen, Germany
| | | | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Mark F O'Reilly
- Department of Special Education, University of Texas at Austin, Austin TX, USA
| | - Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento CA, USA
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany; Leibniz ScienceCampus Primate Cognition, Goettingen, Germany
| | - Herbert Roeyers
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Marija Rankovic
- Department for NMR-based Structural Biology, Max Planck Institute for Biophysical Chemistry, Goettingen, Germany
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Kristiina Tammimies
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Gillian S Townend
- Rett Expertise Centre-GKC, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | - Markus Zweckstetter
- Department for NMR-based Structural Biology, Max Planck Institute for Biophysical Chemistry, Goettingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Peter B Marschik
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany; iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria; Leibniz ScienceCampus Primate Cognition, Goettingen, Germany; Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Seritan AL, Heiry M, Iosif AM, Dodge M, Ostrem JL. Telepsychiatry for patients with movement disorders: a feasibility and patient satisfaction study. J Clin Mov Disord 2019; 6:1. [PMID: 31183157 PMCID: PMC6555013 DOI: 10.1186/s40734-019-0077-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/27/2019] [Indexed: 01/01/2023]
Abstract
Background Telemedicine is a convenient health service delivery modality for patients with movement disorders, including Parkinson's disease (PD), but is currently underutilized in the management of associated psychiatric symptoms. This study explored the feasibility of and patient satisfaction with telepsychiatry services at an academic movement disorders center. Methods All patients seen by telepsychiatry between January and December 2017 at the UCSF Movement Disorders and Neuromodulation Center were invited to participate. Participation was voluntary. Patients received an initial survey after the first telepsychiatry visit and satisfaction surveys after each visit. Survey responses were collected online via Research Electronic Data Capture (REDCap). Frequencies were calculated for categorical variables, and means and standard deviations were generated for continuous variables. Results Thirty-three patients (79% with PD; 72% Medicare recipients; 64% men; mean age, 61.1 ± 10.5 years; mean distance to clinic, 79.9 ± 81.3 miles) completed a total of 119 telepsychiatry and 62 in-person visits. Twenty-two initial surveys and 50 satisfaction surveys (from 21 patients) were collected. Patients were very satisfied with the care (95%), convenience (100%), comfort (95%), and overall visit (95%). Technical quality was somewhat lower rated, with 76% patients reporting they were very satisfied, while 19% were satisfied. All patients would recommend telemedicine to friends or family members. Conclusions Telepsychiatry is a feasible option for patients with movement disorders, leading to high patient satisfaction and improved access to care. Technical aspects still need optimization. Whenever available, telepsychiatry can be considered in addition to in-person visits. Future studies with larger samples should explore its impact on patient care outcomes and caregiver burden.
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Affiliation(s)
- Andreea L Seritan
- 1Department of Psychiatry, University of California, 401 Parnassus Ave, Box 0984-APC, San Francisco, CA 94143 USA.,2University of California, San Francisco Weill Institute for Neurosciences, San Francisco, USA
| | - Melissa Heiry
- 2University of California, San Francisco Weill Institute for Neurosciences, San Francisco, USA.,3Department of Neurology, University of California, San Francisco, San Francisco, California USA
| | - Ana-Maria Iosif
- 4Department of Public Health Sciences, University of California, Davis, Davis, California USA
| | - Michael Dodge
- 5University of California, San Francisco, School of Medicine, San Francisco, USA
| | - Jill L Ostrem
- 2University of California, San Francisco Weill Institute for Neurosciences, San Francisco, USA.,3Department of Neurology, University of California, San Francisco, San Francisco, California USA
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39
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Schmidt RJ, Niu Q, Eyles DW, Hansen RL, Iosif AM. Neonatal vitamin D status in relation to autism spectrum disorder and developmental delay in the CHARGE case-control study. Autism Res 2019; 12:976-988. [PMID: 31094097 PMCID: PMC6546420 DOI: 10.1002/aur.2118] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/22/2019] [Accepted: 04/21/2019] [Indexed: 12/19/2022]
Abstract
Vitamin D appears essential for normal neurodevelopment and cognitive and behavioral function. We examined neonatal vitamin D in relation to the child's later diagnosis of autism spectrum disorder (ASD) or developmental delay (DD). Children aged 24-60 months enrolled in the population-based CHARGE case-control study were evaluated clinically for ASD (n = 357), DD (n = 134), or typical development (TD, n = 234) at the MIND Institute (Sacramento, CA) using standardized assessments. Total 25-hydroxyvitamin D (25[OH]D) was measured using sensitive isotope dilution liquid chromatography-tandem mass spectrometry in archived dried blood spots collected for the California Department of Public Health's Newborn Screening Program. Multinomial logistic regression was used to calculate ORs as measures of the associations between 25 nmol/L change in 25(OH)D and ASD and DD. Associations between 25(OH)D and scores on Mullen Scales of Early Learning and Vineland Adaptive Behavior Scales were assessed using robust linear regression. Effect modification was examined using stratified models and interaction product terms. Unadjusted mean (SD) 25(OH)D was lower for DD (73.2 [37.6]) than for TD (82.7 [39.3]) and ASD (80.1 [37.4]). After adjustment for maternal prepregnancy body mass index and education, a 25 nmol/L increase in total 25(OH)D was not associated with ASD (OR = 0.97; CI: 0.87-1.08) or DD (OR = 0.91; 95% CI: 0.78-1.06). Neonatal 25(OH)D was associated with significantly reduced ASD only in females (adjusted OR = 0.74; 95% CI: 0.55-0.99, Pinteraction = 0.03), and significantly reduced DD only in non-Hispanic white children (adjusted OR = 0.79; 95% CI: 0.63-0.98, Pinteraction = 0.11 for Hispanic, Pinteraction = 0.31 for other), driven by DD children with trisomy 21. This study provides evidence that neonatal vitamin D could be associated with ASD in females and with DD in non-Hispanic white children. Autism Res 2019, 12: 976-988. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Vitamin D appears essential for brain development and function. We examined neonatal total 25-hydroxyvitamin D (25[OH]D) measured in dried blood spots in relation to later diagnoses of autism spectrum disorder (ASD) or developmental delay (DD) and related assessment scores. Higher neonatal 25(OH)D was associated with a 26% reduction in the odds for ASD only in females. After taking into account factors that could contribute to vitamin D status, a significant association with 21% reduced odds for DD was found only in non-Hispanic white children. Though results were nonsignificant overall, certain subgroups might benefit from higher neonatal vitamin D.
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Affiliation(s)
- Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California
| | - Qiaojuan Niu
- Graduate Group in Biostatistics, University of California, Davis, Davis, California
| | - Darryl W Eyles
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Robin L Hansen
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California
- Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, California
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California
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Ozonoff S, Iosif AM. Changing conceptualizations of regression: What prospective studies reveal about the onset of autism spectrum disorder. Neurosci Biobehav Rev 2019; 100:296-304. [PMID: 30885812 PMCID: PMC6451681 DOI: 10.1016/j.neubiorev.2019.03.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 02/12/2019] [Accepted: 03/14/2019] [Indexed: 12/23/2022]
Abstract
Until the last decade, studies of the timing of early symptom emergence in autism spectrum disorder (ASD) relied upon retrospective methods. Recent investigations, however, are raising significant questions about the accuracy and validity of such data. Questions about when and how behavioral signs of autism emerge may be better answered through prospective studies, in which infants are enrolled near birth and followed longitudinally until the age at which ASD can be confidently diagnosed or ruled out. This review summarizes the results of recent studies that utilized prospective methods to study infants at high risk of developing ASD due to family history. Collectively, prospective studies demonstrate that the onset of ASD involves declines in the rates of key social and communication behaviors during the first years of life for most children. This corpus of literature suggests that regressive onset patterns occur much more frequently than previously recognized and may be the rule rather than the exception.
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Affiliation(s)
- Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California - Davis, 2825 50th Street, Sacramento CA, 95817, USA.
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California - Davis, Medical Sciences 1C, Davis CA, 95616, USA.
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Miller M, Iosif AM, Young GS, Bell LJ, Schwichtenberg A, Hutman T, Ozonoff S. The dysregulation profile in preschoolers with and without a family history of autism spectrum disorder. J Child Psychol Psychiatry 2019; 60:516-523. [PMID: 30506566 PMCID: PMC6458078 DOI: 10.1111/jcpp.13003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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] [Accepted: 10/11/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The 'dysregulation profile' (DP) is a measure of emotional and behavioral dysregulation that may cut across diagnostic boundaries. Siblings of children with autism spectrum disorder (ASD) who do not develop ASD themselves are at risk for atypical outcomes including behavioral challenges and therefore may be a useful population in which to investigate the structure of the DP in preschoolers. METHODS We sought to examine the factor structure and predictors of the DP in a sample enriched for a wide range of phenotypic variation-36-month-olds with and without family histories of ASD-and to determine whether children with genetic liability for ASD are at risk for a phenotype characterized by elevated dysregulation. Data were collected from 415 children with (n = 253) and without (n = 162) an older sibling with ASD, all without ASD themselves, at 18, 24, and 36 months of age. RESULTS Our findings replicate prior reports, conducted in predominantly clinically referred and older samples, supporting the superiority of a bifactor model of the DP in the preschool period compared to the second-order and one-factor models. Examiner ratings were longitudinally and concurrently associated with the DP at 36 months of age. Family history of ASD was associated with higher dysregulation in the Anxious/Depressed dimension. CONCLUSIONS These findings support the relevance of examining the structure of psychopathology in preschoolers and suggest that examiner observations as early as 18 months of age, particularly of overactivity, may help identify risk for later DP-related concerns. Non-ASD preschoolers with family histories of ASD may be at risk for a phenotype characterized by elevated dysregulation particularly in the Anxious/Depressed dimension by age 3.
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Affiliation(s)
- Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis
| | - Gregory S. Young
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Laura J. Bell
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - A.J. Schwichtenberg
- Departments of Human Development and Family Studies, Psychological Sciences, and Speech, Language, and Hearing Sciences, Purdue University
| | - Ted Hutman
- Department of Psychiatry, University of California, Los Angeles
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
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Solomon M, Iosif AM, Krug MK, Wu Nordahl C, Adler E, Mirandola C, Ghetti S. Emotional false memory in autism spectrum disorder: More than spared. J Abnorm Psychol 2019; 128:352-363. [PMID: 30973243 PMCID: PMC6540798 DOI: 10.1037/abn0000418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To advance what is known about how emotions affect memory in autism spectrum disorder (ASD), we examined emotional false memory for negative, positive, and neutrally valenced photographs comprising scripts of everyday events in a verbal IQ-case matched sample of youth ages 8-14 with ASD (N = 38) and typical development (TYP, N = 38). The groups exhibited many similarities. Their task performance during a recognition task including previously seen and unseen photographs was largely comparable. They evidenced high hit rates for previously viewed photographs, and low false alarm rates for lure photographs that were inconsistent with the scripts. Both ASD and TYP groups showed relatively higher false alarms for lure photographs depicting previously unseen causes of scenario outcomes (causal errors) compared to errors for script-consistent lure photographs that showed extra potentially related events (gap-filling errors). In both groups, task performance was associated with verbal working memory, but not attention deficit hyperactivity, anxiety, or depression symptoms. However, the ASD group made more causal and gap-filling errors on negative and positive, but not neutral, lures compared to TYP, indicating that viewing emotionally valenced stimuli made it harder to discriminate previously seen and unseen photographs. For the ASD group, task performance was associated with compulsive, ritualistic, and sameness behaviors and stereotypic and restricted interests. Findings suggest that the integration of cognition and emotion in ASD is altered and associated with the presence of repetitive behaviors. The impact of these results on the lives of individuals with ASD and implications for psychosocial interventions are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento
- MIND Institute, University of California-Davis, Sacramento
- Imaging Research Center, University of California-Davis, Sacramento
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California-Davis, Sacramento
| | - Marie K. Krug
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento
- MIND Institute, University of California-Davis, Sacramento
| | - Christine Wu Nordahl
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento
- MIND Institute, University of California-Davis, Sacramento
| | - Elyse Adler
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento
- MIND Institute, University of California-Davis, Sacramento
| | | | - Simona Ghetti
- Department of Psychology, University of California-Davis
- Center for Mind and Brain, University of California-Davis
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Schmidt RJ, Iosif AM, Guerrero Angel E, Ozonoff S. Association of Maternal Prenatal Vitamin Use With Risk for Autism Spectrum Disorder Recurrence in Young Siblings. JAMA Psychiatry 2019; 76:391-398. [PMID: 30810722 PMCID: PMC6450282 DOI: 10.1001/jamapsychiatry.2018.3901] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Maternal use of folic acid supplements has been inconsistently associated with reduced risk for autism spectrum disorder (ASD) in the child. No study to date has examined this association in the context of ASD recurrence in high-risk families. OBJECTIVE To examine the association between maternal prenatal vitamin use and ASD recurrence risk in younger siblings of children with ASD. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study analyzed data from a sample of children (n = 332) and their mothers (n = 305) enrolled in the MARBLES (Markers of Autism Risk in Babies: Learning Early Signs) study. Participants in the MARBLES study were recruited at the MIND Institute of the University of California, Davis and were primarily from families receiving services for children with ASD in the California Department of Developmental Services. In this sample, the younger siblings at high risk for ASD were born between December 1, 2006, and June 30, 2015, and completed a final clinical assessment within 6 months of their third birthday. Prenatal vitamin use during pregnancy was reported by mothers during telephone interviews. Data analysis for this study was conducted from January 1, 2017, to December 3, 2018. MAIN OUTCOMES AND MEASURES Autism spectrum disorder, other nontypical development (non-TD), and typical development (TD) were algorithmically defined according to Autism Diagnostic Observation Schedule and Mullen Scales of Early Learning subscale scores. RESULTS After exclusions, the final sample comprised 241 younger siblings, of which 140 (58.1%) were male and 101 (41.9%) were female, with a mean (SD) age of 36.5 (1.6) months. Most mothers (231 [95.9%]) reported taking prenatal vitamins during pregnancy, but only 87 mothers (36.1%) met the recommendations to take prenatal vitamins in the 6 months before pregnancy. The prevalence of ASD was 14.1% (18) in children whose mothers took prenatal vitamins in the first month of pregnancy compared with 32.7% (37) in children whose mothers did not take prenatal vitamins during that time. Children whose mothers reported taking prenatal vitamins during the first month of pregnancy were less likely to receive an ASD diagnosis (adjusted relative risk [RR], 0.50; 95% CI, 0.30-0.81) but not a non-TD 36-month outcome (adjusted RR, 1.14; 95% CI, 0.75-1.75) compared with children whose mothers reported not taking prenatal vitamins. Children in the former maternal prenatal vitamin group also had statistically significantly lower autism symptom severity (adjusted estimated difference, -0.60; 95% CI, -0.97 to -0.23) and higher cognitive scores (adjusted estimated difference, 7.1; 95% CI, 1.2-13.1). CONCLUSIONS AND RELEVANCE Maternal prenatal vitamin intake during the first month of pregnancy may reduce ASD recurrence in siblings of children with ASD in high-risk families. Additional research is needed to confirm these results; to investigate dose thresholds, contributing nutrients, and biologic mechanisms of prenatal vitamins; and to inform public health recommendations for ASD prevention in affected families.
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Affiliation(s)
- Rebecca J. Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis,MIND Institute, University of California, Davis, Sacramento
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis,MIND Institute, University of California, Davis, Sacramento
| | - Elizabeth Guerrero Angel
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis
| | - Sally Ozonoff
- MIND Institute, University of California, Davis, Sacramento,Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento
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Granillo L, Sethi S, Keil KP, Lin Y, Ozonoff S, Iosif AM, Puschner B, Schmidt RJ. Polychlorinated biphenyls influence on autism spectrum disorder risk in the MARBLES cohort. Environ Res 2019; 171:177-184. [PMID: 30665119 PMCID: PMC6382542 DOI: 10.1016/j.envres.2018.12.061] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is suspected to have environmental and genetic contributions. Polychlorinated biphenyls (PCBs) are environmental risk factors of interest due to their potential as neurodevelopmental toxicants and environmental persistence despite a US production ban in the 1970s. METHODS Participants were mother-child pairs from MARBLES, a high-risk pregnancy cohort that enrolls families who have one child diagnosed with ASD and are planning to have another child. PCB concentrations were measured in maternal blood at each trimester of pregnancy using gas chromatography coupled with triple quadruple mass spectrometry. Concentrations were summed into total PCB and two categories based on function/mechanisms of action: dioxin-like (DL), and ryanodine receptor (RyR)-activating PCBs. Multinomial logistic regression assessed risk of clinical outcome classification of ASD and non-typical development (Non-TD) compared to typically developing (TD) in the children at 3 years old. RESULTS A total of 104 mother-child pairs were included. There were no significant associations for total PCB; however, there were borderline significant associations between DL-PCBs and decreased risk for Non-TD outcome classification (adjusted OR: 0.41 (95% CI 0.15-1.14)) and between RyR-activating PCBs and increased risk for ASD outcome classification (adjusted OR: 2.63 (95% CI 0.87-7.97)). CONCLUSION This study does not provide strong supporting evidence that PCBs are risk factors for ASD or Non-TD. However, these analyses suggest the need to explore more deeply into subsets of PCBs as risk factors based on their function and structure in larger cohort studies where non-monotonic dose-response patterns can be better evaluated.
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Affiliation(s)
- Lauren Granillo
- Graduate Group in Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
| | - Sunjay Sethi
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Kimberly P Keil
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Yanping Lin
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Sally Ozonoff
- MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California Davis, Sacramento, CA, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Birgit Puschner
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Rebecca J Schmidt
- MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA; Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
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Henry SG, Paterniti DA, Feng B, Iosif AM, Kravitz RL, Weinberg G, Cowan P, Verba S. Patients' Experience With Opioid Tapering: A Conceptual Model With Recommendations for Clinicians. J Pain 2019; 20:181-191. [PMID: 30243859 PMCID: PMC6349552 DOI: 10.1016/j.jpain.2018.09.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 08/23/2018] [Accepted: 09/02/2018] [Indexed: 11/25/2022]
Abstract
Clinical guidelines discourage prescribing opioids for chronic pain, but give minimal advice about how to discuss opioid tapering with patients. We conducted focus groups and interviews involving 21 adults with chronic back or neck pain in different stages of opioid tapering. Transcripts were qualitatively analyzed to characterize patients' tapering experiences, build a conceptual model of these experiences, and identify strategies for promoting productive discussions of opioid tapering. Analyses revealed 3 major themes. First, owing to dynamic changes in patients' social relationships, emotional state, and health status, patients' pain and their perceived need for opioids fluctuate daily; this finding may conflict with recommendations to taper by a certain amount each month. Second, tapering requires substantial patient effort across multiple domains of patients' everyday lives; patients discuss this effort superficially, if at all, with clinicians. Third, patients use a variety of strategies to manage the tapering process (eg, keeping an opioid stash, timing opioid consumption based on planned activities). Recommendations for promoting productive tapering discussions include understanding the social and emotional dynamics likely to impact patients' tapering, addressing patient fears, focusing on patients' best interests, providing anticipatory guidance about tapering, and developing an individualized tapering plan that can be adjusted based on patient response. Perspective: This study used interview and focus group data to characterize patients' experiences with opioid tapering and identify communication strategies that are likely to foster productive, patient-centered discussions of opioid tapering. Findings will inform further research on tapering and help primary care clinicians to address this important, often challenging topic.
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Affiliation(s)
- Stephen G Henry
- Division of General Medicine, Geriatrics, and Bioethics; Center for Healthcare Policy and Research, University of California, Davis, Sacramento, California.
| | - Debora A Paterniti
- Department of Sociology, Sonoma State University, Rohnert Park, California
| | | | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, California
| | - Richard L Kravitz
- Division of General Medicine, Geriatrics, and Bioethics; Center for Healthcare Policy and Research, University of California, Davis, Sacramento, California
| | - Gary Weinberg
- Department of Sociology, Sonoma State University, Rohnert Park, California
| | - Penney Cowan
- American Chronic Pain Association, Rocklin, California
| | - Susan Verba
- Center for Design in the Public Interest, University of California, Davis, Davis, California
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Niendam TA, Ray KL, Iosif AM, Lesh TA, Ashby SR, Patel PK, Smucny J, Ferrer E, Solomon M, Ragland JD, Carter CS. Association of Age at Onset and Longitudinal Course of Prefrontal Function in Youth With Schizophrenia. JAMA Psychiatry 2018; 75:1252-1260. [PMID: 30285056 PMCID: PMC6583034 DOI: 10.1001/jamapsychiatry.2018.2538] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/08/2018] [Indexed: 01/19/2023]
Abstract
Importance The extent of cognitive deterioration after schizophrenia (SZ) onset is poorly understood because prior longitudinal studies used small samples of older individuals with established illness. Objective To examine the association of age at onset and subsequent longitudinal course of prefrontal activity during the first 2 years of illness in youths with SZ and healthy control participants (HCs). Design, Setting, and Participants This naturalistic, longitudinal, functional magnetic resonance imaging (fMRI) study included patients with recent-onset SZ and HCs aged 12 to 25 years enrolled in an ongoing study of cognition in recent-onset psychosis in the Sacramento, California, area from October 13, 2004, through June 25, 2013. Participants completed clinical assessments and an established measure of cognitive control, the AX Continuous Performance Task (AX-CPT), during fMRI at baseline and at 6-, 12-, and 24-month follow-up. Whole-brain, voxelwise, and an a priori dorsolateral prefrontal cortex (DLPFC) region of interest analyses were performed. Group differences in developmental trajectories were examined by focusing on behavioral performance (d'-context) and cognitive control-associated brain activity. The association of antipsychotic medication and clinical factors were also examined. Data were analyzed from April 15, 2015, through August 29, 2017. Main Outcomes and Measures Primary outcomes included group differences (HC vs SZ) in behavioral performance (d'-context from AX-CPT) and brain activity for cue B-A trials of the AX-CPT in an a priori DLPFC region of interest at baseline and across the age span. Secondary analysis examined the influence of antipsychotics on behavioral performance and DLPFC activity. Results Among the sample of 180 participants (66.1% male; mean [SD] age at baseline, 19.2 [3.2] years), 87 patients with SZ (mean [SD] age, 19.6 [3.0] years) showed impaired performance compared with 93 HCs (mean [SD] age, 18.8 [3.4] years) across the age span (estimated difference [SE], -0.571 [0.12], d'-context; P < .001). Patients with SZ showed reduced activation in the DLPFC and parietal cortex (false discovery rate cluster corrected to P < .05) compared with HCs under conditions of high cognitive control at baseline. Region-of-interest analysis showed reduced activation in the DLPFC bilaterally for patients with SZ, with a trajectory that paralleled that of HCs across the age span (left DLPFC β [SE] estimates, 0.409 [0.165] for the HC group and -0.285 [0.130] for the SZ group [main effect of group, P = .03]; right DLPFC β [SE] estimates, 0.350 [0.103] for the HC group and -0.469 [0.157] for the SZ group [P = .003]). Antipsychotic medication, clinical symptoms, and global functioning were associated with SZ performance. Conclusions and Relevance During the initial 1 to 2 years after illness onset, young individuals with SZ showed deficits in DLPFC activation and cognitive control, with developmental trajectories comparable to those of HCs. Younger age at onset was not associated with reduced cognition or activation. For individuals contributing to longitudinal analysis, results suggest that young patients do not show deterioration or disruption of ongoing brain development in the initial years after illness onset.
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Affiliation(s)
- Tara A. Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Kimberly L. Ray
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Department of Psychology, The University of Texas at Austin
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Sacramento
| | - Tyler A. Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Stefania R. Ashby
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Department of Psychology, University of Oregon, Eugene
| | - Pooja K. Patel
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Department of Psychology, UCLA (University of California, Los Angeles), Westwood
| | - Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Emilio Ferrer
- Department of Psychology, University of California, Davis, Sacramento
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- MIND Institute, University of California, Davis, Sacramento
| | - J. Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Cameron S. Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Center for Neuroscience, University of California, Davis, Sacramento
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Miller M, Iosif AM, Young GS, Hill MM, Ozonoff S. Early Detection of ADHD: Insights From Infant Siblings of Children With Autism. J Clin Child Adolesc Psychol 2018; 47:737-744. [PMID: 27732091 PMCID: PMC5436956 DOI: 10.1080/15374416.2016.1220314] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Converging evidence suggests shared genetic underpinnings of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Studies of infants at risk for ASD have proliferated over the past decade; the few studies that have followed these infants beyond age 3 report a range of difficulties facing a subset of these infants as they reach school age, including elevated levels of attention problems and externalizing behavior. Given this, we aimed to identify early predictors of school-age ADHD outcomes in a sample of infant siblings at risk for ASD. This study reports on a sample of 59 infants at high and low risk for ASD who had been followed for more than a decade, collecting data at regular intervals from 3 to 36 months and then determining diagnostic outcome at 8-10 years of age. Seventeen participants were diagnosed with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) ADHD at school age (n = 14 high risk, 3 low risk). As infants, the ADHD outcome group demonstrated atypical longitudinal patterns of sustained visual attention. A significantly larger proportion of their parents reported behavior/temperament problems at 36 months of age, and examiners noted the presence of inattentive, hyperactive, and/or impulsive behaviors in this group by 18 months of age. These data suggest that behavioral indicators of risk for later ADHD may be present early in development, which may improve earlier detection and treatment of the disorder.
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Affiliation(s)
- Meghan Miller
- a MIND Institute , University of California , Davis Health System
| | - Ana-Maria Iosif
- b Department of Public Health Sciences , University of California , Davis Health System
| | - Gregory S Young
- a MIND Institute , University of California , Davis Health System
| | | | - Sally Ozonoff
- a MIND Institute , University of California , Davis Health System
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Abstract
Infant social-communicative behavior, such as gaze to the face of an interactive partner, is an important early developmental skill. Children with autism spectrum disorder exhibit atypicalities in social-communicative behavior, including gaze and eye contact. Behavioral differences in infancy may serve as early markers of autism spectrum disorder and help identify individuals at highest risk for developing the disorder. Researchers often assess social-communicative behavior in a single interactive context, such as during assessment with an unfamiliar examiner or play with a parent. Understanding whether infant behavior is consistent across such contexts is important for evaluating the validity of experimental paradigms and the generalizability of findings from one interactive context/partner to another. We examined infant gaze to the face of a social partner at 6, 9, and 12 months of age in infants who were later diagnosed with autism spectrum disorder, as well as low- and high-risk infants without autism spectrum disorder outcomes, across two interactive contexts: structured testing with an unfamiliar examiner and semi-structured play with a parent. By 9 months, infant gaze behavior was significantly associated between the two contexts. By 12 months, infants without autism spectrum disorder outcomes exhibited higher mean rates of gaze to faces during parent-child play than Mullen testing, while the gaze behavior of the autism spectrum disorder group did not differ by context-suggesting that infants developing autism spectrum disorder may be less sensitive to context or interactive partner. Findings support the validity of assessing infant social-communicative behavior during structured laboratory settings and suggest that infant behavior exhibits consistency across settings and interactive partners.
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Benyakorn S, Calub CA, Riley SJ, Schneider A, Iosif AM, Solomon M, Hessl D, Schweitzer JB. Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study. JMIR Ment Health 2018; 5:e40. [PMID: 29802090 PMCID: PMC5993974 DOI: 10.2196/mental.9564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/01/2018] [Accepted: 03/03/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. OBJECTIVE The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. METHODS A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. RESULTS Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child's response. CONCLUSIONS Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics.
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Affiliation(s)
- Songpoom Benyakorn
- Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhonnayok, Thailand.,Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Catrina A Calub
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Steven J Riley
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Andrea Schneider
- MIND Institute, University of California, Davis, Sacramento, CA, United States.,Department of Pediatrics, University of California, Davis, Sacramento, CA, United States
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - David Hessl
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
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Smucny J, Lesh TA, Iosif AM, Niendam TA, Tully LM, Carter CS. Longitudinal stability of cognitive control in early psychosis: Nondegenerative deficits across diagnoses. J Abnorm Psychol 2018; 127:781-788. [PMID: 29781657 DOI: 10.1037/abn0000356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cognitive impairment, particularly in the domain of cognitive control, is characteristic of schizophrenia (SZ) spectrum and bipolar disorders (BDs). The longitudinal trajectory of these impairments, however, remains unclear. Indeed, some studies have observed degeneration and others stability or even improvement over time in these illnesses. Here we examined the longitudinal stability of the AX-Continuous Performance Task (AX-CPT), a cognitive control task, in 52 patients with recent-onset SZ (<2 years from first study measurement), 20 patients with recent-onset BD Type I with psychotic features, and 70 healthy control subjects. Subjects performed the AX-CPT at 2 time points separated by an average of 365 days (range 270-620). Previously identified deficits in cognitive control were replicated in both patient groups. No effects of time or interactions between time and diagnosis were observed. Intraclass correlation coefficients also suggested AX-CPT performance was stable across time for all diagnostic groups. Although performance was stable on average, a positive association was noted between change in cognitive control and change in disorganization symptom severity across patient groups. In conclusion, the present findings suggest that deficits in cognitive control are present in both disorders and stable over the early course of psychotic illness. No evidence was observed for progression or deterioration of cognitive control or differential recovery in SZ compared to BD. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis
| | - Laura M Tully
- Department of Psychiatry and Behavioral Sciences, University of California, Davis
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis
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